scholarly journals Residual Pituitary Function after Brain Injury-Induced Hypopituitarism: A Prospective 12-Month Study

2005 ◽  
Vol 90 (11) ◽  
pp. 6085-6092 ◽  
Author(s):  
Gianluca Aimaretti ◽  
Maria Rosaria Ambrosio ◽  
Carolina Di Somma ◽  
Maurizio Gasperi ◽  
Salvatore Cannavò ◽  
...  
Keyword(s):  
Brain Injury ◽  
High Risk ◽  
Gh Deficiency ◽  
Pituitary Function ◽  
Brain Injured ◽  
Injured Patients ◽  
The Brain ◽  
Over Time

Abstract Context: Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are conditions at high risk for the development of hypopituitarism. Objective: The objective of the study was to clarify whether pituitary deficiencies and normal pituitary function recorded at 3 months would improve or worsen at 12 months after the brain injury. Design and Patients: Pituitary function was tested at 3 and 12 months in patients who had TBI (n = 70) or SAH (n = 32). Results: In TBI, the 3-month evaluation had shown hypopituitarism (H) in 32.8%. Panhypopituitarism (PH), multiple (MH), and isolated (IH) hypopituitarism had been demonstrated in 5.7, 5.7, and 21.4%, respectively. The retesting demonstrated some degree of H in 22.7%. PH, MH, and IH were present in 5.7, 4.2, and 12.8%, respectively. PH was always confirmed at 12 months, whereas MH and IH were confirmed in 25% only. In 5.5% of TBI with no deficit at 3 months, IH was recorded at retesting. In 13.3% of TBI with IH at 3 months, MH was demonstrated at 12-month retesting. In SAH, the 3-month evaluation had shown H in 46.8%. MH and IH had been demonstrated in 6.2 and 40.6%, respectively. The retesting demonstrated H in 37.5%. MH and IH were present in 6.2 and 31.3%, respectively. Although no MH was confirmed at 12 months, two patients with IH at 3 months showed MH at retesting; 30.7% of SAH with IH at 3 months displayed normal pituitary function at retesting. In SAH, normal pituitary function was always confirmed. In TBI and SAH, the most common deficit was always severe GH deficiency. Conclusion: There is high risk for H in TBI and SAH patients. Early diagnosis of PH is always confirmed in the long term. Pituitary function in brain-injured patients may improve over time but, although rarely, may also worsen. Thus, brain-injured patients must undergo neuroendocrine follow-up over time.

Oral-Movement Abilities and Articulatory Characteristics of Brain-Injured Adults

1974 ◽  
Vol 39 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Leonard L. La Pointe ◽  
Robert T. Wertz
Keyword(s):  
Brain Injury ◽  
Apraxia Of Speech ◽  
Oral Motor ◽  
Brain Injured ◽  
History Of ◽  
Injured Patients ◽  
The Brain ◽  
Normal Adults

We compared the performance of 28 brain-injured adults who displayed articulation problems with that of 28 adults with no history of brain-injury on tests of isolated oral movement and oral-motor sequencing. An attempt was made to classify the brain-injured patients by administering an articulation test and employing three criteria for differentiating apraxia of speech from dysarthria: presence of initiation errors, more substitution errors than combined omission and distortion errors, and the presence of islands of error-free production. While the brain-injured group performed significantly worse on the isolated oral-movement and oral-motor sequencing tests than the normal adults, not all brain-injured patients demonstrated difficulty on these tasks. We were able to identify 13 patients who met all three criteria (apraxia of speech), 3 who met none (dysarthria), and 12 who met one or two but not all (mixed apraxia of speech and dysarthria). Isolated oral-movement and oral-motor sequencing deficits were found in all three groups, but no significant differences among groups on these tasks were observed.

Pituitary Function at Long-Term Follow-Up of Childhood Traumatic Brain Injury

2010 ◽  
Vol 27 (10) ◽  
pp. 1827-1835 ◽  
Author(s):  
Rebecca Jane Moon ◽  
Timothy Sutton ◽  
Peter Murray Wilson ◽  
Fenella Jane Kirkham ◽  
Justin Huw Davies
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pituitary Function ◽  
Long Term Follow Up

Long Term Changes in Family Needs After Brain Injury: A Preliminary Review

1997 ◽  
Vol 3 (1) ◽  
pp. 30-39 ◽  
Author(s):  
Peter Stebbins
Keyword(s):  
Brain Injury ◽  
Family Member ◽  
Family Members ◽  
Preliminary Review ◽  
Family Needs ◽  
Rehabilitation Professionals ◽  
Brain Injured ◽  
The Family ◽  
The Brain

When a family member acquires a brain injury the family as a whole is likely to experience severe emotional stress and strain in coping with and adjusting to the injured family member. Longitudinal studies of family adjustment have shown that families find it increasingly difficult to cope with the brain injured family member as the time (years) since injury increases. The increasing difficulty family members experience in coping with their brain injured relative led several researchers to investigate the needs of family members. Research investigating family needs after brain injury is limited to the first couple of years post trauma despite the finding that stress and burden continue to increase as the years progress. This paper reviews family needs research over the last three decades and provides a discussion of family needs and surrounding issues relevant to rehabilitation professionals.

scholarly journals Management of Patients with Brain Injury Using Noninvasive Methods

2020 ◽  
Author(s):  
Gustavo Frigieri ◽  
Nicollas Nunes Rabelo ◽  
Ricardo de Carvalho Nogueira ◽  
Sérgio Brasil
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Brain Injury ◽  
Intensive Care Units ◽  
Clinical Parameters ◽  
Noninvasive Methods ◽  
Brain Injured ◽  
Medical Teams ◽  
Injured Patients

In the last decades, the development of new noninvasive technologies in critical care allowed physicians to continuously monitor clinical parameters, aggregating important information that has been previously inaccessible or restricted due to the invasiveness of the existing techniques. The aim of this chapter is to present noninvasive methods in use on intensive care units (ICU) for brain injured patients monitoring, collaborating to the diagnosis and follow-up, aiding medical teams to achieve better outcomes.

Long-term follow-up in high risk hypertensive patients with carotid dolicoarteriopathies

2020 ◽  
Vol 39 (1) ◽  
Author(s):  
Antonio Valvano ◽  
Giorgio Bosso ◽  
Valentina Apuzzi ◽  
Valentina Mercurio ◽  
Valeria Di Simone ◽  
...  
Keyword(s):  
High Risk ◽  
Hypertensive Patients ◽  
Long Term Follow Up

scholarly journals What are the strongest indicators of intracerebral hemorrhage in mild traumatic brain injury?

2021 ◽  
Vol 6 (1) ◽  
pp. e000717
Author(s):  
Panu Teeratakulpisarn ◽  
Phati Angkasith ◽  
Thanakorn Wannakul ◽  
Parichat Tanmit ◽  
Supatcha Prasertcharoensuk ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
High Risk ◽  
Ct Scan ◽  
Mild Traumatic Brain Injury ◽  
Skull Fracture ◽  
Brain Ct ◽  
Baseline Characteristics ◽  
Gcs Score ◽  
The Brain

BackgroundAlthough there are eight factors known to indicate a high risk of intracranial hemorrhage (ICH) in mild traumatic brain injury (TBI), identification of the strongest of these factors may optimize the utility of brain CT in clinical practice. This study aimed to evaluate the predictors of ICH based on baseline characteristics/mode of injury, indications for brain CT, and a combination of both to determine the strongest indicator.MethodsThis was a descriptive, retrospective, analytical study. The inclusion criteria were diagnosis of mild TBI, high risk of ICH, and having undergone a CT scan of the brain. The outcome of the study was any type of ICH. Stepwise logistic regression analysis was used to find the strongest predictors according to three models: (1) injury pattern and baseline characteristics, (2) indications for CT scan of the brain, and (3) a combination of models 1 and 2.ResultsThere were 100 patients determined to be at risk of ICH based on indications for CT of the brain in patients with acute head injury. Of these, 24 (24.00%) had ICH. Model 1 found that injury due to motor vehicle crash was a significant predictor of ICH, with an adjusted OR (95% CI) of 11.53 (3.05 to 43.58). Models 2 and 3 showed Glasgow Coma Scale (GCS) score of 13 to 14 after 2 hours of observation and open skull or base of skull fracture to be independent predictors, with adjusted OR (95% CI) of 11.77 (1.32 to 104.96) and 5.88 (1.08 to 31.99) according to model 2.DiscussionOpen skull or base of skull fracture and GCS score of 13 to 14 after 2 hours of observation were the two strongest predictors of ICH in mild TBI.Level of evidenceIII.

scholarly journals A 16-year prospective cohort study to evaluate effects of long-term fluctuations in obesity indices of prediabetics on the incidence of future diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shahla Safari ◽  
Maryam Abdoli ◽  
Masoud Amini ◽  
Ashraf Aminorroaya ◽  
Awat Feizi
Keyword(s):  
High Risk ◽  
Transition Probabilities ◽  
Clinical Settings ◽  
High Tendency ◽  
Mean Values ◽  
Latent Markov Model ◽  
Term Evaluation ◽  
Obesity Indices

AbstractThis study aimed to evaluate the patterns of changes in obesity indices over time in prediabetic subjects and to classify these subjects as either having a low, moderate, and high risk for developing diabetes in the future. This study was conducted among 1228 prediabetics. The patterns of changes in obesity indices based on three measurements including first, mean values during the follow-up period, and last visit from these indices were evaluated by using the latent Markov model (LMM). The mean (standard deviation) age of subjects was 44.0 (6.8) years and 73.6% of them were female. LMM identified three latent states of subjects in terms of change in all anthropometric indices: a low, moderate, and high tendency to progress diabetes with the state sizes (29%, 45%, and 26%), respectively. LMM showed that the probability of transitioning from a low to a moderate tendency to progress diabetes was higher than the other transition probabilities. Based on a long-term evaluation of patterns of changes in obesity indices, our results reemphasized the values of all five obesity indices in clinical settings for identifying high-risk prediabetic subjects for developing diabetes in future and the need for more effective obesity prevention strategies.

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