One-year follow-up of mild traumatic brain injury: Post-concussion symptoms, disabilities and life satisfaction in relation to serum levels of S-100B and neurone-specific enolase in acute phase
Abstract:In spite of frequent persistent symptoms, disabilities and low levels of life satisfaction, the sick-leave frequency was low at follow-up. The association between S-100B and disability supports the notion that long-term consequences of a mild brain injury may partly be a result of brain tissue injury.
“…At least one fourth of the adults and the elderly patients gave signs of being under the influence of alcohol, which is the same fraction as reported by, for example, Nygren de Boussard et al (2004) and Stålnacke et al (2005). Our data is based on clinical signs, self-reporting and in some cases blood sample tests, making them minimum numbers.…”
The aim was to describe epidemiological and medical aspects of 449 cases of traumatic brain injury (TBI) from a well-defined geographical area with a population of 137,000 inhabitants. An episode of disturbed consciousness was a prerequisite for inclusion in the study. The incidence of TBI was 354/100,000 inhabitants. Median age was 23 years, range 0-91 years; 55% were men and 45% were women; 33% children 0-14 years, 50% adults 15-64 years, and 17% elderly persons 65-91 years old. Severity classification was based on Glasgow Coma Scale (GCS) on arrival; mild TBI 97% (GCS 13-15), moderate 1% (GCS 9-12), and severe 2% (GCS 3-8). The most common injury events were falls (55%) and vehicle-related events (30%). The percentage of falls was high among children and elderly persons but among adults vehicle-related injury events were also prominent. At least 17% of all patients were under the influence of alcohol, especially adult male bicyclists. CT was performed on 163 cases (36%) revealing 34 cases with intracranial hemorrhage (ICH) which is 21% of the examined or 8% of all the injured. The rate of ICH increased with increasing age (from 3% among children to 17% among the elderly persons) and also increased with decreasing GCS from 6% in the group of mild TBI to 60% among those with severe TBI. Attention should be directed to acute management of mild TBI in order to detect potentially dangerous ICH as well as to preventive actions against falls and vehicle related accidents.
“…At least one fourth of the adults and the elderly patients gave signs of being under the influence of alcohol, which is the same fraction as reported by, for example, Nygren de Boussard et al (2004) and Stålnacke et al (2005). Our data is based on clinical signs, self-reporting and in some cases blood sample tests, making them minimum numbers.…”
The aim was to describe epidemiological and medical aspects of 449 cases of traumatic brain injury (TBI) from a well-defined geographical area with a population of 137,000 inhabitants. An episode of disturbed consciousness was a prerequisite for inclusion in the study. The incidence of TBI was 354/100,000 inhabitants. Median age was 23 years, range 0-91 years; 55% were men and 45% were women; 33% children 0-14 years, 50% adults 15-64 years, and 17% elderly persons 65-91 years old. Severity classification was based on Glasgow Coma Scale (GCS) on arrival; mild TBI 97% (GCS 13-15), moderate 1% (GCS 9-12), and severe 2% (GCS 3-8). The most common injury events were falls (55%) and vehicle-related events (30%). The percentage of falls was high among children and elderly persons but among adults vehicle-related injury events were also prominent. At least 17% of all patients were under the influence of alcohol, especially adult male bicyclists. CT was performed on 163 cases (36%) revealing 34 cases with intracranial hemorrhage (ICH) which is 21% of the examined or 8% of all the injured. The rate of ICH increased with increasing age (from 3% among children to 17% among the elderly persons) and also increased with decreasing GCS from 6% in the group of mild TBI to 60% among those with severe TBI. Attention should be directed to acute management of mild TBI in order to detect potentially dangerous ICH as well as to preventive actions against falls and vehicle related accidents.
“…For example, Stalnacke et al (2005), using a blood biomarker of brain injury, serum concentrations of S-100B and neuron-specific enolase, found that S-100B levels during the acute phase of mTBI related to long-terms sequelae. S-100B findings have not been universal in mTBI (see also Bazarian et al, 2006a;Bazarian et al, 2006b;De Kruijk et al, 2002;Savola & Hillbom, 2003) and these observations are but some of the first.…”
Section: Pathophysiology Of Concussionmentioning
confidence: 99%
“…Thus, some refer to PCS if the symptoms persist for more than a few days and in particular, if the symptoms persist for more than a week Sheedy et al, 2006). If the symptoms last more than 3 months then the term persistent post-concussive syndrome or PPCS has been used (Begaz et al, 2006;Chamelian et al, 2004;Iverson, 2006;Rees, 2003;Satz et al, 1999;Stalnacke et al, 2005;Willer & Leddy, 2006). Whereas there is a relationship between severity of concussion and who develops PPCS (Hessen et al, 2006), concussion severity by itself is a poor predictor of who develops PPCS (Guskiewicz et al, 2004).…”
Section: Introduction: Brief History Of Concussionmentioning
On the mild end of the acquired brain injury spectrum, the terms concussion and mild traumatic brain injury (mTBI) have been used interchangeably, where persistent post-concussive syndrome (PPCS) has been a label given when symptoms persist for more than three months post-concussion. Whereas a brief history of concussion research is overviewed, the focus of this review is on the current status of PPCS as a clinical entity from the perspective of recent advances in the biomechanical modeling of concussion in human and animal studies, particularly directed at a better understanding of the neuropathology associated with concussion. These studies implicate common regions of injury, including the upper brainstem, base of the frontal lobe, hypothalamic-pituitary axis, medial temporal lobe, fornix, and corpus callosum. Limitations of current neuropsychological techniques for the clinical assessment of memory and executive function are explored and recommendations for improved research designs offered, that may enhance the study of long-term neuropsychological sequelae of concussion. (JINS, 2008, 14, 1-22.)
“…Life satisfaction has been intensively studied in many patients groups encountered in rehabilitation medicine, especially patients with spinal cord injury [3,[10][11][12][13][14][15][16][17][18][19][20]. To our knowledge, however, it has scarcely been studied among patients with chronic pain [21][22][23].…”
Life satisfaction in patients with chronic musculoskeletal pain and its predictors Boonstra, Anne M.; Reneman, Michiel F.; Stewart, Roy E.; Post, Marcel W.; Preuper, Henrica R. Schiphorst Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Abstract Purpose To determine the life satisfaction of patients with chronic non-malignant musculoskeletal pain (CMP) compared to the general population (GP) and to identify predictors of life satisfaction. Methods Subjects were patients with CMP (n = 1,082) admitted to multidisciplinary rehabilitation and a general population sample (n = 506). Lisat-9 measures satisfaction with life as a whole and eight life domains. Physical, emotional and social functioning and pain intensity were assessed using the SF-36. Ordinal logistic regression was used to analyse differences between patients with CMP and the GP, and predictors of life satisfaction in patients with CMP.
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