摘要:

The mechanisms of mild traumatic brain injury (TBI) represent the low end of a spectrum in which pathobiological disturbances increase as mechanical forces increase. The article examines agonist-receptor and structural mechanisms of mild TBI. Acutely, TBI can produce increased levels of neurotransmitters, resulting in excessive stimulation of specific receptors that could produce chronic deficits in cholinergic neurotransmission. Axonal injury may occur immediately, or it may be subtle and progressive, involving progressive eytoskeletal derangements. Axonal injury may contribute to cholinergic neurotransmission deficits via diffuse deafferentation. Deficits in central cholinergic neurotransmission may contribute to memory deficits after mild TBI.

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Mild traumatic brain injury, although a prevalent health care problem, is poorly understood by most health care professionals. This lack of understanding may result in underdiagnosis and/or misdiagnosis of the condition and its myriad of cognitive, behavioral, and somatic sequelae. The three main clinical phenomena that must be considered in patients with postconcussive disorders are traumatic brain injury, cranial and cranial adnexal Injury, and cervical hyperflexion/hyperextension injury. The article provides some insights into the historical perspectives on postconcussive disorders, a discussion of the relative magnitude of the problem, and an overview of the neurologic, medical, and rehabilitative assessment and management of persons with postconcussive disorders.

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This article identifies and clarifies some of the methodological issues responsible for inconsistencies in the literature regarding outcome of mild head injury. These issues include classification of head injury severity, biases in selection of patients with mild head injury, and use of controls to account for comorbidities related to other system injuries, preexisting conditions, and emotional reactions to and circumstances surrounding the accident.

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The role of the forensic neuropsychologist in mild head injury litigation is discussed. Similarities between the practice of clinical neuropsychology in the clinical and forensic arenas are outlined. The need to consider preinjury factors and base rates of symptoms in conducting both a scientific and a conservative neuropsychological investigation of mild head injury is described. Finally, the legal issue of proximate cause in litigation of mild head Injury is addressed.

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Postconcussive symptomatology was studied in 587 patients with uncomplicated mild head injury. There was a linear decrease in symptomatology over the 1-year follow-up period. Headache was the most frequently reported postconcussive symptom. Symptom constellations consistent with postconcussive syndrome were rare. A number of patients reported symptoms at 1 year follow-up. Interventions designed to provide education and support appeared to be associated with symptom resolution in some patients. Implications of these findings are discussed.

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Objective techniques such as neuroimaging cannot conclusively document axonal shearing or other trauma resulting from closed brain injury. Consequently, clinicians must rely upon clinical evaluation and psychological and neuropsychological assessment. Because of the subjectivity inherent in these measures, they are susceptible to confounding due to malingering behaviors. Indicators of malingering in mild closed brain injury and approaches to differential diagnosis are discussed. Findings of a study comparing the neuropsychologlcal test results of normal subjects simulating neurological injury with the test results of normal controls, litigants with actual minor brain injury, and nonlitigants with actual minor brain injury are presented. The study concludes that comprehensive multidisciplinary evaluations are required to detect malingering in cases of minor closed brain injury. Guidelines are suggested for the detection and diagnosis of malingering, which continues to represent a major challenge in the assessment of individuals with brain concussion.

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A neuropsychological model of functional disability after mild traumatic brain injury is presented that allows for selecting Individualized treatments for different patients depending on the particular dynamics of their disability. Neurological, psychological, and physical factors are seen as Interacting in complex ways. Objective and subjective cognitive deficits are differentiated. Functionally autonomous cognitive and pain loops are described that can operate after primary symptom resolution. Implications for individualized assessment and treatment for both early preventive intervention and later intervention after functional disability are presented.

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Advances in health care prolong the lives of severely impaired adults with head injury, allowing improvement long after injury. A subset of these patients, designated slow-to-recover (STR) patients, remains minimally or inconsistently responsive to stimuli for months after injury but eventually improves. Little is known about the recovery process of these patients. Results of this study indicated that 55 (47%) of a group of 116 STR patients reached rehabilitation-ready (RR) status at 3 to 48 months after injury; 37 (67%) were RR at 6 months. Two improvement patterns were identified: continuous and abrupt. Visual tracking performance at initial assessment predicted eventual RR status; auditory comprehension performance predicted speed of improvement.

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1993

数据来源: OVID