International review of psychiatry
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Obstructive sleep apnea syndrome (OSAS) is a common disorder in adults and children, which is characterized by repetitive transient reversible upper airway obstructions during sleep. Due to disrupted sleep architecture and intermittent hypoxemia, OSAS leads to impaired daytime functioning in various neuropsychological and affective domains. The most common abnormalities are executive dysfunction, impaired vigilance, depression, and possibly anxiety and, in children, hyperactivity. ⋯ This persistent deficit, despite effective treatment, raises the possibility of a remaining subtle structural brain damage; such damage has been demonstrated through the use of sensitive functional and other neuroimaging techniques. Prefrontal cortical damage may underlie the cognitive dysfunction in OSAS. Early recognition and treatment may prevent this untoward effect of OSAS.
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Individuals sustaining mild traumatic brain injuries often report a constellation of physical, cognitive, and emotional/behavioral symptoms referred to as post concussion symptoms (PCS). The most commonly reported post concussion symptoms are headache, dizziness, decreased concentration, memory problems, irritability, fatigue, visual disturbances, sensitivity to noise, judgment problems, depression, and anxiety. ⋯ Both physiological and psychological etiologies have been suggested as causes for persistent post concussion symptoms and this has led to much controversy and debate in the literature. Most investigators now believe that a variety of pre-morbid, injury-related, and post-morbid neuropathological and psychological factors contribute to the development and continuation of these symptoms in those sustaining mild traumatic brain injury (MTBI).
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Traumatic brain injury (TBI) is a significant public health problem that affects millions of people annually in the USA. Neuropsychiatric symptoms such as cognitive deficits, depression, mania, anxiety, psychosis, apathy, and sleep disturbance are common after TBI. ⋯ Treatment of the neuropsychiatric disturbances associated with TBI should result in decreased handicap, improved quality of life, and decreased societal impact. There is a dire need for large, randomized, double blind, placebo-controlled trials that include a broad range of cognitive and behavioral outcome measures.
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Traumatic brain injury ( TBI) neuropsychiatric sequelae are a significant cause of morbidity in TBI victims. Among the recognized sequelae are anxiety, obsessions, compulsions and obsessive-compulsive disorder (OCD). ⋯ Pre-morbid status can be obtained by structured psychiatric interviews, and TBI brain lesions can be defined with advanced neuroimaging techniques. This information along with the management of family and environmental stressors and the enhanced clinical identification of symptoms of anxiety and OCD can be used in the rehabilitation process to improve prognosis after TBI.
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Traumatic brain injury is a common neurologic condition that can have a significant emotional and financial burden. Neurologic injury is classified on the basis of initial clinical status by the Glasgow Coma Scale, and also by the type and location of head injury. ⋯ In addition, predictive prognostic variables that can be used to predict outcome based on a patient's presentation at the time of a head trauma are discussed. Finally, interventions such as induced hypothermia that can be undertaken to try to optimize outcome, are discussed along with current data in support of or against such techniques.