Traumatic Brain Injured Research Articles

The Emory Cubicle Bed: An Alternative to Restraints for Agitated Traumatically Brain Injured Clients

As traumatically brain injured (TBI) clients emerge from coma, there may be transitory periods of agitation during which they pull at feeding tubes and intravenous catheters and thrash about, thus placing themselves at high risk of injury. During these periods, staff traditionally have resorted to restraints. But chemical restraints actually may be detrimental to cognitive recovery, and physical restraints often serve to increase agitation and foster dependence. Another approach is to modify the environment. The Emory cubicle bed, a modification of the Craig bed used at Craig Hospital in Colorado, allows for freedom of movement while blocking the client's field of vision. In reducing both tactile and visual stimulation, the bed also reduces agitation.

Head injury outcome up to ten years later.

Head injury outcome was studied in 63 severe traumatic brain-injured (TBI) victims up to ten years after injury. Extent of improvement and residual deficits in physical and mental impairment and mood and frustration tolerance changes are reported. The impact of these changes upon ability to work and to establish living situations is presented. It was found that long-term outcome is related significantly both to elapsed time between injury and admission to an intensive rehabilitation hospital program and to level of disability at admission. Major problems and needs at follow-up are reported. Thirteen demographic and clinical profile parameters are suggested to permit meaningful comparisons of long-term outcome among different groups of TBI victims.

Abnormal Cortisol Dynamics after Traumatic Brain Injury

A period of significant agitation affects up to 30% of patients after traumatic brain injury. The severity and persistence of this agitation may be such as to require pharmacologic methods as part of the treatment plan. To define which subgroup of patients develop severe agitation warranting intervention and to utilize the information to predict therapeutic responsiveness to tricyclic antidepressants (TCA), we examined cortisol dynamics in 35 traumatically brain-injured (TBI) patients 2-10 months post-TBI. Fasting hypercortisolemia (cortisol greater than 20 micrograms/dl) and/or an absent diurnal variation (1600:0800 cortisol greater than 0.5) was noted in more than 70% of TBI subjects. These abnormalities in cortisol dynamics were not predictive of severe agitation (chi 2 = 0, df = 1, P = 0.99 for hypercortisolemia; chi 2 = 0.163, df = 1, P = 0.7 for absent diurnal variation) and did not differ significantly between TCA responders and nonresponders. The cortisol response to dexamethasone suppression was abnormal (postdexamethasone cortisol value at 0800 and 1600 greater than 5 micrograms/dl) in 34 of 35 subjects and was also not predictive of the presence of agitation. The 0800 cortisol was lower in TCA nonresponders in comparison with TCA responders (8.3 +/- 5 v 17.2 +/- 9). In summary, severe TBI warranting inpatient rehabilitation results in hypothalamic-pituitary-adrenal dysfunction. The extent of these abnormalities renders the assessment of cortisol secretion of limited value in making clinical judgments concerning the development of post-traumatic agitation or the management of that agitation by tricyclic therapy.

Legal challenges in educating traumatic brain injured students.

Students with a disability that adversely affects educational performance have a right to certain special education services through their public schools. The vast majority of traumatic brain injured (TBI) students would presumably have not been in special education prior to the trauma causing their injury. Their entitlement to special services, their parents' role in securing those services, and the school district's perception of them as disabled will all be new and very sudden. In this writer's experience, the parents of a TBI student are much less likely to be able to advocate effectively for their youngster's special educational needs than the parents of a child born with disabilities who have learned over time how to work with the educational system. In fact, both parents and regular school personnel may be resistant to special educational services.

Management of academic and educational problems in head injury.

Designing and implementing beneficial educational interventions for traumatically brain injured (TBI) children requires a thorough understanding of the sequelae of pediatric head injury and an appreciation for the complex interaction of environmental and neuropsychological variables during the recovery process. This article provides a brief review of data pertaining to educational adjustment for TBI children, followed by a discussion of the major educationally relevant sequelae of head injury in children. Systemic problems in the delivery of appropriate educational interventions are outlined, and suggestions for mitigating the effects of these obstacles are offered. The article concludes with a description of 10 important features of appropriate educational programs for TBI children.

COMPARATIVE PSYCHOPATHOLOGY OF THE BRAIN-INJURED CHILD AND THE TRAUMATIC BRAIN-INJURED ADULT

Back to table of contents Previous article Next article ArticleNo AccessCOMPARATIVE PSYCHOPATHOLOGY OF THE BRAIN-INJURED CHILD AND THE TRAUMATIC BRAIN-INJURED ADULTALFRED A. STRAUSS, and HEINZ WERNERALFRED A. STRAUSSSearch for more papers by this author, and HEINZ WERNERSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.99.6.835AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByThe Journal of Genetic Psychology, Vol. 177, No. 6Developmental Medicine & Child Neurology, Vol. 9, No. 4Infants & Young Children, Vol. 19, No. 2Irish Journal of Psychological Medicine, Vol. 19, No. 2Mental Retardation and Developmental Disabilities Research Reviews, Vol. 5, No. 3The Historical Foundation of Learning Disabilities18 August 2016 | Remedial and Special Education, Vol. 6, No. 5British Journal of Sociology of Education, Vol. 5, No. 1Annals of Neurology, Vol. 12, No. 5Journal of Abnormal Child Psychology, Vol. 9, No. 2Annals of the New York Academy of Sciences, Vol. 205, No. 1 Minimal BrainCRC Critical Reviews in Clinical Laboratory Sciences, Vol. 3, No. 1Perception of Pictured Social Interactions by Brain-Injured and Non-Brain-Injured Children of Normal Intelligence2 December 2016 | Exceptional Children, Vol. 24, No. 6Acta Oto-Laryngologica, Vol. 43, No. sup105The Educational Implications of Psychological Studies of Cerebral-Palsied Children24 July 2016 | Exceptional Children, Vol. 18, No. 1The Journal of General Psychology, Vol. 37, No. 1 Volume 99Issue 6 May 1943Pages 835-838 Metrics PDF download History Published online 1 April 2006 Published in print 1 May 1943

THE MENTAL ORGANIZATION OF THE BRAIN-INJURED MENTALLY DEFECTIVE CHILD

Back to table of contents Previous article Next article ArticleNo AccessTHE MENTAL ORGANIZATION OF THE BRAIN-INJURED MENTALLY DEFECTIVE CHILDALFRED A. STRAUSS, and HEINZ WERNERALFRED A. STRAUSSSearch for more papers by this author, and HEINZ WERNERSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.97.5.1194AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByCorrelation between psychological component of school adaptation and socioeconomic risk factors of early development1 April 2021 | Психология и Психотехника, No. 4The Journal of Genetic Psychology, Vol. 177, No. 6Neuropsychological Assessment and the Neurologically Impaired Child30 March 2012The Actuarial Turn in the Science of Learning Disabilities1 May 2011 | Learning Disability Quarterly, Vol. 34, No. 2Forum Psychotherapeutische Praxis, Vol. 8, No. 3Mental Retardation and Developmental Disabilities Research Reviews, Vol. 5, No. 3The Psychological Record, Vol. 42, No. 3Learning Disabilities18 August 2016 | Remedial and Special Education, Vol. 8, No. 1The Historical Foundation of Learning Disabilities18 August 2016 | Remedial and Special Education, Vol. 6, No. 5, Vol. 11The Psychological Record, Vol. 31, No. 3Validating Optimal Response Modes of Learning Disabled Children4 December 2016 | Perceptual and Motor Skills, Vol. 51, No. 3_suppl2Psychopathology and mental retardation: a statistical study of 100 mentally retarded children treated at a psychiatric clinic: II. hyperactivity1 April 2006 | American Journal of Psychiatry, Vol. 134, No. 4Individual Diagnosis and Remediation of Educational Handicaps Manifested by Learning Disabled Children18 August 2016 | Journal of Learning Disabilities, Vol. 9, No. 10Annals of the New York Academy of Sciences, Vol. 205, No. 1 Minimal BrainBrain Function in Problem Children and Controls: Psychometric, Neurological, and Electroencephalographic ComparisonsABRAHAM WIKLER, JOAN F. DIXON, and JOSEPH B. PARKER, JR.1 April 2006 | American Journal of Psychiatry, Vol. 127, No. 5On Reconciling the “Multidimensional” and “Unitary” Concepts of Brain Damage6 October 2016 | Perceptual and Motor Skills, Vol. 29, No. 2Archiv f�r Psychiatrie und Nervenkrankheiten Vereinigt mit Zeitschrift f�r die Gesamte Neurologie und Psychiatrie, Vol. 206, No. 6Journal of Mental Science, Vol. 90, No. 378COMPARATIVE PSYCHOPATHOLOGY OF THE BRAIN-INJURED CHILD AND THE TRAUMATIC BRAIN-INJURED ADULTALFRED A. STRAUSS, and HEINZ WERNER1 April 2006 | American Journal of Psychiatry, Vol. 99, No. 6Chapter IX: Educational Psychology1 July 2016 | Review of Educational Research, Vol. 12, No. 3 Volume 97Issue 5 March 1941Pages 1194-1203 Metrics PDF download History Published online 1 April 2006 Published in print 1 March 1941