Thanks Richard Forrest 1.Postconcussion Syndrome ◦ A cluster of symptoms which can appear immediately following or after several days or weeks after mild TBI. Up to 50% of patients discharged from the emergency department with minor head injury will develop postconcussive syndrome within 1 month of injury (Bazarian, et al 2000). Manifestations can range from transient, mild symptoms to ongoing disabling problems (Kushner, 1998). ◦Risk factors include female gender, poor social support, elevated self-reported depressive symptoms at 1-month postinjury, and injuries caused by motor vehicle accidents or assaults. Comorbidities include concurrent diagnosis of major depressive disorder and/or posttraumatic stress disorder (McCauley, et al 2001) ◦ Repeated mild brain injuries that occur over an extended period of time, such as months or years, can result in cumulative neurologic and cognitive deficits. Repeated mild brain injuries that occur within a short period of time, such as hours, days, or weeks -- while an individual is still symptomatic from an earlier injury -- are termed "second impact syndrome", result in loss of cerebrovascular autoregulation and progressive cerebral edema, and can be catastrophic or fatal (Anon., 1997; Kushner, 1998). ◦ Symptoms include: ◾ Posttraumatic headaches, the most common symptom, which usually resolve with time, but may take up to one year to resolve ◾ Dizziness/light headedness ◾ Sensitivity to noise and light ◾ Anxiety/irritability ◾ Depression ◾ Fatigue, insomnia, drowsiness; fatigue may be due to sleep disturbances, which are relatively common following TBI and include difficulty sleeping, waking up too early, sleeping more than usual, and problems falling asleep (Clinchot, et al 1998). The Pittsburgh Sleep Quality Index is a valid and useful screening tool for assessing insomnia among postacute TBI patients (Fictenberg, et al 2001) ◾ Nausea/vomiting ◾ Confusion, signs of which include a vacant stare, disorientation, delayed verbal or motor responses, and concentration/attention problems
Posted on: Sun, 04 Aug 2013 12:59:49 +0000