Predictors of Recovery From Posttraumatic Amnesia

Gurin, Lindsey J.; Rabinowitz, Liat; Blum, Sonja

doi:10.1176/appi.neuropsych.15040081

Cited by 5 publications

(5 citation statements)

References 39 publications

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“…There are no standards of treatment specific for DAI so far. The attempts of implementing psychostimulants (amantadine, metylphenidate or modafinil) did not influence duration of amnestic disorders or patients' prognosis [15]. Studies on animals reported neuroprotective effect of combining tacrolimus with therapeutic hypothermia.…”

Section: Treatmentmentioning

confidence: 93%

“…Detecting cognitive impairment with HRB (Halstead-Reitan Neuropsychological Battery), LNNP (Luria-Nebraska Neuropsychological Battery) or GOAT (Galvestone Orientation and Amnesia Test) protocols may hint accurate diagnosis even before ordering imaging test. The repetitive neuropsychological evaluation bears significance in relation to prognosis, despite not being sufficient for final diagnosis of DAI [3,15].…”

Section: Diagnosticsmentioning

confidence: 99%

“…The duration of anterograde amnesia directly correlates with duration of posttraumatic comma and poses the most important risk factor for further intellectual, cognitive or executive functions of patients [15]. Importantly, memory deficits may be the first indication of DAI regardless of the Glasgow Coma Scale (GCS) score, which can remain normal.…”

Section: Clinical Presentation and Prognosismentioning

confidence: 99%

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Diffuse axonal injury – an interdisciplinary problem. Current knowledge and two case reports

Łuc¹,

Pawłowski²,

Rymaszewska³

et al. 2021

Psychiatr Pol

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Rozlany uraz aksonalny (ang. diffuse axonal injury- DAI) jest mikroskopowym uszkodzeniem aksonów biegnących w mózgu. Do jego wystąpienia predysponują urazy głowy z przyśpieszeniem lub zahamowaniem. W niniejszym artykule zaprezentowano aktualny stan wiedzy na temat DAI oraz przypadki dwóch pacjentów, u których DAI wystąpiło w wyniku wypadku komunikacyjnego. U 26- letniego mężczyzny po dachowaniu pojazdu stwierdzono w TK cechy obrzmienia mózgowia oraz rozsiane drobne wybroczyny hyperdensyjnej krwi. Konsultacja psychiatryczna w 9 dobie wykazała między innymi zaburzenia pamięci w postaci niepamięci wstecznej i następczej, zaburzenia koncentracji oraz brak krytycyzmu wobec swojego stanu. U 38- letniej kobiety potrąconej przez samochód opisano w TK głowy cechy obrzmienia mózgowia, niewielkiego krwawienia podpajęczynówkowego oraz liczne złamania. Pacjentka w 10 dobie zdezorientowana, nie zapamiętywała udzielanych informacji, we wzmożonym napędzie i brakiem krytycyzmu wobec stanu zdrowia. Podejrzewając DAI powinniśmy zachować szczególną czujność w przypadku pacjentów hospitalizowanych z powodu wypadków komunikacyjnych z zaburzeniami zachowania, cechami zespołu amnestycznego oraz bez istotnych ogniskowych objawów neurologicznych.

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Section: Treatmentmentioning

confidence: 93%

Section: Diagnosticsmentioning

confidence: 99%

Section: Clinical Presentation and Prognosismentioning

confidence: 99%

See 1 more Smart Citation

Diffuse axonal injury – an interdisciplinary problem. Current knowledge and two case reports

Łuc¹,

Pawłowski²,

Rymaszewska³

et al. 2021

Psychiatr Pol

View full text Add to dashboard Cite

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“…The functional condition upon emergence could have a greater influence on future disability and functional independence. Consistent with this, the duration of post‐traumatic amnesia 35,36 or the baseline score in the Galveston Orientation and Amnesia Test 37,38 after a head trauma has been found to have more predictive value than the duration of coma 39 …”

Section: Discussionmentioning

confidence: 59%

Minimally conscious state plus versus minus: Likelihood of emergence and long‐term functional independence

Llorens,

Ippoliti,

Navarro

et al. 2024

Ann Clin Transl Neurol

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ObjectiveSevere brain injuries can result in disorders of consciousness, such as the Minimally Conscious State (MCS), where individuals display intermittent yet discernible signs of conscious awareness. The varied levels of responsiveness and awareness observed in this state have spurred the progressive delineation of two subgroups within MCS, termed “plus” (MCS+) and “minus” (MCS‐). However, the clinical validity of these classifications remains uncertain. This study aimed to investigate and compare the likelihood of emergence from MCS, as well as the functional independence after emergence, in individuals categorized as in MCS+ and MCS‐.MethodsDemographic and behavioral data of 80 participants, admitted as either in MCS+ (n = 30) or MCS‐ (n = 50) to a long‐term neurorehabilitation unit, were retrospectively analyzed. The neurobehavioral condition of each participant was evaluated weekly until discharge, demise, or emergence from MCS. The functional independence of those participants who emerged from MCS was assessed 6 months after emergence.ResultsWhile only about half of the individuals classified as in MCS‐ (n = 24) emerged from the MCS, all those admitted as in MCS+ did, and in a shorter postinjury period. Despite these differences, all individuals who emerged from the MCS demonstrated similar high disability and low functional independence 6 months after emergence, regardless of their state at admission.InterpretationIndividuals classified as MCS+ exhibited a higher likelihood of emergence and a shorter time to emergence compared to those in MCS‐. However, the level of functional independence 6 months after emergence was found to be unrelated to the initial state at admission.

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“…These states and the time until patients regain day-to-day memory are described as posttraumatic amnesia (PTA), which is used as the best predictor of TBI outcome. 2 Some studies use the term posttraumatic confusional state (PTCS) rather than PTA to emphasise symptoms of confusion rather than affected memory. 3 PTA covers the entire trajectory from injury to recovery of day-to-day memory, whereas PTCS is only present when the patient is confused.…”

Section: Introductionmentioning

confidence: 99%

Sleep and agitation during subacute traumatic brain injury rehabilitation: A scoping review

Poulsen

Langhorn

Egerod

et al. 2021

Australian Critical Care

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Background: Sleep disturbance and agitation are frequent conditions during the subacute period of recovery in moderate to severe traumatic brain injury (TBI). Clarity is needed regarding the association between the two conditions to improve fundamental nursing care. Aim: The aim of our scoping review was to identify the evidence for potential associations between sleep disturbance and agitation during subacute inpatient rehabilitation of adult patients with moderate to severe TBI. Design: We conducted a five-step scoping review. Methods: Sources of evidence were PubMed, CINAHL, PsycINFO, Cochrane, and Web of Science databases. Eligibility criteria were as follows: English or Scandinavian language articles describing sleep and/or agitation during inpatient rehabilitation of adult patients with moderate to severe TBI and published in the period 2000e2019. Results: We identified 152 articles of which we included six. The included articles were all affiliated with the USA using quantitative methodology. The association between sleep disturbance and agitation is highly complex, with disturbed sleep affecting cognitive and emotional functions. Sleep disturbance was associated with posttraumatic amnesia (PTA)/posttraumatic confusional state, cognitive function, and agitation. Our review suggested a bidirectional association between these symptoms during early TBI rehabilitation. We inferred that improved sleep might be a contributing factor to the resolution of PTA, cognitive impairment, and agitation. Conclusion: The association between sleep disturbance and agitation is still undetermined, but we assume that improved sleep may protect against neuropsychiatric problems in patients with moderate to severe TBI. Larger controlled interventional studies are needed to provide the evidence of modifiable factors for improving sleep during inpatient TBI rehabilitation. Owing to the current lack of publications, it is probably too early to perform a systematic review on the topic.

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Predictors of Recovery From Posttraumatic Amnesia

Cited by 5 publications

References 39 publications

Diffuse axonal injury – an interdisciplinary problem. Current knowledge and two case reports

Diffuse axonal injury – an interdisciplinary problem. Current knowledge and two case reports

Minimally conscious state plus versus minus: Likelihood of emergence and long‐term functional independence

Sleep and agitation during subacute traumatic brain injury rehabilitation: A scoping review

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