Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000071.xml
Download PDF
Semin Neurol 2014; 34(05): 572-583
DOI: 10.1055/s-0034-1396010
DOI: 10.1055/s-0034-1396010
Moderate-to-Severe Traumatic Brain Injury
Further Information
Publication History
Publication Date:
17 December 2014 (online)
Abstract
Managing patients with moderate-to-severe traumatic brain injury (TBI), particularly those with combat-related blast injury, is exceptionally challenging. Optimal care requires the coordinated efforts of numerous providers, contributing to an interdisciplinary team. Given the complexities of TBI and the variety of physiologic, physical, cognitive, behavioral, and emotional manifestations of the injury, a holistic approach to patient care is needed throughout the entire continuum of care. In this article, the authors provide an overview of how interdisciplinary care is provided from the acute to the chronic settings, and illustrate the important role that rehabilitation plays throughout the continuum of care in facilitating maximizing recovery, functional independence, and quality of life. Common conditions associated with TBI are illustrated through a case presentation of an individual with blast-related polytrauma and help to frame a more detailed discussion of subtopics including neurointensive care, posttraumatic seizures, venous thromboembolic disease prevention, spasticity management, vestibular disorders, endocrine dysfunction, and psychological trauma.
-
References
- 1 Coronado VG, Xu L, Basavaraju SV , et al; Centers for Disease Control and Prevention
(CDC). Surveillance for traumatic brain injury-related deaths—United States, 1997-2007.
MMWR Surveill Summ 2011; 60 (5) 1-32
MissingFormLabel
- 2 Faul M, Xu L, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Deaths, 2002–2006. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010
- 3 Coronado VG, McGuire LC, Faul M, Sugerman DE, Pearson WS. Traumatic brain injury epidemiology and public health issues. In: Zasler ND, Katz DI, Zafonte RD, , eds. Brain Injury Medicine: Principles and Practice. 2nd ed. New York, NY: Demos Medical Publishing; 2003: 84-100
- 4 Chairman of the Joint Chiefs of Staff. Memorandum D-T (DTM) 09–013, Registration of architecture descriptions in the DoD architecture registry system (DARS), Change 2. Washington, DC: Office of the Assistant Secretary of Defense. ; December 18, 2009
- 5 Jaffee MS, Helmick KM, Girard PD, Meyer KS, Dinegar K, George K. Acute clinical care and care coordination for traumatic brain injury within Department of Defense. J Rehabil Res Dev 2009; 46 (6) 655-666
- 6 Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med 2008; 358 (5) 453-463
- 7 U.S. Department of Defense. DoD numbers for traumatic brain injury. Available at: http://dvbic.dcoe.mil/sites/default/files/uploads/Worldwide%20Totals%202000-2014Q1.pdf . Accessed May 7, 2014
- 8 Belmont Jr PJ, McCriskin BJ, Sieg RN, Burks R, Schoenfeld AJ. Combat wounds in Iraq and Afghanistan from 2005 to 2009. J Trauma Acute Care Surg 2012; 73 (1) 3-12
- 9 Pugh MJ, Finley EP, Copeland LA , et al. Complex comorbidity clusters in OEF/OIF veterans: the polytrauma clinical triad and beyond. Med Care 2014; 52 (2) 172-181
- 10 Wells TS, Miller SC, Adler AB, Engel CC, Smith TC, Fairbank JA. Mental health impact of the Iraq and Afghanistan conflicts: a review of US research, service provision, and programmatic responses. Int Rev Psychiatry 2011; 23 (2) 144-152
- 11 Knuth T, Letarte PB, Geoffrey L , et al. Guidelines for the field management of combat-related head trauma. New York, NY: Brain Trauma Foundation; 2005
- 12 NAEMT, and American College of Surgeons Committee on Trauma. Head trauma. In: PHTLS Prehospital Trauma Life Support, Military Version. 7th ed. St. Louis, MO: Mosby Elsevier; 2011: 216-244
- 13 Badjatia N , et al. Guidelines for prehospital management of traumatic brain injury 2nd ed. Prehosp Emerg Care 2008; 12 (Suppl. 01) S1-S52
- 14 Chesnut RM, Marshall LF, Klauber MR , et al. The role of secondary brain injury in determining outcome from severe head injury. J Trauma 1993; 34 (2) 216-222
- 15 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. XIV. Hyperventilation. J Neurotrauma 2007; 24 (Suppl. 01) S87-S90
- 16 Robertson C. Every breath you take: hyperventilation and intracranial pressure. Cleve Clin J Med 2004; 71 (Suppl. 01) S14-S15
- 17 Robertson Jr CH, Pagel MA, Johnson Jr RL. The distribution of blood flow, oxygen consumption, and work output among the respiratory muscles during unobstructed hyperventilation. J Clin Invest 1977; 59 (1) 43-50
- 18 Coles JP, Fryer TD, Coleman MR , et al. Hyperventilation following head injury: effect on ischemic burden and cerebral oxidative metabolism. Crit Care Med 2007; 35 (2) 568-578
- 19 Koenig MA, Bryan M, Lewin III JL, Mirski MA, Geocadin RG, Stevens RD. Reversal of transtentorial herniation with hypertonic saline. Neurology 2008; 70 (13) 1023-1029
- 20 The Brain Trauma Foundation. The American Association of Neurological Surgeons. Guidelines for the management of severe traumatic brain injury. J Neurotrauma 2007; 24 (Suppl. 01) S1-S106
- 21 Ling GS, Ecklund JM. Traumatic brain injury in modern war. Curr Opin Anaesthesiol 2011; 24 (2) 124-130
- 22 Ling GS, Marshall SA, Moore DF. Diagnosis and management of traumatic brain injury. Continuum (Minneap Minn) 2010; 16 (6 Traumatic Brain Injury) 27-40
- 23 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. IX. Cerebral perfusion thresholds. J Neurotrauma 2007; 24 (Suppl. 01) S59-S64
- 24 Ling GS, Neal CJ. Maintaining cerebral perfusion pressure is a worthy clinical goal. Neurocrit Care 2005; 2 (1) 75-81
- 25 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. VII. Intracranial pressure monitoring technology. J Neurotrauma 2007; 24 (Suppl. 01) S45-S54
- 26 Frattalone AR, Ling GS. Moderate and severe traumatic brain injury: pathophysiology and management. Neurosurg Clin N Am 2013; 24 (3) 309-319
- 27 Suarez JI. Hypertonic saline for cerebral edema and elevated intracranial pressure. Cleve Clin J Med 2004; 71 (Suppl. 01) S9-S13
- 28 Kim Y-I, Park S-W, Nam T-K, Park Y-S, Min B-K, Hwang S-N. The effect of barbiturate coma therapy for the patients with severe intracranial hypertension: a 10-year experience. J Korean Neurosurg Soc 2008; 44 (3) 141-145
- 29 Lee MW, Deppe SA, Sipperly ME, Barrette RR, Thompson DR. The efficacy of barbiturate coma in the management of uncontrolled intracranial hypertension following neurosurgical trauma. J Neurotrauma 1994; 11 (3) 325-331
- 30 Cooper DJ, Rosenfeld JV, Murray L , et al; DECRA Trial Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group. Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med 2011; 364 (16) 1493-1502
- 31 Bell RS, Mossop CM, Dirks MS , et al. Early decompressive craniectomy for severe penetrating and closed head injury during wartime. Neurosurg Focus 2010; 28 (5) E1
- 32 Ragel BT, Klimo Jr P, Martin JE, Teff RJ, Bakken HE, Armonda RA. Wartime decompressive craniectomy: technique and lessons learned. Neurosurg Focus 2010; 28 (5) E2
- 33 Clifton GL, Miller ER, Choi SC , et al. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 2001; 344 (8) 556-563
- 34 Jiang JY, Xu W, Li WP , et al. Effect of long-term mild hypothermia or short-term mild hypothermia on outcome of patients with severe traumatic brain injury. J Cereb Blood Flow Metab 2006; 26 (6) 771-776
- 35 Criteria for diagnosis of Guillain-Barré syndrome. Ann Neurol 1978; 3 (6) 565-566
- 36 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. III. Prophylactic hypothermia. J Neurotrauma 2007; 24 (Suppl. 01) S21-S25
- 37 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. XV. Steroids. J Neurotrauma 2007; 24 (Suppl. 01) S91-S95
- 38 Eerdman J, Oria M, Pillsbury L , Eds. Nutrition and Traumatic Brain Injury. Washington, DC: National Academies Press; 2011
- 39 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. XII. Nutrition. J Neurotrauma 2007; 24 (Suppl. 01) S77-S82
- 40 Daley RJ, Rebuck JA, Welage LS, Rogers FB. Prevention of stress ulceration: current trends in critical care. Crit Care Med 2004; 32 (10) 2008-2013
- 41 Ament PW, Dicola DB, James ME. Reducing adverse effects of proton pump inhibitors. Am Fam Physician 2012; 86 (1) 66-70
- 42 Englander J, Bushnik T, Duong TT , et al. Analyzing risk factors for late posttraumatic seizures: a prospective, multicenter investigation. Arch Phys Med Rehabil 2003; 84 (3) 365-373
- 43 Cuccurullo SJ. Traumatic Brain Injury, Physical Medicine and Rehabilitation Board Review. 2nd ed. New York, NY: Demos Medical; 2010: 71-93
- 44 Braddon RL. Traumatic Brain Injury, Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier Saunders; 2011: 1133-1165
- 45 Wagner AK, Miller MA, Scanlon J, Ren D, Kochanek PM, Conley YP. Adenosine A1 receptor gene variants associated with post-traumatic seizures after severe TBI. Epilepsy Res 2010; 90 (3) 259-272
- 46 Ben-Menachem E. Is prolactin a clinically useful measure of epilepsy?. Epilepsy Curr 2006; 6 (3) 78-79
- 47 Temkin NR, Dikmen SS, Wilensky AJ, Keihm J, Chabal S, Winn HR. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. [see comments] N Engl J Med 1990; 323 (8) 497-502
- 48 Temkin NR, Dikmen SS, Anderson GD , et al. Valproate therapy for prevention of posttraumatic seizures: a randomized trial. J Neurosurg 1999; 91 (4) 593-600
- 49 Kirmani BF, Mungall D, Ling G. Role of intravenous levetiracetam in seizure prophylaxis of severe traumatic brain injury patients. Front Neurol 2013; 4: 170
- 50 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. XIII. Antiseizure prophylaxis. J Neurotrauma 2007; 24 (Suppl. 01) S83-S86
- 51 De Luca R, Calabrò RS, Gervasi G , et al. Is computer-assisted training effective in improving rehabilitative outcomes after brain injury? A case-control hospital-based study. Disabil Health J 2014; 7 (3) 356-360
- 52 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. V. Deep vein thrombosis prophylaxis. J Neurotrauma 2007; 24 (Suppl. 01) S32-S36
- 53 Lin M, Davis JV, Wong DT. Evaluation of heparin prophylaxis protocol on deep venous thrombosis and pulmonary embolism in traumatic brain injury. Am Surg 2013; 79 (10) 1050-1053
- 54 Phelan HA. Pharmacologic venous thromboembolism prophylaxis after traumatic brain injury: a critical literature review. J Neurotrauma 2012; 29 (10) 1821-1828
- 55 Phelan HA, Wolf SE, Norwood SH , et al. A randomized, double-blinded, placebo-controlled pilot trial of anticoagulation in low-risk traumatic brain injury: The Delayed Versus Early Enoxaparin Prophylaxis I (DEEP I) study. J Trauma Acute Care Surg 2012; 73 (6) 1434-1441
- 56 Kanaan AO, Silva MA, Donovan JL, Roy T, Al-Homsi AS. Meta-analysis of venous thromboembolism prophylaxis in medically ill patients. Clin Ther 2007; 29 (11) 2395-2405
- 57 Cowen TD, Meythaler JM, DeVivo MJ, Ivie III CS, Lebow J, Novack TA. Influence of early variables in traumatic brain injury on functional independence measure scores and rehabilitation length of stay and charges. Arch Phys Med Rehabil 1995; 76 (9) 797-803
- 58 Hawkins ML, Lewis FD, Medeiros RS. Impact of length of stay on functional outcomes of TBI patients. Am Surg 2005; 71 (11) 920-929 , discussion 929–930
- 59 Rancho Los Amigos Scale AKA Level of Cognitive Functioning Scale. Available at: http://www.tbims.org/combi/lcfs/lcfs.pdf . Accessed June 22, 2014
- 60 Bondi CO, Klitsch KC, Leary JB, Kline AE. Environmental enrichment as a viable neurorehabilitation strategy for experimental traumatic brain injury. J Neurotrauma 2014; 31 (10) 873-888
- 61 Gomes da Silva S, Unsain N, Mascó DH , et al. Early exercise promotes positive hippocampal plasticity and improves spatial memory in the adult life of rats. Hippocampus 2012; 22 (2) 347-358
- 62 Griesbach GS. Exercise after traumatic brain injury: is it a double-edged sword?. PM R 2011; 3 (6) (Suppl. 01) S64-S72
- 63 Kozlowski DA, Leasure JL, Schallert T. The control of movement following traumatic brain injury. Compr Physiol 2013; 3 (1) 121-139
- 64 Alfieri KA, Forsberg JA, Potter BK. Blast injuries and heterotopic ossification. Bone Joint Res 2012; 1 (8) 192-197
- 65 Chandrasekhar SS. The assessment of balance and dizziness in the TBI patient. NeuroRehabilitation 2013; 32 (3) 445-454
- 66 Isaacson BM, Swanson TM, Pasquina PF. The use of a computer-assisted rehabilitation environment (CAREN) for enhancing wounded warrior rehabilitation regimens. J Spinal Cord Med 2013; 36 (4) 296-299
- 67 Behan LA, Phillips J, Thompson CJ, Agha A. Neuroendocrine disorders after traumatic brain injury. J Neurol Neurosurg Psychiatry 2008; 79 (7) 753-759
- 68 Bondanelli M, Ambrosio MR, Zatelli MC, De Marinis L, degli Uberti EC. Hypopituitarism after traumatic brain injury. Eur J Endocrinol 2005; 152 (5) 679-691
- 69 Kreitschmann-Andermahr I, Poll EM, Reineke A , et al. Growth hormone deficient patients after traumatic brain injury—baseline characteristics and benefits after growth hormone replacement—an analysis of the German KIMS database. Growth Horm IGF Res 2008; 18 (6) 472-478
- 70 Alphonso AL, Monson BT, Zeher MJ , et al. Use of a virtual integrated environment in prosthetic limb development and phantom limb pain. Stud Health Technol Inform 2012; 181: 305-309
- 71 Hudak AM, Hynan LS, Harper CR, Diaz-Arrastia R. Association of depressive symptoms with functional outcome after traumatic brain injury. J Head Trauma Rehabil 2012; 27 (2) 87-98
- 72 Jorge RE, Robinson RG, Moser D, Tateno A, Crespo-Facorro B, Arndt S. Major depression following traumatic brain injury. Arch Gen Psychiatry 2004; 61 (1) 42-50
- 73 Rapoport MJ, Chan F, Lanctot K, Herrmann N, McCullagh S, Feinstein A. An open-label study of citalopram for major depression following traumatic brain injury. J Psychopharmacol 2008; 22 (8) 860-864
- 74 Fann JR, Uomoto JM, Katon WJ. Sertaline in the treatment of major depression following mild traumatic brain injury. Psychosomatics 2001; 42: 48-54