Mild traumatic brain injury

Katz, Douglas I.; Cohen, Suzanne L.; Alexander, Michael P.

doi:10.1016/b978-0-444-52892-6.00009-x

Cited by 142 publications

(114 citation statements)

References 208 publications

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“…It may results from any combination of labyrinthopathy or vestibular migraine dysfunction, chronic subjective dizziness or anxiety, or the direct neurological effect of mTBI [78]. Different patients may have symptoms primarily from one or another domain, although in general these domains are not mutually exclusive and can interact and feed on each other [79].…”

Section: Diagnosismentioning

confidence: 99%

Treatment of persistent post-concussion syndrome due to mild traumatic brain injury: current status and future directions

Hadanny

Efrati

2016

Expert Review of Neurotherapeutics

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Persistent post-concussion syndrome caused by mild traumatic brain injury has become a major cause of morbidity and poor quality of life. Unlike the acute care of concussion, there is no consensus for treatment of chronic symptoms. Moreover, most of the pharmacologic and non-pharmacologic treatments have failed to demonstrate significant efficacy on both the clinical symptoms as well as the pathophysiologic cascade responsible for the permanent brain injury. This article reviews the pathophysiology of PCS, the diagnostic tools and criteria, the current available treatments including pharmacotherapy and different cognitive rehabilitation programs, and promising new treatment directions. A most promising new direction is the use of hyperbaric oxygen therapy, which targets the basic pathological processes responsible for post-concussion symptoms; it is discussed here in depth.

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Section: Diagnosismentioning

confidence: 99%

Treatment of persistent post-concussion syndrome due to mild traumatic brain injury: current status and future directions

Hadanny

Efrati

2016

Expert Review of Neurotherapeutics

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“…According to an influential American College of Rehabilitation Medicine (ACRM, 1993) position statement (45), mild TBI is defined as an alteration of brain function caused by external forces that results in one or more of the following clinical features: (i) change in mental status (confusion, disorientation, or slowed thinking), (ii) LOC lasting 0–30 min, (ii) post-traumatic amnesia (PTA) lasting less than 24 h; (iii) focal neurologic deficits that may or may not be transient, and (iv) GCS score of 13–15 at 30 min post-injury. The 1993 ACRM position statement was the first consensus definition of mild TBI that does not require LOC for diagnosis and also the first to recognize PTA as an independent diagnostic feature (43, 46). The World Health Organization (WHO, 2004) (47, 48) definition of mild TBI generally follows the 1993 ACRM criteria but does not include alterations in mental status for diagnosis.…”

Section: Clarity Of Definitionsmentioning

confidence: 99%

Considerations for Experimental Animal Models of Concussion, Traumatic Brain Injury, and Chronic Traumatic Encephalopathy—These Matters Matter

et al. 2017

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Animal models of concussion, traumatic brain injury (TBI), and chronic traumatic encephalopathy (CTE) are widely available and routinely deployed in laboratories around the world. Effective animal modeling requires careful consideration of four basic principles. First, animal model use must be guided by clarity of definitions regarding the human disease or condition being modeled. Concussion, TBI, and CTE represent distinct clinical entities that require clear differentiation: concussion is a neurological syndrome, TBI is a neurological event, and CTE is a neurological disease. While these conditions are all associated with head injury, the pathophysiology, clinical course, and medical management of each are distinct. Investigators who use animal models of these conditions must take into account these clinical distinctions to avoid misinterpretation of results and category mistakes. Second, model selection must be grounded by clarity of purpose with respect to experimental questions and frame of reference of the investigation. Distinguishing injury context (“inputs”) from injury consequences (“outputs”) may be helpful during animal model selection, experimental design and execution, and interpretation of results. Vigilance is required to rout out, or rigorously control for, model artifacts with potential to interfere with primary endpoints. The widespread use of anesthetics in many animal models illustrates the many ways that model artifacts can confound preclinical results. Third, concordance between key features of the animal model and the human disease or condition being modeled is required to confirm model biofidelity. Fourth, experimental results observed in animals must be confirmed in human subjects for model validation. Adherence to these principles serves as a bulwark against flawed interpretation of results, study replication failure, and confusion in the field. Implementing these principles will advance basic science discovery and accelerate clinical translation to benefit people affected by concussion, TBI, and CTE.

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“…T raumatic brain injury (TBI) is among the most common neurological disorders worldwide, and globally, its incidence continues to rise. 1,2 According to the Centers for Disease Control (CDC) in the United States, over the past decade, rates of TBIrelated emergency department (ED) visits have increased by 70%. Most of these TBIs are classified as mild (mTBI), posing a substantial everyday workload.…”

Section: Introductionmentioning

confidence: 99%

Blood-Based Protein Biomarkers for the Management of Traumatic Brain Injuries in Adults Presenting to Emergency Departments with Mild Brain Injury: A Living Systematic Review and Meta-Analysis

Mondello

Sorinola

Czeiter

et al. 2021

Journal of Neurotrauma

124

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Accurate diagnosis of traumatic brain injury (TBI) is critical to effective management and intervention, but can be challenging in patients with mild TBI. A substantial number of studies have reported the use of circulating biomarkers as signatures for TBI, capable of improving diagnostic accuracy and clinical decision making beyond current practice standards. We performed a systematic review and meta-analysis to comprehensively and critically evaluate the existing body of evidence for the use of blood protein biomarkers (S100 calcium binding protein B [S100B], glial fibrillary acidic protein [GFAP], neuron specific enolase [NSE], ubiquitin C-terminal hydrolase-L1 [UCH-L1]. tau, and neurofilament proteins) for diagnosis of intracranial lesions on CT following mild TBI. Effects of potential confounding factors and differential diagnostic performance of the included markers were explored. Further, appropriateness of study design, analysis, quality, and demonstration of clinical utility were assessed. Studies published up to October 2016 were identified through a MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) search. Following screening of the identified articles, 26 were selected as relevant. We found that measurement of S100B can help informed decision making in the emergency department, possibly reducing resource use; however, there is insufficient evidence that any of the other markers is ready for clinical application. Our work pointed out serious problems in the design, analysis, and reporting of many of the studies, and identified substantial heterogeneity and research gaps. These findings emphasize the importance of methodologically rigorous studies focused on a biomarker's intended use, and defining standardized, validated, and reproducible approaches. The living nature of this systematic review, which will summarize key updated information as it becomes available, can inform and guide future implementation of biomarkers in the clinical arena.

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Mild traumatic brain injury

Cited by 142 publications

References 208 publications

Treatment of persistent post-concussion syndrome due to mild traumatic brain injury: current status and future directions

Treatment of persistent post-concussion syndrome due to mild traumatic brain injury: current status and future directions

Considerations for Experimental Animal Models of Concussion, Traumatic Brain Injury, and Chronic Traumatic Encephalopathy—These Matters Matter

Blood-Based Protein Biomarkers for the Management of Traumatic Brain Injuries in Adults Presenting to Emergency Departments with Mild Brain Injury: A Living Systematic Review and Meta-Analysis

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