At a recent conference, I was asked to see a toddler who received a nasty whack to the back of the head and ended up with a lump and a small cut at the site of injury. Although the child in question was ok, head injuries are. Instead, childhood arterial ischemic stroke is associated with congenital heart disease, vascular anomalies, prothrombotic conditions, genetic or metabolic disease and head trauma. WebMD discusses head injuries related to sports, how they are caused during physical activities, and which treatments can help. About 10% of people who’ve suffered from head trauma severe enough to be hospitalized, end up having a seizure. Most of the time, if someone is at risk of seizure after TBI it happens within the first few days or weeks after. Traumatic brain injury - Wikipedia, the free encyclopedia. Traumatic brain injury (TBI), also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism (closed or penetrating head injury), or other features (e. Injuries-emergencies~American Academy of Pediatrics (AAP) provides information on what to do in case of a head injury.Head injury usually refers to TBI, but is a broader category because it can involve damage to structures other than the brain, such as the scalp and skull. TBI is a major cause of death and disability worldwide, especially in children and young adults. Males sustain traumatic brain injuries more frequently than do females. Causes include falls, vehicle accidents, and violence. Prevention measures include use of technology to protect those suffering from automobile accidents, such as seat belts and sports or motorcycle helmets, as well as efforts to reduce the number of automobile accidents, such as safety education programs and enforcement of traffic laws. Brain trauma can occur as a consequence of a focal impact upon the head, by a sudden acceleration/deceleration within the cranium or by a complex combination of both movement and sudden impact. In addition to the damage caused at the moment of injury, brain trauma causes secondary injury, a variety of events that take place in the minutes and days following the injury. These processes, which include alterations in cerebral blood flow and the pressure within the skull, contribute substantially to the damage from the initial injury. TBI can cause a host of physical, cognitive, social, emotional, and behavioral effects, and outcome can range from complete recovery to permanent disability or death. Profesional DJ Service for School dances, Weddings, banquets, corporate events and all events. Other imaging modalities such as MR imaging depict nonsurgical pathology not visible on CT. Cervical spine imaging is indicated for patients with head injury who have signs, symptoms, or a mechanism of injury that might result. Head Trauma Subliminal - Vocals Randall Alm - Guitar/Vocals Adam Bowen - Keyboard/bass Aaron Bowen - Drums. Head trauma refers to any injury to the scalp, skull, and even brain. It varies according to classification, may it be neuronal injuries, vascular injuries, subdural hygromas, hemorrhages, and cranial nerve injuries. The 2. 0th century saw critical developments in diagnosis and treatment that decreased death rates and improved outcome. Some of the current imaging techniques used for diagnosis and treatment include computed tomography and MRIs (magnetic resonance imaging). Depending on the injury, treatment required may be minimal or may include interventions such as medications, emergency surgery or surgery years later. Physical therapy, speech therapy, recreation therapy, occupational therapy and vision therapy may be employed for rehabilitation. Counseling, supported employment, and community support services may also be useful. Classification. Traumatic brain injury is defined as damage to the brain resulting from external mechanical force, such as rapid acceleration or deceleration, impact, blast waves, or penetration by a projectile. Because of this, other classification systems such as the one shown in the table are also used to help determine severity. A current model developed by the Department of Defense and Department of Veterans Affairs uses all three criteria of GCS after resuscitation, duration of post- traumatic amnesia (PTA), and loss of consciousness (LOC). Extra- axial lesions include epidural hematoma, subdural hematoma, subarachnoid hemorrhage, and intraventricular hemorrhage. With mild TBI, the patient may remain conscious or may lose consciousness for a few seconds or minutes. Domestic violence is another cause of TBI. Other factors in secondary injury are changes in the blood flow to the brain; ischemia (insufficient blood flow); cerebral hypoxia (insufficient oxygen in the brain); cerebral edema (swelling of the brain); and raised intracranial pressure (the pressure within the skull). Since the pterion is so weak, this type of injury can easily occur and can be secondary due to trauma to other parts of the skull where the impact forces spreads to the pterion. Diagnosis. CT scan showing epidural hematoma (arrow)Diagnosis is suspected based on lesion circumstances and clinical evidence, most prominently a neurological examination, for example checking whether the pupils constrict normally in response to light and assigning a Glasgow Coma Score. X- rays are still used for head trauma, but evidence suggests they are not useful; head injuries are either so mild that they do not need imaging or severe enough to merit the more accurate CT. The most sensitive physical measure to date is the quantitative EEG, which has documented an 8. In accidents, damage can be reduced by use of seat belts, child safety seats. An increase in use of helmets could reduce the incidence of TBI. The essential concept of daily dietary supplementation with DHA, so that those at significant risk may be preloaded to provide protection against the acute effects of TBI, has tremendous public health implications. In particular, it has been demonstrated through multiple studies to significantly reduce neuronal losses and to improve cognitive and neurological outcomes associated with these traumatic events. Acetylcysteine has been safely used to treat paracetamol overdose for over forty years and is extensively used in emergency medicine. Treatment. It is important to begin emergency treatment within the so- called . In the acute stage the primary aim of the medical personnel is to stabilize the patient and focus on preventing further injury because little can be done to reverse the initial damage caused by trauma. Other methods to prevent damage include management of other injuries and prevention of seizures. Sedatives, analgesics and paralytic agents are often used. Failing to maintain blood pressure can result in inadequate blood flow to the brain. While they can be treated with benzodiazepines, these drugs are used carefully because they can depress breathing and lower blood pressure. Mass lesions such as contusions or hematomas causing a significant mass effect (shift of intracranial structures) are considered emergencies and are removed surgically. Physiatrists or neurologists are likely to be the key medical staff involved, but depending on the person, doctors of other medical specialties may also be helpful. Allied health professions such as physiotherapy, speech and language therapy, cognitive rehabilitation therapy, and occupational therapy will be essential to assess function and design the rehabilitation activities for each person. Treatment of neuropsychiatric symptoms such as emotional distress and clinical depression may involve mental health professionals such as therapists, psychologists, and psychiatrists, while neuropsychologists can help to evaluate and manage cognitive deficits. Community- based rehabilitation will be required for a high proportion of people, including vocational rehabilitation; this supportive employment matches job demands to the worker's abilities. The most effective research documented intervention approach is the activation database guided EEG biofeedback approach, which has shown significant improvements in memory abilities of the TBI subject that are far superior than traditional approaches (strategies, computers, medication intervention). Gains of 2. 6. 1 standard deviations have been documented. The TBI's auditory memory ability was superior to the control group after the treatment. Subarachnoid hemorrhage approximately doubles mortality. The Functional Independence Measure is a way to track progress and degree of independence throughout rehabilitation. Examples are hypotension (low blood pressure), hypoxia (low blood oxygen saturation), lower cerebral perfusion pressures and longer times spent with high intracranial pressures. Factors thought to worsen it include abuse of substances such as illicit drugs and alcohol and age over sixty or under two years (in children, younger age at time of injury may be associated with a slower recovery of some abilities). For many years it was believed that recovery was fastest during the first six months, but there is no evidence to support this. It may be related to services commonly being withdrawn after this period, rather than any physiological limitation to further progress. The results of traumatic brain injury vary widely in type and duration; they include physical, cognitive, emotional, and behavioral complications. TBI can cause prolonged or permanent effects on consciousness, such as coma, brain death, persistent vegetative state (in which patients are unable to achieve a state of alertness to interact with their surroundings). Development of diabetes insipidus or an electrolyte abnormality acutely after injury indicate need for endocrinologic work up. Signs and symptoms of hypopituitarism may develop and be screened for in adults with moderate TBI and in mild TBI with imaging abnormalities. Children with moderate to severe head injury may also develop hypopituitarism. Screening should take place 3 to 6 months, and 1. About one in five career boxers is affected by chronic traumatic brain injury (CTBI), which causes cognitive, behavioral, and physical impairments. It commonly manifests as dementia, memory problems, and parkinsonism (tremors and lack of coordination). Typical challenges identified by families recovering from TBI include: frustration and impatience with one another, loss of former lives and relationships, difficulty setting reasonable goals, inability to effectively solve problems as a family, increased level of stress and household tension, changes in emotional dynamics, and overwhelming desire to return to pre- injury status. In addition, families may exhibit less effective functioning in areas including coping, problem solving and communication. Psychoeducation and counseling models have been demonstrated to be effective in minimizing family disruption . A World Health Organization study estimated that between 7. In the US, patients with fall- related TBIs have an 8. TBIs survive. This hypothesis was confirmed around the end of the 1. The introduction of intracranial pressure monitoring in the 1. However, clinical trials to test agents that could halt these cellular mechanisms have met largely with failure. Microdialysis allows ongoing sampling of extracellular fluid for analysis of metabolites that might indicate ischemia or brain metabolism, such as glucose, glycerol, and glutamate. Bleeding, tearing of tissues and brain swelling can occur when the brain moves inside the skull at the time of an impact. But most people recover from head injuries and have no lasting effects.
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