traumatic brain injury case report male patient

CASE REPORT: In this case report, we demonstrate the unanticipated recovery of a 28-year-old male patient who presented with a severe traumatic brain injury after being in a motorcycle accident without wearing a helmet. He presented with several exam and imaging findings that are statistically associated with increased mortality and morbidity.

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Is there variability among patients with severe traumatic brain injuries?

The care of severe traumatic brain injuries is challenging and dynamic. This case highlights the unexpected recovery of a patient and serves as a reminder that there is variability among patients. MeSH Keywords: Brain Injuries, Clostridium difficile, Glasgow Coma Scale, Intracranial Pressure, Saline Solution, Hypertonic Background

What happened to the 29 year old man with traumatic brain injury?

A 29-year-old man presented to a major trauma centre with traumatic brain injury. Following cranial decompression, the patient was admitted to the intensive care unit for medical management and monitoring. This case report reviews the evidence for the management of traumatic brain injury.

How many traumatic brain injuries occur each year?

Literature Review: The Brain Injury Association of America notes that 1-5 million traumatic brain injuries are sustained annually (Morkides, 2009.) Each year, traumatic brain injuries (TBI) contribute to a substantial number of deaths and cases of permanent disability.

Which CT characteristics predict poor outcome after traumatic brain injury?

The model which provided the most accurate prediction of poor outcome included age, hypotension and three different CT characteristics, subarachnoid blood, intracerebral haematoma or intracerebral contusion (accuracy 72.5%). Traumatic brain injury (TBI) is a leading cause of death and disability among persons in the United States.

Is TBI more common in males or females?

Epidemiological data suggest that men are approximately 40% more likely to suffer a TBI compared with women in the general adult population, although the sex difference disappears above 75 years of age.

Is TBI more common in males?

Men have a higher incidence of TBI than women, particularly during young adulthood. Hospitalization rates between men and women even out in older adulthood as injury rates become similar. Men more often leave hospital after admission against medical advice.

What are the 4 types of traumatic brain injuries?

Types of TBIsConcussions.Contusions.Penetrating injuries.Anoxic brain injuries.

What are some examples of traumatic brain injuries?

Some examples of traumatic brain injuries, include:Concussion. Concussions are one of the more common traumatic brain injuries. ... Edema. ... Diffuse Axonal Injury. ... Hematoma. ... Skull Fracture. ... Hemorrhage. ... Hypoxic/anoxic Brain Injury. ... Stroke.

Are boys and girls that different an analysis of traumatic brain injury in children?

Falls were the leading cause of TBI in children (56% in total) with higher rates in girls (66%) than boys (51%). Boys were more likely to be injured on the roads (30% of all boys injured) or by being struck by or against an object (17% of all boys' injuries).

Who is most affected by TBI?

TBI is the leading cause of death and disability in children and adults ages 1 to 44. Populations that are most affected are youth and elderly who have falls. Each year about 2.5 million individuals have TBIs of which approximately 50,000 result in death, and over 80,000 suffer permanent disability.

What are the 7 types of TBI?

Types of Traumatic Brain InjuryConcussions. Concussions are the most common type of traumatic brain injury. ... Contusions. These often accompany concussions. ... Brain Hemorrhages. ... Intracranial Hematomas. ... Coup-Contrecoup Brain Injury. ... Diffuse Axonal Injury (DAI) ... Penetrating Brain Injury. ... Second Impact Syndrome.

Is TBI serious?

Symptoms of a TBI can be mild, moderate, or severe. Concussions are a type of mild TBI. The effects of a concussion can sometimes be serious, but most people completely recover in time. More severe TBI can lead to serious physical and psychological symptoms, coma, and even death.

What are 3 types of brain injuries?

What are the different types of TBI?Closed brain injury. Closed brain injuries happen when there is a nonpenetrating injury to the brain with no break in the skull. ... Penetrating brain injury. Penetrating, or open head injuries happen when there is a break in the skull, such as when a bullet pierces the brain.

What are the two types of brain injury?

There are two types of acquired brain injury: traumatic and non-traumatic. A traumatic brain injury (TBI) is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force. Traumatic impact injuries can be defined as closed (or non-penetrating) or open (penetrating) .

What are the two types of head injury?

Head injuries may be either closed or open. A closed head injury is any injury that doesn't break your skull. An open (penetrating) head injury is one in which something breaks your scalp and skull and enters your brain.

How does brain damage affect a person?

The physical effects of brain injury are wide ranging but can include fatigue, sleep issues, headaches, dizziness and hearing problems. These physical effects can have an impact on your quality of life and make it harder to complete every day activities.

What is the cause of death in RTA?

Road traffic accidents (RTAs) are a common cause of untimely death, particularly of youth. RTA mortality and morbidity are predominantly associated with trauma to the brain tissue resulting in traumatic brain injury (TBI). The Glasgow Coma Scale (GCS) is commonly employed to predict the prognosis of such cases at the time of hospital admission. A lower GCS score is invariably found to be associated with poor prognosis, often resulting in death or severely com-promised recovery. A 17-year-old male suffering from TBI due to a RTA was treated with Ayurveda after initially been kept under modern neurological care. The whole course of Ayurvedic therapy began 2 weeks after the initial trauma, continued for about 3 months, and resulted in coma reversal with near complete recovery. This case is one among few reports describing a complete recovery despite presence of bad prognostic predictors in TBI. This is the first such case reported where Ayurveda was used as the intervention in case of TBI, resulting in coma reversal and near complete recovery of neurological deficits. © 2019 S. Karger AG, Basel.

Is TBI a challenging disease?

Background: Traumatic brain injury remains a challenging and complicated disease process to care for, despite the advance of technology used to monitor and guide treatment. Currently, the mainstay of treatment is aimed at limiting secondary brain injury, with the help of multiple specialties in a critical care setting. Prognosis after TBI is often even more challenging than the treatment itself, although there are various exam and imaging findings that are associated with poor outcome. These findings are important because they can be used to guide families and loved ones when making decisions about goals of care. Case report: In this case report, we demonstrate the unanticipated recovery of a 28-year-old male patient who presented with a severe traumatic brain injury after being in a motorcycle accident without wearing a helmet. He presented with several exam and imaging findings that are statistically associated with increased mortality and morbidity. Conclusions: The care of severe traumatic brain injuries is challenging and dynamic. This case highlights the unexpected recovery of a patient and serves as a reminder that there is variability among patients.

What is a mild traumatic brain injury?

A mild traumatic brain injury or a concussion represents the majority of all traumatic brain injuries. The consequences show on physical, cognitive, and emotional functioning and even though the injury classifies as mild, it can have a significant effect on a patient, patient’s family and their quality of life. Defects are often overlooked as objective clinical methods are lacking. Neuropsychological evaluation can aid in appraisal of the defect magnitude and determine factors that influence the outcome of the injured. The following case report addresses the importance of neuropsychological evaluation in treating cognitive defects along with the Cognitive Behavioral therapy approach toward emotional and behavioral disorders treatment in mild traumatic brain injury. It has been shown how important it is to find possible causes for slow recovery. The annuity tendencies have been noted as an important factor for prolongation of the post-concussion syndrome. We can detect the symptom simulation with appropriate psychological instruments. Described is a case of 38-year-old man who suffered a mild traumatic brain injury.

What are the symptoms of a mild TBI?

The most common symptoms are a headache, dizziness, nausea, memory problems, fatigue, irritability, anxiety, insomnia, concentration difficulties, and light and sound sensitivity [15]. Occurrence and perseverance of the cognitive symptoms after a mild TBI significantly influence the reintegration to the professional, academic and social activities [16]. Despite the classification of the injury as “mild”, the consequences can be persistent and persevering. The possible cognitive deficits that occur post-trauma express in form of attention, concentration, processing speed, memory, and executive functioning problems [17,18]. In acute phase of the injury brain’s metabolic activity changes and perfusions most commonly occur in the prefrontal cortex, reflecting on the impaired executive functioning [19]. The expected cognitive symptoms rehabilitation takes from one week to 6 months whereas young athletes recover significantly faster [20]. At this point it is not clear whether persisting cognitive symptoms come from the pathophysiological background of the injury or from other factors that could also influence cognitive functioning; for instance pain, fatigue, drugs, sleeping, pre-morbid personality factors, legal claims, psychological factors or emotional disturbances [21,22]. The cognitive sump-toms directly linked to the injury typically do not deteriorate with time. When the cognitive functioning problems persist after 3 months, a neuropsychological evaluation is recommended.

What is symptom simulation?

The symptom simulation is an intentional reporting of false or exaggerated physical and/or psychological symptoms. The motives are usually externally motivated by avoiding military duties, avoiding work, gaining financial benefits, annuity, avoiding prosecution or other legal procedures, gaining drugs or merely to draw attention and compassion of others [42]. Binder and colleagues [42] reported a meta-analysis of 17 studies where investigation of 2353 patients showed that one of the significant risk factors for long-term impairment, symptom presence, and objective clinical signs after a mild TBI is involvement in the legal claims. Similar findings were reported in a Cassidy and colleagues [1] study of patients injured in motor vehicle accidents. The assessment of the simulation probability in the neuropsychological testing varies from 5-50% or more [43,44]. The variance in simulation detection results from the evaluation procedure, nature of the referral, and definition or determination of either simulation, somatization, or conversion disorder. The differentiation can be difficult as the symptoms often overlap. In all of the above cases, we face the discrepancy between medical results and patient’s complaint and the objective signs and subjective symptoms [45].

What is the best treatment for TBI?

It includes support and problem solving strategies in addition to formal approach to psychotherapy. Cognitive Behavioral Therapy (C BT) is recommended for long lasting problems after a mild TBI [46] and post-concussion syndrome in general, for treating PTSD and improving coping in stressful situations after the injury. Past experiences in CBT and patients with mild TBI generated models professionals can follow in order to treat most common symptoms associated with PCS including depression, anxiety, sleep problems, chronic fatigue, and chronic pain.

What are the symptoms of a post-concussion?

It is generally noticed that post-concussion symptoms along with a headache, dizziness and attention deficits result from neurophysiological influences. However, the persistent and long-term symptoms are harder to explain. The pre-injury and post-injury psychological factors significantly influence the persistence and exaggeration of the symptoms. Stressful life events, poor coping strategies, depression and individual fragility influence the psycho-genesis of the post-concussion syndrome, though concrete and objective evidence are limited [23-25].

Is a mild TBI a neurologic condition?

It is generally accepted that acute physical and cognitive symptoms have underlying neurophysiological causes whereas, long lasting symptoms of the mild TBI are often seen as a consequence of premorbid emotional and personality factors, current emotional state, stress, secondary benefits or the influence of the iatrogenic effects.

What is the cause of traumatic brain injury?

A TBI is caused by a bump, blow or jolt to the head, or a penetrating head injury, that disrupts the normal function of the brain.

How severe is a TBI?

The severity of a TBI may range from “mild” (e.g. concussion), to “severe” (e.g. involving midline shift), based upon variables such as duration of loss of consciousness and/or duration of post-traumatic amnesia.

How long does it take for a TBI patient to become depressed?

Endocrinological research and clinical practice in the treatment of TBI indicates that ½ or more of patients referred for treatment become clinically depressed within one year post-injury.

When did neurofeedback end?

Neurofeedback began on November 7, 2014 and was terminated on September 11, 2015 (after roughly 10 consecutive months). A total of 36 sessions using five different protocols involving single-channel Monopolar and two-channel Bipolar protocols were used during the course of her neurofeedback training. The patient’s overall progress ranged from good to excellent, and her self-report indicated that all symptoms had improved. The patient was encouraged to practice diaphragmatic breathing multiple times per day.