History Of Traumatic Head Injury Research Articles

Unilateral Internuclear Ophthalmoplegia in a 14-year-old Female

Purpose: Internuclear ophthalmoplegia (INO) is an eye movement disorder caused by a lesion of the medial longitudinal fasciculus. It typically manifests bilaterally and is commonly caused by multiple sclerosis. We report a case of pediatric unilateral INO, which is rare in the pediatric population.Case summary: A 14-year-old female, with a history of traumatic head injury 9 days previously, presented with diplopia, nausea and vomiting for the past 5 days. Her ophthalmic examination revealed severely impaired adduction of the right eye and abduction nystagmus in the left eye. Orbital computed tomography showed no evidence of orbital wall fracture or muscle impingement. However, an magnetic resonance imaging of her brain demonstrated an infarct in the right paramedian midbrain, leading to a diagnosis of unilateral INO. Diplopia and impaired adduction of the right eye resolved completely 7 weeks after the trauma.Conclusions: Demyelinating diseases, such as multiple sclerosis, account for most of the pediatric INO cases. Although most of these cases are bilateral, this reports highlights a pediatric case of unilateral INO following head injury, which is an uncommon occurrence in this age group.

Computed Tomography Evaluation Of Patients With Traumatic Head In Juries

Background and Objectives: - The aim of this study was to evaluate the role of CT scan in evaluation of patients with traumatic head injury, to study the imaging spectrum of traumatic head injury, to study the relative prevalence of different traumatic head injury lesions.Methods: The study was prospective and was carried out between December 2019 and January 2020 at the Department of Radiology, AMC MET Medical College and Sheth L.G. Hospital, Ahmedabad. Total 50 patients having clinical history of traumatic head injury and sent to department of radiodiagnosis and diagnosed having abnormal findings on CT scan were included in the study. Confirmation of diagnosis by CT Scan done prior to data collection. (Only those patients were included who had traumatic head injury confirmed with history correlation and then were confirmed by CT scan.)Results: Out of 50 patients diagnosed by CT scan, the most common traumatic head injury seen in our study were- subarachnoid hemorrhage, subdural hematoma, epidural hematoma, skull fractures, pneumocephalus, scalp injures and focal areas of contusions/laceration. CT scan had an average specificity of 94%, with 100% specificity for common traumatic head injury like subdural hematoma.Conclusion: CT scan is a safe and effective method of detecting traumatic head injury. It aids in defining therapeutic decision quickly and allows predicting outcomes of the patient. High degree of specificity of CT scan diagnosis in the present study confirms the value of CT scan evaluation of traumatic head injury and suggests that it can be effectively used in the routine diagnostic work.

Acute ICH in patients identified as being treated with either warfarin or direct-acting oral anticoagulant agents (DOACs) from a radiology perspective; a cross-sectional observational of 2359 emergency CT head studies

To determine and compare the rates of acute intracranial haemorrhage (ICH) in emergency computed tomography (CT) head studies performed on patients treated with either warfarin or a direct-acting oral anticoagulant agent (DOAC) in a real-world acute setting from a radiology service perspective. A retrospective automated search was undertaken via the hospital's radiology information system (RIS) for emergency CT head studies performed over a 2-year period where the clinical details indicated treatment with warfarin or a DOAC. The report of each scan was reviewed for the presence of unequivocal ICH. Duplicate and follow-up scans were excluded. Other parameters (trauma history and time of scan) were also reviewed. Following exclusions, 2,359 cases were eligible for analysis; 1,822 patients were treated with warfarin and 537 treated with DOACs. One hundred and nineteen CT heads, of which 104 were treated with warfarin and 15 treated with DOACs, were positive for various types of ICH. The positive rate for ICH was lower in the DOACs group than the warfarin group; 2.7% (number needed to scan: 37) versus 5.7% (number needed to scan: 17.5; p=0.0067). This is also true in a cohort of patients who had traumatic head injury; 2.14% (number needed to scan: 46.7) versus 5.80% (number needed to scan: 17.2; p=0.02). The present study has shown a lower rate of ICH in patients treated with DOACs compared to those treated with warfarin in an acute setting. A similar trend is demonstrated in a cohort of patients with a history of traumatic head injury.

An Epidemiological Study of Traumatic Head Injury in a Tertiary Care Center in Kancheepuram, Tamil Nadu, India

Introduction: Traumatic brain injury is a major public health problem in India. The severity of a traumatic brain injury may range from mild to severe. The increase in economic growth in India coupled with rise in population, motorization and industrialization has contributed to a significant increase in TBI with each advancing year. India having the highest rate of head injury in the world. In India more than 100000 lives are lost every year with over 1 million suffering from serious head injury.
 Objectives: To assess the risk factors among for head injury cases and assess the outcome of the traumatic brain injury patients.
 Materials and Methods: A cross sectional Study conducted among all patients with traumatic head injury attending tertiary care centre and those admitted in intensive care unit with the history of traumatic head injury for the duration of one year (August 2016 to July 2017). Data was collected through questionnaire, hospital records and collected from patients. Data Collected was entered in MS office excel and analyzed in SPSS version 21.
 Results: Totally 295 cases were reported with history of traumatic brain injury, out of which 82.7% were males and 17.3% were females. Road traffic accidents was the most common cause for TBI 86.4%. Most of the patient was between the age group of 21-40 (51.5%). Most of the cases were from rural areas 55.3%. Based on GCS 49.5%, 28.5% and 22.0% patients had mild, moderate and severe injury respectively. 44.7% injuries occurred between the time period 04.00PM to 12.00AM.
 Conclusion: This study revealed that most traumatic head injury occur due to Road traffic accident stressing the urgent need to create awareness and conduct health education about prevention of traumatic head injury.

Hemodialysis Increases the Incidence of Post-Traumatic Seizure in Hemodialysis Patients with Traumatic Intracranial Hemorrhage

In Japan, the number of hemodialysis patients increases every year, along with the average age of this patient population. Further, certain complications of hemodialysis make the care of traumatic head injury(THI)patients particularly difficult. This study was aimed at investigating the occurrence of and risk factors for post-traumatic seizures in hemodialysis patients with a history of THI, and determining patient outcomes. Subjects were selected from patients who were admitted to Yaizu Municipal Hospital in Shizuoka, Japan for traumatic intracranial hemorrhage(TICH). Retrospective medical histories of TICH patients who were and were not receiving hemodialysis were reviewed to investigate the risk factors for seizures and to determine patient outcomes. We identified 18 THI patients on hemodialysis and 86 THI patients not on hemodialysis treatment. We determined that predictive factors of post-traumatic seizure include:current hemodialysis treatment, enlargement of an existing hematoma, and an acute subdural hematoma. Moreover, 66.7% of seizures in our dialysis patients occurred during hemodialysis. Our data also suggest that Glasgow Coma Scale(GCS)scores on admission are a predictive factor for patient outcomes following discharge. Current hemodialysis treatment, enlargement of an existing hematoma, and an acute subdural hematoma are predictive factors of seizure occurrence in THI patients. As post-traumatic seizures triggered unfavorable outcomes in some dialysis patients, it is important to create appropriate plans for preventing dialysis disequilibrium syndrome that may lead to seizures in TICH/TIH patients on hemodialysis. We also determined that a low GCS score upon admission is a significant predictor of unfavorable outcomes.

Cervical Intramedullary Ganglioma

A 48 year male presented to the ER with severe headaches which were episodic in nature and which had been present for several weeks. Patient had a history of traumatic head injury (TBI) several years prior. Otherwise, he was in good health with no significant past medical or surgical history.

Epidemiología de la cefalea en pacientes psiquiátricos hospitalizados

To determine the frequency and characteristics of the headaches suffered by hospitalised psychiatric patients.A descriptive, retrospective study was conducted among the patients admitted to the National Psychiatric Hospital in Zimbabwe who required consultation in Internal Medicine due to headaches. The International Headache Society classification was used. Demographic data (age and sex), alarm signals (age of onset of headaches after the age of 50 years, thunderclap headache, persistent unilateral location, presence of febrile symptoms, mental changes, new focal symptoms, history of traumatic head injury, Aids or cancer and the presence of meningeal signs) and definitive diagnosis.Altogether 180 (8.7%) patients visited mainly due to headaches, 28 (15.6%) of whom were attended for primary headaches and 152 (84.4%) had secondary type headaches. Chronic tension-type headache was the most common among primary headaches (39.3%); the most frequently diagnosed secondary headaches were those due to systemic disorders, with 119 cases; and a neurological cause was found in 33 patients. Most of the alarm signals appeared in patients with secondary headaches.Headache is a frequent reason for visiting in the Internal Medicine consultation at the National Psychiatric Hospital in Zimbabwe; the prevalence of secondary headaches due to neurological causes is high.

99mTc-ECD Brain SPECT for the Evaluation of Persistent Complaints After Mild Closed Head Injury

Background. We evaluated the usefulness of 99mTc-ethyl cysteinate dimer (ECD) brain single photon emission computed tomography (SPECT) for detecting brain perfusion abnormalities in patients with persistent clinical complaints and normal computed tomography (CT) findings after mild closed head injury. Methods. We studied 81 patients (44 men and 37 women; age range: 21 to 76 yr) with a history of traumatic head injury (from 2 weeks to5years) using 99mTc-ECD brain SPECT. The major clinical complaints were headache, poor memory, insomnia, dizziness and vertigo. Brain CT scan was normal in all patients. None of the patients had previous CVA, psychiatric disorders or history of drug or alcohol abuse. Results. Brain perfusion abnormalities were detected in57 patients on 99m Tc-ECD brain SPECT. Twenty-four patients had normal 99mTc-ECD brain SPECT. Conclusions. 99mTc-ECD brain SPECT appears to be a very useful complement to CT for evaluating cerebral perfusion abnormalities in morphologically intact brain regions of patients with persistent neuropsychiatric complaints after mild closed head injury.

Effect of age, ethnicity, and head injury on the association between APOE genotypes and Alzheimer's disease.

The association between apolipoprotein E (APOE)-epsilon 4 and Alzheimer's disease has been confirmed worldwide. We and others have observed a diminished association in the very old and among African-Americans compared to Caucasians and Hispanics in New York. In this review we describe a new method we developed to compare relative risks by APOE genotypes in an expanded cohort of cases and controls from three ethnic groups in a New York City community and discuss the association as between APOE epsilon 4 and Alzheimer's disease as modified by head injury. Compared to persons with APOE epsilon 3/epsilon 3 genotypes, relative risk (RR) for Alzheimer's disease associated with APOE epsilon 4 homozygosity was similar across ethnic groups (African-American RR = 3.3; 95% c.i. 1.6-6.8; Caucasian RR = 5.3; 1.6-16.0; Hispanic RR = 2.5; 1.1-5.8). The risk was also increased for APOE epsilon 4 heterozygous Caucasians (RR = 3.2; 1.8-5.8) and Hispanics (RR 1.5; 1.0-2.2) but not African-Americans (RR = 0.6; 0.4-0.9). Risk of AD was not significantly diminished for individuals in any group with APOE epsilon 2/epsilon 2 or -epsilon 2/epsilon 3 genotypes. A 10-fold increase in the risk of Alzheimer's disease was associated with both APOE epsilon 4 and a history of traumatic head injury, compared to a twofold increase in risk with APOE epsilon 4 alone. Head injury in the absence of an APOE epsilon 4 allele did not increase risk. These results imply that in Alzheimer's disease genotypic risk associated with APOE may be influenced by age, ethnicity, and certain environmental factors.

Synergistic effects of traumatic head injury and apolipoprotein-epsilon 4 in patients with Alzheimer's disease.

The apolipoprotein-epsilon 4 allele increases the risk of Alzheimer's disease (AD), but cerebral deposition of beta-amyloid with age, a genetic mutation, or head injury may contribute to the pathogenesis of this disease. We examined the risks of AD associated with traumatic head injury and apolipoprotein-epsilon 4 in 236 community-dwelling elderly persons. A 10-fold increase in the risk of AD was associated with both apolipoprotein-epsilon 4 and a history of traumatic head injury, compared with a two-fold increase in risk with apolipoprotein-epsilon 4 alone. Head injury in the absence of an apolipoprotein-epsilon 4 allele did not increase risk. These data imply that the biological effects of head injury may increase the risk of AD, but only through a synergistic relationship with apolipoprotein-epsilon 4.

The Traumatic Coma Data Bank: design, methods, and baseline characteristics

✓ The Traumatic Coma Data Bank is a collaborative project to prospectively collect data on the clinical course and outcome of severely head-injured patients. The objectives were to further define the natural history of traumatic head injury, to identify prognostic factors, and to provide planning data for future studies. A brief historical development and a description of the organizational structure and methods are given. The characteristics of the cohort at baseline for the 1030 patients enrolled between January, 1984, and September, 1987, are presented, including a summary of the patients' demographic profile, mechanisms of injury, and intracranial diagnoses. The utility and limitations of these data are discussed.