Talk:Traumatic brain injury

Sports Related Traumatic Brain Injuries

Sports Related Traumatic Brain Injuries is an orphan (no other articles link to it). Any ideas on integrating this material? ~KvnG 22:47, 24 March 2014 (UTC)

Therapeuic hypothermia

... might actually be good doi:10.1186/cc13835. JFW | T@lk 19:55, 28 April 2014 (UTC)

Moved

All of this was inserted at Neurodevelopmental disorder, and is off-topic there. I am copying it here in case anything can be incorporated here. SandyGeorgia (Talk) 21:28, 27 February 2015 (UTC)

In industrial nations, the most common causes of childhood brain trauma are overwhelmingly falls and transportation-related incidents. Child maltreatment such as shaken baby syndrome can produce neurodevelopmental consequences including blindness, neuromotor deficits and cognitive impairment. According to information published by the American Association of Neurological Surgeons, sports injuries account for 21% of the US incidence, however their site includes transportation-related sports injuries. They assert that cycling produced 64,993 head injuries requiring emergency room visits in 2007 while the second most common cause, football, only produced 36,412.

There are age differences for the effects of traumatic brain injury (TBI) in children due to changes in skull formation. Infants’ skulls are divided into eight separated bones, which can spread during TBI and decrease the cranial pressure and brain swelling. These bones normally fuse by two years of age. In contrast, children are more vulnerable during TBI than adolescents, because they have wider subarachnoid spaces with blood vessels, which can become damaged by the shearing forces.

Psychiatric disorders may worsen or develop de novo in a child following TBI. Statistically about 54% to 63% of children develop novel psychiatric disorders about 24 months after severe TBI, and 10% to 21% after mild or moderate TBI, the most common of which is changes in personality. The symptoms include affective instability, aggression, disinhibited behavior, apathy, and may last for 6 to 24 months on average. Other disorders that may arise are ADHD, PTSD, OCD, anxiety disorder, depressive disorder and mania. Most symptoms decrease between 12 to 24 months. The superior frontal lesions correlate with the type of outcome, but more importantly, subcortical network damage may affect the recovery due to the lesions in white matter tracts.

Studies show that children with severe TBI are affected in intellectual functioning, executive functioning (including speed processing and attention), and verbal immediate and delayed memory with some recovery during the first 2 years post-injury. Such children are at more risk for long term consequences of TBI, because of the crucial developmental stage at which recovery takes place. The dynamics of recovery are correlated with pre-injury adaptive ability and environmental social factors (e.g. family support).

References

Semi-protected edit request on 28 February 2015

I would like to add information to the section "Severity" about the age differences on severity or, perhaps, add a section about "pediatric TBI". It's important to mention about it because there are major differences that take place. Here is information I'd like to be added:

There are age differences for the effects of traumatic brain injury (TBI) in children due to changes in skull formation. Infants’ skulls are divided into eight separated bones, which can spread during TBI and decrease the cranial pressure and brain swelling. These bones normally fuse by two years of age. In contrast, children are more vulnerable during TBI than adolescents, because they have wider subarachnoid spaces with blood vessels, which can become damaged by the shearing forces.

Psychiatric disorders may worsen or develop de novo in a child following TBI. Statistically about 54% to 63% of children develop novel psychiatric disorders about 24 months after severe TBI, and 10% to 21% after mild or moderate TBI, the most common of which is changes in personality. The symptoms include affective instability, aggression, disinhibited behavior, apathy, and may last for 6 to 24 months on average. Other disorders that may arise are ADHD, PTSD, OCD, anxiety disorder, depressive disorder and mania. Most symptoms decrease between 12 to 24 months. The superior frontal lesions correlate with the type of outcome, but more importantly, subcortical network damage may affect the recovery due to the lesions in white matter tracts.

Studies show that children with severe TBI are affected in intellectual functioning, executive functioning (including speed processing and attention), and verbal immediate and delayed memory with some recovery during the first 2 years post-injury. Such children are at more risk for long term consequences of TBI, because of the crucial developmental stage at which recovery takes place.

Ebuglo (talk) 16:48, 28 February 2015 (UTC)

References

Hi, Ebuglo. I've altered your post a bit to add PMIDs to your sources (I hope you don't mind). Your final source, PMID 22271691, is a primary study, so that sentence isn't cited according to WP:MEDRS, but the other sources are recent reviews. I haven't checked your text, but will ping Doc James and Jfdwolff, who are better equipped to determine if the text can be added, and where. Best regards, SandyGeorgia (Talk) 22:59, 28 February 2015 (UTC)

Hi, SandyGeorgia Thank you for checking PMIDs. Indeed, I didn't catch the mistake about the last article. Thus I have deleted the last sentence. Doc James and Jfdwolff , please, let me know if that would be possible to incorporate my added content accordingly. Kind regards. — Preceding unsigned comment added by Ebuglo (talk • contribs) 15:07, March 2, 2015 Ebuglo (talk) 20:08, 2 March 2015 (UTC)

Ebuglo, you can sign your entries by adding four tildes ( ~~~~ ) after them; pinging other editors doesn't always work, and it doesn't work on unsigned entries. I cannot add your proposed text as I don't have full journal access, and this is listed as (not sure it is) a Good Article, so I'd rather have Doc James or Jfdwolff look at the proposed content. SandyGeorgia (Talk) 15:31, 2 March 2015 (UTC)

last paragraph is empty of content, pretty much. affected to what extent, in what kinds of injury? thx. Jytdog (talk) 21:00, 2 March 2015 (UTC)

I apologize for interference. I agree that this content does not quite fit into this page. I found another page with similar content on pediatric trauma. Ebuglo (talk) 18:38, 3 March 2015 (UTC)

i think you are doing great; i should have said that i find the 1st 2 paragraphs fine. The third just doesn't say anything. If you fix that i would support adding this to the article. Jytdog (talk) 18:46, 3 March 2015 (UTC)

Ebuglo Sorry for the delay. I'd say the sources are all very good. The current page doesn't distinguish between adults and children. I'd say a discussion about the longer-term outcomes from (M)TBI is highly relevant. Could you tell us where in the article (i.e. which sections) you would like to make these additions? JFW | T@lk 06:58, 4 March 2015 (UTC)

Reverted new additions as

Concerns include:

1. The references used are mostly more than 20 years old. You will notice that most of the references currently in the article are from the last 10 years.
2. Some of your additions were unreferenced
3. This "An increase in use of helmets could reduce the incidence of TBI" was changed to "An increase in use of helmets could reduce the incidence of TBI as could common use for more casual sports participants or users." I do not understand what this change means?#This has no ref "Traditional sports that are being studied in the 2000s (e.g., monitors on contact and impact) include all physical contact ballsports from high school through professional levels, and long-term effects on professional boxers."
4. We typically use heading per WP:MEDMOS
5. The references added are not formatted for per the other references present in the article
6. We typically keep the lead at 4 paragraphs

Best Doc James (talk · contribs · email) 01:01, 16 May 2015 (UTC)

Unable to find evidence for this ref "O'Keefe, J. (1994). Long term services and supports for persons with traumatic brain injuries. Journal of Head Trauma Rehabilitation, 9(2): 42-60."

Trimmed some primary sources. Doc James (talk · contribs · email) 12:18, 17 May 2015 (UTC)

Removed this as it was discussed above [1] Doc James (talk · contribs · email) 12:20, 17 May 2015 (UTC)

Adding to external links section

Hi,

I wonder if it'd be possible to add a link to the Headway - the brain injury association website in the external links section? It's www.headway.org.uk

We have a large library of information and offer help and support to people affected by brain injury in the UK. I notice there is another UK charitable organisation listed, the Children's Trust's Brain Injury Hub, so this will add our support for adults with a brain injury.

Many thanks,

Andrew Headwayuk (talk) 10:47, 24 November 2015 (UTC)

We typically have very few external links. Try DMOZ. Doc James (talk · contribs · email) 12:04, 24 November 2015 (UTC)

Semi-protected edit request on 1 August 2016

Stuhoffphd65 (talk) 18:56, 1 August 2016 (UTC) Please remove the following information from the "chronic" subheading, since it has not been validated by a phase III clinical trial and therefore conjecture:

The most effective research documented intervention approach is the activation database guided EEG biofeedback approach, which has shown significant improvements in memory abilities of the TBI subject that are far superior than traditional approaches (strategies, computers, medication intervention). Gains of 2.61 standard deviations have been documented. The TBI's auditory memory ability was superior to the control group after the treatment.

Not done: please establish a consensus for this alteration before using the {{edit semi-protected}} template. Seems arguable since it is reliably sourced. Welcome to Wikipedia, and please remember to sign your posts at the end, not at the beginning.  Temporal Sunshine Paine  19:09, 7 August 2016 (UTC)

Semi-protected edit request on 8 November 2016

One of the things that needs to be added to this article is what is known as Tau. When a violent brain injury occurs, there's a buildup of the protein, Tau, which negatively affects the brain. Tau is most commonly seen in Alzheimer's patients, so if an individual has suffered form a TBI, this buildup will increase as they age. This protein is present in many other neurodegeerative diseases, so that's how doctors are able to track the degradation of the brain after a TBI.

Tau is a protein that was first discovered in 1975 by Marc Kirschner at Princeton University and was produced through alternative splicing of a single gene called MAPT (microtubule-associated protein tau) (REF 1, 2015). Tau proteins are mainly active in the distal portions of axons where they stabilize microtubules as well as providing flexibility. The proteins work together with a globular protein called tubulin to stabilize microtubules and aid the assembly of tubulin in the microtubules. Tau proteins achieve their control of microtubule stability through isoforms and phosphorylation (REF 2, 2013). Tau has been associated with Alzheimer's disease and other neurodegenerative conditions. Under ordinary conditions, tau is essential to neuron health, but in Alzheimer's the protein aggregates into two abnormal forms: "neurofibrillary tangles," and collections of two, three, or four or more tau units known as "oligomers” (REF 3, 2016). Hyperphosphorylation of tau proteins is what creates the neurofibrillary tangles by causing the helical and straight filaments to tangle. This contributes to the pathology of Alzheimer’s disease (REF 2, 2013). Tau oligomers, on the other hand, have been found to be very toxic to nerve cells. They are also thought to have an additional damaging property. When they come into contact with healthy tau proteins, they cause them to also clump together into oligomers, and so spread toxic tau oligomers to other parts of the brain. Scientists have found that traumatic brain injuries also generate tau oligomers. The destructive protein assemblages form within four hours after injury and persist for at least two weeks. This is long enough to suggest that they might contribute to lasting brain damage (REF 2, 2013). Researchers from the University of Texas Medical Branch have found that a substantial amount of Tau is enough to play an important role in the effects of traumatic brain injury. Those effects can include memory deficits, which have been recently shown by UTMB researchers to be induced by tau oligomers. Other long-term ramifications of TBI include seizures, and disruptions in the sleep-wake cycle (REF 3, 2016).

References

1. Mandelkow, E.-M., and E. Mandelkow. "Biochemistry and Cell Biology of Tau Protein in Neurofibrillary Degeneration." Cold Spring Harbor Perspectives in Medicine 2.7 (2012).

2. Krishnamurthy, S., Sengupta, U., Castillo-Carranza, D., Dr. Prough, D., Dr. Jackson, G., Dr. DeWitt, D. (2013). “From trauma to tau – researchers tie brain injury to toxic form of protein.” http://www.utmbhealth.com/wtn/Page.asp?PageID=WTN000831

3. Gerson, J., Castillo-Carranza, D., Sengupta, U., Bodani, R., Prough, D., DeWitt, D. (2016). “Traumatic brain injury induces mental impairments using mechanisms linked with Alzheimer’s.” http://www.utmb.edu/newsroom/article10817.aspx

Emiemilyyy (talk) 23:38, 8 November 2016 (UTC)

ω Awaiting- Provide more WP:RS.The first two of your sources are inaccessible.Also have a look at WP:MEDPRI(they are gen. of a low and controversial quality.Aru@baska^{❯❯❯ Vanguard} 16:44, 8 December 2016 (UTC)

In the *Demographics* section, after this sentence: "However, when matched for severity of injury, women appear to fare more poorly than men" Add this sentence: "This is also true for women veterans, who are at increased risk for TBI compared to women who have not served in the military." Cite: Amoroso, T., & Iverson, K. M. (2017). Acknowledging the risk for traumatic brain injury in women veterans. The Journal of nervous and mental disease, 205(4), 318-323. — Preceding unsigned comment added by 2601:18B:8200:61D8:DC6A:19FE:92:875D (talk) 23:45, 3 April 2017 (UTC)

Lancet Neurol

Critical care management doi:10.1016/S1474-4422(17)30118-7 JFW | T@lk 11:30, 11 May 2017 (UTC)

Semi-protected edit request on 7 March 2018

Remove or replace picture "Measurement of ICP in a case of TBI" It does not show a external ventricular drainage used for mesurement of ICP but a VP-shunt.

I suggest adding the following under the title Causes "In elderly the most common cause of traumatic brain injury are falls" references HarveyL.A., and CloseJ.C.T. (2012). Traumatic brain injury in older adults: characteristics, causes and consequences. Injury 43, 1821–1826.Crossref, Medline Centers for Disease Control and Prevention (CDC). (2003). Nonfatal fall-related traumatic brain injury among older adults—California, 1996–1999. MMWR Morb. Mortal. Wkly. Rep. 52, 276–278.Medline Samuel Lenell (UU) (talk) 21:33, 7 March 2018 (UTC)

 Not done: The sources provided are, at the least, more than 6 years old, and at the most, 15 years old. Spintendo      21:57, 7 March 2018 (UTC)

Note: regarding the first part of this request, I've removed the image as it was indeed an incorrectly labelled diagram of a VP shunt which is unlikely to be used for acute ICP monitoring. Although there's apparently a role for shunting in the management of posttraumatic hydrocephalus (see https://emedicine.medscape.com/article/326411-overview), it's not really an acute measure where an external ventricular drain is more common. EVDs can easily be hooked up to a transducer and monitored.

On another note, it's nice to see this article still ticking along... I was peripherally involved with it a few years back, though I no longer work in an ICU! Basie (talk) 23:06, 20 May 2018 (UTC)

Excellence in Prehospital Injury Care - Traumatic Brain Injury Project

See Epic and University of Arizona College of Medicine - Tucson and Traumatic_brain_injury#Treatment and this new news https://epic.arizona.edu/more-info/association-statewide-implementation-prehospital-traumatic-brain-injury-treatment and do you thing editors :) thanks

Role of vWF

doi:10.1111/jth.15096 JFW | T@lk 15:55, 25 October 2020 (UTC)

Permanent Brain Damage redirect?

I'm not sure the redirect from Permanent Brain Damage to Traumatic Brain Injury is correct. That's because - according to this article - the cause of a Traumatic Brain Injury is an "external force." However, one can achieve Permanent Brain Damage without application of force. For example, here is the story of a woman who drank a bottle of soy sauce during a failed attempt at body cleansing who achieved permanent brain damage. There was no force required; just internet misinformation.

Jeffrey Walton (talk) 02:55, 2 October 2021 (UTC)

You're quite right, thanks for pointing this out. Redirected to Brain damage. Better late than never! delldot ∇. 12:46, 13 August 2022 (UTC)

Semi-protected edit request on 9 July 2022

The word "pterion" is linked, but not in its first appearance. Please move the link from appearance #2 to appearance #1. 49.198.51.54 (talk) 11:52, 9 July 2022 (UTC)

 Done Nice catch! Gave me a headache trying to figure out which one was blue.Fbifriday (talk) 02:44, 10 July 2022 (UTC)

Outdated article could use a rewrite

The cited sources of this article are quite old, and it appears not to have been updated since its creation There is a surfeit of seemingly copy-pasted how-to, and a lack of secondary or tertiary sources. A full rewrite would take much effort on the part of brave editors.--Quisqualis (talk) 00:12, 11 August 2022 (UTC)

If you have time you are certainly welcome and encouraged to take a crack at it! An entire rewrite is daunting but it'd be a good start to add newer references to the info that's still good (or update it if it's not), and remove the how to and other crud that's accumulated. Thanks for pointing out the need for improvement! delldot ∇. 12:41, 13 August 2022 (UTC)

Risk factors is not old age, but late teen young adult age

The age group at highest risk for TBI is 15-25 due to sports, etc... Not old age 104.192.232.8 (talk) 12:20, 27 November 2022 (UTC)

Wiki Education assignment: English 102

This article was the subject of a Wiki Education Foundation-supported course assignment, between 9 January 2023 and 5 May 2023. Further details are available on the course page. Student editor(s): ZionSmart453 (article contribs).

— Assignment last updated by Rbg.coco (talk) 18:19, 23 January 2023 (UTC)