A review of mild head trauma. part II: Clinical implications

Binder, Laurence M.

doi:10.1080/01688639708403871

Cited by 225 publications

(107 citation statements)

References 200 publications

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“…Posttraumatic dizziness affects 20 to 65 percent of patients with TBI [67,[78][79] and remains disabling for many months [8,[80][81][82]. Dizziness is among the top five postconcussive symptoms distinguishing patients with mild TBI from healthy controls [79,[83][84] and appears to have important vocational implications.…”

Section: Dizzinessmentioning

confidence: 99%

Minimizing the effect of TBI-related physical sequelae on vocational return

McNamee

Walker²,

Cifu³

et al. 2009

JRRD

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Abstract-This article evaluated the common physical sequelae that affect return to work (RTW) after traumatic brain injury (TBI). We performed a Medline search and evaluation of current TBI rehabilitation texts. The information presented is a combination of published literature and clinical guidelines. The limitations faced by many patients with TBI can best be overcome through clever job search, job redesign, and community linkages with business and industry that are willing to partner in helping the patient with TBI regain employment. The physician plays a key role in communicating suggestions to the vocational specialist. The comorbidities described represent challenges to successful RTW. These problems are recurrent, long-term, and clearly affect job procurement, nature of job, level of required support, and likelihood of job retention. Conversely, these challenges should not be viewed as impenetrable obstacles. With appropriate supports such as compensatory strategies, job coaching, assistive technology, medical management, and job restructuring, successful RTW is viable option. Physicians must focus on employment outcomes in real jobs and not settle for volunteer work, sheltered work, or assessment and planning. Individuals should be placed in real work for real pay. Through close collaboration between the survivor of TBI, the physician, the vocational specialist, and community resources, successful employment for survivors of TBI is possible and must be prescribed a high value.

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Section: Dizzinessmentioning

confidence: 99%

Minimizing the effect of TBI-related physical sequelae on vocational return

McNamee

Walker²,

Cifu³

et al. 2009

JRRD

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“…Although deficits have been found in speed of information processing, memory, attention and executive functions, both the clinical significance and the etiology of these deficits have been questioned (Binder, 1997;Binder et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Neuropsychological and information processing deficits following mild traumatic brain injury

Mathias

Beall

Bigler

2004

J Int Neuropsychol Soc

120

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Neuroradiological and neuropathological investigations have found evidence of diffuse brain damage in the frontal and temporal lobes, corpus callosum, and fornices in patients who have sustained a mild traumatic brain injury (TBI). However, neuropsychological assessments of these patients do not typically target many of the subtle information processing deficits that may arise from diffuse damage involving the frontotemporal regions of the brain as well as white matter pathology, including the corpus callosum. Consequently, we have a limited understanding of the deficits that may be attributable to temporary or permanent disruptions to these functional pathways. This study assessed a group of mild TBI patients (N 5 40) and a matched control group (N 5 40) on a number of standard neuropsychological tests of selective and sustained attention, verbal and non-verbal fluency, and verbal memory. In addition, reaction time (RT) tasks, requiring both the inter-and intra-hemispheric processing of visual and tactile information, were used to assess the functional integrity of the tracts that are likely to be affected by diffuse damage. In the 1st month after sustaining their injury, the mild TBI group demonstrated deficits in attention, non-verbal fluency, and verbal memory. They also demonstrated slower visual and tactile RTs, with the visual RTs of mild TBI patients being more affected by increased task difficulty and the need to transfer information across the corpus callosum, than did their matched controls. (JINS, 2004, 10, 286-297.)

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“…In 80%-90% of these individuals, the neuropsychological problems resolve within 10 days to 2 weeks after their injury. [1][2][3] However, in 10%-20% of mTBI patients, some or all of these neuropsychological problems will persist for months. 4 While standard head computed tomography (CT) does not typically indicate overt brain injury in mTBI patients, recent studies employing diffusion tensor imaging (DTI) have reported damage to major fiber tracts, including the corpus callosum, in some individuals with mTBI.…”

Section: Introductionmentioning

confidence: 99%

Behavioral and Histopathological Alterations Resulting from Mild Fluid Percussion Injury

Hylin

Orsi

Zhao

et al. 2013

Journal of Neurotrauma

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The majority of people who sustain a traumatic brain injury (TBI) have an injury that can be classified as mild (often referred to as concussion). Although head CT scans for most subjects who have sustained a mild TBI (mTBI) are negative, these persons may still suffer from neurocognitive and neurobehavioral deficits. In order to expedite pre-clinical research and develop therapies, there is a need for well-characterized animal models of mTBI that reflect the neurological, neurocognitive, and pathological changes seen in human patients. In the present study, we examined the motor, cognitive, and histopathological changes resulting from 1.0 and 1.5 atmosphere (atm) overpressure fluid percussion injury (FPI). Both 1.0 and 1.5 atm FPI injury caused transient suppression of acute neurological functions, but did not result in visible brain contusion. Animals injured with 1.0 atm FPI did not show significant motor, vestibulomotor, or learning and memory deficits. In contrast, 1.5 atm injury caused transient motor disturbances, and resulted in a significant impairment of spatial learning and short-term memory. In addition, 1.5 atm FPI caused a marked reduction in cerebral perfusion at the site of injury that lasted for several hours. Consistent with previous studies, 1.5 atm FPI did not cause visible neuronal loss in the hippocampus or in the neocortex. However, a robust inflammatory response (as indicated by enhanced GFAP and Iba1 immunoreactivity) in the corpus callosum and the thalamus was observed. Examination of fractional anisotropy color maps after diffusion tensor imaging (DTI) revealed a significant decrease of FA values in the cingulum, an area found to have increased silver impregnation, suggesting axonal injury. Increased silver impregnation was also observed in the corpus callosum, and internal and external capsules. These findings are consistent with the deficits and pathologies associated with mild TBI in humans, and support the use of mild FPI as a model to evaluate putative therapeutic options.

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A review of mild head trauma. part II: Clinical implications

Cited by 225 publications

References 200 publications

Minimizing the effect of TBI-related physical sequelae on vocational return

Minimizing the effect of TBI-related physical sequelae on vocational return

Neuropsychological and information processing deficits following mild traumatic brain injury

Behavioral and Histopathological Alterations Resulting from Mild Fluid Percussion Injury

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