Annually, some 500,000 people are hospitalized with brain lesions acquired after
traumatic brain injury (TBI) in Brazil. Between 75,000 and 100,000 individuals
die within hours of the event and 70,000 to 90,000 evolve to irreversible loss
of some neurological function. The principal causes of TBI include motor vehicle
accidents (50%), falls (21%), assaults and robberies (12%) and accidents during
leisure activities (10%). Within this context, cognitive rehabilitation, a
clinical area encompassing interdisciplinary action aimed at recovery as well as
compensation of cognitive functions altered as a result of cerebral injury, is
extremely important for these individuals. Therefore, the aim of this study was
to review the basic concepts related to TBI, including mechanisms of injury,
severity levels of TBI, the most common findings in moderate and severe TBI
survivors, and the most frequent cognitive impairments following TBI, and also
to discuss the strategies used to handle patients post-TBI. The study results
yielded relevant information on a structured cognitive rehabilitation service,
representing an alternative for patients and families afflicted by TBI, enabling
the generation of multiple research protocols.
Traumatic brain injury (TBI) is a major cause of lifelong disability and death
worldwide. Sport-related traumatic brain injury is an important public health
concern. The purpose of this review was to highlight the importance of
sport-related concussions. Concussion refers to a transient alteration in
consciousness induced by external biomechanical forces transmitted directly or
indirectly to the brain. It is a common, although most likely underreported,
condition. Contact sports such as American football, rugby, soccer, boxing,
basketball and hockey are associated with a relatively high prevalence of
concussion. Various factors may be associated with a greater risk of
sport-related concussion, such as age, sex, sport played, level of sport played
and equipment used. Physical complaints (headache, fatigue, dizziness),
behavioral changes (depression, anxiety, irritability) and cognitive impairment
are very common after a concussion. The risk of premature return to activities
includes the prolongation of post-concussive symptoms and increased risk of
concussion recurrence.
Decompressive craniectomy is an established procedure to lower intracranial pressure and can save patients’ lives. However, this procedure is associated with delayed cognitive decline and cerebral hemodynamics complications. Studies show the benefits of cranioplasty beyond cosmetic aspects, including brain protection, and functional and cerebrovascular aspects, but a detailed description of the concrete changes following this procedure are lacking. In this paper, the authors report a patient with trephine syndrome who underwent cranioplasty; comprehensive cognitive and cerebral hemodynamic evaluations were performed prior to and following the cranioplasty. The discussion was based on a critical literature review.
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