Arya, V; Chigurupati, R
Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle Journal Article
In: Journal of Oral & Maxillofacial Surgery, vol. 74, no. 3, pp. 569–581, 2016.
Abstract | Links | BibTeX | Tags: Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident
@article{Arya2016,
title = {Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle},
author = {Arya, V and Chigurupati, R},
doi = {10.1016/j.joms.2015.09.033},
year = {2016},
date = {2016-01-01},
journal = {Journal of Oral \& Maxillofacial Surgery},
volume = {74},
number = {3},
pages = {569--581},
abstract = {Purpose Traumatic injuries of the mandible resulting in intrusion of the condyle into the middle cranial fossa are rare and treatment is often based on anecdotal experience. The objective of this study was to develop an algorithm for the management of condylar intrusion injuries by identifying factors that influenced the treatment decision of closed versus open reduction of the condyle. Materials and Methods This study was a systematic review of the literature on intracranial intrusion injuries of the mandibular condyle. A thorough search of the PubMed and Cochrane databases and individual maxillofacial and craniofacial journal databases was conducted using the Medical Subject Heading terms condylar impaction, condylar dislocation, condylar intrusion, and middle cranial fossa and condyle without date and language restriction. Quantitative data on the patient's age, gender, etiology of injury, and time from injury to diagnosis were analyzed using descriptive statistics. The authors studied how the predictor variables of age, etiology, time from injury to diagnosis, and associated neurologic injuries influenced the outcome variable of closed versus open reduction of the condyle. Results Forty-eight of the 62 retrieved case reports, case series, and review articles were published in the English-language literature from 1963 to 2015. Data on 51 patients with these injuries showed that 38 (75%) were female and younger than 30 years. The most common etiology of injury was motor vehicular accidents, occurring in 25 of 51 patients (49%). The mean time from injury to diagnosis was 31.2 days (0 to 106.4 days). Forty of the 51 patients (78%) were diagnosed within the first 2 weeks of injury. A good proportion of patients underwent open reduction (63%) and 18 of the 51 of patients (35%) underwent closed reduction. Conclusions Predictor variables that influenced the treatment decision of open versus closed reduction were age of the patient, etiology of injury, and time from injury to diagnosis. Based on the present results, younger patients (0 to 15 yr old), patients who sustain condylar intrusion injuries from bicycle accidents, and those diagnosed within the first 2 weeks of injury are more likely to benefit from closed reduction. The treatment algorithm emphasizes the importance of assessment of associated neurologic injuries and an interdisciplinary approach for the management of these injuries. © 2016 American Association of Oral and Maxillofacial Surgeons.},
keywords = {Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident},
pubstate = {published},
tppubtype = {article}
}
Aomura, S; Zhang, Y; Nakadate, H; Koyama, T; Nishimura, A
Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident Journal Article
In: Journal of Biomechanical Science and Engineering, vol. 11, no. 4, 2016.
Abstract | Links | BibTeX | Tags: Accidents, Brain Injury, Brain injury risk estimation, Collision accidents, DIAGNOSIS, FEM, Finite element method, FOOTBALL players, Game video, Game videos, Health risks, Initial conditions, Mechanical parameters, Motion analysis, Relative positions, RISK assessment, Risk perception, Rotational velocity, Sports, Sports-related concussion
@article{Aomura2016,
title = {Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident},
author = {Aomura, S and Zhang, Y and Nakadate, H and Koyama, T and Nishimura, A},
doi = {10.1299/jbse.16-00393},
year = {2016},
date = {2016-01-01},
journal = {Journal of Biomechanical Science and Engineering},
volume = {11},
number = {4},
abstract = {The collision accident in collegiate football game was simulated based on the game video and the concussive impact on the head was analyzed. First, the collision motion of players was reproduced based on the video by using motion analysis, and the translational and rotational velocities, relative position and contact location of the struck and the striking players' heads just before the collision were calculated. Then the data obtained were input to two helmeted finite element (FE) human head models as the initial condition, and the brain injury risk was evaluated by using the impact analysis. The FE helmet model was validated by a drop test of the helmet in which the head impactor was embedded. In the present study, two concussion suspected accident cases were analyzed; then the concussion was evaluated by ten mechanical parameters generated inside the skull caused by the collision. The injury risk evaluated by multi parameters belonged to the dangerous range that may cause concussion and was consistent with the diagnosis of the medical team doctor. The brain injury risk can be successfully estimated by the reconstructed simulation of the game video and FE analysis. To our knowledge, this study is the first attempt in Japan to estimate the brain injury risk systematically by a combination of game video analysis which is originally introduced for the players' health care and FE analysis by helmeted human head model. In the future, brain injury risk caused by an accident can be evaluated with higher accuracy by analyzing more accident cases. © 2016 The Japan Society of Mechanical Engineers.},
keywords = {Accidents, Brain Injury, Brain injury risk estimation, Collision accidents, DIAGNOSIS, FEM, Finite element method, FOOTBALL players, Game video, Game videos, Health risks, Initial conditions, Mechanical parameters, Motion analysis, Relative positions, RISK assessment, Risk perception, Rotational velocity, Sports, Sports-related concussion},
pubstate = {published},
tppubtype = {article}
}
Naeser, M A; Martin, P I; Ho, M D; Krengel, M H; Bogdanova, Y; Knight, J A; Yee, M K; Zafonte, R; Frazier, J; Hamblin, M R; Koo, B B
Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury Journal Article
In: Photomedicine and Laser Surgery, vol. 34, no. 12, pp. 610–626, 2016.
Abstract | Links | BibTeX | Tags: Accidents, Adenosinetriphosphate, brain, Cognitive dysfunction, Diodes, Explosives, Head Injuries, Hemodynamics, Infrared devices, LED, Light, Light emitting diodes, Lightemitting diodes, LLLT, Nitric oxide, Patient monitoring, Patient treatment, PBM, Photobiomodulation, postconcussion syndrome, PTSD, Sports, Sports head injury, TBI, TBI treatment, Traumatic Brain Injuries, traumatic brain injury
@article{Naeser2016,
title = {Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury},
author = {Naeser, M A and Martin, P I and Ho, M D and Krengel, M H and Bogdanova, Y and Knight, J A and Yee, M K and Zafonte, R and Frazier, J and Hamblin, M R and Koo, B B},
doi = {10.1089/pho.2015.4037},
year = {2016},
date = {2016-01-01},
journal = {Photomedicine and Laser Surgery},
volume = {34},
number = {12},
pages = {610--626},
abstract = {Objective: We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. LED therapy is nonthermal, painless, and noninvasive. An LED-based device classified as nonsignificant risk (FDA cleared) was used. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm2) was applied for 9 min 45 sec (13 J/cm2) using 11 locations on the scalp: midline from front-to-back hairline and bilaterally on frontal, parietal, and temporal areas. Testing was performed before and after transcranial LED (tLED; at 1 week, 1 month, and at 2 months after the 18th treatment) and showed significant improvements in executive function and verbal memory. There were also fewer post-traumatic stress disorder (PTSD) symptoms reported. Ongoing studies: Ongoing, current studies involve TBI patients who have been treated with tLED using either 26 J/cm2 per LED location on the head or treated with intranasal only (iLED) using red (633 nm) and NIR (810 nm) diodes placed into the nostrils. The NIR iLED is hypothesized to deliver photons to the hippocampus, and the red 633 nm iLED is believed to increase melatonin. Results have been similar to the previously published tLED study. Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing. © Mary Ann Liebert, Inc.},
keywords = {Accidents, Adenosinetriphosphate, brain, Cognitive dysfunction, Diodes, Explosives, Head Injuries, Hemodynamics, Infrared devices, LED, Light, Light emitting diodes, Lightemitting diodes, LLLT, Nitric oxide, Patient monitoring, Patient treatment, PBM, Photobiomodulation, postconcussion syndrome, PTSD, Sports, Sports head injury, TBI, TBI treatment, Traumatic Brain Injuries, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Oeur, R A; Karton, C; Post, A; Rousseau, P; Hoshizaki, T B; Marshall, S; Brien, S E; Smith, A; Cusimano, M D; Gilchrist, M D
In: Journal of Neurosurgery, vol. 123, no. 2, pp. 415–422, 2015.
Abstract | Links | BibTeX | Tags: accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult
@article{Oeur2015,
title = {A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma},
author = {Oeur, R A and Karton, C and Post, A and Rousseau, P and Hoshizaki, T B and Marshall, S and Brien, S E and Smith, A and Cusimano, M D and Gilchrist, M D},
doi = {10.3171/2014.10.JNS14440},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery},
volume = {123},
number = {2},
pages = {415--422},
abstract = {Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p \< 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p \< 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.},
keywords = {accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stemper, B D; Shah, A S; Pintar, F A; McCrea, M; Kurpad, S N; Glavaski-Joksimovic, A; Olsen, C; Budde, M D
Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion Journal Article
In: Annals of Biomedical Engineering, vol. 43, no. 5, pp. 1071–1088, 2015.
Abstract | Links | BibTeX | Tags: Acceleration, Accidents, BEHAVIORAL assessment, Behavioral assessments, Behavioral outcomes, Biomechanics, brain, Cognitive deficits, Diffusion, Diffusion Tensor Imaging, Diffusion tensor imaging (DTI), fractional anisotropy, Full factorial design, Magnetic Resonance Imaging, Microstructure, Motor vehicle crashes, neuroimaging, Rats, Rotational acceleration, Tensors, Traumatic Brain Injuries, Traumatic brain injury (mTBI)
@article{Stemper2015,
title = {Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion},
author = {Stemper, B D and Shah, A S and Pintar, F A and McCrea, M and Kurpad, S N and Glavaski-Joksimovic, A and Olsen, C and Budde, M D},
doi = {10.1007/s10439-014-1171-9},
year = {2015},
date = {2015-01-01},
journal = {Annals of Biomedical Engineering},
volume = {43},
number = {5},
pages = {1071--1088},
abstract = {A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague\textendashDawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s2 and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the parameter fractional anisotropy (FA). While the injury did not cause significant locomotor or cognitive deficits measured with the CN and MWM, respectively, a main effect of duration was consistently observed for the EPM. Increased duration caused significantly greater activity and exploratory behaviors measured as open arm time and number of arm changes. DTI demonstrated significant effects of both magnitude and duration, with the FA of the amygdala related to both the magnitude and duration. Increased duration also caused FA changes at the interface of gray and white matter. Collectively, the findings demonstrate that the consequences of rotational acceleration mTBI were more closely associated with duration of the rotational acceleration impulse, which is often neglected as an independent factor, and highlight the need for animal models of TBI with strong biomechanical foundations to associate behavioral outcomes with brain microstructure. © 2014, Biomedical Engineering Society (Outside the U.S.).},
keywords = {Acceleration, Accidents, BEHAVIORAL assessment, Behavioral assessments, Behavioral outcomes, Biomechanics, brain, Cognitive deficits, Diffusion, Diffusion Tensor Imaging, Diffusion tensor imaging (DTI), fractional anisotropy, Full factorial design, Magnetic Resonance Imaging, Microstructure, Motor vehicle crashes, neuroimaging, Rats, Rotational acceleration, Tensors, Traumatic Brain Injuries, Traumatic brain injury (mTBI)},
pubstate = {published},
tppubtype = {article}
}
Huang, M X; Nichols, S; Baker, D G; Robb, A; Angeles, A; Yurgil, K A; Drake, A; Levy, M; Song, T; McLay, R; Theilmann, R J; Diwakar, M; Risbrough, V B; Ji, Z; Huang, C W; Chang, D G; Harrington, D L; Muzzatti, L; Canive, J M; Christopher Edgar, J; Chen, Y H; Lee, R R
Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 5, pp. 109–119, 2014.
Abstract | BibTeX | Tags: Accidents, Traffic Adult *Blast Injuries/co [Compl
@article{Huang2014a,
title = {Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury},
author = {Huang, M X and Nichols, S and Baker, D G and Robb, A and Angeles, A and Yurgil, K A and Drake, A and Levy, M and Song, T and McLay, R and Theilmann, R J and Diwakar, M and Risbrough, V B and Ji, Z and Huang, C W and Chang, D G and Harrington, D L and Muzzatti, L and Canive, J M and {Christopher Edgar}, J and Chen, Y H and Lee, R R},
year = {2014},
date = {2014-01-01},
journal = {NeuroImage Clinical},
volume = {5},
pages = {109--119},
address = {Huang,Ming-Xiong. Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA ; Department of Radiology, University of California, San Diego, CA, USA. Nichols,Sharon. Department of Neuroscience, University of Californi},
abstract = {Traumatic brain injury (TBI) is a leading cause of sustained impairment in military and civilian populations. However, mild TBI (mTBI) can be difficult to detect using conventional MRI or CT. Injured brain tissues in mTBI patients generate abnormal slow-waves (1-4 Hz) that can be measured and localized by resting-state magnetoencephalography (MEG). In this study, we develop a voxel-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mTBI on a single-subject basis. A normative database of resting-state MEG source magnitude images (1-4 Hz) from 79 healthy control subjects was established for all brain voxels. The high-resolution MEG source magnitude images were obtained by our recent Fast-VESTAL method. In 84 mTBI patients with persistent post-concussive symptoms (36 from blasts, and 48 from non-blast causes), our method detected abnormalities at the positive detection rates of 84.5%, 86.1%, and 83.3% for the combined (blast-induced plus with non-blast causes), blast, and non-blast mTBI groups, respectively. We found that prefrontal, posterior parietal, inferior temporal, hippocampus, and cerebella areas were particularly vulnerable to head trauma. The result also showed that MEG slow-wave generation in prefrontal areas positively correlated with personality change, trouble concentrating, affective lability, and depression symptoms. Discussion is provided regarding the neuronal mechanisms of MEG slow-wave generation due to deafferentation caused by axonal injury and/or blockages/limitations of cholinergic transmission in TBI. This study provides an effective way for using MEG slow-wave source imaging to localize affected areas and supports MEG as a tool for assisting the diagnosis of mTBI.},
keywords = {Accidents, Traffic Adult *Blast Injuries/co [Compl},
pubstate = {published},
tppubtype = {article}
}
Balendra, G; Turner, M; McCrory, P
Career-ending injuries to professional jockeys in British horse racing (1991-2005) Journal Article
In: British Journal of Sports Medicine, vol. 42, pp. 22–24, 2008.
Abstract | BibTeX | Tags: Accidents, Occupational/ec [Economics] *Accidents
@article{Balendra2008,
title = {Career-ending injuries to professional jockeys in British horse racing (1991-2005)},
author = {Balendra, G and Turner, M and McCrory, P},
year = {2008},
date = {2008-01-01},
journal = {British Journal of Sports Medicine},
volume = {42},
pages = {22--24},
address = {Paul McCrory, University of Melbourne, Victoria, Australia. p.mccrory@unimelb.edu.au},
abstract = {BACKGROUND: It has been previously shown that professional jump and flat racing jockeys suffer a high incidence of injury as a consequence of their profession. This paper specifically examines career-ending injuries to professional jockeys in Great Britain. AIMS: To investigate career-ending injuries in professional jockeys. Method: Analysis of prospectively collected injury database on professional jockeys. RESULTS: The majority of injuries in this study occurred to the head, shoulder or torso. Fractures were the most common type of injury that led to a decision to end a career, followed by neurological injury to the head and/or spine. CONCLUSION: Injuries to the head are the most common career-ending injuries, and consideration of injury counter measures could be an important strategy in equestrian sports.},
keywords = {Accidents, Occupational/ec [Economics] *Accidents},
pubstate = {published},
tppubtype = {article}
}
Setnik, Lon; Bazarian, Jeffrey J
The characteristics of patients who do not seek medical treatment for traumatic brain injury Journal Article
In: Brain Injury, vol. 21, pp. 1–9, 2007.
Abstract | BibTeX | Tags: Accidents, Home/sn [Statistics & Numerical Data] A
@article{Setnik2007,
title = {The characteristics of patients who do not seek medical treatment for traumatic brain injury},
author = {Setnik, Lon and Bazarian, Jeffrey J},
year = {2007},
date = {2007-01-01},
journal = {Brain Injury},
volume = {21},
pages = {1--9},
address = {The Elliot Hospital, Manchester, NH, USA.},
abstract = {PRIMARY OBJECTIVE: To identify factors associated with not seeking medical care for traumatic brain injury (TBI). RESEARCH DESIGN: Internet survey. METHODS AND PROCEDURES: The survey consisted of 17 questions related to demographics, TBI case ascertainment, location and mechanism of injury, type of treatment sought, and post-concussive (PC) symptoms. Logistic regression was used to identify factors associated with not seeking medical care. MAIN OUTCOME AND RESULTS: Of the 1381 survey respondents with TBI, 584 (42%) did not seek medical care. TBI respondents were less likely to seek care if they were older (OR 0.98, 95% CI 0.97-0.99), suffered a mild TBI grade 2/3 (OR 0.42, 95% CI 0.31-0.58), or were injured in the home (OR 0.53, 95% CI 0.36-0.78). CONCLUSIONS: Several factors associated with not seeking medical care after TBI were identified. Raising public awareness of the signs and symptoms of TBI, and the benefits of medical care, could help increase the number of TBI patients who seek medical care.},
keywords = {Accidents, Home/sn [Statistics \& Numerical Data] A},
pubstate = {published},
tppubtype = {article}
}
Butcher, I; McHugh, G S; Lu, J; Steyerberg, E W; Hernandez, A V; Mushkudiani, N; Maas, A I; Marmarou, A; Murray, G D
Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study Journal Article
In: Journal of Neurotrauma, vol. 24, no. 2, pp. 281–286, 2007.
Abstract | BibTeX | Tags: *Brain Injuries/di [Diagnosis], *Brain Injuries/et [Etiology], Accidents, adult, Age Factors, Athletic Injuries/co [Complications], Athletic Injuries/di [Diagnosis], Databases, Factual, Glasgow Outcome Scale, Humans, middle aged, Predictive Value of Tests, Prognosis, violence
@article{Butcher2007,
title = {Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study},
author = {Butcher, I and McHugh, G S and Lu, J and Steyerberg, E W and Hernandez, A V and Mushkudiani, N and Maas, A I and Marmarou, A and Murray, G D},
year = {2007},
date = {2007-01-01},
journal = {Journal of Neurotrauma},
volume = {24},
number = {2},
pages = {281--286},
abstract = {We aimed to describe and quantify the relationship between cause of injury and final outcome following traumatic brain injury (TBI). Individual patient data (N = 8708) from eight therapeutic Phase III randomized clinical trials in moderate or severe TBI, and three TBI surveys were used to investigate the relationship between cause of injury and outcome, as assessed by the Glasgow Outcome Scale (GOS) at 6 months. Proportional odds methodology was applied to quantify the strength of the association and expressed as an odds ratio in a meta-analysis. Heterogeneity across studies was assessed and associations with other predictive factors explored. In a univariate analysis, a strong association between the cause of injury and long-term outcome in moderate to severe TBI patients was observed, with consistent results across the studies. Road traffic accidents (OR 0.66, 95% CI 0.60-0.73), assaults (OR 0.66, 95% CI 0.52-0.84), and injuries sustained during sporting or recreational activities (OR 0.45, 95% CI 0.28-0.71) were all associated with better outcomes than the reference category of falls. Falls were found to be associated with an older age and with a higher incidence of mass lesions. Following adjustment for age in the analysis, the relationship between cause of injury and outcome was lost.},
keywords = {*Brain Injuries/di [Diagnosis], *Brain Injuries/et [Etiology], Accidents, adult, Age Factors, Athletic Injuries/co [Complications], Athletic Injuries/di [Diagnosis], Databases, Factual, Glasgow Outcome Scale, Humans, middle aged, Predictive Value of Tests, Prognosis, violence},
pubstate = {published},
tppubtype = {article}
}
Hashimoto, Keiji; Okumura, Ayumi; Shinoda, Jun; Abo, Masahiro; Nakamura, Toshinori
Tensor magnetic resonance imaging in a case of mild traumatic brain injury with lowered verbal intelligence quotient Journal Article
In: Journal of Rehabilitation Medicine, vol. 39, pp. 418–420, 2007.
Abstract | BibTeX | Tags: Accidents, Traffic Adult Brain/pa [Pathology] Comm
@article{Hashimoto2007,
title = {Tensor magnetic resonance imaging in a case of mild traumatic brain injury with lowered verbal intelligence quotient},
author = {Hashimoto, Keiji and Okumura, Ayumi and Shinoda, Jun and Abo, Masahiro and Nakamura, Toshinori},
year = {2007},
date = {2007-01-01},
journal = {Journal of Rehabilitation Medicine},
volume = {39},
pages = {418--420},
address = {Department of Neutrotraumatology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan. keiman@jikei.ac.jp},
abstract = {We report the case of a 31-year-old man who had mild traumatic brain injury as a result of an accident at the age of 24 years. Seven years after the trauma, at the age of 31 years, he had a lower verbal intelligence quotient than performance intelligence quotient by the Wechsler Adult Intelligence Scale - Revised, and frontal lobe dysfunction, for example, difficulty in maintaining or changing the set as revealed by the Wisconsin Card Sorting Test Keio Version. Conventional brain magnetic resonance imaging had not shown any abnormalities. Abnormal brain areas were detected on magnetic resonance diffusion tensor imaging. On tractography, some fibres from the corpus callosum towards the frontal cortex were noted to be lacking in the left hemisphere compared with the right. The tractography results may explain the patient's lowered verbal intelligence quotient and focal left frontal lobe dysfunction. Diffusion tensor imaging is therefore helpful in detecting lesions in mild traumatic brain injury with diffuse axonal injury.},
keywords = {Accidents, Traffic Adult Brain/pa [Pathology] Comm},
pubstate = {published},
tppubtype = {article}
}
Chiu, W T; Huang, S J; Tsai, S H; Lin, J W; Tsai, M D; Lin, T J; Huang, W C
The impact of time, legislation, and geography on the epidemiology of traumatic brain injury Journal Article
In: Journal of Clinical Neuroscience, vol. 14, no. 10, pp. 930–935, 2007.
Abstract | BibTeX | Tags: *Accidents, *Brain Injuries/ep [Epidemiology], *Legislation as Topic/sn [Statistics & Numerical D, *Rural Population/sn [Statistics & Numerical Data], *Urban Population/sn [Statistics & Numerical Data], Accidents, adult, age distribution, aged, Cohort Studies, Female, Head Protective Devices/sn [Statistics & Numerical, Head Protective Devices/st [Standards], Humans, Incidence, Legislation as Topic/td [Trends], Male, middle aged, Motorcycles/lj [Legislation & Jurisprudence], Motorcycles/sn [Statistics & Numerical Data], Motorcycles/st [Standards], Prospective Studies, Rural Population/td [Trends], Sex Distribution, Taiwan/ep [Epidemiology], Time Factors, Traffic/lj [Legislation & Jurisprudence, Traffic/pc [Prevention & Control], Traffic/sn [Statistics & Numerical Dat, Trauma Severity Indices, Urban Population/td [Trends]
@article{Chiu2007,
title = {The impact of time, legislation, and geography on the epidemiology of traumatic brain injury},
author = {Chiu, W T and Huang, S J and Tsai, S H and Lin, J W and Tsai, M D and Lin, T J and Huang, W C},
year = {2007},
date = {2007-01-01},
journal = {Journal of Clinical Neuroscience},
volume = {14},
number = {10},
pages = {930--935},
abstract = {In 1991, a population-based epidemiologic traumatic brain injury (TBI) study was done in urban and rural areas of Taiwan; this was 5 years before the helmet use law was passed and 8 years before the drink driving law was passed. In order to evaluate the impact of three major determinants (time, geography, and legislation) on the epidemiology of TBI, we conducted a prospective study in 2001 and used the 1991 data to examine the differences in TBI distribution in urban and rural Taiwan a decade after these laws were passed. In 2001, 5754 TBI cases were collected from the urban area of Taipei City, and 1474 TBI cases were collected from the rural area of Hualien County. The TBI incidence rate in Taipei City in 2001 was estimated to be 218/100,000 population (285/100,000 for males and 152/100,000 for females). When compared to the 1991 data, the incidence rate in 2001 had increased by 20%. The TBI incidence rate in Hualien County in 2001 was estimated to be 417/100,000 population (516/100,000 for males and 306/100,000 for females); this was a 37% increase over the 1991 data. Our study found that the distribution of causes and age distribution had shifted significantly over the 10-year period. In 2001, the age group with the highest incidence was 20-29 years, while in 1991 it had been the over 70 years age group. While traffic-related TBI had decreased, falls and assaults had increased in 2001. We also found that legislation, such as the helmet law, affects TBI distribution by decreasing the traffic-related TBI rate, decreasing the admission severity of TBI, and reducing TBI-related mortality. Finally, geography plays a crucial role in the outcome of TBI; over the 10 year period, Taipei had an increase in moderately severe outcomes, while Hualien had an increase in more severe outcomes. Comparative studies of TBI in urban and rural areas have shown that time, legislation, and geography are crucial determinants of TBI epidemiology. Although time and legal interventions seem to have more of an impact, geography does affect TBI outcomes.},
keywords = {*Accidents, *Brain Injuries/ep [Epidemiology], *Legislation as Topic/sn [Statistics \& Numerical D, *Rural Population/sn [Statistics \& Numerical Data], *Urban Population/sn [Statistics \& Numerical Data], Accidents, adult, age distribution, aged, Cohort Studies, Female, Head Protective Devices/sn [Statistics \& Numerical, Head Protective Devices/st [Standards], Humans, Incidence, Legislation as Topic/td [Trends], Male, middle aged, Motorcycles/lj [Legislation \& Jurisprudence], Motorcycles/sn [Statistics \& Numerical Data], Motorcycles/st [Standards], Prospective Studies, Rural Population/td [Trends], Sex Distribution, Taiwan/ep [Epidemiology], Time Factors, Traffic/lj [Legislation \& Jurisprudence, Traffic/pc [Prevention \& Control], Traffic/sn [Statistics \& Numerical Dat, Trauma Severity Indices, Urban Population/td [Trends]},
pubstate = {published},
tppubtype = {article}
}
Mulhern, Sharon; McMillan, Thomas M
Knowledge and expectation of postconcussion symptoms in the general population Journal Article
In: Journal of Psychosomatic Research, vol. 61, pp. 439–445, 2006.
Abstract | BibTeX | Tags: Accidents, Traffic/sn [Statistics & Numerical Data
@article{Mulhern2006,
title = {Knowledge and expectation of postconcussion symptoms in the general population},
author = {Mulhern, Sharon and McMillan, Thomas M},
year = {2006},
date = {2006-01-01},
journal = {Journal of Psychosomatic Research},
volume = {61},
pages = {439--445},
address = {Psychological Medicine, Faculty of Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow G12 OXH, United Kingdom.},
abstract = {OBJECTIVE: Beliefs about mild traumatic brain injury (MTBI) may affect complaints and their persistence. This study investigates the relationships between knowledge, experience, and expectation in the general population. METHODS: One hundred seventy-one people reported symptoms expected from vignettes about MTBI, depression, posttraumatic stress disorder (PTSD), and orthopedic injury. Then they completed a postconcussional syndrome (PCS) checklist about these vignettes and about personal symptoms. RESULTS: The ability to generate symptoms from vignettes was poor for PCS, depression, and PTSD, and was greatly improved using a PCS checklist, probably by symptom guessing. No postconcussion symptoms were associated specifically with MTBI. Those with more personal symptoms expected more symptoms. Past experience of MTBI did not improve symptom knowledge. Beliefs about the 'undesirability' of conditions were associated with expected outcomes. CONCLUSIONS: People know little about PCS. Expectations about MTBI are influenced by psychological factors that are relevant if we consider information given in hospitals. Symptom overlap means that psychological conditions such as depression may be misdiagnosed as PCS, and checklists should not be used for diagnosis.},
keywords = {Accidents, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A K; To, T M; Macarthur, C; Chipman, M L; Wright, J G; Parkin, P C
Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study Journal Article
In: Pediatrics, vol. 110, no. 5, pp. e60, 2002.
Abstract | BibTeX | Tags: *Bicycling/in [Injuries], *Bicycling/lj [Legislation & Jurisprudence], *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics & Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics & Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics & Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics & Numerical Data, Trauma Severity Indices
@article{Macpherson2002,
title = {Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study},
author = {Macpherson, A K and To, T M and Macarthur, C and Chipman, M L and Wright, J G and Parkin, P C},
year = {2002},
date = {2002-01-01},
journal = {Pediatrics},
volume = {110},
number = {5},
pages = {e60},
abstract = {OBJECTIVE: Childhood bicycle-related head injuries can be prevented through the use of helmets. Although helmet legislation has proved to be a successful strategy for the adoption of helmets, its effect on the rates of head injury is uncertain. In Canada, 4 provinces have such legislation. The objective of this study was to measure the impact of helmet legislation on bicycle-related head injuries in Canadian children. METHODS: Routinely collected data from the Canadian Institute for Health Information identified all Canadian children (5-19 years) who were hospitalized for bicycling-related injuries from 1994-1998. Children were categorized as head or other injury on the basis of International Classification of Diseases, Ninth Revision, codes. Rates of head injuries and other injuries were compared over time in provinces that adopted legislation and those that did not. RESULTS: Of the 9650 children who were hospitalized because of a bicycle-related injury, 3426 sustained injuries to the head and face and the remaining 6224 had other injuries. The bicycle-related head injury rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and territories that did not adopt legislation (27% reduction). CONCLUSION: This country-wide study compared rates of head injury in regions with and without mandatory helmet legislation. Comparing head injuries with other non-head-injured children controlled for potential differences in children's cycling habits. The strong protective association between helmet legislation and head injuries supports the adoption of helmet legislation as an effective tool in the prevention of childhood bicycle-related head injuries.},
keywords = {*Bicycling/in [Injuries], *Bicycling/lj [Legislation \& Jurisprudence], *Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics \& Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics \& Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics \& Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics \& Numerical Data, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}
Horner, A; VanDemark, M; Jensen, G A
The challenge of assessing a patient with dementia and head injury Journal Article
In: AACN Clinical Issues, vol. 13, no. 1, pp. 73–83, 2002.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/co [Complications], *Dementia/co [Complications], Accidental Falls, Accidents, aged, Alzheimer Disease/di [Diagnosis], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/pp [Physiopathology], Delirium/di [Diagnosis], Delirium/et [Etiology], Home, Humans
@article{Horner2002,
title = {The challenge of assessing a patient with dementia and head injury},
author = {Horner, A and VanDemark, M and Jensen, G A},
year = {2002},
date = {2002-01-01},
journal = {AACN Clinical Issues},
volume = {13},
number = {1},
pages = {73--83},
abstract = {Alzheimer's disease is emerging as a major health challenge for the 21st century. The reported case study discusses a 74-year-old woman with dementia of the Alzheimer type who sustained a head injury when she fell down the basement stairs. Differentiating the head injury from the preexisting dementia was complicated and required creative and astute assessment. Objective assessment tools discussed include the Mini-Mental State Examination, a delirium guide, and the Tinetti assessment tool. Predisposition to delirium is significant because of the comorbidities associated with cognitive impairment and head injury. Interventions to prevent delirium are recommended.},
keywords = {*Craniocerebral Trauma/co [Complications], *Dementia/co [Complications], Accidental Falls, Accidents, aged, Alzheimer Disease/di [Diagnosis], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/pp [Physiopathology], Delirium/di [Diagnosis], Delirium/et [Etiology], Home, Humans},
pubstate = {published},
tppubtype = {article}
}
McLean, A J
Brain injury without head impact? Journal Article
In: Journal of Neurotrauma, vol. 12, no. 4, pp. 621–625, 1995.
Abstract | BibTeX | Tags: *Brain Injuries/et [Etiology], Acceleration, Accidents, autopsy, Brain Injuries/mo [Mortality], cause of death, Head, Humans, Mechanical, Nonpenetrating, Stress, Traffic, Wounds
@article{McLean1995,
title = {Brain injury without head impact?},
author = {McLean, A J},
year = {1995},
date = {1995-01-01},
journal = {Journal of Neurotrauma},
volume = {12},
number = {4},
pages = {621--625},
abstract = {The proposition that acceleration of the brain without direct impact to the head can result in brain injury is examined by reviewing a series of 414 road users who were fatally injured in the vicinity of Adelaide, South Australia. The series comprises 170 pedestrians, 10 pedal cyclists, 143 motorcyclists, and 91 vehicle occupants. In each case a member of the research team attended the autopsy to look for evidence of impact on the body, particularly to the head or face. The brain was examined by a neuropathologist and the type and pattern of injury was recorded. The circumstances of the crash were investigated, including an examination of the crash site and the vehicles involved and, where relevant, interviews with witnesses. In cases involving a motorcyclist the helmet worn was retrieved by the police and assigned to the research unit for examination. Particular attention was paid to the identification of objects causing injury to the head or face and also to objects impacted by a helmet. Brain injury was recorded as a cause of death in 55% of the 403 cases for which there was a clear classification of cause of death. Brain injury, at any level of severity, was identified by a neuropathologist in 86 percent of the 414 fatally injured road users in the sample, including 24 cases that were examined microscopically. There were no cases in which there was an injury to the brain in the absence of evidence of an impact to the head.},
keywords = {*Brain Injuries/et [Etiology], Acceleration, Accidents, autopsy, Brain Injuries/mo [Mortality], cause of death, Head, Humans, Mechanical, Nonpenetrating, Stress, Traffic, Wounds},
pubstate = {published},
tppubtype = {article}
}
Arya, V; Chigurupati, R
Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle Journal Article
In: Journal of Oral & Maxillofacial Surgery, vol. 74, no. 3, pp. 569–581, 2016.
@article{Arya2016,
title = {Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle},
author = {Arya, V and Chigurupati, R},
doi = {10.1016/j.joms.2015.09.033},
year = {2016},
date = {2016-01-01},
journal = {Journal of Oral \& Maxillofacial Surgery},
volume = {74},
number = {3},
pages = {569--581},
abstract = {Purpose Traumatic injuries of the mandible resulting in intrusion of the condyle into the middle cranial fossa are rare and treatment is often based on anecdotal experience. The objective of this study was to develop an algorithm for the management of condylar intrusion injuries by identifying factors that influenced the treatment decision of closed versus open reduction of the condyle. Materials and Methods This study was a systematic review of the literature on intracranial intrusion injuries of the mandibular condyle. A thorough search of the PubMed and Cochrane databases and individual maxillofacial and craniofacial journal databases was conducted using the Medical Subject Heading terms condylar impaction, condylar dislocation, condylar intrusion, and middle cranial fossa and condyle without date and language restriction. Quantitative data on the patient's age, gender, etiology of injury, and time from injury to diagnosis were analyzed using descriptive statistics. The authors studied how the predictor variables of age, etiology, time from injury to diagnosis, and associated neurologic injuries influenced the outcome variable of closed versus open reduction of the condyle. Results Forty-eight of the 62 retrieved case reports, case series, and review articles were published in the English-language literature from 1963 to 2015. Data on 51 patients with these injuries showed that 38 (75%) were female and younger than 30 years. The most common etiology of injury was motor vehicular accidents, occurring in 25 of 51 patients (49%). The mean time from injury to diagnosis was 31.2 days (0 to 106.4 days). Forty of the 51 patients (78%) were diagnosed within the first 2 weeks of injury. A good proportion of patients underwent open reduction (63%) and 18 of the 51 of patients (35%) underwent closed reduction. Conclusions Predictor variables that influenced the treatment decision of open versus closed reduction were age of the patient, etiology of injury, and time from injury to diagnosis. Based on the present results, younger patients (0 to 15 yr old), patients who sustain condylar intrusion injuries from bicycle accidents, and those diagnosed within the first 2 weeks of injury are more likely to benefit from closed reduction. The treatment algorithm emphasizes the importance of assessment of associated neurologic injuries and an interdisciplinary approach for the management of these injuries. © 2016 American Association of Oral and Maxillofacial Surgeons.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Aomura, S; Zhang, Y; Nakadate, H; Koyama, T; Nishimura, A
Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident Journal Article
In: Journal of Biomechanical Science and Engineering, vol. 11, no. 4, 2016.
@article{Aomura2016,
title = {Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident},
author = {Aomura, S and Zhang, Y and Nakadate, H and Koyama, T and Nishimura, A},
doi = {10.1299/jbse.16-00393},
year = {2016},
date = {2016-01-01},
journal = {Journal of Biomechanical Science and Engineering},
volume = {11},
number = {4},
abstract = {The collision accident in collegiate football game was simulated based on the game video and the concussive impact on the head was analyzed. First, the collision motion of players was reproduced based on the video by using motion analysis, and the translational and rotational velocities, relative position and contact location of the struck and the striking players' heads just before the collision were calculated. Then the data obtained were input to two helmeted finite element (FE) human head models as the initial condition, and the brain injury risk was evaluated by using the impact analysis. The FE helmet model was validated by a drop test of the helmet in which the head impactor was embedded. In the present study, two concussion suspected accident cases were analyzed; then the concussion was evaluated by ten mechanical parameters generated inside the skull caused by the collision. The injury risk evaluated by multi parameters belonged to the dangerous range that may cause concussion and was consistent with the diagnosis of the medical team doctor. The brain injury risk can be successfully estimated by the reconstructed simulation of the game video and FE analysis. To our knowledge, this study is the first attempt in Japan to estimate the brain injury risk systematically by a combination of game video analysis which is originally introduced for the players' health care and FE analysis by helmeted human head model. In the future, brain injury risk caused by an accident can be evaluated with higher accuracy by analyzing more accident cases. © 2016 The Japan Society of Mechanical Engineers.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Naeser, M A; Martin, P I; Ho, M D; Krengel, M H; Bogdanova, Y; Knight, J A; Yee, M K; Zafonte, R; Frazier, J; Hamblin, M R; Koo, B B
Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury Journal Article
In: Photomedicine and Laser Surgery, vol. 34, no. 12, pp. 610–626, 2016.
@article{Naeser2016,
title = {Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury},
author = {Naeser, M A and Martin, P I and Ho, M D and Krengel, M H and Bogdanova, Y and Knight, J A and Yee, M K and Zafonte, R and Frazier, J and Hamblin, M R and Koo, B B},
doi = {10.1089/pho.2015.4037},
year = {2016},
date = {2016-01-01},
journal = {Photomedicine and Laser Surgery},
volume = {34},
number = {12},
pages = {610--626},
abstract = {Objective: We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. LED therapy is nonthermal, painless, and noninvasive. An LED-based device classified as nonsignificant risk (FDA cleared) was used. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm2) was applied for 9 min 45 sec (13 J/cm2) using 11 locations on the scalp: midline from front-to-back hairline and bilaterally on frontal, parietal, and temporal areas. Testing was performed before and after transcranial LED (tLED; at 1 week, 1 month, and at 2 months after the 18th treatment) and showed significant improvements in executive function and verbal memory. There were also fewer post-traumatic stress disorder (PTSD) symptoms reported. Ongoing studies: Ongoing, current studies involve TBI patients who have been treated with tLED using either 26 J/cm2 per LED location on the head or treated with intranasal only (iLED) using red (633 nm) and NIR (810 nm) diodes placed into the nostrils. The NIR iLED is hypothesized to deliver photons to the hippocampus, and the red 633 nm iLED is believed to increase melatonin. Results have been similar to the previously published tLED study. Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing. © Mary Ann Liebert, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Oeur, R A; Karton, C; Post, A; Rousseau, P; Hoshizaki, T B; Marshall, S; Brien, S E; Smith, A; Cusimano, M D; Gilchrist, M D
In: Journal of Neurosurgery, vol. 123, no. 2, pp. 415–422, 2015.
@article{Oeur2015,
title = {A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma},
author = {Oeur, R A and Karton, C and Post, A and Rousseau, P and Hoshizaki, T B and Marshall, S and Brien, S E and Smith, A and Cusimano, M D and Gilchrist, M D},
doi = {10.3171/2014.10.JNS14440},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery},
volume = {123},
number = {2},
pages = {415--422},
abstract = {Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p \< 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p \< 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stemper, B D; Shah, A S; Pintar, F A; McCrea, M; Kurpad, S N; Glavaski-Joksimovic, A; Olsen, C; Budde, M D
Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion Journal Article
In: Annals of Biomedical Engineering, vol. 43, no. 5, pp. 1071–1088, 2015.
@article{Stemper2015,
title = {Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion},
author = {Stemper, B D and Shah, A S and Pintar, F A and McCrea, M and Kurpad, S N and Glavaski-Joksimovic, A and Olsen, C and Budde, M D},
doi = {10.1007/s10439-014-1171-9},
year = {2015},
date = {2015-01-01},
journal = {Annals of Biomedical Engineering},
volume = {43},
number = {5},
pages = {1071--1088},
abstract = {A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague\textendashDawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s2 and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the parameter fractional anisotropy (FA). While the injury did not cause significant locomotor or cognitive deficits measured with the CN and MWM, respectively, a main effect of duration was consistently observed for the EPM. Increased duration caused significantly greater activity and exploratory behaviors measured as open arm time and number of arm changes. DTI demonstrated significant effects of both magnitude and duration, with the FA of the amygdala related to both the magnitude and duration. Increased duration also caused FA changes at the interface of gray and white matter. Collectively, the findings demonstrate that the consequences of rotational acceleration mTBI were more closely associated with duration of the rotational acceleration impulse, which is often neglected as an independent factor, and highlight the need for animal models of TBI with strong biomechanical foundations to associate behavioral outcomes with brain microstructure. © 2014, Biomedical Engineering Society (Outside the U.S.).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Huang, M X; Nichols, S; Baker, D G; Robb, A; Angeles, A; Yurgil, K A; Drake, A; Levy, M; Song, T; McLay, R; Theilmann, R J; Diwakar, M; Risbrough, V B; Ji, Z; Huang, C W; Chang, D G; Harrington, D L; Muzzatti, L; Canive, J M; Christopher Edgar, J; Chen, Y H; Lee, R R
Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 5, pp. 109–119, 2014.
@article{Huang2014a,
title = {Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury},
author = {Huang, M X and Nichols, S and Baker, D G and Robb, A and Angeles, A and Yurgil, K A and Drake, A and Levy, M and Song, T and McLay, R and Theilmann, R J and Diwakar, M and Risbrough, V B and Ji, Z and Huang, C W and Chang, D G and Harrington, D L and Muzzatti, L and Canive, J M and {Christopher Edgar}, J and Chen, Y H and Lee, R R},
year = {2014},
date = {2014-01-01},
journal = {NeuroImage Clinical},
volume = {5},
pages = {109--119},
address = {Huang,Ming-Xiong. Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA ; Department of Radiology, University of California, San Diego, CA, USA. Nichols,Sharon. Department of Neuroscience, University of Californi},
abstract = {Traumatic brain injury (TBI) is a leading cause of sustained impairment in military and civilian populations. However, mild TBI (mTBI) can be difficult to detect using conventional MRI or CT. Injured brain tissues in mTBI patients generate abnormal slow-waves (1-4 Hz) that can be measured and localized by resting-state magnetoencephalography (MEG). In this study, we develop a voxel-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mTBI on a single-subject basis. A normative database of resting-state MEG source magnitude images (1-4 Hz) from 79 healthy control subjects was established for all brain voxels. The high-resolution MEG source magnitude images were obtained by our recent Fast-VESTAL method. In 84 mTBI patients with persistent post-concussive symptoms (36 from blasts, and 48 from non-blast causes), our method detected abnormalities at the positive detection rates of 84.5%, 86.1%, and 83.3% for the combined (blast-induced plus with non-blast causes), blast, and non-blast mTBI groups, respectively. We found that prefrontal, posterior parietal, inferior temporal, hippocampus, and cerebella areas were particularly vulnerable to head trauma. The result also showed that MEG slow-wave generation in prefrontal areas positively correlated with personality change, trouble concentrating, affective lability, and depression symptoms. Discussion is provided regarding the neuronal mechanisms of MEG slow-wave generation due to deafferentation caused by axonal injury and/or blockages/limitations of cholinergic transmission in TBI. This study provides an effective way for using MEG slow-wave source imaging to localize affected areas and supports MEG as a tool for assisting the diagnosis of mTBI.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Balendra, G; Turner, M; McCrory, P
Career-ending injuries to professional jockeys in British horse racing (1991-2005) Journal Article
In: British Journal of Sports Medicine, vol. 42, pp. 22–24, 2008.
@article{Balendra2008,
title = {Career-ending injuries to professional jockeys in British horse racing (1991-2005)},
author = {Balendra, G and Turner, M and McCrory, P},
year = {2008},
date = {2008-01-01},
journal = {British Journal of Sports Medicine},
volume = {42},
pages = {22--24},
address = {Paul McCrory, University of Melbourne, Victoria, Australia. p.mccrory@unimelb.edu.au},
abstract = {BACKGROUND: It has been previously shown that professional jump and flat racing jockeys suffer a high incidence of injury as a consequence of their profession. This paper specifically examines career-ending injuries to professional jockeys in Great Britain. AIMS: To investigate career-ending injuries in professional jockeys. Method: Analysis of prospectively collected injury database on professional jockeys. RESULTS: The majority of injuries in this study occurred to the head, shoulder or torso. Fractures were the most common type of injury that led to a decision to end a career, followed by neurological injury to the head and/or spine. CONCLUSION: Injuries to the head are the most common career-ending injuries, and consideration of injury counter measures could be an important strategy in equestrian sports.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Setnik, Lon; Bazarian, Jeffrey J
The characteristics of patients who do not seek medical treatment for traumatic brain injury Journal Article
In: Brain Injury, vol. 21, pp. 1–9, 2007.
@article{Setnik2007,
title = {The characteristics of patients who do not seek medical treatment for traumatic brain injury},
author = {Setnik, Lon and Bazarian, Jeffrey J},
year = {2007},
date = {2007-01-01},
journal = {Brain Injury},
volume = {21},
pages = {1--9},
address = {The Elliot Hospital, Manchester, NH, USA.},
abstract = {PRIMARY OBJECTIVE: To identify factors associated with not seeking medical care for traumatic brain injury (TBI). RESEARCH DESIGN: Internet survey. METHODS AND PROCEDURES: The survey consisted of 17 questions related to demographics, TBI case ascertainment, location and mechanism of injury, type of treatment sought, and post-concussive (PC) symptoms. Logistic regression was used to identify factors associated with not seeking medical care. MAIN OUTCOME AND RESULTS: Of the 1381 survey respondents with TBI, 584 (42%) did not seek medical care. TBI respondents were less likely to seek care if they were older (OR 0.98, 95% CI 0.97-0.99), suffered a mild TBI grade 2/3 (OR 0.42, 95% CI 0.31-0.58), or were injured in the home (OR 0.53, 95% CI 0.36-0.78). CONCLUSIONS: Several factors associated with not seeking medical care after TBI were identified. Raising public awareness of the signs and symptoms of TBI, and the benefits of medical care, could help increase the number of TBI patients who seek medical care.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Butcher, I; McHugh, G S; Lu, J; Steyerberg, E W; Hernandez, A V; Mushkudiani, N; Maas, A I; Marmarou, A; Murray, G D
Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study Journal Article
In: Journal of Neurotrauma, vol. 24, no. 2, pp. 281–286, 2007.
@article{Butcher2007,
title = {Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study},
author = {Butcher, I and McHugh, G S and Lu, J and Steyerberg, E W and Hernandez, A V and Mushkudiani, N and Maas, A I and Marmarou, A and Murray, G D},
year = {2007},
date = {2007-01-01},
journal = {Journal of Neurotrauma},
volume = {24},
number = {2},
pages = {281--286},
abstract = {We aimed to describe and quantify the relationship between cause of injury and final outcome following traumatic brain injury (TBI). Individual patient data (N = 8708) from eight therapeutic Phase III randomized clinical trials in moderate or severe TBI, and three TBI surveys were used to investigate the relationship between cause of injury and outcome, as assessed by the Glasgow Outcome Scale (GOS) at 6 months. Proportional odds methodology was applied to quantify the strength of the association and expressed as an odds ratio in a meta-analysis. Heterogeneity across studies was assessed and associations with other predictive factors explored. In a univariate analysis, a strong association between the cause of injury and long-term outcome in moderate to severe TBI patients was observed, with consistent results across the studies. Road traffic accidents (OR 0.66, 95% CI 0.60-0.73), assaults (OR 0.66, 95% CI 0.52-0.84), and injuries sustained during sporting or recreational activities (OR 0.45, 95% CI 0.28-0.71) were all associated with better outcomes than the reference category of falls. Falls were found to be associated with an older age and with a higher incidence of mass lesions. Following adjustment for age in the analysis, the relationship between cause of injury and outcome was lost.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hashimoto, Keiji; Okumura, Ayumi; Shinoda, Jun; Abo, Masahiro; Nakamura, Toshinori
Tensor magnetic resonance imaging in a case of mild traumatic brain injury with lowered verbal intelligence quotient Journal Article
In: Journal of Rehabilitation Medicine, vol. 39, pp. 418–420, 2007.
@article{Hashimoto2007,
title = {Tensor magnetic resonance imaging in a case of mild traumatic brain injury with lowered verbal intelligence quotient},
author = {Hashimoto, Keiji and Okumura, Ayumi and Shinoda, Jun and Abo, Masahiro and Nakamura, Toshinori},
year = {2007},
date = {2007-01-01},
journal = {Journal of Rehabilitation Medicine},
volume = {39},
pages = {418--420},
address = {Department of Neutrotraumatology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan. keiman@jikei.ac.jp},
abstract = {We report the case of a 31-year-old man who had mild traumatic brain injury as a result of an accident at the age of 24 years. Seven years after the trauma, at the age of 31 years, he had a lower verbal intelligence quotient than performance intelligence quotient by the Wechsler Adult Intelligence Scale - Revised, and frontal lobe dysfunction, for example, difficulty in maintaining or changing the set as revealed by the Wisconsin Card Sorting Test Keio Version. Conventional brain magnetic resonance imaging had not shown any abnormalities. Abnormal brain areas were detected on magnetic resonance diffusion tensor imaging. On tractography, some fibres from the corpus callosum towards the frontal cortex were noted to be lacking in the left hemisphere compared with the right. The tractography results may explain the patient's lowered verbal intelligence quotient and focal left frontal lobe dysfunction. Diffusion tensor imaging is therefore helpful in detecting lesions in mild traumatic brain injury with diffuse axonal injury.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Chiu, W T; Huang, S J; Tsai, S H; Lin, J W; Tsai, M D; Lin, T J; Huang, W C
The impact of time, legislation, and geography on the epidemiology of traumatic brain injury Journal Article
In: Journal of Clinical Neuroscience, vol. 14, no. 10, pp. 930–935, 2007.
@article{Chiu2007,
title = {The impact of time, legislation, and geography on the epidemiology of traumatic brain injury},
author = {Chiu, W T and Huang, S J and Tsai, S H and Lin, J W and Tsai, M D and Lin, T J and Huang, W C},
year = {2007},
date = {2007-01-01},
journal = {Journal of Clinical Neuroscience},
volume = {14},
number = {10},
pages = {930--935},
abstract = {In 1991, a population-based epidemiologic traumatic brain injury (TBI) study was done in urban and rural areas of Taiwan; this was 5 years before the helmet use law was passed and 8 years before the drink driving law was passed. In order to evaluate the impact of three major determinants (time, geography, and legislation) on the epidemiology of TBI, we conducted a prospective study in 2001 and used the 1991 data to examine the differences in TBI distribution in urban and rural Taiwan a decade after these laws were passed. In 2001, 5754 TBI cases were collected from the urban area of Taipei City, and 1474 TBI cases were collected from the rural area of Hualien County. The TBI incidence rate in Taipei City in 2001 was estimated to be 218/100,000 population (285/100,000 for males and 152/100,000 for females). When compared to the 1991 data, the incidence rate in 2001 had increased by 20%. The TBI incidence rate in Hualien County in 2001 was estimated to be 417/100,000 population (516/100,000 for males and 306/100,000 for females); this was a 37% increase over the 1991 data. Our study found that the distribution of causes and age distribution had shifted significantly over the 10-year period. In 2001, the age group with the highest incidence was 20-29 years, while in 1991 it had been the over 70 years age group. While traffic-related TBI had decreased, falls and assaults had increased in 2001. We also found that legislation, such as the helmet law, affects TBI distribution by decreasing the traffic-related TBI rate, decreasing the admission severity of TBI, and reducing TBI-related mortality. Finally, geography plays a crucial role in the outcome of TBI; over the 10 year period, Taipei had an increase in moderately severe outcomes, while Hualien had an increase in more severe outcomes. Comparative studies of TBI in urban and rural areas have shown that time, legislation, and geography are crucial determinants of TBI epidemiology. Although time and legal interventions seem to have more of an impact, geography does affect TBI outcomes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Mulhern, Sharon; McMillan, Thomas M
Knowledge and expectation of postconcussion symptoms in the general population Journal Article
In: Journal of Psychosomatic Research, vol. 61, pp. 439–445, 2006.
@article{Mulhern2006,
title = {Knowledge and expectation of postconcussion symptoms in the general population},
author = {Mulhern, Sharon and McMillan, Thomas M},
year = {2006},
date = {2006-01-01},
journal = {Journal of Psychosomatic Research},
volume = {61},
pages = {439--445},
address = {Psychological Medicine, Faculty of Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow G12 OXH, United Kingdom.},
abstract = {OBJECTIVE: Beliefs about mild traumatic brain injury (MTBI) may affect complaints and their persistence. This study investigates the relationships between knowledge, experience, and expectation in the general population. METHODS: One hundred seventy-one people reported symptoms expected from vignettes about MTBI, depression, posttraumatic stress disorder (PTSD), and orthopedic injury. Then they completed a postconcussional syndrome (PCS) checklist about these vignettes and about personal symptoms. RESULTS: The ability to generate symptoms from vignettes was poor for PCS, depression, and PTSD, and was greatly improved using a PCS checklist, probably by symptom guessing. No postconcussion symptoms were associated specifically with MTBI. Those with more personal symptoms expected more symptoms. Past experience of MTBI did not improve symptom knowledge. Beliefs about the 'undesirability' of conditions were associated with expected outcomes. CONCLUSIONS: People know little about PCS. Expectations about MTBI are influenced by psychological factors that are relevant if we consider information given in hospitals. Symptom overlap means that psychological conditions such as depression may be misdiagnosed as PCS, and checklists should not be used for diagnosis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A K; To, T M; Macarthur, C; Chipman, M L; Wright, J G; Parkin, P C
Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study Journal Article
In: Pediatrics, vol. 110, no. 5, pp. e60, 2002.
@article{Macpherson2002,
title = {Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study},
author = {Macpherson, A K and To, T M and Macarthur, C and Chipman, M L and Wright, J G and Parkin, P C},
year = {2002},
date = {2002-01-01},
journal = {Pediatrics},
volume = {110},
number = {5},
pages = {e60},
abstract = {OBJECTIVE: Childhood bicycle-related head injuries can be prevented through the use of helmets. Although helmet legislation has proved to be a successful strategy for the adoption of helmets, its effect on the rates of head injury is uncertain. In Canada, 4 provinces have such legislation. The objective of this study was to measure the impact of helmet legislation on bicycle-related head injuries in Canadian children. METHODS: Routinely collected data from the Canadian Institute for Health Information identified all Canadian children (5-19 years) who were hospitalized for bicycling-related injuries from 1994-1998. Children were categorized as head or other injury on the basis of International Classification of Diseases, Ninth Revision, codes. Rates of head injuries and other injuries were compared over time in provinces that adopted legislation and those that did not. RESULTS: Of the 9650 children who were hospitalized because of a bicycle-related injury, 3426 sustained injuries to the head and face and the remaining 6224 had other injuries. The bicycle-related head injury rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and territories that did not adopt legislation (27% reduction). CONCLUSION: This country-wide study compared rates of head injury in regions with and without mandatory helmet legislation. Comparing head injuries with other non-head-injured children controlled for potential differences in children's cycling habits. The strong protective association between helmet legislation and head injuries supports the adoption of helmet legislation as an effective tool in the prevention of childhood bicycle-related head injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Horner, A; VanDemark, M; Jensen, G A
The challenge of assessing a patient with dementia and head injury Journal Article
In: AACN Clinical Issues, vol. 13, no. 1, pp. 73–83, 2002.
@article{Horner2002,
title = {The challenge of assessing a patient with dementia and head injury},
author = {Horner, A and VanDemark, M and Jensen, G A},
year = {2002},
date = {2002-01-01},
journal = {AACN Clinical Issues},
volume = {13},
number = {1},
pages = {73--83},
abstract = {Alzheimer's disease is emerging as a major health challenge for the 21st century. The reported case study discusses a 74-year-old woman with dementia of the Alzheimer type who sustained a head injury when she fell down the basement stairs. Differentiating the head injury from the preexisting dementia was complicated and required creative and astute assessment. Objective assessment tools discussed include the Mini-Mental State Examination, a delirium guide, and the Tinetti assessment tool. Predisposition to delirium is significant because of the comorbidities associated with cognitive impairment and head injury. Interventions to prevent delirium are recommended.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
McLean, A J
Brain injury without head impact? Journal Article
In: Journal of Neurotrauma, vol. 12, no. 4, pp. 621–625, 1995.
@article{McLean1995,
title = {Brain injury without head impact?},
author = {McLean, A J},
year = {1995},
date = {1995-01-01},
journal = {Journal of Neurotrauma},
volume = {12},
number = {4},
pages = {621--625},
abstract = {The proposition that acceleration of the brain without direct impact to the head can result in brain injury is examined by reviewing a series of 414 road users who were fatally injured in the vicinity of Adelaide, South Australia. The series comprises 170 pedestrians, 10 pedal cyclists, 143 motorcyclists, and 91 vehicle occupants. In each case a member of the research team attended the autopsy to look for evidence of impact on the body, particularly to the head or face. The brain was examined by a neuropathologist and the type and pattern of injury was recorded. The circumstances of the crash were investigated, including an examination of the crash site and the vehicles involved and, where relevant, interviews with witnesses. In cases involving a motorcyclist the helmet worn was retrieved by the police and assigned to the research unit for examination. Particular attention was paid to the identification of objects causing injury to the head or face and also to objects impacted by a helmet. Brain injury was recorded as a cause of death in 55% of the 403 cases for which there was a clear classification of cause of death. Brain injury, at any level of severity, was identified by a neuropathologist in 86 percent of the 414 fatally injured road users in the sample, including 24 cases that were examined microscopically. There were no cases in which there was an injury to the brain in the absence of evidence of an impact to the head.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Arya, V; Chigurupati, R
Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle Journal Article
In: Journal of Oral & Maxillofacial Surgery, vol. 74, no. 3, pp. 569–581, 2016.
Abstract | Links | BibTeX | Tags: Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident
@article{Arya2016,
title = {Treatment Algorithm for Intracranial Intrusion Injuries of the Mandibular Condyle},
author = {Arya, V and Chigurupati, R},
doi = {10.1016/j.joms.2015.09.033},
year = {2016},
date = {2016-01-01},
journal = {Journal of Oral \& Maxillofacial Surgery},
volume = {74},
number = {3},
pages = {569--581},
abstract = {Purpose Traumatic injuries of the mandible resulting in intrusion of the condyle into the middle cranial fossa are rare and treatment is often based on anecdotal experience. The objective of this study was to develop an algorithm for the management of condylar intrusion injuries by identifying factors that influenced the treatment decision of closed versus open reduction of the condyle. Materials and Methods This study was a systematic review of the literature on intracranial intrusion injuries of the mandibular condyle. A thorough search of the PubMed and Cochrane databases and individual maxillofacial and craniofacial journal databases was conducted using the Medical Subject Heading terms condylar impaction, condylar dislocation, condylar intrusion, and middle cranial fossa and condyle without date and language restriction. Quantitative data on the patient's age, gender, etiology of injury, and time from injury to diagnosis were analyzed using descriptive statistics. The authors studied how the predictor variables of age, etiology, time from injury to diagnosis, and associated neurologic injuries influenced the outcome variable of closed versus open reduction of the condyle. Results Forty-eight of the 62 retrieved case reports, case series, and review articles were published in the English-language literature from 1963 to 2015. Data on 51 patients with these injuries showed that 38 (75%) were female and younger than 30 years. The most common etiology of injury was motor vehicular accidents, occurring in 25 of 51 patients (49%). The mean time from injury to diagnosis was 31.2 days (0 to 106.4 days). Forty of the 51 patients (78%) were diagnosed within the first 2 weeks of injury. A good proportion of patients underwent open reduction (63%) and 18 of the 51 of patients (35%) underwent closed reduction. Conclusions Predictor variables that influenced the treatment decision of open versus closed reduction were age of the patient, etiology of injury, and time from injury to diagnosis. Based on the present results, younger patients (0 to 15 yr old), patients who sustain condylar intrusion injuries from bicycle accidents, and those diagnosed within the first 2 weeks of injury are more likely to benefit from closed reduction. The treatment algorithm emphasizes the importance of assessment of associated neurologic injuries and an interdisciplinary approach for the management of these injuries. © 2016 American Association of Oral and Maxillofacial Surgeons.},
keywords = {Accidents, age, Age Factors, algorithm, ALGORITHMS, Article, assault, brain concussion, brain hematoma, Brain Injuries, clinical protocol, Clinical Protocols, condylar intrusion injury, contusion, Cranial Fossa, DECISION making, Dislocations, Early Diagnosis, facial nerve paralysis, falling, fracture reduction, hearing impairment, human, Humans, Injuries, intermethod comparison, jaw disease, laceration, liquorrhea, mandible condyle, mandible fracture, Mandibular Condyle, Mandibular Fractures, Middle, middle cranial fossa, occupational accident, open reduction, sex difference, soft tissue injury, sport injury, Systematic Review, Traffic, traffic accident},
pubstate = {published},
tppubtype = {article}
}
Aomura, S; Zhang, Y; Nakadate, H; Koyama, T; Nishimura, A
Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident Journal Article
In: Journal of Biomechanical Science and Engineering, vol. 11, no. 4, 2016.
Abstract | Links | BibTeX | Tags: Accidents, Brain Injury, Brain injury risk estimation, Collision accidents, DIAGNOSIS, FEM, Finite element method, FOOTBALL players, Game video, Game videos, Health risks, Initial conditions, Mechanical parameters, Motion analysis, Relative positions, RISK assessment, Risk perception, Rotational velocity, Sports, Sports-related concussion
@article{Aomura2016,
title = {Brain injury risk estimation of collegiate football player based on game video of concussion suspected accident},
author = {Aomura, S and Zhang, Y and Nakadate, H and Koyama, T and Nishimura, A},
doi = {10.1299/jbse.16-00393},
year = {2016},
date = {2016-01-01},
journal = {Journal of Biomechanical Science and Engineering},
volume = {11},
number = {4},
abstract = {The collision accident in collegiate football game was simulated based on the game video and the concussive impact on the head was analyzed. First, the collision motion of players was reproduced based on the video by using motion analysis, and the translational and rotational velocities, relative position and contact location of the struck and the striking players' heads just before the collision were calculated. Then the data obtained were input to two helmeted finite element (FE) human head models as the initial condition, and the brain injury risk was evaluated by using the impact analysis. The FE helmet model was validated by a drop test of the helmet in which the head impactor was embedded. In the present study, two concussion suspected accident cases were analyzed; then the concussion was evaluated by ten mechanical parameters generated inside the skull caused by the collision. The injury risk evaluated by multi parameters belonged to the dangerous range that may cause concussion and was consistent with the diagnosis of the medical team doctor. The brain injury risk can be successfully estimated by the reconstructed simulation of the game video and FE analysis. To our knowledge, this study is the first attempt in Japan to estimate the brain injury risk systematically by a combination of game video analysis which is originally introduced for the players' health care and FE analysis by helmeted human head model. In the future, brain injury risk caused by an accident can be evaluated with higher accuracy by analyzing more accident cases. © 2016 The Japan Society of Mechanical Engineers.},
keywords = {Accidents, Brain Injury, Brain injury risk estimation, Collision accidents, DIAGNOSIS, FEM, Finite element method, FOOTBALL players, Game video, Game videos, Health risks, Initial conditions, Mechanical parameters, Motion analysis, Relative positions, RISK assessment, Risk perception, Rotational velocity, Sports, Sports-related concussion},
pubstate = {published},
tppubtype = {article}
}
Naeser, M A; Martin, P I; Ho, M D; Krengel, M H; Bogdanova, Y; Knight, J A; Yee, M K; Zafonte, R; Frazier, J; Hamblin, M R; Koo, B B
Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury Journal Article
In: Photomedicine and Laser Surgery, vol. 34, no. 12, pp. 610–626, 2016.
Abstract | Links | BibTeX | Tags: Accidents, Adenosinetriphosphate, brain, Cognitive dysfunction, Diodes, Explosives, Head Injuries, Hemodynamics, Infrared devices, LED, Light, Light emitting diodes, Lightemitting diodes, LLLT, Nitric oxide, Patient monitoring, Patient treatment, PBM, Photobiomodulation, postconcussion syndrome, PTSD, Sports, Sports head injury, TBI, TBI treatment, Traumatic Brain Injuries, traumatic brain injury
@article{Naeser2016,
title = {Transcranial, red/near-infrared light-emitting diode therapy to improve cognition in chronic traumatic brain injury},
author = {Naeser, M A and Martin, P I and Ho, M D and Krengel, M H and Bogdanova, Y and Knight, J A and Yee, M K and Zafonte, R and Frazier, J and Hamblin, M R and Koo, B B},
doi = {10.1089/pho.2015.4037},
year = {2016},
date = {2016-01-01},
journal = {Photomedicine and Laser Surgery},
volume = {34},
number = {12},
pages = {610--626},
abstract = {Objective: We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. LED therapy is nonthermal, painless, and noninvasive. An LED-based device classified as nonsignificant risk (FDA cleared) was used. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm2) was applied for 9 min 45 sec (13 J/cm2) using 11 locations on the scalp: midline from front-to-back hairline and bilaterally on frontal, parietal, and temporal areas. Testing was performed before and after transcranial LED (tLED; at 1 week, 1 month, and at 2 months after the 18th treatment) and showed significant improvements in executive function and verbal memory. There were also fewer post-traumatic stress disorder (PTSD) symptoms reported. Ongoing studies: Ongoing, current studies involve TBI patients who have been treated with tLED using either 26 J/cm2 per LED location on the head or treated with intranasal only (iLED) using red (633 nm) and NIR (810 nm) diodes placed into the nostrils. The NIR iLED is hypothesized to deliver photons to the hippocampus, and the red 633 nm iLED is believed to increase melatonin. Results have been similar to the previously published tLED study. Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing. © Mary Ann Liebert, Inc.},
keywords = {Accidents, Adenosinetriphosphate, brain, Cognitive dysfunction, Diodes, Explosives, Head Injuries, Hemodynamics, Infrared devices, LED, Light, Light emitting diodes, Lightemitting diodes, LLLT, Nitric oxide, Patient monitoring, Patient treatment, PBM, Photobiomodulation, postconcussion syndrome, PTSD, Sports, Sports head injury, TBI, TBI treatment, Traumatic Brain Injuries, traumatic brain injury},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Oeur, R A; Karton, C; Post, A; Rousseau, P; Hoshizaki, T B; Marshall, S; Brien, S E; Smith, A; Cusimano, M D; Gilchrist, M D
In: Journal of Neurosurgery, vol. 123, no. 2, pp. 415–422, 2015.
Abstract | Links | BibTeX | Tags: accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult
@article{Oeur2015,
title = {A comparison of head dynamic response and brain tissue stress and strain using accident reconstructions for concussion, concussion with persistent postconcussive symptoms, and subdural hematoma},
author = {Oeur, R A and Karton, C and Post, A and Rousseau, P and Hoshizaki, T B and Marshall, S and Brien, S E and Smith, A and Cusimano, M D and Gilchrist, M D},
doi = {10.3171/2014.10.JNS14440},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery},
volume = {123},
number = {2},
pages = {415--422},
abstract = {Object Concussions typically resolve within several days, but in a few cases the symptoms last for a month or longer and are termed persistent postconcussive symptoms (PPCS). These persisting symptoms may also be associated with more serious brain trauma similar to subdural hematoma (SDH). The objective of this study was to investigate the head dynamic and brain tissue responses of injury reconstructions resulting in concussion, PPCS, and SDH. Methods Reconstruction cases were obtained from sports medicine clinics and hospitals. All subjects received a direct blow to the head resulting in symptoms. Those symptoms that resolved in 9 days or fewer were defined as concussions (n = 3). Those with symptoms lasting longer than 18 months were defined as PPCS (n = 3), and 3 patients presented with SDHs (n = 3). A Hybrid III headform was used in reconstruction to obtain linear and rotational accelerations of the head. These dynamic response data were then input into the University College Dublin Brain Trauma Model to calculate maximum principal strain and von Mises stress. A Kruskal-Wallis test followed by Tukey post hoc tests were used to compare head dynamic and brain tissue responses between injury groups. Statistical significance was set at p \< 0.05. Results A significant difference was identified for peak resultant linear and rotational acceleration between injury groups. Post hoc analyses revealed the SDH group had higher linear and rotational acceleration responses (316 g and 23,181 rad/sec2, respectively) than the concussion group (149 g and 8111 rad/sec2, respectively; p \< 0.05). No significant differences were found between groups for either brain tissue measures of maximum principal strain or von Mises stress. Conclusions The reconstruction of accidents resulting in a concussion with transient symptoms (low severity) and SDHs revealed a positive relationship between an increase in head dynamic response and the risk for more serious brain injury. This type of relationship was not found for brain tissue stress and strain results derived by finite element analysis. Future research should be undertaken using a larger sample size to confirm these initial findings. Understanding the relationship between the head dynamic and brain tissue response and the nature of the injury provides important information for developing strategies for injury prevention. © AANS, 2015.},
keywords = {accident, Accident reconstruction, accidental injury, Accidents, Adolescent, adult, Article, Biomechanical Phenomena, Biomechanics, brain, brain concussion, brain stem, brain tissue, Cerebellum, clinical article, comparative study, Concussion, controlled study, Female, finite element analysis, Finite element modelling, gray matter, Hematoma, human, Humans, Hybrid iii headform, injury severity, laboratory test, Male, Mechanical, mechanical stress, middle aged, pathology, Pathophysiology, Persistent postconcussive symptoms, PHYSIOLOGY, Post Hoc Analysis, Post-Concussion Syndrome, postconcussion syndrome, priority journal, shear stress, simulation, SPORTS medicine, STATISTICAL significance, Stress, stress strain relationship, Subdural, subdural hematoma, traumatic brain injury, white matter, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stemper, B D; Shah, A S; Pintar, F A; McCrea, M; Kurpad, S N; Glavaski-Joksimovic, A; Olsen, C; Budde, M D
Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion Journal Article
In: Annals of Biomedical Engineering, vol. 43, no. 5, pp. 1071–1088, 2015.
Abstract | Links | BibTeX | Tags: Acceleration, Accidents, BEHAVIORAL assessment, Behavioral assessments, Behavioral outcomes, Biomechanics, brain, Cognitive deficits, Diffusion, Diffusion Tensor Imaging, Diffusion tensor imaging (DTI), fractional anisotropy, Full factorial design, Magnetic Resonance Imaging, Microstructure, Motor vehicle crashes, neuroimaging, Rats, Rotational acceleration, Tensors, Traumatic Brain Injuries, Traumatic brain injury (mTBI)
@article{Stemper2015,
title = {Head Rotational Acceleration Characteristics Influence Behavioral and Diffusion Tensor Imaging Outcomes Following Concussion},
author = {Stemper, B D and Shah, A S and Pintar, F A and McCrea, M and Kurpad, S N and Glavaski-Joksimovic, A and Olsen, C and Budde, M D},
doi = {10.1007/s10439-014-1171-9},
year = {2015},
date = {2015-01-01},
journal = {Annals of Biomedical Engineering},
volume = {43},
number = {5},
pages = {1071--1088},
abstract = {A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague\textendashDawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s2 and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the parameter fractional anisotropy (FA). While the injury did not cause significant locomotor or cognitive deficits measured with the CN and MWM, respectively, a main effect of duration was consistently observed for the EPM. Increased duration caused significantly greater activity and exploratory behaviors measured as open arm time and number of arm changes. DTI demonstrated significant effects of both magnitude and duration, with the FA of the amygdala related to both the magnitude and duration. Increased duration also caused FA changes at the interface of gray and white matter. Collectively, the findings demonstrate that the consequences of rotational acceleration mTBI were more closely associated with duration of the rotational acceleration impulse, which is often neglected as an independent factor, and highlight the need for animal models of TBI with strong biomechanical foundations to associate behavioral outcomes with brain microstructure. © 2014, Biomedical Engineering Society (Outside the U.S.).},
keywords = {Acceleration, Accidents, BEHAVIORAL assessment, Behavioral assessments, Behavioral outcomes, Biomechanics, brain, Cognitive deficits, Diffusion, Diffusion Tensor Imaging, Diffusion tensor imaging (DTI), fractional anisotropy, Full factorial design, Magnetic Resonance Imaging, Microstructure, Motor vehicle crashes, neuroimaging, Rats, Rotational acceleration, Tensors, Traumatic Brain Injuries, Traumatic brain injury (mTBI)},
pubstate = {published},
tppubtype = {article}
}
Huang, M X; Nichols, S; Baker, D G; Robb, A; Angeles, A; Yurgil, K A; Drake, A; Levy, M; Song, T; McLay, R; Theilmann, R J; Diwakar, M; Risbrough, V B; Ji, Z; Huang, C W; Chang, D G; Harrington, D L; Muzzatti, L; Canive, J M; Christopher Edgar, J; Chen, Y H; Lee, R R
Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury Journal Article
In: NeuroImage Clinical, vol. 5, pp. 109–119, 2014.
Abstract | BibTeX | Tags: Accidents, Traffic Adult *Blast Injuries/co [Compl
@article{Huang2014a,
title = {Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury},
author = {Huang, M X and Nichols, S and Baker, D G and Robb, A and Angeles, A and Yurgil, K A and Drake, A and Levy, M and Song, T and McLay, R and Theilmann, R J and Diwakar, M and Risbrough, V B and Ji, Z and Huang, C W and Chang, D G and Harrington, D L and Muzzatti, L and Canive, J M and {Christopher Edgar}, J and Chen, Y H and Lee, R R},
year = {2014},
date = {2014-01-01},
journal = {NeuroImage Clinical},
volume = {5},
pages = {109--119},
address = {Huang,Ming-Xiong. Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA ; Department of Radiology, University of California, San Diego, CA, USA. Nichols,Sharon. Department of Neuroscience, University of Californi},
abstract = {Traumatic brain injury (TBI) is a leading cause of sustained impairment in military and civilian populations. However, mild TBI (mTBI) can be difficult to detect using conventional MRI or CT. Injured brain tissues in mTBI patients generate abnormal slow-waves (1-4 Hz) that can be measured and localized by resting-state magnetoencephalography (MEG). In this study, we develop a voxel-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mTBI on a single-subject basis. A normative database of resting-state MEG source magnitude images (1-4 Hz) from 79 healthy control subjects was established for all brain voxels. The high-resolution MEG source magnitude images were obtained by our recent Fast-VESTAL method. In 84 mTBI patients with persistent post-concussive symptoms (36 from blasts, and 48 from non-blast causes), our method detected abnormalities at the positive detection rates of 84.5%, 86.1%, and 83.3% for the combined (blast-induced plus with non-blast causes), blast, and non-blast mTBI groups, respectively. We found that prefrontal, posterior parietal, inferior temporal, hippocampus, and cerebella areas were particularly vulnerable to head trauma. The result also showed that MEG slow-wave generation in prefrontal areas positively correlated with personality change, trouble concentrating, affective lability, and depression symptoms. Discussion is provided regarding the neuronal mechanisms of MEG slow-wave generation due to deafferentation caused by axonal injury and/or blockages/limitations of cholinergic transmission in TBI. This study provides an effective way for using MEG slow-wave source imaging to localize affected areas and supports MEG as a tool for assisting the diagnosis of mTBI.},
keywords = {Accidents, Traffic Adult *Blast Injuries/co [Compl},
pubstate = {published},
tppubtype = {article}
}
Balendra, G; Turner, M; McCrory, P
Career-ending injuries to professional jockeys in British horse racing (1991-2005) Journal Article
In: British Journal of Sports Medicine, vol. 42, pp. 22–24, 2008.
Abstract | BibTeX | Tags: Accidents, Occupational/ec [Economics] *Accidents
@article{Balendra2008,
title = {Career-ending injuries to professional jockeys in British horse racing (1991-2005)},
author = {Balendra, G and Turner, M and McCrory, P},
year = {2008},
date = {2008-01-01},
journal = {British Journal of Sports Medicine},
volume = {42},
pages = {22--24},
address = {Paul McCrory, University of Melbourne, Victoria, Australia. p.mccrory@unimelb.edu.au},
abstract = {BACKGROUND: It has been previously shown that professional jump and flat racing jockeys suffer a high incidence of injury as a consequence of their profession. This paper specifically examines career-ending injuries to professional jockeys in Great Britain. AIMS: To investigate career-ending injuries in professional jockeys. Method: Analysis of prospectively collected injury database on professional jockeys. RESULTS: The majority of injuries in this study occurred to the head, shoulder or torso. Fractures were the most common type of injury that led to a decision to end a career, followed by neurological injury to the head and/or spine. CONCLUSION: Injuries to the head are the most common career-ending injuries, and consideration of injury counter measures could be an important strategy in equestrian sports.},
keywords = {Accidents, Occupational/ec [Economics] *Accidents},
pubstate = {published},
tppubtype = {article}
}
Setnik, Lon; Bazarian, Jeffrey J
The characteristics of patients who do not seek medical treatment for traumatic brain injury Journal Article
In: Brain Injury, vol. 21, pp. 1–9, 2007.
Abstract | BibTeX | Tags: Accidents, Home/sn [Statistics & Numerical Data] A
@article{Setnik2007,
title = {The characteristics of patients who do not seek medical treatment for traumatic brain injury},
author = {Setnik, Lon and Bazarian, Jeffrey J},
year = {2007},
date = {2007-01-01},
journal = {Brain Injury},
volume = {21},
pages = {1--9},
address = {The Elliot Hospital, Manchester, NH, USA.},
abstract = {PRIMARY OBJECTIVE: To identify factors associated with not seeking medical care for traumatic brain injury (TBI). RESEARCH DESIGN: Internet survey. METHODS AND PROCEDURES: The survey consisted of 17 questions related to demographics, TBI case ascertainment, location and mechanism of injury, type of treatment sought, and post-concussive (PC) symptoms. Logistic regression was used to identify factors associated with not seeking medical care. MAIN OUTCOME AND RESULTS: Of the 1381 survey respondents with TBI, 584 (42%) did not seek medical care. TBI respondents were less likely to seek care if they were older (OR 0.98, 95% CI 0.97-0.99), suffered a mild TBI grade 2/3 (OR 0.42, 95% CI 0.31-0.58), or were injured in the home (OR 0.53, 95% CI 0.36-0.78). CONCLUSIONS: Several factors associated with not seeking medical care after TBI were identified. Raising public awareness of the signs and symptoms of TBI, and the benefits of medical care, could help increase the number of TBI patients who seek medical care.},
keywords = {Accidents, Home/sn [Statistics \& Numerical Data] A},
pubstate = {published},
tppubtype = {article}
}
Butcher, I; McHugh, G S; Lu, J; Steyerberg, E W; Hernandez, A V; Mushkudiani, N; Maas, A I; Marmarou, A; Murray, G D
Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study Journal Article
In: Journal of Neurotrauma, vol. 24, no. 2, pp. 281–286, 2007.
Abstract | BibTeX | Tags: *Brain Injuries/di [Diagnosis], *Brain Injuries/et [Etiology], Accidents, adult, Age Factors, Athletic Injuries/co [Complications], Athletic Injuries/di [Diagnosis], Databases, Factual, Glasgow Outcome Scale, Humans, middle aged, Predictive Value of Tests, Prognosis, violence
@article{Butcher2007,
title = {Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study},
author = {Butcher, I and McHugh, G S and Lu, J and Steyerberg, E W and Hernandez, A V and Mushkudiani, N and Maas, A I and Marmarou, A and Murray, G D},
year = {2007},
date = {2007-01-01},
journal = {Journal of Neurotrauma},
volume = {24},
number = {2},
pages = {281--286},
abstract = {We aimed to describe and quantify the relationship between cause of injury and final outcome following traumatic brain injury (TBI). Individual patient data (N = 8708) from eight therapeutic Phase III randomized clinical trials in moderate or severe TBI, and three TBI surveys were used to investigate the relationship between cause of injury and outcome, as assessed by the Glasgow Outcome Scale (GOS) at 6 months. Proportional odds methodology was applied to quantify the strength of the association and expressed as an odds ratio in a meta-analysis. Heterogeneity across studies was assessed and associations with other predictive factors explored. In a univariate analysis, a strong association between the cause of injury and long-term outcome in moderate to severe TBI patients was observed, with consistent results across the studies. Road traffic accidents (OR 0.66, 95% CI 0.60-0.73), assaults (OR 0.66, 95% CI 0.52-0.84), and injuries sustained during sporting or recreational activities (OR 0.45, 95% CI 0.28-0.71) were all associated with better outcomes than the reference category of falls. Falls were found to be associated with an older age and with a higher incidence of mass lesions. Following adjustment for age in the analysis, the relationship between cause of injury and outcome was lost.},
keywords = {*Brain Injuries/di [Diagnosis], *Brain Injuries/et [Etiology], Accidents, adult, Age Factors, Athletic Injuries/co [Complications], Athletic Injuries/di [Diagnosis], Databases, Factual, Glasgow Outcome Scale, Humans, middle aged, Predictive Value of Tests, Prognosis, violence},
pubstate = {published},
tppubtype = {article}
}
Hashimoto, Keiji; Okumura, Ayumi; Shinoda, Jun; Abo, Masahiro; Nakamura, Toshinori
Tensor magnetic resonance imaging in a case of mild traumatic brain injury with lowered verbal intelligence quotient Journal Article
In: Journal of Rehabilitation Medicine, vol. 39, pp. 418–420, 2007.
Abstract | BibTeX | Tags: Accidents, Traffic Adult Brain/pa [Pathology] Comm
@article{Hashimoto2007,
title = {Tensor magnetic resonance imaging in a case of mild traumatic brain injury with lowered verbal intelligence quotient},
author = {Hashimoto, Keiji and Okumura, Ayumi and Shinoda, Jun and Abo, Masahiro and Nakamura, Toshinori},
year = {2007},
date = {2007-01-01},
journal = {Journal of Rehabilitation Medicine},
volume = {39},
pages = {418--420},
address = {Department of Neutrotraumatology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan. keiman@jikei.ac.jp},
abstract = {We report the case of a 31-year-old man who had mild traumatic brain injury as a result of an accident at the age of 24 years. Seven years after the trauma, at the age of 31 years, he had a lower verbal intelligence quotient than performance intelligence quotient by the Wechsler Adult Intelligence Scale - Revised, and frontal lobe dysfunction, for example, difficulty in maintaining or changing the set as revealed by the Wisconsin Card Sorting Test Keio Version. Conventional brain magnetic resonance imaging had not shown any abnormalities. Abnormal brain areas were detected on magnetic resonance diffusion tensor imaging. On tractography, some fibres from the corpus callosum towards the frontal cortex were noted to be lacking in the left hemisphere compared with the right. The tractography results may explain the patient's lowered verbal intelligence quotient and focal left frontal lobe dysfunction. Diffusion tensor imaging is therefore helpful in detecting lesions in mild traumatic brain injury with diffuse axonal injury.},
keywords = {Accidents, Traffic Adult Brain/pa [Pathology] Comm},
pubstate = {published},
tppubtype = {article}
}
Chiu, W T; Huang, S J; Tsai, S H; Lin, J W; Tsai, M D; Lin, T J; Huang, W C
The impact of time, legislation, and geography on the epidemiology of traumatic brain injury Journal Article
In: Journal of Clinical Neuroscience, vol. 14, no. 10, pp. 930–935, 2007.
Abstract | BibTeX | Tags: *Accidents, *Brain Injuries/ep [Epidemiology], *Legislation as Topic/sn [Statistics & Numerical D, *Rural Population/sn [Statistics & Numerical Data], *Urban Population/sn [Statistics & Numerical Data], Accidents, adult, age distribution, aged, Cohort Studies, Female, Head Protective Devices/sn [Statistics & Numerical, Head Protective Devices/st [Standards], Humans, Incidence, Legislation as Topic/td [Trends], Male, middle aged, Motorcycles/lj [Legislation & Jurisprudence], Motorcycles/sn [Statistics & Numerical Data], Motorcycles/st [Standards], Prospective Studies, Rural Population/td [Trends], Sex Distribution, Taiwan/ep [Epidemiology], Time Factors, Traffic/lj [Legislation & Jurisprudence, Traffic/pc [Prevention & Control], Traffic/sn [Statistics & Numerical Dat, Trauma Severity Indices, Urban Population/td [Trends]
@article{Chiu2007,
title = {The impact of time, legislation, and geography on the epidemiology of traumatic brain injury},
author = {Chiu, W T and Huang, S J and Tsai, S H and Lin, J W and Tsai, M D and Lin, T J and Huang, W C},
year = {2007},
date = {2007-01-01},
journal = {Journal of Clinical Neuroscience},
volume = {14},
number = {10},
pages = {930--935},
abstract = {In 1991, a population-based epidemiologic traumatic brain injury (TBI) study was done in urban and rural areas of Taiwan; this was 5 years before the helmet use law was passed and 8 years before the drink driving law was passed. In order to evaluate the impact of three major determinants (time, geography, and legislation) on the epidemiology of TBI, we conducted a prospective study in 2001 and used the 1991 data to examine the differences in TBI distribution in urban and rural Taiwan a decade after these laws were passed. In 2001, 5754 TBI cases were collected from the urban area of Taipei City, and 1474 TBI cases were collected from the rural area of Hualien County. The TBI incidence rate in Taipei City in 2001 was estimated to be 218/100,000 population (285/100,000 for males and 152/100,000 for females). When compared to the 1991 data, the incidence rate in 2001 had increased by 20%. The TBI incidence rate in Hualien County in 2001 was estimated to be 417/100,000 population (516/100,000 for males and 306/100,000 for females); this was a 37% increase over the 1991 data. Our study found that the distribution of causes and age distribution had shifted significantly over the 10-year period. In 2001, the age group with the highest incidence was 20-29 years, while in 1991 it had been the over 70 years age group. While traffic-related TBI had decreased, falls and assaults had increased in 2001. We also found that legislation, such as the helmet law, affects TBI distribution by decreasing the traffic-related TBI rate, decreasing the admission severity of TBI, and reducing TBI-related mortality. Finally, geography plays a crucial role in the outcome of TBI; over the 10 year period, Taipei had an increase in moderately severe outcomes, while Hualien had an increase in more severe outcomes. Comparative studies of TBI in urban and rural areas have shown that time, legislation, and geography are crucial determinants of TBI epidemiology. Although time and legal interventions seem to have more of an impact, geography does affect TBI outcomes.},
keywords = {*Accidents, *Brain Injuries/ep [Epidemiology], *Legislation as Topic/sn [Statistics \& Numerical D, *Rural Population/sn [Statistics \& Numerical Data], *Urban Population/sn [Statistics \& Numerical Data], Accidents, adult, age distribution, aged, Cohort Studies, Female, Head Protective Devices/sn [Statistics \& Numerical, Head Protective Devices/st [Standards], Humans, Incidence, Legislation as Topic/td [Trends], Male, middle aged, Motorcycles/lj [Legislation \& Jurisprudence], Motorcycles/sn [Statistics \& Numerical Data], Motorcycles/st [Standards], Prospective Studies, Rural Population/td [Trends], Sex Distribution, Taiwan/ep [Epidemiology], Time Factors, Traffic/lj [Legislation \& Jurisprudence, Traffic/pc [Prevention \& Control], Traffic/sn [Statistics \& Numerical Dat, Trauma Severity Indices, Urban Population/td [Trends]},
pubstate = {published},
tppubtype = {article}
}
Mulhern, Sharon; McMillan, Thomas M
Knowledge and expectation of postconcussion symptoms in the general population Journal Article
In: Journal of Psychosomatic Research, vol. 61, pp. 439–445, 2006.
Abstract | BibTeX | Tags: Accidents, Traffic/sn [Statistics & Numerical Data
@article{Mulhern2006,
title = {Knowledge and expectation of postconcussion symptoms in the general population},
author = {Mulhern, Sharon and McMillan, Thomas M},
year = {2006},
date = {2006-01-01},
journal = {Journal of Psychosomatic Research},
volume = {61},
pages = {439--445},
address = {Psychological Medicine, Faculty of Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow G12 OXH, United Kingdom.},
abstract = {OBJECTIVE: Beliefs about mild traumatic brain injury (MTBI) may affect complaints and their persistence. This study investigates the relationships between knowledge, experience, and expectation in the general population. METHODS: One hundred seventy-one people reported symptoms expected from vignettes about MTBI, depression, posttraumatic stress disorder (PTSD), and orthopedic injury. Then they completed a postconcussional syndrome (PCS) checklist about these vignettes and about personal symptoms. RESULTS: The ability to generate symptoms from vignettes was poor for PCS, depression, and PTSD, and was greatly improved using a PCS checklist, probably by symptom guessing. No postconcussion symptoms were associated specifically with MTBI. Those with more personal symptoms expected more symptoms. Past experience of MTBI did not improve symptom knowledge. Beliefs about the 'undesirability' of conditions were associated with expected outcomes. CONCLUSIONS: People know little about PCS. Expectations about MTBI are influenced by psychological factors that are relevant if we consider information given in hospitals. Symptom overlap means that psychological conditions such as depression may be misdiagnosed as PCS, and checklists should not be used for diagnosis.},
keywords = {Accidents, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A K; To, T M; Macarthur, C; Chipman, M L; Wright, J G; Parkin, P C
Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study Journal Article
In: Pediatrics, vol. 110, no. 5, pp. e60, 2002.
Abstract | BibTeX | Tags: *Bicycling/in [Injuries], *Bicycling/lj [Legislation & Jurisprudence], *Craniocerebral Trauma/pc [Prevention & Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics & Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics & Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics & Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics & Numerical Data, Trauma Severity Indices
@article{Macpherson2002,
title = {Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study},
author = {Macpherson, A K and To, T M and Macarthur, C and Chipman, M L and Wright, J G and Parkin, P C},
year = {2002},
date = {2002-01-01},
journal = {Pediatrics},
volume = {110},
number = {5},
pages = {e60},
abstract = {OBJECTIVE: Childhood bicycle-related head injuries can be prevented through the use of helmets. Although helmet legislation has proved to be a successful strategy for the adoption of helmets, its effect on the rates of head injury is uncertain. In Canada, 4 provinces have such legislation. The objective of this study was to measure the impact of helmet legislation on bicycle-related head injuries in Canadian children. METHODS: Routinely collected data from the Canadian Institute for Health Information identified all Canadian children (5-19 years) who were hospitalized for bicycling-related injuries from 1994-1998. Children were categorized as head or other injury on the basis of International Classification of Diseases, Ninth Revision, codes. Rates of head injuries and other injuries were compared over time in provinces that adopted legislation and those that did not. RESULTS: Of the 9650 children who were hospitalized because of a bicycle-related injury, 3426 sustained injuries to the head and face and the remaining 6224 had other injuries. The bicycle-related head injury rate declined significantly (45% reduction) in provinces where legislation had been adopted compared with provinces and territories that did not adopt legislation (27% reduction). CONCLUSION: This country-wide study compared rates of head injury in regions with and without mandatory helmet legislation. Comparing head injuries with other non-head-injured children controlled for potential differences in children's cycling habits. The strong protective association between helmet legislation and head injuries supports the adoption of helmet legislation as an effective tool in the prevention of childhood bicycle-related head injuries.},
keywords = {*Bicycling/in [Injuries], *Bicycling/lj [Legislation \& Jurisprudence], *Craniocerebral Trauma/pc [Prevention \& Control], *Head Protective Devices/ut [Utilization], Accidents, Adolescent, adult, Bicycling/sn [Statistics \& Numerical Data], Canada/ep [Epidemiology], Child, Cohort Studies, Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/ep [Epidemiology], Female, Hospitalized/sn [Statistics \& Numerical Dat, Humans, Incidence, Legislation as Topic/sn [Statistics \& Numerical Da, Male, Preschool, Public Policy, Traffic/sn [Statistics \& Numerical Data, Trauma Severity Indices},
pubstate = {published},
tppubtype = {article}
}
Horner, A; VanDemark, M; Jensen, G A
The challenge of assessing a patient with dementia and head injury Journal Article
In: AACN Clinical Issues, vol. 13, no. 1, pp. 73–83, 2002.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/co [Complications], *Dementia/co [Complications], Accidental Falls, Accidents, aged, Alzheimer Disease/di [Diagnosis], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/pp [Physiopathology], Delirium/di [Diagnosis], Delirium/et [Etiology], Home, Humans
@article{Horner2002,
title = {The challenge of assessing a patient with dementia and head injury},
author = {Horner, A and VanDemark, M and Jensen, G A},
year = {2002},
date = {2002-01-01},
journal = {AACN Clinical Issues},
volume = {13},
number = {1},
pages = {73--83},
abstract = {Alzheimer's disease is emerging as a major health challenge for the 21st century. The reported case study discusses a 74-year-old woman with dementia of the Alzheimer type who sustained a head injury when she fell down the basement stairs. Differentiating the head injury from the preexisting dementia was complicated and required creative and astute assessment. Objective assessment tools discussed include the Mini-Mental State Examination, a delirium guide, and the Tinetti assessment tool. Predisposition to delirium is significant because of the comorbidities associated with cognitive impairment and head injury. Interventions to prevent delirium are recommended.},
keywords = {*Craniocerebral Trauma/co [Complications], *Dementia/co [Complications], Accidental Falls, Accidents, aged, Alzheimer Disease/di [Diagnosis], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/pp [Physiopathology], Delirium/di [Diagnosis], Delirium/et [Etiology], Home, Humans},
pubstate = {published},
tppubtype = {article}
}
McLean, A J
Brain injury without head impact? Journal Article
In: Journal of Neurotrauma, vol. 12, no. 4, pp. 621–625, 1995.
Abstract | BibTeX | Tags: *Brain Injuries/et [Etiology], Acceleration, Accidents, autopsy, Brain Injuries/mo [Mortality], cause of death, Head, Humans, Mechanical, Nonpenetrating, Stress, Traffic, Wounds
@article{McLean1995,
title = {Brain injury without head impact?},
author = {McLean, A J},
year = {1995},
date = {1995-01-01},
journal = {Journal of Neurotrauma},
volume = {12},
number = {4},
pages = {621--625},
abstract = {The proposition that acceleration of the brain without direct impact to the head can result in brain injury is examined by reviewing a series of 414 road users who were fatally injured in the vicinity of Adelaide, South Australia. The series comprises 170 pedestrians, 10 pedal cyclists, 143 motorcyclists, and 91 vehicle occupants. In each case a member of the research team attended the autopsy to look for evidence of impact on the body, particularly to the head or face. The brain was examined by a neuropathologist and the type and pattern of injury was recorded. The circumstances of the crash were investigated, including an examination of the crash site and the vehicles involved and, where relevant, interviews with witnesses. In cases involving a motorcyclist the helmet worn was retrieved by the police and assigned to the research unit for examination. Particular attention was paid to the identification of objects causing injury to the head or face and also to objects impacted by a helmet. Brain injury was recorded as a cause of death in 55% of the 403 cases for which there was a clear classification of cause of death. Brain injury, at any level of severity, was identified by a neuropathologist in 86 percent of the 414 fatally injured road users in the sample, including 24 cases that were examined microscopically. There were no cases in which there was an injury to the brain in the absence of evidence of an impact to the head.},
keywords = {*Brain Injuries/et [Etiology], Acceleration, Accidents, autopsy, Brain Injuries/mo [Mortality], cause of death, Head, Humans, Mechanical, Nonpenetrating, Stress, Traffic, Wounds},
pubstate = {published},
tppubtype = {article}
}