Traumatic Brain Injury Blog

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Tagged with “Mild Traumatic Brain Injury”

February 8, 2023

Harvard Medical School Researchers find that TBI Increases Risk of Cardiovascular, Endocrine, Neurological and Psychiatric Disorders in all Patients

A recent study published in JAMA Network Open finds that patients with a history of traumatic brain injury (TBI), including mild TBI (mTBI), are at significantly greater risk of developing chronic cardiovascular, endocrine, neurological and psychiatric disorders. This proved to be true in all age groups, including younger adults (18-40).

This study is important because, as the authors note, “the risks of incident comorbidities in previously healthy patients who sustained mTBI and msTBI (moderate-severe TBI) has not previously been reported.” The most important takeaway of the study is that “patients with TBI in all age groups may benefit from a proactive targeted screening program for chronic multisystem diseases, particularly cardiometabolic diseases.” Read More

October 19, 2022

Major study finds that a majority of patients seen in the ER with mild TBI do not fully recover within 6 months, highlighting the importance of follow-up care

As highlighted in prior posts in this blog, TBI research increasingly highlights the importance of providing follow-up care to patients discharged from the ER with a diagnosis of TBI. Put simply, patients with follow up care have better outcomes.

In August, 2022 JAMA Network Open (an American Medical Association journal) published the results of a large cohort study following patients discharged from emergency rooms with the mildest form of traumatic brain injury, patients with a Glasgow Coma score of 15 (the best possible score) and negative head CT scans. The study tracked 991 TBI patients meeting these criteria seen in 18 different level 1 trauma centers. (Participants met the American College of Rehabilitation Medicine definition for TBI.) Read More

July 7, 2022

Early Mental Health Intervention Improves TBI Outcomes

Victims of mild traumatic brain injury (“mTBI”) commonly report psychological distress, which is not surprising given the impact the injury can have on every aspect of everyday life including but not limited to balance, vision, sleeping, physical discomfort including headaches, and perhaps most significantly thinking clearly. Patients often report that they are not the same person and fear that person will never return.

We often recommend counseling support, but this has been based more on instinct and anecdotal information than on data. In prior posts we have reported on studies showing that depression is a common sequelae of mTBI that should be treated before it becomes disabling.  Read More

April 20, 2022

One in Four Children with Mild Traumatic Brain Injury Suffer from Post-Concussive Symptoms

Israeli study finds that one in four children with mild traumatic brain injury (mTBI) suffer from persistent post-concussive symptoms

In a large multi-center retrospective matched cohort study, Israeli scientists recently found that one in four children (25.3%) who have been discharged from the emergency room after a mild head injury suffered from persistent post- concussive symptoms.

Among the chronic symptoms seen in these children were forgetfulness, memory problems, sensitivity to light and noise, ADHD and even psychological problems. Sadly, many of these children had been misdiagnosed as suffering from unrelated ADHD, sleep disorders, depression, etc.  This misdiagnosis, the researchers noted, leads to treatment that is not suited to the problem, thus causing the children prolonged suffering. Read More

March 1, 2022

Study published by the American Academy of Neurology Finds that Poor Cognitive Outcomes Following Concussion are more Common than Previously Thought

A new study published February 16, 2022 by the American Academy of Neurology in the Journal “Neurology” finds that the frequency of clinically meaningful poor cognitive outcomes one year after a concussion are more common than previously thought.  The results, says study author Raquel Gardner, MD, of the University of California San Francisco, “highlight the need to better understand the mechanisms underlying poor cognitive outcome, even after relatively mild brain injuries, to improve therapy for recovery.” Read More

June 29, 2021

Defense Department Study Finds that Targeted Treatment Improves Chronic Symptoms Following Mild Traumatic Brain Injury

A recent Defense Department/University of Pittsburgh study confirms three important points made in prior posts:

  1. So called “mild” traumatic brain injury (“mTBI”) can have long-term, disabling consequences (in both civilian and military populations);
  2. that this injury is heterogeneous in both presentation and clinical outcome (in other words, every injury is different); and
  3. that interventions targeted to the individual presentation of the injury (whether it is predominantly vestibular, cognitive, oculomotor, headache, sleep or mood related, or some combination) can reduce symptoms in otherwise intractable patients.

The message is that ignoring the symptoms and hoping that they will ultimately disappear – the approach often taken in the past – is not wise for either the individual or for society as a whole. Read More

June 1, 2021

Alzheimer’s Researchers Find “Compelling” Evidence that Mild Traumatic Brain Injuries Increase the Risk of Dementia as much as Diabetes, Hypertension and Obesity

In a peer-reviewed article published in the Journal of Alzheimer’s Disease, 2020;78(2):757-775. doi: 10.3233/JAD-200662, Canadian researcher found that a history of mild traumatic brain injury (mTBI) almost doubled the risk of being diagnosed with dementia and that mTBI was the strongest environmental risk factor for dementia, comparable to health risk factors such as diabetes, hypertension and obesity. Read More

April 8, 2021

Montreal Study Finds Subtle Long-Term Cognitive Effects of a Single Mild Traumatic Brain Injury

Adding to a growing volume of literature on this topic, Montreal researchers published a study in January, 2021 demonstrating that a single mild traumatic brain injury involving late adulthood patients (ages 50-70) leads to subtle, long-term cognitive consequences.

The article, authored by Camille Larson-Dupuis et. al., entitled Subtle long-term cognitive effects of a single mild traumatic brain injury and the impact of a three-month aerobic exercise intervention, was published in The Journal of Sports Medicine and Physical Fitness (2021 January: 61(1): 87-95).  What makes these findings particularly significant is that all participants in the study were exempt from confounding factors sometimes associated with long-term consequences. All participants:

  • had negative scans
  • were symptom-free within three months of their accident (including depression and anxiety)
  • did not present with chronic conditions known as risk factors for cognitive decline (uncontrolled diabetes, uncontrolled high blood pressure or cardiovascular disease)
  • were all well-educated

Read More

May 13, 2020

Emory Study Finds that Underdiagnosis of Mild Traumatic Brain Injury is a Pervasive Problem in the Emergency Setting

An article published in April, 2020 by the American College of Emergency Physicians reports on evidence that underdiagnosis of Mild Traumatic Brain Injury (mTBI) “is a pervasive problem in the emergency setting,” and that even patients who receive a diagnosis are unlikely to receive appropriate discharge education and are therefore at risk of missing opportunities for treatment, referral and improvement in outcomes. Koval et. at., Concussion Care in the Emergency Department: A Prospective Operational Brief Report, Annals of Emergency Medicine 2020 Apr;75(4):483-490. Read More

March 27, 2020

Neuroendocrine issues, often overlooked following TBI, leave patients with unnecessary chronic symptoms

In prior posts I have discussed the growing evidence that traumatic brain injuries, even so-called “mild” traumatic brain injuries (mTBI), can lead to neuroendocrine dysfunction (NED) – most commonly growth hormone (GH) deficiency due to pituitary dysfunction. Although growth hormone deficiency often results in physical symptoms such as loss of lean muscle mass and strength, increased body fat around the waist, and dyslipidemia, other common GH deficiency symptoms overlap with the symptoms of “persistent post-concussion”- such as fatigue, poor memory, anxiety, depression, emotional lability, poor attention and poor concentration.

My earliest post on this issue discussed the August 2012 Department of Defense (DOD) clinical recommendations for screening for neuroendocrine dysfunction in “mild” traumatic brain injury (“mTBI”) cases – where indicative symptoms persist for more than three month or appear within three years. The guidelines contemplated a simple blood test, but subsequent studies, also discussed in this blog, showed that the only reliable means of detecting GH deficiency is provocative testing, which is expensive and takes several hours (the guidelines do suggest further assessment by an endocrinologist, even where the screening test is negative, if symptoms of NED persist.) Read More