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Book Details
Abstract
Covering the full spectrum of rehabilitation after traumatic brain injury, this practical reference by Drs. Blessen C. Eapen and David X. Cifu presents best practices and considerations for numerous patient populations and their unique needs. In an easy-to-read, concise format, it covers the key information you need to guide your treatment plans and help patients relearn critical life skills and regain their independence.
- Covers neuroimaging, neurosurgical and critical care management, management of associated complications after TBI, pharmacotherapy, pain management, sports concussion, assistive technologies, and preparing patients for community reintegration.
- Discusses special populations, including pediatric, geriatric, and military and veteran patients.
- Consolidates today’s available information and guidance in this challenging and diverse area into one convenient resource.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Rehabilitation After Traumatic Brain Injury | i | ||
| Rehabilitation After Traumatic Brain Injury | iii | ||
| Copyright | iv | ||
| List of Contributors | v | ||
| Preface | ix | ||
| Contents | xi | ||
| 1 - Acute Management of Traumatic Brain Injury | 1 | ||
| INTRODUCTION | 1 | ||
| PREHOSPITAL CARE | 1 | ||
| EVALUATION OF THE PATIENT WITH ACUTE TRAUMATIC BRAIN INJURY | 2 | ||
| EMERGENT SURGERY IN TRAUMATIC BRAIN INJURY | 2 | ||
| CRITICAL CARE MANAGEMENT | 3 | ||
| Blood Pressure Management | 3 | ||
| Intubation and Ventilation | 3 | ||
| Sedation and Analgesia | 3 | ||
| Intracranial Pressure Monitoring | 4 | ||
| Cerebral Perfusion Pressure Monitoring | 4 | ||
| Brain Oxygenation Monitoring | 5 | ||
| Intracranial Pressure Management | 5 | ||
| Tier 1 | 5 | ||
| Tier 2 | 6 | ||
| Tier 3 | 6 | ||
| Seizures/EEG | 6 | ||
| Nutrition | 7 | ||
| Transfusions | 7 | ||
| Deep Vein Thrombosis | 7 | ||
| Temperature Management | 7 | ||
| Tracheostomy | 8 | ||
| OTHER NEUROSURGICAL PROCEDURES | 8 | ||
| PROGNOSIS | 9 | ||
| CONCLUSION | 9 | ||
| REFERENCES | 9 | ||
| 2 - TBI Classifications and Rehabilitation Intensities | 13 | ||
| DEFINITION | 13 | ||
| TRAUMATIC BRAIN INJURY SEVERITY | 13 | ||
| CLASSIFICATION OF TRAUMATIC BRAIN INJURY SEVERITY | 13 | ||
| Incidence and Epidemiology | 14 | ||
| Pathophysiology | 15 | ||
| Mechanism | 15 | ||
| MILD TRAUMATIC BRAIN INJURY | 15 | ||
| FOCAL INJURIES AND CONTUSIONS | 16 | ||
| DIFFUSE AXONAL INJURY | 16 | ||
| PENETRATING INJURIES | 16 | ||
| BLAST INJURY | 17 | ||
| SECONDARY INJURY | 17 | ||
| PROGNOSIS | 18 | ||
| LEVELS OF REHABILITATION CARE | 18 | ||
| Inpatient Settings | 18 | ||
| Outpatient Settings | 19 | ||
| REHABILITATION OUTCOMES | 19 | ||
| DEVELOPMENT OF CARE SYSTEMS | 21 | ||
| SUMMARY | 21 | ||
| REFERENCES | 21 | ||
| 3 - Medical Complications After Moderate to Severe Traumatic Brain Injury | 23 | ||
| INTRODUCTION | 23 | ||
| SPASTICITY | 23 | ||
| DEEP VENOUS THROMBOSIS | 26 | ||
| PAROXYSMAL SYMPATHETIC HYPERACTIVITY | 26 | ||
| NEUROENDOCRINE DYSFUNCTION | 27 | ||
| HETEROTOPIC OSSIFICATION | 29 | ||
| NUTRITION | 29 | ||
| BLADDER/BOWEL DYSFUNCTION | 30 | ||
| SLEEP DISTURBANCES | 30 | ||
| SEXUALITY/INTIMACY | 31 | ||
| TRAUMATIC BRAIN INJURY AND SPINAL CORD INJURY | 33 | ||
| SUMMARY | 33 | ||
| REFERENCES | 33 | ||
| 4 - Neurologic Complications After Traumatic Brain Injury | 37 | ||
| INTRODUCTION | 37 | ||
| POSTTRAUMATIC SEIZURES | 37 | ||
| SLEEP/WAKE/FATIGUE | 38 | ||
| Cranial Nerves | 38 | ||
| Olfactory nerve (CN I) | 39 | ||
| Optic nerve (CN II) | 39 | ||
| Oculomotor nerve (CN III) | 39 | ||
| Trochlear nerve (CN IV) | 39 | ||
| Trigeminal nerve (CN V) | 39 | ||
| Abducens nerve (CN VI) | 39 | ||
| Facial nerve (CN VII) | 39 | ||
| Vestibulocochlear nerve (CN VIII) | 39 | ||
| Glossopharyngeal nerve (CN IX) | 39 | ||
| Vagus nerve (CN X) | 39 | ||
| Spinal accessory nerve (CN XI) | 40 | ||
| Hypoglossal nerve (CN XII) | 40 | ||
| VISUAL DYSFUNCTION | 40 | ||
| POSTTRAUMATIC HYDROCEPHALUS | 41 | ||
| INTRACRANIAL PRESSURE MANAGEMENT: CRANIECTOMY AND CRANIOPLASTY | 42 | ||
| MOVEMENT DISORDERS | 43 | ||
| SPATIAL NEGLECT | 44 | ||
| DIZZINESS/BALANCE DISORDERS | 45 | ||
| CONCLUSION | 45 | ||
| REFERENCES | 45 | ||
| 5 - Assessment and Management of Military and Veteran Traumatic Brain Injury | 49 | ||
| MODERATE AND SEVERE TRAUMATIC BRAIN INJURY | 49 | ||
| Combat Care and Medical Evacuation | 49 | ||
| Rehabilitative Care in Veteran Affairs | 50 | ||
| Behavioral Health Issues | 51 | ||
| Community Reintegration | 51 | ||
| MILD TRAUMATIC BRAIN INJURY | 53 | ||
| Mild Traumatic Brain Injury Screening and Assessment in Department of Defense | 53 | ||
| Mild Traumatic Brain Injury Screening and Assessment in VA | 54 | ||
| Mild Traumatic Brain Injury Clinical Management | 54 | ||
| CONCLUSION | 56 | ||
| REFERENCES | 56 | ||
| 6 - Assessment and Management of Sports Concussion | 59 | ||
| INTRODUCTION | 59 | ||
| EPIDEMIOLOGY OF SPORTS-RELATED CONCUSSION | 59 | ||
| PATHOPHYSIOLOGY OF SPORTS-RELATED CONCUSSIONS | 60 | ||
| Neurotransmitter Dysregulation | 60 | ||
| Metabolic Mismatch and Need for Energy | 60 | ||
| Diffuse Axonal Injury | 60 | ||
| Neuroinflammation | 60 | ||
| Pathophysiology and Symptoms | 60 | ||
| SIDELINE ASSESSMENT AND MANAGEMENT | 60 | ||
| CLINICAL ASSESSMENT AND MANAGEMENT | 61 | ||
| History and Physical Examination | 61 | ||
| Clinical Testing | 62 | ||
| Neuroimaging | 63 | ||
| New Approaches | 63 | ||
| MANAGEMENT OF POSTCONCUSSION SYMPTOMS | 63 | ||
| Posttraumatic Headache | 64 | ||
| Cervical and Vestibular Dysfunction | 64 | ||
| Sleep Disorders and Fatigue | 65 | ||
| Cognitive Dysfunction | 66 | ||
| PERSISTING POSTCONCUSSION SYNDROME | 67 | ||
| REFERENCES | 67 | ||
| 7 - Pediatric Traumatic Brain Injury | 73 | ||
| EPIDEMIOLOGY OF PEDIATRIC TRAUMATIC BRAIN INJURY | 74 | ||
| Age | 75 | ||
| Gender | 75 | ||
| Premorbid History of Child and Family Environment | 76 | ||
| Injury Characteristics | 76 | ||
| MEASUREMENT, PATHOPHYSIOLOGY, AND CLASSIFICATION OF TRAUMATIC BRAIN INJURY | 76 | ||
| Measurement Scales in Pediatric Traumatic Brain Injury | 76 | ||
| Pathophysiology of the Developing Pediatric Brain | 77 | ||
| Classification of Pediatric Traumatic Brain Injury | 77 | ||
| Mechanisms of Injury | 77 | ||
| Primary injury | 77 | ||
| Secondary injury | 78 | ||
| ABUSIVE HEAD TRAUMA—FORMERLY SHAKEN BABY SYNDROME | 79 | ||
| MILD TRAUMATIC BRAIN INJURY AND CONCUSSION | 80 | ||
| REHABILITATION IN PEDIATRIC TRAUMATIC BRAIN INJURY | 80 | ||
| PHARMACOLOGIC INTERVENTIONS FOR COGNITION AND AROUSAL | 80 | ||
| Amantadine | 81 | ||
| Melatonin | 81 | ||
| Atomoxetine | 81 | ||
| MEDICATIONS FOR DYSAUTONOMIA | 82 | ||
| Bromocriptine | 82 | ||
| Morphine | 82 | ||
| β-Adrenergic Receptor Antagonists | 82 | ||
| Clonidine | 82 | ||
| Gabapentin | 82 | ||
| PHARMACOLOGIC INTERVENTIONS FOR THE TREATMENT OF SPASTICITY | 83 | ||
| ORAL MEDICATIONS FOR SPASTICITY | 83 | ||
| Baclofen | 83 | ||
| Tizanidine | 83 | ||
| Benzodiazepines | 86 | ||
| Dantrolene | 86 | ||
| Clonidine | 86 | ||
| Gabapentin | 86 | ||
| Cannabinoids | 87 | ||
| Tolperisone | 87 | ||
| INTERVENTIONAL MEDICATIONS FOR SPASTICITY | 87 | ||
| Botulinum Toxin | 88 | ||
| Intrathecal Baclofen | 89 | ||
| Neurolysis With Alcohol/Phenol | 89 | ||
| Hyaluronidase | 89 | ||
| SELECTED MEDICAL COMPLICATIONS IN PEDIATRIC TRAUMATIC BRAIN INJURY | 89 | ||
| Heterotopic Ossification | 89 | ||
| Venous Thromboembolism | 90 | ||
| Psychological and Behavioral Difficulties | 90 | ||
| Endocrine Dysfunction | 91 | ||
| Epilepsy | 91 | ||
| Olfactory Dysfunction | 92 | ||
| Noninvasive Brain Stimulation for Neuronal Repair and Remodeling | 92 | ||
| REHABILITATION STRATEGIES IN PEDIATRIC TRAUMATIC BRAIN INJURY | 92 | ||
| REHABILITATION OUTCOME MEASURES IN PEDIATRIC TRAUMATIC BRAIN INJURY | 94 | ||
| Glasgow Outcome Scale Extended Peds | 94 | ||
| Children’s Orientation and Amnesia Test | 94 | ||
| Time to Follow Commands | 94 | ||
| Functional Independence Measure for Children | 94 | ||
| Pediatric Evaluation of Disability Inventory | 94 | ||
| TRANSITION TO ADULT CARE | 96 | ||
| CONCLUSION | 96 | ||
| REFERENCES | 96 | ||
| 8 - Geriatric Traumatic Brain Injury | 109 | ||
| INTRODUCTION | 109 | ||
| EPIDEMIOLOGY | 109 | ||
| PATHOPHYSIOLOGY OF THE AGING BRAIN AND PATHOLOGY | 109 | ||
| MECHANISM OF INJURY | 110 | ||
| MILD TRAUMATIC BRAIN INJURY IN OLDER INDIVIDUALS | 110 | ||
| ACUTE CARE | 110 | ||
| REHABILITATION | 110 | ||
| Level of Rehabilitation Care | 110 | ||
| Behavior and Cognition | 111 | ||
| Special Senses | 111 | ||
| Vision | 112 | ||
| Smell and taste | 112 | ||
| Medications | 112 | ||
| Bowel and Bladder Continence | 112 | ||
| PAIN | 112 | ||
| ORTHOSTASIS | 112 | ||
| HYDROCEPHALUS | 113 | ||
| ETHICAL CONSIDERATIONS | 113 | ||
| AFTERCARE | 113 | ||
| CONCLUSION | 113 | ||
| REFERENCES | 113 | ||
| 9 - Anoxic Brain Injury | 115 | ||
| ETIOLOGY | 115 | ||
| EPIDEMIOLOGY | 115 | ||
| PATHOPHYSIOLOGY | 115 | ||
| EXAMINATION AND EVALUATION | 116 | ||
| PROGNOSIS | 116 | ||
| TREATMENT | 116 | ||
| REHABILITATION-SPECIFIC TREATMENT | 117 | ||
| BRAIN DEATH | 119 | ||
| ETHICS AND ANOXIC BRAIN INJURY | 119 | ||
| CONCLUSIONS | 120 | ||
| REFERENCES | 120 | ||
| 10 - Neuropsychiatric Sequelae of Traumatic Brain Injury | 123 | ||
| INTRODUCTION | 123 | ||
| EMOTIONAL DISTURBANCES | 123 | ||
| Depression | 123 | ||
| Mania, Hypomania, and Mixed Mood States | 125 | ||
| Anxiety | 125 | ||
| Emotional Dyscontrol | 126 | ||
| Trauma-Related Disorders | 127 | ||
| Psychosis | 128 | ||
| BEHAVIORAL DISTURBANCES | 128 | ||
| Apathy | 128 | ||
| Disinhibition | 129 | ||
| Aggression | 129 | ||
| CONCLUSION | 129 | ||
| REFERENCES | 130 | ||
| 11 - Pharmacologic Management of the Patient With Traumatic Brain Injury | 133 | ||
| PHILOSOPHY OF MEDICATION MANAGEMENT AFTER BRAIN INJURY: GENERAL GUIDELINES | 133 | ||
| COGNITION | 134 | ||
| Disorders of Consciousness and Hypoarousal | 134 | ||
| Attention and Processing Speed | 135 | ||
| Memory | 136 | ||
| Executive Functioning | 137 | ||
| Aphasia | 137 | ||
| Agitation | 137 | ||
| SLEEP DISTURBANCE | 139 | ||
| MOOD AND PSYCHIATRIC ISSUES | 140 | ||
| Depression | 141 | ||
| Anxiety | 143 | ||
| Emotional Lability/Mania | 143 | ||
| Involuntary Emotional Expressive Disorder | 144 | ||
| Neuroses/Perseveration/Paranoia | 145 | ||
| Psychosis/Hallucinations | 146 | ||
| Aggression/Explosive Behavior | 147 | ||
| NEUROLOGIC ISSUES | 147 | ||
| Posttraumatic Seizures | 147 | ||
| Disorder of Initiation | 149 | ||
| Movement Disorders | 150 | ||
| Fatigue | 151 | ||
| Paroxysmal Sympathetic Hyperactivity | 153 | ||
| Spasticity and Rigidity | 154 | ||
| CONCLUSION | 156 | ||
| REFERENCES | 156 | ||
| 12 - Posttraumatic Pain Management | 165 | ||
| EPIDEMIOLOGY | 165 | ||
| PATHOPHYSIOLOGY | 165 | ||
| ASSESSMENT OF PAIN | 166 | ||
| PAINFUL CONDITIONS | 168 | ||
| Painful Orthopedic and Musculoskeletal Conditions | 168 | ||
| Heterotopic Ossification | 170 | ||
| NEUROPATHIC PAIN | 171 | ||
| Peripheral Neuropathic Pain | 171 | ||
| Central Pain | 171 | ||
| Complex Regional Pain Syndrome | 172 | ||
| POSTTRAUMATIC HEADACHES | 172 | ||
| Posttraumatic Migraine Headaches | 173 | ||
| Tension-Type Headaches | 173 | ||
| Other Types of Posttraumatic Headaches | 173 | ||
| PHARMACOLOGIC CONSIDERATIONS TO TREAT PAIN FOR PATIENTS WITH TRAUMATIC BRAIN INJURY | 174 | ||
| SUMMARY | 174 | ||
| REFERENCES | 175 | ||
| 13 - Neuroimaging in Traumatic Brain Injury | 179 | ||
| INTRODUCTION | 179 | ||
| COMMON COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING FINDINGS IN TRAUMATIC BRAIN INJURY | 179 | ||
| Computed Tomography Imaging Findings | 179 | ||
| Lesion location and gross findings | 179 | ||
| Prognostic accuracy and temporal changes | 180 | ||
| Computed tomography summary | 180 | ||
| Magnetic Resonance Imaging Findings | 180 | ||
| Structural imaging findings | 180 | ||
| Susceptibility-weighted imaging findings | 183 | ||
| Diffusion magnetic resonance imaging findings | 183 | ||
| Magnetic resonance imaging summary | 185 | ||
| DIRECT EXAMINATION OF IMAGING FINDINGS TRACKING REHABILITATION OUTCOMES | 186 | ||
| FUTURE DIRECTIONS AND CONCLUSIONS | 188 | ||
| REFERENCES | 188 | ||
| 14 - Disorders of Consciousness | 191 | ||
| TAXONOMY AND NOMENCLATURE | 191 | ||
| EPIDEMIOLOGY | 193 | ||
| NEURAL SUBSTRATE OF CONSCIOUSNESS | 194 | ||
| ASSESSMENT AND DIAGNOSIS: GENERAL PRINCIPLES | 194 | ||
| ASSESSMENT AND DIAGNOSIS: BEHAVIORAL ASSESSMENTS | 196 | ||
| ASSESSMENT AND DIAGNOSIS: NONBEHAVIORAL ASSESSMENTS | 198 | ||
| TREATMENT: GENERAL APPROACH | 200 | ||
| INTERVENTIONS TO ENHANCE THE LEVEL OF CONSCIOUSNESS | 201 | ||
| MEDICAL, NEUROLOGIC, AND NEUROMUSCULAR ISSUES | 204 | ||
| OUTCOMES IN DISORDER OF CONSCIOUSNESS | 205 | ||
| FAMILIES AND CAREGIVERS | 206 | ||
| ETHICAL ISSUES | 207 | ||
| DOC PROGRAMS AND SYSTEMS OF CARE | 207 | ||
| REFERENCES | 208 | ||
| 15 - Assessment and Cognitive/Behavioral Interventions in Moderate to Severe Traumatic Brain Injury Along the Healthcare Continuum | 215 | ||
| INTRODUCTION | 215 | ||
| ACUTE TRAUMATIC BRAIN INJURY REHABILITATION: DISORDERS OF CONSCIOUSNESS AND BEHAVIORAL MANAGEMENT | 215 | ||
| POSTACUTE TRAUMATIC BRAIN INJURY: FROM A DISORDER OF CONSCIOUSNESS TO A DISORDER OF COGNITION | 216 | ||
| Neuropsychologic Assessment of Neurocognitive Disorders | 216 | ||
| Interventions for Neurocognitive Disorders in Postacute Care | 217 | ||
| Assessment and Intervention of Impaired Self-Awareness | 217 | ||
| LATE TRAUMATIC BRAIN INJURY REHABILITATION: OUTCOMES, INTERVENTIONS, AND EXTENDED CARE | 218 | ||
| Cognitive and Behavioral Interventions in Late Traumatic Brain Injury Rehabilitation | 218 | ||
| Caregiver’s Role in Cognitive/Behavioral Interventions | 219 | ||
| Community Reintegration and Extended Care | 219 | ||
| Cultural Diversity Considerations in Traumatic Brain Injury Rehabilitation | 220 | ||
| CONCLUSIONS | 220 | ||
| REFERENCES | 221 | ||
| 16 - Prognosis, Outcome Measures, and Prevention | 227 | ||
| PROGNOSIS AND OUTCOME MEASURES | 227 | ||
| Demographic and Premorbid Characteristics | 227 | ||
| Mechanism of Injury | 228 | ||
| Injury Severity and Related Outcome Measures | 229 | ||
| Glasgow Coma Scale | 229 | ||
| The Glasgow Outcome Scale and the Extended Glasgow Outcome Scale | 229 | ||
| Abbreviated Injury Score | 229 | ||
| Loss of consciousness and posttraumatic amnesia | 229 | ||
| Galveston Orientation and Amnesia Test | 230 | ||
| Orientation Log | 230 | ||
| Westmead Post-traumatic Amnesia Scale and its abbreviated form | 230 | ||
| Computed Tomography and Traumatic Brain Injury Outcome | 232 | ||
| Magnetic Resonance Imaging and Traumatic Brain Injury Outcome | 232 | ||
| PREVENTION | 233 | ||
| Prevention of Fall-Related Traumatic Brain Injury | 233 | ||
| Prevention of Transport-Related Traumatic Brain Injury | 234 | ||
| Prevention of Work-Related Traumatic Brain Injury | 234 | ||
| CONCLUSIONS | 234 | ||
| REFERENCES | 234 | ||
| 17 - Neuroprosthetics | 241 | ||
| INTRODUCTION | 241 | ||
| ASSISTIVE TECHNOLOGY, AUGMENTATIVE AND ALTERNATIVE COMMUNICATION, INFORMATION AND COMMUNICATION TECHNOLOGIES | 241 | ||
| Switches | 241 | ||
| Environmental Control | 242 | ||
| Electronic Memory Aids | 242 | ||
| FUNCTIONAL ELECTRICAL STIMULATION AND NEUROMUSCULAR ELECTRICAL STIMULATION | 243 | ||
| PERIPHERAL NERVE STIMULATION FOR PAIN RELIEF | 244 | ||
| ROBOTICS | 244 | ||
| VIDEO GAMING | 244 | ||
| Gaming Systems and Computer-Based Systems | 244 | ||
| Virtual Reality | 244 | ||
| NEUROMODULATION | 245 | ||
| Transcranial Magnetic Stimulation | 245 | ||
| Transcranial Direct Current Stimulation | 246 | ||
| Deep Brain Stimulation | 246 | ||
| Transcranial Focused Ultrasound Stimulation | 247 | ||
| Vagal Nerve Stimulation | 247 | ||
| Summary | 247 | ||
| BRAIN-COMPUTER INTERFACES | 247 | ||
| Brain-Computer Interfaces in Traumatic Brain Injury | 247 | ||
| Summary | 248 | ||
| ETHICAL ISSUES | 248 | ||
| REFERENCES | 249 | ||
| 18 - Community Reintegration | 255 | ||
| GENERAL HEALTH AND WELL-BEING | 255 | ||
| Mental Health | 256 | ||
| Mood and anxiety disorders | 256 | ||
| Treatment | 257 | ||
| Substance Abuse | 257 | ||
| Exercise and Nutrition | 258 | ||
| Leisure Activities | 259 | ||
| MOBILITY | 259 | ||
| RETURN TO WORK/SCHOOL | 260 | ||
| Employment | 260 | ||
| Academic | 261 | ||
| DRIVING | 262 | ||
| SUMMARY | 263 | ||
| REFERENCES | 266 | ||
| Index | 271 | ||
| A | 271 | ||
| B | 272 | ||
| C | 272 | ||
| D | 273 | ||
| E | 274 | ||
| F | 275 | ||
| G | 275 | ||
| H | 275 | ||
| I | 276 | ||
| J | 276 | ||
| K | 276 | ||
| L | 276 | ||
| M | 276 | ||
| N | 278 | ||
| O | 278 | ||
| P | 279 | ||
| Q | 280 | ||
| R | 280 | ||
| S | 280 | ||
| T | 281 | ||
| U | 282 | ||
| V | 282 | ||
| W | 282 | ||
| Z | 282 |