Persistent symptoms and activity changes three months after mild traumatic brain injury

Cooksley, Rebecca; Maguire, E. A.; Lannin, Natasha A.; Unsworth, Carolyn A.; Farquhar, Michelle J.; Galea, Claire; Mitra, Biswadev; Schmidt, Julia

doi:10.1111/1440-1630.12457

Cited by 46 publications

(26 citation statements)

References 33 publications

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“…Included in this case report is a young, previously healthy male with no significant psychiatric or past medical history who presented with hallucinations, behavioral changes, and a headache three weeks postcontusion. His presenting symptoms of auditory and visual hallucinations with suicidal ideations are unlike previously reported cases of cerebral contusion [ 12 - 13 ]. In addition to this rare presentation, the patient suffered from seven days of insomnia which most likely exacerbated his psychosis.…”

Section: Introductioncontrasting

confidence: 62%

A Sub-acute Cerebral Contusion Presenting with Medication-resistant Psychosis

Rubin

Espiridion

Lofgren

2018

Cureus

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The most common symptoms of a cerebral contusion include headache, dizziness, concentration problems, and memory loss. Insomnia is reported by more than half of the patients and can exacerbate symptoms. A 24-year-old previously healthy male presented with psychosis, acute personality changes, auditory and visual hallucinations three weeks after falling 15 feet with concurrent head trauma. A right-sided cerebral contusion with concussion was diagnosed on initial admission with increasing homicidal and suicidal ideations after 26 hours of insomnia. The patient accomplished rest after seven days of medication-resistant insomnia with the final combination of ziprasidone and lorazepam. After one night of sleep, the patient was alert and oriented with normal mood, affect, and cognition. The insomnia appeared to exacerbate this patient’s symptoms, and an atypical insomnia treatment regimen was required to induce somnolence and restore function in this patient. The combination of this abnormal patient presentation along with the unorthodox medication regimen makes this case unique compared to other traumatic brain injury symptoms and treatments.

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Section: Introductioncontrasting

confidence: 62%

A Sub-acute Cerebral Contusion Presenting with Medication-resistant Psychosis

Rubin

Espiridion

Lofgren

2018

Cureus

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“…There remains debate as to why incidence is possibly higher in milder injuries if the common pathoetiology is the brain injury itself (Zasler, Leddy, Etheredge, Martelli, 2019). In one recent study, 45% of adults with mild TBI experienced headaches with a prevalence of continued headaches at 3 months following injury as high as 22% (Cooksley et al, 2018). PTC meeting ICHD-3 criteria for migraine and tension subtypes are the most frequently encountered (Ashina et al, 2019).…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Post-traumatic cephalalgia

Dwyer

Zasler

2020

NRE

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After traumatic brain injury (TBI), a host of symptoms of varying severity and associated functional impairment may occur. One of the most commonly encountered and challenging to treat are the post-traumatic cephalalgias. Post-traumatic cephalalgia (PTC) or headache is often conceptualized as a single entity as currently classified using the ICHD-3. Yet, the terminology applicable to the major primary, non-traumatic, headache disorders such as migraine, tension headache, and cervicogenic headache are often used to specify the specific type of headache the patients experiences seemingly disparate from the unitary definition of post-traumatic headache adopted by ICHD-3. More complex post-traumatic presentations attributable to brain injury as well as other headache conditions are important to consider as well as other causes such as medication overuse headache and medication induced headache. Treatment of any post-traumatic cephalalgia must be optimized by understanding that there may be more than one headache pain generator, that comorbid traumatic problems may contribute to the pain presentation and that pre-existing conditions could impact both symptom complaint, clinical presentation and recovery. Any treatment for PTC must harmonize with ongoing medical and psychosocial aspects of recovery.

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“…Social participation is necessary for learners to ensure they do not become isolated, which can lead to depression and anxiety 23 . A number of symptoms may influence their inability to engage in social participation, including decreased emotional regulation due to frontal lobe damage 28 , decreased balance and an encouraged decrease in the amount of time spent on cell phones and electronic devices 57 . To ensure a learner who sustained a concussion can engage in social participation in an appropriate manner, the occupational therapist needs to understand the client factor and performance skill demands that engaging socially has on the learner.…”

Section: Social Participationmentioning

confidence: 99%

Clinical practice in occupational therapy for treatment of concussion in schoolboys: An integrative review

Sinnett

Franzsen

2020

S. Afr. j. occup. ther.

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Rugby in South Africa is one of the fastest growing contact sports and schoolboys competing in rugby will sustain injuries such as concussions. Concussion protocol regulations indicate that young players be removed from play and training for two weeks as there are many misconceptions about the long-term implications of concussion. Concussion has been shown to impact on cognitive functioning and the ability to perform at school. Occupational therapy has a role in the intervention of occupational performance post-concussion in learners playing this contact sport. A clinical practice framework to provide guidelines for the occupational therapy intervention for schoolboy rugby players post-concussion in the South African setting is presented. The framework was based on the occupations, client factors, performance skills, performance patterns and context and environments in the Occupational Therapy Practice Framework III (OTPF III). Screening assessment including the learners, parents and teachers were suggested to determine the use of specific occupational performance assessments in education, social participation, activities of daily living and rest and sleep as well as client factor assessments to determine the outcomes of concussion. Intervention guidelines include the occupational therapy process approaches for Create/Promote, Establish/Restore, Maintain, Modify (compensate) and Prevent with a focus on create/promote; or promotion of safety in rugby. The assessments given in this framework are easily accessible in the South African setting and provide knowledge for all level of practitioners. The role of occupational therapy in reducing residual risks of concussion sustained while playing rugby at school and the long-term consequences of concussion on occupations needs to be researched further. AUTHOR CONTRIBUTIONS Faye Sinnett: Primary contributor. Developed the research idea, conducted the research and developed the clinical guidelines. Denise Franszen: Assisted with the development and final writeup of the article.

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Persistent symptoms and activity changes three months after mild traumatic brain injury

Cited by 46 publications

References 33 publications

A Sub-acute Cerebral Contusion Presenting with Medication-resistant Psychosis

A Sub-acute Cerebral Contusion Presenting with Medication-resistant Psychosis

Post-traumatic cephalalgia

Clinical practice in occupational therapy for treatment of concussion in schoolboys: An integrative review

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