scholarly journals Before the light fades, who blows the whistle? : a narrative review on sports dementia

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S290-S291
Author(s):  
Olusegun Sodiya ◽  
Ovwigho Edafegwotu ◽  
Jide Jeje
Keyword(s):  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Head Trauma ◽  
Early Onset ◽  
American Football ◽  
Current Evidence ◽  
Contact Sports ◽  
Early Onset Dementia ◽  
The Impact

AimsTraumatic brain injury is a leading risk factor for degenerative conditions. Although in the past this was believed to affect mostly boxers, recent studies have expanded the at-risk population to include American football players, rugby players, hockey players and other athletes involved in contact sports. Hence, there has been growing interest in the media and the public at large on the short and long term impacts of head trauma in sportspersons. The aim of this study is provide an overview of the impact of traumatic brain injury in contact sports and the link to early onset dementia.MethodFor the purpose of this study we conducted a literature search using PubMed electronic base and Google scholar. The search was made in February 2021 and using the following keywords ‘early onset dementia’, ‘presenile dementia’, ‘traumatic brain injury’, ‘contact sports’, ‘sportsmen’, and ‘athletes’. The search words were used individually and in combination to gather relevant articles. Types of studies included were case reports, case series, cohorts, cross-sectional, editorial and newspaper articles.ResultMost of the published studies have shown significant associations between repeated head trauma and brain morphological changes evidenced by the presence of myelinated axons, astrocytosis, perivascular neuroinflammation and formation of phosphorylated Tau proteinopathy. These contribute significantly to alterations in axonal functioning and synaptic transmissions which sets the stage for neuronal degeneration. These changes affect both the macroscopic and microscopic structures with consequent neurochemical disturbances and functional deficits which, manifest primarily as executive dysfunction.ConclusionCurrent evidence supports an association between participation in contact sports and neurodegenerative disease, despite the protective aspects of sporting activities. Overall the studies reviewed have shown that brain injury remains a potent risk factor for the early onset dementia seen in sportspersons. Consequently, it is prudent for more proactive and precautionary measures to be put in place to reduce impacts of head injury and to better identify and manage brain injury in sports.

scholarly journals Comorbidity and outcomes in traumatic brain injury: protocol for a systematic review on functional status and risk of death

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e018626 ◽  
Author(s):  
Tatyana Mollayeva ◽  
Chen Xiong ◽  
Sara Hanafy ◽  
Vincy Chan ◽  
Zheng Jing Hu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Functional Status ◽  
Medical Information ◽  
Longitudinal Design ◽  
Adverse Outcomes ◽  
Current Evidence ◽  
Risk Of Death ◽  
The Impact

IntroductionReports on the association between comorbidity and functional status and risk of death in patients with traumatic brain injury (TBI) have been inconsistent; it is currently unknown which additional clinical entities (comorbidities) have an adverse influence on the evolution of outcomes across the lifespan of men and women with TBI. The current protocol outlines a strategy for a systematic review of the current evidence examining the impact of comorbidity on functional status and early-term and late-term mortality, taking into account known risk factors of these adverse outcomes (ie, demographic (age and sex) and injury-related characteristics).Methods and analysisA comprehensive search strategy for TBI prognosis, functional (cognitive and physical) status and mortality studies has been developed in collaboration with a medical information specialist of the large rehabilitation teaching hospital. All peer-reviewed English language studies with longitudinal design in adults with TBI of any severity, published from May 1997 to April 2017, found through Medline, Central, Embase, Scopus, PsycINFO and bibliographies of identified articles, will be considered eligible. Study quality will be assessed using published guidelines.Ethics and disseminationThe authors will publish findings from this review in a peer-reviewed scientific journal(s) and present the results at national and international conferences. This work aims to understand how comorbidity may contribute to adverse outcomes in TBI, to inform risk stratification of patients and guide the management of brain injury acutely and at the chronic stages postinjury on a population level.PROSPERO registration numberCRD42017070033.

Head Trauma in the Cat: 2. Assessment and Management of Traumatic Brain Injury

2011 ◽  
Vol 13 (11) ◽  
pp. 815-823 ◽  
Author(s):  
Laurent Garosi ◽  
Sophie Adamantos
Keyword(s):  
Traumatic Brain Injury ◽  
General Practice ◽  
Brain Injury ◽  
Head Trauma ◽  
Brain Injuries ◽  
Experimental Studies ◽  
Clinical Signs ◽  
Evidence Base ◽  
Neurological Deficits ◽  
Current Evidence

Practical relevance Feline trauma patients are commonly seen in general practice and frequently have sustained some degree of brain injury. Clinical challenges Cats with traumatic brain injuries may have a variety of clinical signs, ranging from minor neurological deficits to life-threatening neurological impairment. Appropriate management depends on prompt and accurate patient assessment, and an understanding of the pathophysiology of brain injury. The most important consideration in managing these patients is maintenance of cerebral perfusion and oxygenation. For cats with severe head injury requiring decompressive surgery, early intervention is critical. Evidence base There is a limited clinical evidence base to support the treatment of traumatic brain injury in cats, despite its relative frequency in general practice. Appropriate therapy is, therefore, controversial in veterinary medicine and mostly based on experimental studies or human head trauma studies. This review, which sets out to describe the specific approach to diagnosis and management of traumatic brain injury in cats, draws on the current evidence, as far as it exists, as well as the authors' clinical experience.

scholarly journals Profilaxia de Trombose Venosa Profunda em Doentes com Traumatismo Cranioencefálico

2015 ◽  
Vol 28 (2) ◽  
pp. 250
Author(s):  
Vinícius Trindade Gomes da Silva ◽  
Ricardo Iglesio ◽  
Wellingson Silva Paiva ◽  
Mario Gilberto Siqueira ◽  
Manoel Jacobsen Teixeira
Keyword(s):  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Deep Vein Thrombosis ◽  
Brain Injury ◽  
Head Trauma ◽  
Thrombosis Prophylaxis ◽  
Mechanical Prophylaxis ◽  
Vein Thrombosis ◽  
Deep Vein Thrombosis Prophylaxis ◽  
Deep Vein

<strong>Introduction: </strong>The risk of deep vein thrombosis is increased in patients with head trauma, but the prophylaxis against this event is confronted with the possible risk of worsening hemorrhagic injuries. In this article, we present an overview about deep vein thrombosis prophylaxis in patients with head trauma and we propose a practical protocol for clinical management of deep vein thrombosis prophylaxis.<br /><strong>Material and Methods:</strong> We reviewed relevant papers cited in the Medline/PubMed, Cochrane, and Scielo databases from January 1998 to January 2014. Based on a search with the following search expression: “deep venous thrombosis and prophylaxis and traumatic brain injury”, we found 44 eligible articles. Twenty-three papers were selected using criteria as published in English or Portuguese, patients in acute phase of moderate and severe traumatic brain injury and noninvasive mechanical prophylaxis or chemistry.<br /><strong>Results:</strong> Head trauma alone is a risk factor for deep vein thrombosis. The chance of deep vein thrombosis is 2.59 times higher in patients with head trauma. The prevalence of deep vein thrombosis and pulmonary embolism in patients who have suffered head trauma is 20% in the literature, reaching 30% in some studies.<br /><strong>Discussion and Conclusion:</strong> Head trauma alone is a risk factor for deep vein thrombosis and pulmonary thromboembolism and the risks inherent in this disease requires methods of prevention for these complications. Clinical trials are needed to establish the efficacy of prophylaxis and the best time to start medication for deep vein thrombosis in patients with traumatic brain injury.

The Role of Neck Muscle Activities on the Risk of Mild Traumatic Brain Injury in American Football

2017 ◽  
Vol 139 (10) ◽  
Author(s):  
Xin Jin ◽  
Zhaoying Feng ◽  
Valerie Mika ◽  
Haiyan Li ◽  
David C. Viano ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Muscle Activation ◽  
Neck Muscles ◽  
American Football ◽  
Preventive Strategy ◽  
Muscle Response ◽  
Neck Strength ◽  
The Impact

Concussion, or mild traumatic brain injury (mTBI), is frequently associated with sports activities. It has generally been accepted that neck strengthening exercises are effective as a preventive strategy for reducing sports-related concussion risks. However, the interpretation of the link between neck strength and concussion risks remains unclear. In this study, a typical helmeted head-to-head impact in American football was simulated using the head and neck complex finite element (FE) model. The impact scenario selected was previously reported in lab-controlled incident reconstructions from high-speed video footages of the National Football League using two head-neck complexes taken from Hybrid III dummies. Four different muscle activation strategies were designed to represent no muscle response, a reactive muscle response, a pre-activation response, and response due to stronger muscle strength. Head kinematics and various head/brain injury risk predictors were selected as response variables to compare the effects of neck muscles on the risk of sustaining the concussion. Simulation results indicated that active responses of neck muscles could effectively reduce the risk of brain injury. Also, anticipatory muscle activation played a dominant role on impact outcomes. Increased neck strength can decrease the time to compress the neck and its effects on reducing brain injury risks need to be further studied.

scholarly journals A-126 Clinical Utility of Risk Factors to Predict Self-reported Neurobehavioral Outcome Following Traumatic Brain Injury: PTSD, Sleep, Resilience, and Lifetime Blast Exposure

2020 ◽  
Vol 35 (6) ◽  
pp. 919-919
Author(s):  
Lange R ◽  
Lippa S ◽  
Hungerford L ◽  
Bailie J ◽  
French L ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Clinical Utility ◽  
Poor Sleep ◽  
Post Injury ◽  
Poor Outcome ◽  
Blast Exposure ◽  
Neurobehavioral Outcome

Abstract Objective To examine the clinical utility of PTSD, Sleep, Resilience, and Lifetime Blast Exposure as ‘Risk Factors’ for predicting poor neurobehavioral outcome following traumatic brain injury (TBI). Methods Participants were 993 service members/veterans evaluated following an uncomplicated mild TBI (MTBI), moderate–severe TBI (ModSevTBI), or injury without TBI (Injured Controls; IC); divided into three cohorts: (1) &lt; 12 months post-injury, n = 237 [107 MTBI, 71 ModSevTBI, 59 IC]; (2) 3-years post-injury, n = 370 [162 MTBI, 80 ModSevTBI, 128 IC]; and (3) 10-years post-injury, n = 386 [182 MTBI, 85 ModSevTBI, 119 IC]. Participants completed a 2-hour neurobehavioral test battery. Odds Ratios (OR) were calculated to determine whether the ‘Risk Factors’ could predict ‘Poor Outcome’ in each cohort separately. Sixteen Risk Factors were examined using all possible combinations of the four risk factor variables. Poor Outcome was defined as three or more low scores (&lt; 1SD) on five TBI-QOL scales (e.g., Fatigue, Depression). Results In all cohorts, the vast majority of risk factor combinations resulted in ORs that were ‘clinically meaningful’ (ORs &gt; 3.00; range = 3.15 to 32.63, all p’s &lt; .001). Risk factor combinations with the highest ORs in each cohort were PTSD (Cohort 1 & 2, ORs = 17.76 and 25.31), PTSD+Sleep (Cohort 1 & 2, ORs = 18.44 and 21.18), PTSD+Sleep+Resilience (Cohort 1, 2, & 3, ORs = 13.56, 14.04, and 20.08), Resilience (Cohort 3, OR = 32.63), and PTSD+Resilience (Cohort 3, OR = 24.74). Conclusions Singularly, or in combination, PTSD, Poor Sleep, and Low Resilience were strong predictors of poor outcome following TBI of all severities and injury without TBI. These variables may be valuable risk factors for targeted early interventions following injury.

scholarly journals Ketamine in acute phase of severe traumatic brain injury “an old drug for new uses?”

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Daniel Agustin Godoy ◽  
Rafael Badenes ◽  
Paolo Pelosi ◽  
Chiara Robba
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Acute Phase ◽  
Severe Traumatic Brain Injury ◽  
Safety Profile ◽  
Point Of View ◽  
Current Evidence ◽  
Potential Benefits ◽  
Sedation And Analgesia

AbstractMaintaining an adequate level of sedation and analgesia plays a key role in the management of traumatic brain injury (TBI). To date, it is unclear which drug or combination of drugs is most effective in achieving these goals. Ketamine is an agent with attractive pharmacological and pharmacokinetics characteristics. Current evidence shows that ketamine does not increase and may instead decrease intracranial pressure, and its safety profile makes it a reliable tool in the prehospital environment. In this point of view, we discuss different aspects of the use of ketamine in the acute phase of TBI, with its potential benefits and pitfalls.

Impact of routine S100B protein assay on CT scan use in children with mild traumatic brain injury

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fleur Lorton ◽  
Jeanne Simon-Pimmel ◽  
Damien Masson ◽  
Elise Launay ◽  
Christèle Gras-Le Guen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
University Hospital ◽  
S100b Protein ◽  
Research Network ◽  
Ct Scans ◽  
Intermediate Risk ◽  
Protein Assay ◽  
The Impact

AbstractObjectivesTo evaluate the impact of implementing a modified Pediatric Emergency Care Applied Research Network (PECARN) rule including the S100B protein assay for managing mild traumatic brain injury (mTBI) in children.MethodsA before-and-after study was conducted in a paediatric emergency department of a French University Hospital from 2013 to 2015. We retrospectively included all consecutive children aged 4 months to 15 years who presented mTBI and were at intermediate risk for clinically important traumatic brain injury (ciTBI). We compared the proportions of CT scans performed and of in-hospital observations before (2013–2014) and after (2014–2015) implementation of a modified PECARN rule including the S100B protein assay.ResultsWe included 1,062 children with mTBI (median age 4.5 years, sex ratio [F/M] 0.73) who were at intermediate risk for ciTBI: 494 (46.5%) during 2013–2014 and 568 (53.5%) during 2014–2015. During 2014–2015, S100B protein was measured in 451 (79.4%) children within 6 h after mTBI. The proportion of CT scans and in-hospital observations significantly decreased between the two periods, from 14.4 to 9.5% (p=0.02) and 73.9–40.5% (p<0.01), respectively. The number of CT scans performed to identify a single ciTBI was reduced by two-thirds, from 18 to 6 CT scans, between 2013–2014 and 2014–2015. All children with ciTBI were identified by the rules.ConclusionsThe implementation of a modified PECARN rule including the S100B protein assay significantly decreased the proportion of CT scans and in-hospital observations for children with mTBI who were at intermediate risk for ciTBI.

Sign in / Sign up

Export Citation Format

Share Document