Comparison of indices of traumatic brain injury severity: Glasgow Coma Scale, length of coma and post-traumatic amnesia

2007 ◽  
Vol 79 (6) ◽  
pp. 678-685 ◽  
Author(s):  
M Sherer ◽  
M A Struchen ◽  
S A Yablon ◽  
Y Wang ◽  
T G Nick
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Injury Severity ◽  
Coma Scale ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
Traumatic Brain Injury Severity ◽  
Scale Length

scholarly journals Galveston Orientation and Amnesia Test: applicability and relation with the Glasgow Coma Scale

2007 ◽  
Vol 15 (4) ◽  
pp. 651-657 ◽  
Author(s):  
Silvia Cristina Fürbringer e Silva ◽  
Regina Marcia Cardoso de Sousa
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Prospective Study ◽  
Trauma Care ◽  
Coma Scale ◽  
Traumatic Amnesia ◽  
Scale Scores ◽  
Post Traumatic ◽  
The Relationship

Restrictions in the application of the Galveston Orientation and Amnesia Test and questionings about the relationship between conscience and post-traumatic amnesia motivated this study, which aims to identify, through the Glasgow Coma Scale scores, when to initiate the application of this amnesia test, as well to verify the relationship between the results of these two indicators. The longitudinal prospective study was carried at a referral center for trauma care in São Paulo - Brazil. The sample consisted of 73 victims of blunt traumatic brain injury, admitted at this institution between January 03rd and May 03rd 2001. Regarding the applicability, the test could be applied in patients with a Glasgow Coma Scale score > 12; however, the end of post traumatic amnesia was verified in patients who scored > 14 on the scale. A significant relationship (r s = 0.65) was verified between these measures, although different kinds of relationship between the end of the amnesia and changes in consciousness were observed.

Blast Injury in a Civilian Trauma Setting is Associated with a Delay in Diagnosis of Traumatic Brain Injury

2008 ◽  
Vol 74 (3) ◽  
pp. 267-270 ◽  
Author(s):  
Grant V. Bochicchio ◽  
Kimberly Lumpkins ◽  
James O'Connor ◽  
Marc Simard ◽  
Stacey Schaub ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Injury Severity ◽  
Disease Process ◽  
Blast Injury ◽  
Coma Scale ◽  
The Mean

High-pressure waves (blast) account for the majority of combat injuries and are becoming increasingly common in terrorist attacks. To our knowledge, there are no data evaluating the epidemiology of blast injury in a domestic nonterrorist setting. Data were analyzed retrospectively on patients admitted with any type of blast injury over a 10-year period at a busy urban trauma center. Injuries were classified by etiology of explosion and anatomical location. Eighty-nine cases of blast injury were identified in 57,392 patients (0.2%) treated over the study period. The majority of patients were male (78%) with a mean age of 40 ± 17 years. The mean Injury Severity Score was 13 ± 11 with an admission Trauma and Injury Severity Score of 0.9 ± 0.2 and Revised Trauma Score of 7.5 ± 0.8. The mean intensive care unit and hospital length of stay was 2 ± 7 days and 4.6 ± 10 days, respectively, with an overall mortality rate of 4.5 per cent. Private dwelling explosion [n = 31 (35%)] was the most common etiology followed by industrial pressure blast [n = 20 (22%)], industrial gas explosion [n = 16 (18%)], military training-related explosion [n = 15 (17%)], home explosive device [n = 8 (9%)], and fireworks explosion [n = 1 (1%)]. Maxillofacial injuries were the most common injury (n = 78) followed by upper extremity orthopedic (n = 29), head injury (n = 32), abdominal (n = 30), lower extremity orthopedic (n = 29), and thoracic (n = 19). The majority of patients with head injury [28 of 32 (88%)] presented with a Glasgow Coma Scale score of 15. CT scans on admission were initially positive for brain injury in 14 of 28 patients (50%). Seven patients (25%) who did not have a CT scan on admission had a CT performed later in their hospital course as a result of mental status change and were positive for traumatic brain injury (TBI). Three patients (11%) had a negative admission CT with a subsequently positive CT for TBI over the next 48 hours. The remaining four patients (14%) were diagnosed with skull fractures. All patients (n = 4) with an admission Glasgow Coma Scale score of less than 8 died from diffuse axonal injury. Blast injury is a complicated disease process, which may evolve over time, particularly with TBI. The missed injury rate for TBI in patients with a Glasgow Coma Scale score of 15 was 36 per cent. More studies are needed in the area of blast injury to better understand this disease process.

scholarly journals Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury

2009 ◽  
Vol 15 (6) ◽  
pp. 862-867 ◽  
Author(s):  
RICHARD A. BRYANT ◽  
MARK CREAMER ◽  
MEAGHAN O’DONNELL ◽  
DERRICK SILOVE ◽  
C. RICHARD CLARK ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Injury Severity ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Traumatic Amnesia ◽  
Post Traumatic

AbstractThe prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for PTSD 3 months later (N = 920). At the follow-up assessment, 90 (9.4%) patients met criteria for PTSD (MTBI: 50, 11.8%; No-TBI: 40, 7.5%); MTBI patients were more likely to develop PTSD than no-TBI patients, after controlling for injury severity (adjusted odds ratio: 1.86; 95% confidence interval, 1.78–2.94). Longer post-traumatic amnesia was associated with less severe intrusive memories at the acute assessment. These findings indicate that PTSD may be more likely following MTBI, however, longer post-traumatic amnesia appears to be protective against selected re-experiencing symptoms. (JINS, 2009, 15, 862–867.)

Using the Abbreviated Injury Severity and Glasgow Coma Scale Scores to Predict 2-Week Mortality After Traumatic Brain Injury

2011 ◽  
Vol 71 (5) ◽  
pp. 1172-1178 ◽  
Author(s):  
Shelly D. Timmons ◽  
Tiffany Bee ◽  
Sharon Webb ◽  
Ramon R. Diaz-Arrastia ◽  
Dale Hesdorffer
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Injury Severity ◽  
Coma Scale ◽  
Scale Scores

scholarly journals Pediatric Firearm-Related Traumatic Brain Injury in United States Trauma Centers

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Hansen Deng ◽  
John K Yue ◽  
Ethan A Winkler ◽  
Sanjay S Dhall ◽  
Geoffrey T Manley ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Injury Severity ◽  
Trauma Centers ◽  
Lower Odds ◽  
Coma Scale ◽  
Level Ii ◽  
Suicide Intent ◽  
Overall Mortality

Abstract INTRODUCTION Firearm injury is a leading cause of death and disability in the American youth. Epidemiology and outcomes following gunshot wound to the head (GSWH) are in need of systematic characterization. Here, we analyzed pediatric GSWH to identify predictors of prolonged hospitalization, morbidity and mortality. METHODS All patients < 18 yr with GSWH in the National Sample Program (NSP) of the National Trauma Data Bank (NTDB) from 2003 to 2012 were identified. Variables included injury intent, firearm choice, injury site, age, sex, race, health insurance, geographic region, trauma center level, isolated TBI, emergency department (ED) hypotension, Glasgow Coma Scale (GCS), and Injury Severity Score (ISS). Outcomes were hospital length of stay (HLOS), morbidity and mortality. Odds ratios (OR), mean increase/decrease (B), and 95% confidence intervals (CI) were reported. Statistical significance was assessed at a < 0.001 accounting for multiple comparisons. RESULTS In a weighted sample of 2847 pediatric GSWHs, age was 14.8 ± 3.3 yr, 79.2% were male, and 59.0% had severe traumatic brain injury (TBI; Glasgow Coma Scale [GCS] score 3-8). Assault (63.0%), handgun as firearm (45.6%), and injury in residential areas (40.6%) were most common. HLOS was 11.6 ± 14.4 d for the survivors, for which suicide injuries had longer hospitalization (B = 5.9 day increase, 95% CI [3.3-8.6], P < .001) relative to accidents. The overall mortality was 45.1%, and was greater with suicide intent (mortality = 71.5%, P < .001) and shotgun as firearm (mortality = 56.5%, P < .001). Lower GCS, higher ISS, and hypotension predicted poorer outcomes. Management at level II centers was associated with lower odds of returning home (OR = 0.3, [0.2-0.5], P < .001). CONCLUSION From 2003 to 2012, the proportion of accidental injuries decreased while suicides increased. The overall mortality was 45%, with hypotension, cranial and overall injury severity, and suicide intent being associated with poor prognosis. Patients treated at level II trauma centers had lower odds of being discharged home. Improved risk screening, parental education and standardization of critical care management are needed.

scholarly journals Relationship between post-traumatic amnesia and white matter integrity in traumatic brain injury using tract-based spatial statistics

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min Jye Cho ◽  
Sung Ho Jang
Keyword(s):  
Traumatic Brain Injury ◽  
White Matter ◽  
Patient Group ◽  
Injury Severity ◽  
White Matter Integrity ◽  
Superior Cerebellar Peduncle ◽  
Uncinate Fasciculus ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
Cerebellar Peduncle

AbstractThis study used tract-based spatial statistics to examine the relationship between post-traumatic amnesia (PTA) and white matter integrity in patients with a traumatic brain injury (TBI). Forty-seven patients with TBI in the chronic stage and 47 age- and sex-matched normal control subjects were recruited to the study. Correlation coefficients were calculated to observe the relationships among the PTA duration, white matter fractional anisotropy (FA) values, and mini-mental state examination (MMSE) results in the patient group. Both before and after Benjamini–Hochberg (BH) corrections, FA values of 46 of the 48 regions of interests of the patient group were lower than those of the control group. The FA values of column and body of fornix, left crus of fornix, left uncinate fasciculus, right hippocampus part of cingulum, left medial lemniscus, right superior cerebellar peduncle, left superior cerebellar peduncle, and left posterior thalamic radiation (after BH correction: the uncinate fasciculus and right hippocampus part of cingulum) in the patient group were negatively correlated with PTA duration. PTA duration was related to the injury severity of eight neural structures, each of which is involved in the cognitive functioning of patients with TBI. Therefore, PTA duration can indicate injury severity of the above neural structures in TBI patients.

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