Articles: traumatic-brain-injuries.
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Experimental neurology · Mar 2016
Diminished amygdala activation and behavioral threat response following traumatic brain injury.
Each year, approximately 3.8 million people suffer mild to moderate traumatic brain injuries (mTBI) that result in an array of neuropsychological symptoms and disorders. Despite these alarming statistics, the neurological bases of these persistent, debilitating neuropsychological symptoms are currently poorly understood. In this study we examined the effects of mTBI on the amygdala, a brain structure known to be critically involved in the processing of emotional stimuli. ⋯ Thus, not only does activation of the LA require increased stimulation, but the proportion of this activation that is propagated to the primary output of the amygdala, the central amygdala, is also diminished following LFPI. Intracellular recordings revealed no changes in the intrinsic properties of BLA pyramidal neurons after LFPI. This data suggests that mild to moderate TBI has prominent effects on amygdala function and provides a potential neurological substrate for many of the neuropsychological symptoms suffered by TBI patients.
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Fever in the neurocritical care unit has a high prevalence and is associated with worse outcomes in patients with severe neurologic illness. While it is well accepted that fever is associated with worse outcomes in this patient population, it is unclear if aggressive temperature management will improve outcomes. Temperature should be monitored routinely in this high-risk population, fever worked up appropriately to identify infectious etiology, and reasonable measures taken to control elevated temperature. ⋯ Depending on the degree and severity of the febrile response, advanced temperature-control devices should be added to pharmacological measures. Several types of temperature-control devices are available, including invasive (intravascular catheters) and noninvasive (external cooling pads) technologies. The clinician should utilize both pharmacologic and device-based temperature therapies to minimize the amount of time spent in a febrile state and help to mitigate the secondary brain injury brought on by fever.
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To describe the prevalence and persistence of headache and associated conditions in an inception cohort of U.S. veterans of Iraq and Afghanistan wars. ⋯ Our results indicate that TBI alone is a strong predictor of headache in the first year of VA care among IAV and that comorbid psychiatric comorbidities increase the likelihood of headache among individuals with TBI. However, among those with baseline headache, only tinnitus, insomnia, and vertigo were baseline clinical predictors of headache persistence. These results suggest that attention to other symptoms and conditions early in the diagnosis and treatment of headaches may be important for understanding prognosis. These comorbidities offer potential targets for intervention strategies that may help address postdeployment headaches.
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To examine the relationship between homocysteine (Hcy) plasma levels and the outcome of patients with traumatic brain injury (TBI). ⋯ There was a significant correlation in this study between plasma Hcy levels and severity of trauma and prognosis in patients with TBI.
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We present a clinical case of treatment and neurorehabilitation of a patient with severe neurological deficit due to extensive traumatic lesion of the left hemisphere of the brain. Until recently, such cases were considered incurable and remained marginalized throughout their lives. ⋯ This process is addressed in the individual patient. The greatest efficiency of the neurorehabilitation treatment of patients with severe consequences of a stroke and traumatic brain injury can be reached under the following conditions: the earliest possible start of rehabilitation with a sufficient duration and intensity; interdisciplinary and integrative rehabilitation process at various stages of rehabilitation treatment; systematic clinical and neuropsychological diagnostics; systematic monitoring of somatic, neurological, psychiatric, and psychological condition of the patient; assistance with sociopsychological and labor issues; and problem-solving support.