摘要:

Through the use of newly developed experimental models of traumatic brain injury (TBI), researchers now recognize that much of the delayed neuronal damage that develops over hours to days following the initial injury may result from pathological alterations in the brain's endogenous neurochemistry. This dis regulation of central nervous system (CNS) homeostasis may lead to cell swelling, membrane disruption, cytoskeletal disorganization and proteolysis, alterations in brain metabolism and blood flow, and changes in neurotransmitter receptor physiology. The recent identification of many molecular and cellular responses to brain trauma has assisted in the development of rational targeted neuroprotective therapies. This column summarizes recent experimental advances in the development of therapeutic strategies and will provide an overview of the pharmacological compounds that are now being considered for, or used in, clinical trials for brain trauma.

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The coincidence of mild head injury and chronic pain is quite high. In fact, there appears to be an inverse relationship between the severity of head injury and the incidence of pain complaints. Many of the presenting problems, which in the past have been thought to be due to cerebral causes only or perhaps to vaguely defined psychological or psychosocial factors, may be more appropriately viewed as part of a constellation of factors, including myofascial pain, sleep disorders, psychological factors, and iatrogenic harm. A treatment protocol is presented that outlines a sequential approach that has been found to be helpful with patients who have a history of head injury and chronic pain complaints. Two case studies are presented that illustrate the issues described above and the importance of concurrent treatment of myofascial pain, sleep disorders, and psychological dysfunction to prevent excess disability in this patient population.

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Many patients sustaining traumatic brain injury (TBI) experience multiple deficits affecting cognition, personality, and physical independence. Often there is a dramatic and permanent change in work status, income, family life, support network, and quality of life. Clinical experience indicates that this can predispose patients to significant depressive reactions and increased risk of suicide. This article will describe clinical evaluation and treatment techniques that attempt to address suicide in TBI patients participating in an outpatient milieu-oriented rehabilitation program. Historical theories and research on suicide will be reviewed. Risk factors for TBI and their similarity to suicide will be explored. Preliminary clinical findings from a retrospective study of 111 TBI program participants will also be provided.

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The primary purpose of this article is to present a conceptual framework designed to guide educational planning for students returning to school after severe traumatic brain injury (TBI). Eleven basic principles are offered that derive educational implications from important characteristics of many students with TBI. The article concludes with specific program considerations for students representing four different profiles of cognitive, behavioral, and academic functioning. While embracing the ideal of fully individualized educational planning, the authors argue that specific sets of services and supports are important to consider for students with identifiable profiles of ability and disability after TBI.

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Mild traumatic brain injury (TBI) in children is generally associated with excellent long-term outcome. In rare cases sequelae persist indefinitely. More commonly, cognitive and behavioral symptoms persist for a few days to a few weeks, possibly resulting in academic and social failure that could generate consequences that outlive the neurological sequelae. This article presents a mild TBI hospital-to-school protocol that uses real academic and social tasks and contexts as the screening procedure and creates a system of temporary accommodations in the event of persisting cognitive or behavioral consequences of the injury.

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Although the importance of the involvement of the person served in establishing goals for rehabilitation is clearly recognized, the role of the person served has typically been limited in team meetings where goals are discussed. This article describes a model for team meetings in non residential community-integrated programs. The features, advantages, and disadvantages of the model are presented. The disadvantages pertain primarily to the logistical considerations of having the team meetings at the home of the person served. The advantages outweigh the disadvantages, since the process fosters empowerment and enhances the ecological validity of the treatment plan.

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Head injury patients often develop vertigo and imbalance. The mechanisms of these symptoms include unilateral or bilateral vestibular hypofunction, benign paroxysmal positioning vertigo (BPPV), and central vestibular dysfunction. Vestibular rehabilitation techniques have developed over the past 50 years to help patients compensate for these deficits. Liberatory maneuvers effectively treat BPPV. Rotational head movements with visual fixation (ie, vestibulo-ocular reflex [VOR] exercises) may enhance compensation for vestibular hypofunction. Motion habituation may decrease dizziness associated with head movements. Balance retraining can improve stability during ambulation. While few controlled studies have been performed, results suggest fair to good efficacy for most vestibular diagnoses, especially BPPV.

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1995

数据来源: OVID