Journal of neurotrauma
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Journal of neurotrauma · Dec 2015
Conversion equation between the drop height in the New York University impactor and the impact force in the Infinite Horizon impactor in the contusion spinal cord injury model.
There are several widely used devices for controlled contusion of the spinal cord, including the Ohio State University device, the University of British Columbia multi-mechanisms injury device, the New York University (NYU) impactor, and the Infinite Horizon (IH) impactor. Although various devices and protocols have been used to generate consistent injury severities, further investigation of the relationship between the key parameters of different spinal cord injury (SCI) contusion devices (e.g., drop height in the NYU impactor and impact force in the IH impactor) will improve our understanding of SCI mechanisms. ⋯ The consistent correlation was represented as a simple equation (Force = (28.2 ± 3.2) · Height((0.83 ± 0.07))) under the experimental conditions of a 10-g rod in the NYU impactor and an impact velocity of 125 mm/sec in the IH impactor. Thus, the key biomechanical parameter for a contusion device can be converted or translated to that of another device to analyze experimental results from multiple contusion devices.
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Journal of neurotrauma · Dec 2015
Life Expectancy following Inpatient Rehabilitation for Traumatic Brain Injury in the United States.
This study characterized life expectancy after traumatic brain injury (TBI). The TBI Model Systems (TBIMS) National Database (NDB) was weighted to represent those ≥16 years of age completing inpatient rehabilitation for TBI in the United States (US) between 2001 and 2010. Analyses included Standardized Mortality Ratios (SMRs), Cox regression, and life expectancy. ⋯ Individuals with TBI were at greatest risk of death from seizures; accidental poisonings; sepsis; aspiration pneumonia; respiratory, mental/behavioral, or nervous system conditions; and other external causes of injury and poisoning, compared with individuals in the general population of similar age, gender, and race. This study confirms prior life expectancy study findings, and provides evidence that the TBIMS NDB is representative of the larger population of adults receiving inpatient rehabilitation for TBI in the US. There is an increased risk of death for individuals with TBI requiring inpatient rehabilitation.
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Psychiatric disorders are common following traumatic brain injury (TBI) and can include depression, anxiety, and psychosis, as well as other maladaptive behaviors and personality changes. The epidemiologic data of psychiatric disorders post-TBI vary widely, although the incidence and prevalence rates typically are higher than in the general population. Although the experience of psychiatric symptoms may be temporary and may resolve in the acute period, many patients with TBI can experience psychopathology that is persistent or that develops in the post-acute period. ⋯ The current review of the literature considers the common psychiatric problems affecting individuals with TBI in the post-acute period, including personality changes, psychosis, executive dysfunction, depression, anxiety, and substance misuse. Although treatment considerations (pharmacological and nonpharmacological) are referred to, an extensive description of such protocols is beyond the scope of the current review. The impact of persistent psychiatric symptoms on perceived caregiver burden and distress is also discussed.
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The aim of this review was to explain the role played by pituitary hormonal deficiencies in the traumatic brain injury (TBI) disease process. Chronic dysfunction of the pituitary axis is observed in approximately 35% of individuals who sustain a moderate-to-severe TBI. The most common deficiency is that of growth hormone, followed by gonadotropin, cortisol, and thyroid. ⋯ Many of the consequences of a chronic symptomatic TBI have, in the past, been solely attributed to the brain injury per se. Analysis of the signs and symptoms of pituitary axis dysfunction suggests that many of these consequences can be attributed to post-traumatic hypopituitarism (PTH). PTH may well play a significant role in the progressive signs and symptoms that follow a chronic TBI.
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Journal of neurotrauma · Dec 2015
ReviewLong-Term Consequences of Traumatic Brain Injury: Current Status of Potential Mechanisms of Injury and Neurologic Outcomes.
Traumatic brain injury (TBI) is a significant clinical problem with few therapeutic interventions successfully translated to the clinic. Increased importance on the progressive, long-term consequences of TBI have been emphasized, both in the experimental and clinical literature. Thus, there is a need for a better understanding of the chronic consequences of TBI, with the ultimate goal of developing novel therapeutic interventions to treat the devastating consequences of brain injury. ⋯ Recently, the increased incidence in age-dependent neurodegenerative diseases in this patient population has also been emphasized. Pathomechanisms felt to be active in the acute and long-term consequences of TBI include excitotoxicity, apoptosis, inflammatory events, seizures, demyelination, white matter pathology, as well as decreased neurogenesis. The current article will review many of these pathophysiological mechanisms that may be important targets for limiting the chronic consequences of TBI.