2001 Feb 12,. [Medline]. J Clin Neurosci. Trends in hospitalization associated with traumatic brain injury. [Medline]. J Neurotrauma. 2017 Mar;52(3):175-185. doi: 10.4085/1062-6050-52.1.15. This review concentrates primarily on current developments in the diagnosis and management of closed head injuries in adults. Head injury can be either closed or open (penetrating). 15(2):783-91. 2015 Nov-Dec. 24 (6):1045-50. [Medline]. Gusmao SN, Pittella JE. 2008 Sep. 207(3):398-406. Effect of marijuana use on outcomes in traumatic brain injury. Traumatic brain injury (TBI) is a nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or … 2007. 2000 Sep. 49(3):404-10. Mauritz W, Leitgeb J, Wilbacher I, et al. Children may be more likely to have a minor head injury because they have high energy levels and little sense of … Cogn Behav Neurol. The Brain Trauma Foundation, The American Association of Neurological Surgeons, The Joint Section on Neurotrauma and Critical Care. 111(1062):99-101. What is a minor head injury? Top Magn Reson Imaging. White H, Cook D, Venkatesh B. Acta Neurochir (Wien). [Medline]. Haig AJ, Ruess JM. Haider AH, Efron DT, Haut ER, DiRusso SM, Sullivan T, Cornwell EE 3rd. 1989 Sep. 29(9):1273-5. Cerebral salt wasting syndrome in brain injury patients: a potential cause of hyponatremia. Zhao H, Bai XJ. Melatonin as a free radical scavenger in experimental head trauma. [Medline]. Evaluating the role of botulinum toxin in the management of focal hypertonia in adults. Brain Trauma Foundation. One year outcome in mild to moderate head injury: the predictive value of acute injury characteristics related to complaints and return to work. Neurochem Res. 1996 Aug 21. [Medline]. [Medline]. Bruce DA, Alavi A, Bilaniuk L, et al. 2014 Jul 2. Br J Sports Med. 630:241-6. [Medline]. Temkin NR, Anderson GD, Winn HR, Ellenbogen RG, Britz GW, Schuster J. Magnesium sulfate for neuroprotection after traumatic brain injury: a randomised controlled trial. 2007 Mar. Wong DK, Lurie F, Wong LL. Farzanegan GR, Derakhshan N, Khalili H, Ghaffarpasand F, Paydar S. Effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury; a randomized double-blind placebo-controlled clinical trial. Traditionally, a score of 13–15 indicates mild injury, a score of 9-12 indicates moderate injury, and a score of 8 or less indicates severe injury. Feb/2010. 2013 Jun 11. Between 1998 and 2000, the incidence of mild traumatic brain injury was 503 cases per 100,000 persons, with a doubling of this incidence in Native Americans and children. 65:500-1. Patel NY, Hoyt DB, Nakaji P, et al. According to the Centers for Disease Control and Prevention (CDC), more than 50,000 individuals die from traumatic brain injuries each year in the United States. Journal of paediatrics and child health, 2009.  ; hyponatremia may be due to the syndrome of inappropriate antidiuretic hormone (SIADH) or cerebral salt wasting; elevated sodium levels in head injury indicate simple dehydration or diabetes insipidus, Magnesium levels: These are depleted in the acute phases of minor and severe head injuries, Coagulation studies: Including prothrombin time (PT), activated partial thromboplastin time (aPTT), and platelet count; these are important to exclude a coagulopathy, Blood alcohol levels and drug screens: May help to explain subnormal levels of consciousness and cognition in some patients with head trauma, Renal function tests and creatine kinase levels: To help exclude rhabdomyolysis if a crush injury has occurred or marked rigidity is present, Neuron-specific enolase and protein S-100 B: Although earlier studies suggested that elevated serum levels may correlate with persistent cognitive impairment at 6 months in patients with severe or mild head injuries, current opinion considers these tests no longer useful. Timler D, Dworzyński MJ, Szarpak Ł, Gaszyńska E, Dudek K, Gałązkowski R. Head Trauma in Elderly Patients: Mechanisms of Injuries and CT Findings. J Neurol Neurosurg Psychiatry. Neurology. [Medline]. 247(3):179-82. Markianos M, Seretis A, Kotsou S, et al. In patients with mild head injury, a skull fracture markedly increases the chance of significant intracranial injury. 2000 Jul. 1992 Jul-Aug. 6(4):315-9. [Medline]. Shahim P, Linemann T, Inekci D, Karsdal MA, Blennow K, Tegner Y, et al. 74:906-11. [Medline]. [Medline]. The knowledge of the pathophysiology after traumatic head injury is necessary for adequate and patient-oriented treatment. J Trauma. Bullock R, Zauner A, Woodward JJ, et al. Singapore Med J. Use of barbiturates in the control of intracranial hypertension. Lane PL, Skoretz TG, Doig G, et al. Stein TD, Alvarez VE, McKee AC. [Medline]. [Medline]. Bhatt M, Desai J, Mankodi A, Elias M, Wadia N. Posttraumatic akinetic-rigid syndrome resembling Parkinson's disease: a report on three patients. Definition. A double-blind controlled study of methylphenidate treatment in closed head injury. 2018. See Clinical Presentation for more detail. Clipboard, Search History, and several other advanced features are temporarily unavailable. CD000033. [Medline]. Long-term continuously infused intrathecal baclofen for spastic-dystonic hypertonia in traumatic brain injury: 1-year experience. Chin J Traumatol. 1999 Oct. 14(5):435-47. Gessel LM, Fields SK, Collins CL, Dick RW, Comstock RD. J Trauma Acute Care Surg. Adv Clin Exp Med. Lancet. 2012;3:16. doi: 10.4103/2152-7806.92930. [Medline]. Consensus statement on Concussion in Sport 3rd International Conference on Concussion in Sport held in Zurich, November 2008. [Medline]. Sports-related recurrent brain injuries--United States. Sep/2009. Almost twice that many people suffer permanent disability. [Medline]. Arch Phys Med Rehabil. 13 (7):e0200394. 2007 Aug. 14(8):1529-41. Obsessive-compulsive disorder secondary to bilateral frontal damage due to a closed head injury. 1993 Feb. 34(2):216-22. 2000 Nov 7. His scan shows a right acute subdural hematoma with no mass effect. Zubkov AY, Lewis AI, Raila FA, et al. Brain Inj. Mishaps in the workplace (for example, while operating machinery) and firearms also cause head injuries. [Medline]. Following ascertainment of the GCS score, the examination is focused on signs of external trauma, as follows: Bruising or bleeding on the head and scalp and blood in the ear canal or behind the tympanic membranes: May be clues to occult brain injuries, Anosmia: Common; probably caused by the shearing of the olfactory nerves at the cribriform plate Guerra WK, Gaab MR, Dietz H, et al. Büchele G, Rapp K, König HH, Jaensch A, Rothenbacher D, Becker C, et al. Arch Phys Med Rehabil. Feeney JM, Santone E, DiFiori M, Kis L, Jayaraman V, Montgomery SC. Front Aging Neurosci. Asikainen I, Kaste M, Sarna S. Early and late posttraumatic seizures in traumatic brain injury rehabilitation patients: brain injury factors causing late seizures and influence of seizures on long-term outcome. 2006 Jul. [Medline]. The protective effect of cyclosporin A upon N-acetylaspartate and mitochondrial dysfunction following experimental diffuse traumatic brain injury. 1999 Jan. 134(1):14-7. [Medline]. 32 (1):84-90. [Medline]. CJEM. [Medline]. 2016 Sep-Oct. 31 (5):E1-7. J Trauma. Lazaridis C, Robertson CS. Hypothermia for Increased Intracranial Pressure: Is It Dead?. Other symptoms of a minor head injury may include: a mild headache; nausea (feeling sick) mild dizziness; mild blurred vision Rutland-Brown W, Langlois JA, Thomas KE, Xi YL. 1997 Jul 9. Rutgers DR, Toulgoat F, Cazejust J, Fillard P, Lasjaunias P, Ducreux D. White matter abnormalities in mild traumatic brain injury: a diffusion tensor imaging study. Effects of pegorgotein on neurologic outcome of patients with severe head injury. 2006 May. Behav Neurol. 2004 Nov. 44(5):439-50. 2017 Sep. 7 (9):e00791. Why do neuroprotective drugs work in animals but not humans?. [Medline]. Berger-Pelleiter E, Émond M, Lauzier F, Shields JF, Turgeon AF. 2018 Apr 27. Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head Injury causes damage to the brain. Am Surg. Halpern CH, Reilly PM, Turtz AR, Stein SC. 13 (4):e0195318. J Neurosurg. Neurology. 1992. Belanger HG, Kretzmer T, Yoash-Gantz R, Pickett T, Tupler LA. September 2016; Accessed: September 22, 2016. 2008 Jan 25. Traumatic brain injury-induced excitotoxicity assessed in a controlled cortical impact model. [Medline]. Sullivan PG, Rabchevsky AG, Waldmeier PC, Springer JE. COVID-19 is an emerging, rapidly evolving situation. [Medline]. Brain Inj. Arch Surg. Donepezil in the treatment of cognitive dysfunction associated with traumatic brain injury. 2000 May. [Medline]. Dharap SB, Khandkar AA, Pandey A, Sharma AK. If you do not need to go to hospital, you can usually look after yourself or your child at home. A closed head injury is any injury that doesn’t break your skull. [Medline]. Saline or Albumin for Fluid Resuscitation in Patients with Traumatic Brain Injury. A randomized, placebo-controlled trial. 90 (20):e1780-e1788. 2011 Nov. 39(11):2331-7. | Cassidy JD, Carroll LJ, Peloso PM, Borg J, von Holst H, Holm L. Incidence, risk factors and prevention of mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. 12(2):123-6. [Medline]. 1998 Jun. Minor head injury: 13 is an unlucky number. 319(5862):406-8. Neurology. 2000 Jul. J Neurosurg. Joseph Carcione, Jr, DO, MBA Consultant in Neurology and Medical Acupuncture, Medical Management and Organizational Consulting, Central Westchester Neuromuscular Care, PC; Medical Director, Oxford Health Plans [Medline]. Criteria for medical treatment. 1999 Oct. 91(4):588-92. 70(4):530-3. Available at http://www.medscape.com/viewarticle/778999. Posttraumatic epilepsy risk factors: one-year prospective study after head injury. Am Surg. Khateb A, Ammann J, Annoni JM, Diserens K. Cognition-enhancing effects of donepezil in traumatic brain injury. [Medline]. The acute period of recovery from traumatic brain injury: posttraumatic amnesia or posttraumatic confusional state?. Medicine (Baltimore). 113 (21):365-72. 2011 Feb. 10(2):131-9.  This test reportedly identifies 98% of patients with abnormal head CT scans. 80(4):675-80. Epilepsia. Traumatic brain injury usually results from a violent blow or jolt to the head or body. Sakellaris G, Nasis G, Kotsiou M, Tamiolaki M, Charissis G, Evangeliou A. Neuroreport. 1999 Dec. 14(6):602-15. The Association Between Apolipoprotein E and Functional Outcome After Traumatic Brain Injury: A Meta-Analysis. Effects of methylphenidate on attentional function after traumatic brain injury. 54(2):340-5. Epidemiology of Sport-Related Concussions in High School Athletes: National Athletic Treatment, Injury and Outcomes Network (NATION), 2011-2012 Through 2013-2014. Lancet Neurol. Of these, more than 80% only have a minor injury. Røe C, Skandsen T, Manskow U, Ader T, Anke A. Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted. Since it is closed, the extent of the injury cannot be identified immediately by the naked eye. Accordingly, another recent study reported that death and increased disability outcomes correlated with the durations of both systemic hypotension and elevated intracranial pressures. 2018. Jordan BD, Relkin NR, Ravdin LD, et al. The use of amyloid precursor protein staining has resulted in increased recognition of this form of injury. Keenan HT, Brundage SI, Thompson DC, et al. [Medline]. Towne AR, Waterhouse EJ, Boggs JG, et al. NIH 14(2):223-30. J Neurosurg. 2001 Feb 22. Demonstration of massive traumatic brain swelling within 20 minutes after injury. Rates of TBI-related Emergency Department Visits, Hospitalizations, and Deaths--United States, 2001-2010. J Head Trauma Rehabil. 1996 Apr. Abnormal postresuscitation pupillary reactivity: Correl… MMWR Surveill Summ. 69(1):15-23. Arch Phys Med Rehabil. Hall JR, Reyes HM, Horvat M, et al. Lack of effect of induction of hypothermia after acute brain injury.  These failures have prompted development of more complex models of neuronal injury and cell death. 48(3):367-74; discussion 374-5. March 2003 The worst injuries can lead to permanent brain damage or death. Epub 2012 Feb 15. Centers for Disease Control and Prevention. 32(4-5):905-15. Nguyen BM, Kim D, Bricker S, Bongard F, Neville A, Putnam B, et al. Thomas KE, Stevens JA, Sarmiento K, Wald MM. 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