As highlighted in prior posts in this blog, TBI research increasingly highlights the importance of providing follow-up care to patients discharged from the ER with a diagnosis of TBI. Put simply, patients with follow up care have better outcomes.
Israeli study finds that one in four children with mild traumatic brain injury (mTBI) suffer from persistent post-concussive symptoms
In a large multi-center retrospective matched cohort study, Israeli scientists recently found that one in four children (25.3%) who have been discharged from the emergency room after a mild head injury suffered from persistent post- concussive symptoms.
Among the chronic symptoms seen in these children were forgetfulness, memory problems, sensitivity to light and noise, ADHD and even psychological problems. Sadly, many of these children had been misdiagnosed as suffering from unrelated ADHD, sleep disorders, depression, etc. This misdiagnosis, the researchers noted, leads to treatment that is not suited to the problem, thus causing the children prolonged suffering. Read More
In the first systematic review on this topic, researchers at the University of Texas report on growing consistent evidence that traumatic brain injury (TBI) changes the gut microbiome. Evaluating these changes, they conclude, will be a fertile ground for new therapeutic interventions. Read More
An article published in April, 2020 by the American College of Emergency Physicians reports on evidence that underdiagnosis of Mild Traumatic Brain Injury (mTBI) “is a pervasive problem in the emergency setting,” and that even patients who receive a diagnosis are unlikely to receive appropriate discharge education and are therefore at risk of missing opportunities for treatment, referral and improvement in outcomes. Koval et. at., Concussion Care in the Emergency Department: A Prospective Operational Brief Report, Annals of Emergency Medicine 2020 Apr;75(4):483-490. Read More
A review published in the September 2017 issue of Frontiers in Neurology proposes use of “systems science” to better understand concussion diagnosis and prognosis. This is a discipline that analyzes complex problems as whole systems and integrates research findings from different disciplines. In explaining the need for a systems approach, the reviewers note one description of concussion that is uniformly recognized – that it is a highly heterogeneous phenomenon, with numerous factors interacting dynamically to influence an individual’s recovery trajectory. (This concept is highlighted in the title of one of the Concussion WebCasts made available by the American Association of Family Physicians : “If you have seen one concussion, you have seen one concussion.”) Read More
In a study published in the Journal of the American Medical Association (JAMA) on December 20, 2016, Canadian researchers found that children and adolescents who returned to exercise within seven days of experiencing a concussion had nearly half the rate of persistent post-concussive symptoms a month later. This finding challenges the current cornerstone of pediatric concussion management, which is physical and cognitive rest until acute symptoms have resolved. Read More
The April, 2015 issue of The American Surgeonreports on a retrospective study of 395 patients admitted to the ER following concussions (MTBI, or mild traumatic brain injury). The patients had “normal” Glascow Coma scores of 15 and normal CT scans and therefore met discharge criteria. The study found that a surprisingly high percentage of these patients (27%) had persistent deficits after neurocognitive testing and benefitted from referral for ongoing therapy. The study is authored by Hartwell et. al. and entitled “You Cannot Go Home: Routine Concussion Evaluation is Not Enough.” Read More
Researchers at the Henry Ford Neuroscience Institute, a leading neuroscience research facility, recently announced the results of research showing that the only drug currently approved to treat the crippling effects of stroke shows promise, when administered as a nasal spray, to help heal the effects of less severe forms of traumatic brain injury. This is exciting news, since researchers have been struggling unsuccessfully for years to find an effective drug treatment for TBI. The research results are based on animal studies, so further work will be needed to determine the best dose and window for administration in humans. Read More
Most current guidelines recommend “cognitive rest” during the initial stages of recovery from concussion. “Cognitive rest” involves limiting activities that require attention and concentration such as reading, doing homework, text messaging, playing video games, working online, watching movies and television and listening to music. Cognitive rest has been recommended in the past based on somewhat limited evidence suggesting that failing to minimize these activities in the early stages following a concussion could delay recovery. Read More
Recent literature has highlighted the prevalence of dysfunctions in vision following traumatic brain injuries of all levels of severity (including concussion.) Research published by the Veterans Administration (VA) in 2012 indicates that the percentage of TBI victims with vision problems could be as high as 60%. They explain that this prevalence is not surprising, since over 50% of the brain is involved in visual processing. Alvarez et. al. explain how visual and other symptoms occur when the brain is subjected to “acceleration/deceleration” forces: Read More
