Continuum of the United States military’s traumatic brain injury care: adjusting to the changing battlefield

Lazarus, Rachel C.; Helmick, Katherine; Malik, Saafan; Gregory, Emma; Agimi, Yll; Marion, Donald W.

doi:10.3171/2018.9.focus18396

Cited by 13 publications

(7 citation statements)

References 7 publications

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“…At the presence of hematoma, the high absorption of blood within the hematoma made it harder for photons to pass through to the brain tissue and resulted in higher sensitivity to superficial layers. NIRS products available in market have been tested to prove the ability to detect cerebral hematoma , all with SDS greater than 25 mm.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the source‐detector separation in near infrared spectroscopy for healthy and clinical applications

Wang

Ayaz

İzzetoğlu

2019

Journal of Biophotonics

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Understanding near infrared light propagation in tissue is vital for designing next generation optical brain imaging devices. Monte Carlo (MC) simulations provide a controlled mechanism to characterize and evaluate contributions of diverse near infrared spectroscopy (NIRS) sensor configurations and parameters. In this study, we developed a multilayer adult digital head model under both healthy and clinical settings and assessed light‐tissue interaction through MC simulations in terms of partial differential pathlength, mean total optical pathlength, diffuse reflectance, detector light intensity and spatial sensitivity profile of optical measurements. The model incorporated four layers: scalp, skull, cerebrospinal‐fluid and cerebral cortex with and without a customizable lesion for modeling hematoma of different sizes and depths. The effect of source‐detector separation (SDS) on optical measurements' sensitivity to brain tissue was investigated. Results from 1330 separate simulations [(4 lesion volumes × 4 lesion depths for clinical +3 healthy settings) × 7 SDS × 10 simulation = 1330)] each with 100 million photons indicated that selection of SDS is critical to acquire optimal measurements from the brain and recommended SDS to be 25 to 35 mm depending on the wavelengths to obtain optical monitoring of the adult brain function. The findings here can guide the design of future NIRS probes for functional neuroimaging and clinical diagnostic systems.

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Section: Discussionmentioning

confidence: 99%

Investigation of the source‐detector separation in near infrared spectroscopy for healthy and clinical applications

Wang

Ayaz

İzzetoğlu

2019

Journal of Biophotonics

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“…In the current study, the patients were divided into "Military Hospital" group and "Other Hospital" group according to the institution that the patients are admitted to. In addition, patients were classified as mild (13)(14)(15) and moderate/severe TBIs (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) according to their GCS scores.…”

Section: Patients and Data Acquisitionmentioning

confidence: 99%

“…During the nonwar years (a confrontation with the North), military medical service usually takes care of small numbers of the patients; therefore, a few military hospitals are concentrated and equipped with the medical resources to treat the severe traumatic brain injury (TBI) patients. However, the characteristics of the military personnel's TBI in ROK during the non-war years has never been reported; and the majority of the literatures on military TBI are limited to the wartime situation such as combat injuries 1,7,9) . By the merest chance, two military hospitals (AFCH, Armed Forces Capital Hospital; and AFYH, Armed Forces Yangju Hospital) participated in the Korean multi-centered TBI (KMTBI) study for identifying the clinical features and analyzing risk factors for young TBI patients.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Traumatic Brain Injury Patients in Korean Military Hospitals During Non-War Years

Kim¹,

Kim²

2021

J Neurointensive Care

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Because of the specialty of the military medical system, there might be different characteristics of patients with traumatic brain injury (TBI) comparing to the patients in university hospitals. However, the characteristics of the soldiers' TBI has never been reported. Therefore, we tried to identify the different characteristics of TBI patients in military hospitals by comparing them of other hospitals. MethodsWe extracted the data of TBI patients from the databank of the Korean Multicenter TBI study. Patients, who were diagnosed with TBI and admitted to the ten institutions (including two military hospitals) between January 2016 and December 2018, were retrospectively enrolled. They are divided into 'Military' and 'Other' groups according to the admitted hospitals, and statistical comparisons were conducted on gathered information. ResultsAmong 4601 enrolled patients, 133 patients were from two military hospitals and 4468 patients belong to the eight university hospitals. Military patients show significant younger age and male predominance. In general, they have fewer past histories and different trauma mechanisms -more sports-related and lesser traffic accident-related. They usually show higher initial Glasgow coma scale scores and better favorable outcomes -lower incidence of neurologic deterioration in mild TBIs and better modified Rankin Scale scores in moderate to severe TBIs. ConclusionsMilitary hospitals usually take care of small numbers of patients who are young males with mild TBIs. Because of the different characteristics of group members and traumatic severity, the patients usually show favorable outcomes. Therefore, the optimized medical system is mandatory.

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“…4,5 Military service members and veterans are a population with high risk of exposure to TBI, with nearly 40% of those with TBI reporting PTH . [6][7][8] In this population, blast-related injuries are the most common cause of TBI due to high exposure to combat and artillery. 9 One often overlooked feature of blast injury-induced TBI is concurrent damage to surrounding tissues such as cervical musculoskeletal structures that in many ways resembles whiplash injury.…”

Section: Introductionmentioning

confidence: 99%

Greater Severity and Functional Impact of Post-traumatic Headache in Veterans With Comorbid Neck Pain Following Traumatic Brain Injury

et al. 2020

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Background Post-traumatic headache (PTH) is a commonly experienced symptom after mild traumatic brain injury (mTBI). Blast injury– or blunt injury–related mechanisms for mTBI in veterans can also affect musculoskeletal structures in the neck, resulting in comorbid neck pain (NP). However, it is unknown whether the presence of comorbid NP may be associated with a different pattern of headache symptoms, physical functioning, or emotional functioning compared to those without comorbid NP. The purpose of this study is to examine the role of comorbid NP in veterans with mTBI and PTH. Design and Methods This was a cross-sectional investigation of an existing dataset that included 33 veterans who met inclusion criteria for PTH after mTBI. Standardized measures of headache severity and frequency, insomnia, fatigue, mood disorders, and physical and emotional role function were compared between groups with and without comorbid NP. Results The majority of participants with PTH reported comorbid NP (n = 22/33, 67%). Those with comorbid NP experienced more headache symptoms that were severe or incapacitating, as compared to mild or moderate for those without NP (φ = 0.343, P = .049); however, no differences in headache frequency (φ = 0.231, P = .231) or duration (φ = 0.129, P = .712) were observed. Participants with comorbid NP also reported greater insomnia (d = 1.16, P = .003) and fatigue (d = 0.868, P = .040) as well as lower physical functioning (d = 0.802, P = .036) and greater bodily pain (d = 0.762, P = .012). There were no differences in anxiety, depression, mental health, emotional role limitations, vitality, or social functioning between those with and without comorbid NP (d ≤ 0.656, P ≥ .079). Conclusions A majority of veterans with mTBI and PTH in our sample reported comorbid NP that was associated with greater headache symptom severity and physical limitations, but not with mood or emotional limitations. Preliminary findings from this small convenience sample indicate that routine assessment of comorbid NP and associated physical limitations should be considered in veterans with mTBI and PTH.

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Continuum of the United States military’s traumatic brain injury care: adjusting to the changing battlefield

Cited by 13 publications

References 7 publications

Investigation of the source‐detector separation in near infrared spectroscopy for healthy and clinical applications

Investigation of the source‐detector separation in near infrared spectroscopy for healthy and clinical applications

Characteristics of Traumatic Brain Injury Patients in Korean Military Hospitals During Non-War Years

Greater Severity and Functional Impact of Post-traumatic Headache in Veterans With Comorbid Neck Pain Following Traumatic Brain Injury

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