Head injury

头部受伤
  • 文章类型: Journal Article
    使用暴力的妇女是澳大利亚囚犯人口中增长最快的群体之一,包括与非土著妇女相比,更有可能因暴力犯罪而被监禁的土著妇女。许多被监禁的妇女报告了不良童年经历(ACE)和亲密伴侣暴力的历史。这项探索性研究检查了参与特定性别暴力行为计划的3个西澳大利亚州女子监狱中167名妇女样本的基线数据。它描述了他们接触亲密伴侣暴力的情况,头部受伤,和童年的逆境。总的来说,94%的女性至少经历过一次童年逆境(中位数为6)。94%的人报告是现任或前任亲密伴侣身体暴力的受害者。与非土著妇女相比,土著妇女更有可能报告家庭成员被监禁为儿童(p=.001)。ACE数量的增加与意识丧失的头部损伤之间存在关联(p=.008)。总的来说,这些结果显示了童年在成年后遭受逆境和暴力的惨痛景象。因暴力犯罪而被监禁的妇女的成功康复应该认识到大多数这些妇女遭受极端暴力的历史。
    Women who use violence represent one of the fastest growing groups within the Australian prisoner population, including Aboriginal women who are more likely to be incarcerated than non-Aboriginal women for violent crimes. Many incarcerated women report histories of adverse childhood experiences (ACEs) and intimate partner violence. This exploratory study examines baseline data from a sample of 167 women in 3 Western Australia women\'s prisons enrolled in a gender-specific violent behavior program. It describes their exposure to intimate partner violence, head injury, and childhood adversities. Overall, 94% of women had experienced at least one childhood adversity (median 6), and 94% reported being a victim of physical violence by a current or former intimate partner. Aboriginal women were more likely than non-Aboriginal women to report that a family member was incarcerated as a child (p = .001). There was an association between an increased number of ACEs and head injury with a loss of consciousness (p = .008). Overall, these results present a harrowing picture of childhood exposure to adversity and violence in adulthood. Successful rehabilitation of women incarcerated for violent crimes should be cognizant of the histories of extreme violence endured by most of these women.
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  • 文章类型: Journal Article
    轻度创伤性脑损伤(mTBI)可导致某些患者的精神和躯体症状,包括创伤后头痛(PTH)和抑郁症。这项研究试图进一步建立PTH与mTBI后抑郁症之间的关系,并调查创伤后立即出现PTH是否可以确定有6个月后出现抑郁症状风险的患者。
    这项研究是对颅脑损伤血清标志物数据的二次分析,用于评估创伤反应(HeadSMART),一项针对急诊科头部受伤成年患者的前瞻性研究。参与者包括265名符合mTBI标准并完成Rivermead脑震荡后症状问卷的患者,在受伤后24小时内鉴定PTH,和患者健康问卷-9,以评估随访期间的抑郁症状。措施是在急诊室受伤后立即进行的初次就诊和1-,3-,6个月的随访。
    受伤时患有急性PTH(aPTH)的患者在1、3和6个月时更有可能报告PTH。他们在所有时间点也有更严重的抑郁症状和更大的临床上显著抑郁的可能性。
    受伤后24小时内患有aPTH的患者在1、3和6个月时更有可能报告PTH的持续症状和临床显着抑郁。这些发现为mTBI后急诊科使用aPTH作为监测急性恢复期持续PTH和抑郁症状的指标提供了支持。
    UNASSIGNED: Mild traumatic brain injury (mTBI) can lead to psychiatric and somatic symptoms for some patients, including posttraumatic headache (PTH) and depression. This study attempted to further establish the relationship between PTH and depression following mTBI and investigate whether the presence of PTH immediately following injury can identify patients at risk for developing depressive symptoms up to 6 months later.
    UNASSIGNED: This study was a secondary analysis of data from Head Injury Serum Markers for Assessing Response to Trauma (HeadSMART), a prospective study of adult patients in the emergency department with head injury. Participants included 265 patients who met criteria for mTBI and completed the Rivermead Post-Concussion Symptoms Questionnaire, to identify PTH within 24 hours after injury, and the Patient Health Questionnaire-9, to assess depressive symptoms during follow-up. Measures were completed at the initial visit immediately after the injury in the emergency department and at 1-, 3-, and 6-month follow-up visits.
    UNASSIGNED: Patients with acute PTH (aPTH) at time of injury were more likely to report PTH at 1, 3, and 6 months. They also had more severe depressive symptoms and a greater likelihood of clinically significant depression at all time points.
    UNASSIGNED: Patients with aPTH within 24 hours after injury were more likely to report continued symptoms of PTH and clinically significant depression at 1, 3, and 6 months. These findings provide support for using the presence of aPTH in the emergency department following mTBI as an indicator for monitoring persistent PTH and depressive symptoms in the postacute recovery period.
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  • 文章类型: Journal Article
    目的:轻度创伤性脑损伤(mTBI)后通常有主观认知症状,但通常与客观认知表现无关。这可能是由于传统认知性能测量的局限性,这可能对急性mTBI后认知的细微变化不敏感。这项研究探索了使用基于计算机的任务增加认知负荷的客观和主观认知之间的关联,建议对性能的细微差异更敏感。
    方法:前瞻性招募mTBI患者(n=68)和创伤对照组(n=40),并在伤后约8周进行评估。参与者完成了主观症状报告的测量,客观认知表现(包括两个基于计算机的增加认知负荷的任务),和心理困扰。
    结果:mTBI组主观和客观认知报告之间没有显著关联,在双变量相关(|r|=0.01-0.20,p>.05)和控制心理困扰时(|r|=0.00-0.17,p>.05)。在创伤对照组中观察到类似的结果模式,这表明mTBI中客观和主观认知之间的有限关系可能并不特定于该人群。
    结论:尽管采用了比传统任务更敏感的认知表现措施,在急性mTBI后的客观和主观认知之间没有观察到显著的关系,估计的效应大小小到可以忽略不计。这提供了进一步的证据,表明在mTBI后8周,主观认知症状主要反映了除客观认知外的因素。
    OBJECTIVE: Subjective cognitive symptoms are commonly reported after mild traumatic brain injury (mTBI) but are often not associated with objective cognitive performance. This may be due to limitations in traditional cognitive performance measures, which may not be sensitive to subtle variations in cognition in post-acute mTBI. This study explored associations between objective and subjective cognition using computer-based tasks of increasing cognitive load, proposed to be more sensitive to subtle differences in performance.
    METHODS: Individuals with mTBI (n = 68) and trauma controls (n = 40) were prospectively recruited and assessed approximately 8 weeks post-injury. Participants completed measures of subjective symptom reporting, objective cognitive performance (including two computer-based tasks of increasing cognitive load), and psychological distress.
    RESULTS: There were no significant associations between subjective and objective cognition reporting in the mTBI group, both in bivariate correlations (|r| = 0.01-0.20, p > .05) and when controlling for psychological distress (|r| = 0.00-0.17, p > .05). A similar pattern of results was observed in trauma controls, suggesting that the limited relationships between objective and subjective cognition in mTBI may not be specific to this population.
    CONCLUSIONS: Despite employing measures of cognitive performance proposed to be more sensitive than traditional tasks, no significant relationships were observed between objective and subjective cognition in post-acute mTBI, and estimated effect sizes were small to negligible. This provides further evidence that at a group level 8 weeks after mTBI subjective cognitive symptoms primarily reflect factors aside from objective cognition.
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  • 文章类型: Journal Article
    目的:这项研究的主要目的是通过对所有六个半规管(SCC)进行完整的vHIT测试来检查参与高风险头部创伤运动的运动员的前庭功能。次要目标是调查在某些高风险运动中,运动员的前庭功能是否显着降低。
    方法:对137名足球成年运动员进行前瞻性横断面研究,手球,拳击,骑马,和冰球,在过去五年内至少有一次报告与运动有关的头部受伤。所有受试者都接受了筛查,并对所有六个SCC进行了全面检查,并完成了头晕障碍清单(DHI)。
    结果:两名受试者(1.5%)符合病理性vHIT的标准。自上次头部受伤以来,将数据分为个人运动和时间时,可以看到前庭功能受到一定程度的损害。同样,通过DHI总分进行评价时,运动员组未发现主观头晕.当分为头部受伤次数或自上次头部受伤以来的时间时,该评分在组间没有显着差异。当分为运动类型时,总DHI评分在组间差异显著.这些总DHI分数确实如此,然而,都在“无头晕障碍”分类的范围内。
    结论:结果表明,在高风险头部创伤运动中,运动员的前庭功能不受高风险头部创伤运动的影响。因此,vHIT在评估运动员的运动相关脑震荡(SRC)时没有临床实用性,没有主观的头晕感觉。
    OBJECTIVE: The primary aim of this study was to examine the vestibular function of athletes involved in high-risk head trauma sports by means of complete vHIT testing of all six semicircular canals (SCCs). The secondary objective was to investigate whether the vestibular function is significantly reduced among athletes within certain high-risk sports.
    METHODS: A prospective cross-sectional study of 137 adult athletes in football, handball, boxing, horseback riding, and ice hockey with a minimum of one reported sports-related head injury within the past five years. All subjects underwent screening with a complete examination of all six SCCs with vHIT and fulfillment of the dizziness handicap inventory (DHI).
    RESULTS: Two subjects (1.5 %) fulfilled the criteria of having a pathological vHIT. Some degree of impairment of the vestibular function was seen when data was divided into individual sports and time since the last head injury. Likewise, no subjective dizziness was seen in the group of athletes when evaluated by total DHI scores. This score did not differ significantly between groups when subgrouped into number of head injuries or time since the last head injury. When divided into type of sport, total DHI scores differed significantly between groups. These total DHI-scores did, however, all fall within the range of the \"no dizziness handicap\" classification.
    CONCLUSIONS: The results suggest that the vestibular function of athletes in high-risk head trauma sports is unaffected by the practice of a high-risk head trauma sport. Therefore, vHIT has no clinical utility in the assessment of a sports-related concussion (SRC) in athletes with no subjective feeling of dizziness.
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  • 文章类型: Journal Article
    本研究旨在通过在运动员季前和季后以及可疑头部受伤后利用动眼动和前庭耐力筛查(MoVES)评估来评估动眼动和前庭耐力。招募运动员(N=311,19.4±1.3岁)执行以下七个任务:(1)水平扫视,(2)垂直扫视,(3)趋近性跳跃,(4)水平前庭-眼球运动反射(VOR),(5)垂直VOR,(6)调节幅度(AoA),和(7)近收敛点(NPC)。在季前赛中,60秒内观察到的眼球运动次数为水平扫视(74±13初始30秒;67±11后30秒),垂直扫视(70±13;66±10),趋近度跳跃(48±12;45±13),水平VOR(38±11;38±11),和垂直VOR(8±11;38±11)。这些结果为MoVES评估中的眼球运动建立了规范数据库,并显示了从季前到季后运动次数的一致性。初步结果显示,在头部受伤后的最初几天,眼球运动次数呈下降趋势,这改善了受伤后14-21天的季前措施。该基础可用于未来的研究,以探索由头部损伤在两周内消退引起的双眼和前庭耐力功能障碍的程度。
    This study aims to assess oculomotor and vestibular endurance by utilizing the Oculomotor and Vestibular Endurance Screening (MoVES) assessment in athletes\' pre-season and post-season and after a suspected head injury to detect impairment. Athletes (N = 311, 19.4 ± 1.3 years) were recruited to perform the following seven tasks: (1) horizontal saccades, (2) vertical saccades, (3) vergence jumps, (4) horizontal vestibular-oculomotor reflex (VOR), (5) vertical VOR, (6) amplitude of accommodation (AoA), and (7) near point of convergence (NPC). At pre-season, the observed number of eye movements in 60 s are horizontal saccades (74 ± 13 initial 30 s; 67 ± 11 latter 30 s), vertical saccades (70 ± 13; 66 ± 10), vergence jumps (48 ± 12; 45 ± 13), horizontal VOR (38 ± 11; 38 ± 11), and vertical VOR (8 ± 11; 38 ± 11). These results establish a normative database for eye movements within the MoVES assessment and show consistency in the number of movements from pre-season to post-season. The initial results show a trending decrease in the number of eye movements in the initial days post-head injury, which improves to pre-season measures 14-21 days post-injury. This foundation can be used by future studies to explore the extent of binocular and vestibular endurance dysfunctions caused by head injuries that subside within two weeks.
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  • 文章类型: Journal Article
    弥漫性外伤性轴索损伤(dTAI)的死后诊断依赖于β-淀粉样蛋白前体蛋白(β-APP)免疫组织化学。大多数与dTAI相关的因素报告已有数十年历史。我们比较了今天有和没有β-APP阳性dTAI(dTAI和dTAI-,分别)。这些病例在死亡前头部受伤,并接受了包括β-APP染色在内的全面神经病理学检查。背景和间接数据以及神经病理学发现是从警察文件中收集的,医疗记录,尸检和神经病理学报告.计算每个因素的患病率比率以促进dTAI+和dTAI-组之间的比较。数据集包括57例(66.7%为男性),17分类为dTAI+,40分类为dTAI-。根据患病率,与dTAI-病例相比,dTAI+病例的患病率至少为2倍的因素有:损伤机制不明;并发硬膜外或硬膜下出血;意外死亡.相比之下,与dTAI+病例相比,dTAI-病例的患病率至少为2倍的因素包括:伤后生存期短(<30分钟);并发脑/脑室内出血或挫伤;vermal萎缩;自然死亡或杀人死亡方式.这项研究揭示了当今医学法律尸检材料中dTAI和dTAI-病例之间的间接特征和神经病理学发现的差异。有关典型病例资料的数据不仅可以在医学验尸中,而且可以在头部受伤的在世患者中帮助估计dTAI的先验概率。
    The postmortem diagnosis of diffuse traumatic axonal injury (dTAI) relies on β-amyloid precursor protein (β-APP) immunohistochemistry. Most reports of factors associating with dTAI are decades old. We compared background characteristics and neuropathology findings of today\'s Finnish medico-legal autopsy cases with and without β-APP-positive dTAI (dTAI+ and dTAI-, respectively). The cases had suffered a head injury prior to death and underwent a full neuropathological examination including β-APP stain. Background and circumstantial data as well as neuropathology findings were collected from police documents, medical records, and autopsy and neuropathology reports. Prevalence ratios were calculated for each factor to facilitate comparisons between the dTAI+ and dTAI- groups. The dataset comprised 57 cases (66.7% males), with 17 classified as dTAI+ and 40 as dTAI-. Based on prevalence ratios, the factors that had at least two-fold prevalence among dTAI+ cases compared to dTAI- cases were: an unknown injury mechanism; concurrent epidural or subdural haemorrhage; and an accidental manner of death. In contrast, the factors that had at least two-fold prevalence among dTAI- cases compared to dTAI+ cases were: a short postinjury survival (<30 min); concurrent intracerebral/ventricular haemorrhage or contusion; vermal atrophy; and a natural or homicidal manner of death. This study revealed differences in circumstantial features and neuropathology findings between dTAI+ and dTAI- cases in today\'s medico-legal autopsy material. Data on typical case profiles may help estimate the prior probability of dTAI not only in medico-legal autopsies but also among living patients with head injuries.
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  • 文章类型: Journal Article
    背景:尽管酒精中毒患者很难评估他们的意识水平并在院前运送,有证据表明,酒精中毒的头部损伤患者的生存结局更好.本研究使用日本创伤数据库(JTDB)评估了酒精中毒的颅脑损伤患者的生存率和脑功能结果是否优于清醒患者。日本全国范围内的创伤登记处.
    方法:17,823例钝性外伤患者,包括头部受伤,对2019年1月至2021年12月在JTDB数据库中注册的人进行回顾性分析.对钝性创伤患者的院内生存率进行Logistic回归分析。包括头部受伤的人,根据格拉斯哥预后量表(GOS),仅头部受伤的患者具有良好的脑功能。使用简化损伤量表(AIS)2008或损伤严重程度评分(ISS)类别,比较了饮酒和不饮酒组之间的头部损伤评分的生存率。
    结果:饮酒显着影响生存率(比值比1.800,p<0.001)和良好的脑功能(比值比1.546,p<0.001),如使用单独的头部损伤或钝性多部位创伤(包括头部损伤)的逻辑回归分析所示,分别。根据ISS类别或负责人AIS评分的分析,在钝性创伤的存活率方面,饮酒组和非饮酒组在几个类别(ISS9-15、16-24和25-40以及AIS3和5)之间存在显着差异。包括头部受伤,或良好的GOS率与头部受伤。
    结论:钝性创伤的存活率,包括头部受伤,饮酒组基于GOS的脑功能预后优于对照组。多变量分析还显示,饮酒与更好的结果显着相关。
    BACKGROUND: Although alcohol-intoxicated patients have difficulties evaluating their consciousness level and being transported prehospital, there is some evidence that the survival outcomes for alcohol-intoxicated patients with head injuries are better. The present study evaluated whether the survival and brain function outcomes in alcohol-intoxicated trauma patients with head injuries were better than those in sober patients using the Japan Trauma Data Bank (JTDB), a nationwide trauma registry in Japan.
    METHODS: The 17,823 patients with blunt trauma, including head injuries, who were registered in the JTDB database between January 2019 and December 2021 were retrospectively analyzed. Logistic regression analyses were performed for in-hospital survival in patients with blunt trauma, including those with head injuries, and for good brain function based on the Glasgow outcome scale (GOS) in patients with only head injuries. Survival rates by head injury score using the abbreviated injury scale (AIS) 2008 or injury severity score (ISS) categories were compared between drinking and nondrinking groups.
    RESULTS: Drinking significantly affected survival (odds ratio 1.800, p<0.001) and good brain function (odds ratio 1.546, p<0.001), as indicated by logistic regression analysis using head injuries alone or blunt multisite trauma (including head injuries), respectively. According to analyses by the ISS category or head AIS score, there were significant differences between the drinking and non-drinking groups in several categories (ISS 9-15, 16-24, and 25-40 and AIS 3 and 5) regarding survival rates with blunt trauma, including head injuries, or good GOS rates with head injuries alone.
    CONCLUSIONS: The survival rates for blunt trauma, including head injuries, and the prognosis for brain function based on the GOS were better in the drinking group than in the control group for cases with head injuries alone. A multivariate analysis also showed that alcohol consumption was significantly associated with better outcomes.
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  • 文章类型: Journal Article
    检查父母的头部受伤报告与病历中头部受伤证据之间的一致性,并比较这两种措施在预测早期行为障碍(CD)方面的作用。
    将父母调查数据与国家卫生服务登记册中的儿童头部受伤记录进行了比较(魁北克马拉迪保证,RAMQ)管理数据库。
    6-9岁有和没有CD的儿童(N=685)。有147名RAMQ记录头部受伤的儿童和39名父母报告头部受伤的儿童。
    父母报告和/或医疗数据中指出的6岁之前的一个或多个头部受伤的指示。根据父母和/或老师的说法,早期CD(9岁之前)。
    结果表明,两种报告形式κ=.161(95%CI,.083至.239)之间的一致性较差,p<0.001。医学数据显著预测了儿童中CD的存在,RAMQ编码的头部受伤表明儿童患CD的可能性是其1.88倍。父母的头部受伤报告并未显着预测CD。结论:在针对小儿颅脑损伤的研究中,应优先考虑医学数据。考虑到家长报告可能无法捕获损伤的发生率,因此对其他已知的头部损伤相关因素的预测可能较少。
    UNASSIGNED: To examine agreement between parental reports of head injury and evidence of head injury in medical records and to compare these two measures in predicting early conduct disorder (CD).
    UNASSIGNED: Parent survey data was compared with records of child head injury from the National Health Services Register (Régie de l\'assurance maladie du Québec, RAMQ) administrative database.
    UNASSIGNED: Children (N = 685) ages 6-9 with and without CD. There were 147 children with RAMQ recorded head injury and 39 children with parent-reported head injury.
    UNASSIGNED: Indication of one or more head injury before 6 years of age as reported by parents and/or as noted in medical data. Early CD (present by age 9) according to parents and/or teachers.
    UNASSIGNED: Results indicated poor agreement between the two forms of reporting κ = .161 (95% CI, .083 to .239), p < 0.001. Medical data significantly predicted the presence of CD in children, with a RAMQ coded head injury suggesting a child was 1.88 times more likely to have CD. Parent reports of head injuries did not significantly predict CD. Conclusion: Medical data should be prioritized in research addressing pediatric head injury, given that parent reports may fail to capture incidence of injury and therefore may be less predictive of other known correlates of head injury.
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  • 文章类型: Case Reports
    献血通常被认为是安全的程序,但偶尔会出现不同严重程度的不良反应,捐赠,或捐赠后阶段。各种研究报道供体不良反应的发生率为0.6%-5.6%。供体反应分为轻度,中度,和严重类型或立即和延迟。尽管延迟反应占总供体不良反应的<2%,27.6%的人严重,有或没有受伤。在这里,我们报告了一例56岁的替代献血者可能可预防的延迟2级血管迷走反应.
    Blood donation is generally considered to be a safe procedure, but occasionally adverse reactions of varying severity may occur predonation, donation, or postdonation phases. Various studies have reported the incidence of adverse donor reaction as 0.6%-5.6%. Donor reactions are classified into mild, moderate, and severe types or immediate and delayed. Although delayed reactions account for <2% of total adverse donor reactions, 27.6% are severe with or without injury. Herein, we report a case of potentially preventable delayed Grade 2 vasovagal reaction in a 56-year-old replacement blood donor.
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  • 文章类型: Case Reports
    皮下积液是幼儿头皮肿胀的罕见现象,在许多情况下,青少年。当流体积聚在水下空间时,它呈现为柔软,不明确,波动,移动肿胀不限于缝合线。这种情况与婴儿期分娩期间的真空辅助装置和镊子有关。超越婴儿期,这种情况可以自发地看到,或者,最常见的是,在轻微的头部创伤之后。近年来报道的这种轻微创伤包括拉发或编织头发。早期认识到这种情况及其并发症对于适当的治疗和管理至关重要。在这个案例报告中,我们强调了静脉下液体收集被认为是头痛鉴别诊断的重要性,特别是在儿童和青少年谁表现出过度拉发或头发编织。
    Subgaleal fluid collection is a rare phenomenon of scalp swelling among young infants and, in many cases, adolescents. As fluid accumulates in the subgaleal space, it presents as a soft, ill-defined, fluctuant, mobile swelling not limited to suture lines. This condition is associated with vacuum-assisted devices and forceps during delivery in infancy. Beyond infancy, this condition can be seen spontaneously or, most commonly, after minor head traumas. Such minor traumas that have been reported in recent years include hair pulling or hair braiding. Early recognition of this condition and its complications is essential for appropriate treatment and management. In this case report, we highlight the importance of subgaleal fluid collection being considered a differential diagnosis of headaches, particularly in children and adolescents who present with excessive hair pulling or hair braiding.
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