SEARCH · PubMed Health

Results for “Traumatic Brain Injuries”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources

PubMed1998

Outcomes in the first 5 years after traumatic brain injury.

OBJECTIVE: To examine the extent to which outcomes from traumatic brain injury differ as a function of time and can be predicted at discharge from inpatient rehabilitation. DESIGN: Survey method employing cross-sectional analyses. SETTING: An inpatient brain injury rehabilitation unit in a large midwestern academic medical center. SUBJECTS: Ninety-five adults with traumatic brain injuries, 6 months to 5 years after inpatient rehabilitation, stratified by time postdischarge. MAIN OUTCOME MEASURES: Functional Independence Measure (FIM), Sickness Impact Profile (SIP), Medical Outcomes Survey SF-36, Community Integration Questionnaire (CIQ), Craig Handicap Assessment and Reporting Technique (CHART), Brief Symptom Inventory (BSI), Satisfaction With Life Scale (SWLS), and indices of current psychosocial functioning. RESULTS: Substance abuse, need for supervision, life satisfaction, and selected subscales of the CIQ and CHART differed over the period 6 months to 5 years after discharge. Approximately 75% of the variance in current FIM scores, and 40% to 50% of CHART, CIQ, and SIP total scores, could be predicted at time of discharge. CONCLUSIONS: Outcomes over the first 5 years after discharge were dynamic, with most change being improvement, at least after the first 2 years. Important aspects of outcome could not be predicted based on premorbid characteristics, injury severity, and initial functional abilities.

Activities of Daily Living↗

PubMed2006

Neuropsychiatric disturbances and hypopituitarism after traumatic brain injury in an elderly man.

Neuropsychiatric or cognitive disturbances are common complications after traumatic brain injury. They are commonly regarded as irreversible sequelae of organic brain injuries. We report a case of hypopituitarism in a 77-year-old man who presented with long-term neuropsychiatric disturbances, including cognitive impairment, disturbed sleep patterns, personality change, loss of affect, and visual and auditory hallucinations after a traumatic subdural hemorrhage. The treatment response to hormone replacement therapy was nearly complete. Hypopituitarism is rarely considered in patients who sustain traumatic brain injury and the neuropsychiatric manifestations of posttraumatic hypopituitarism have rarely been reported. This case highlights the importance of hypopituitarism as a potential reversible cause of neuropsychiatric disturbances after traumatic brain injury.

Aged↗

PubMed2003

Changes in linear dynamics of cerebrovascular system after severe traumatic brain injury.

BACKGROUND AND PURPOSE: We sought to describe the dynamic changes in the cerebrovascular system after traumatic brain injury by transfer function estimation and coherence. METHODS: In 42 healthy volunteers (mean+/-SD age, 37+/-17 years; range, 17 to 65 years), spontaneous fluctuations of middle cerebral artery blood flow velocity and of finger blood pressure (BP) were simultaneously recorded over a period of 10 minutes under normocapnic and hypocapnic conditions to generate normative spectra of coherence, phase shift, and gain over the frequency range of 0 to 0.25 Hz. Similar recordings were performed in 24 patients with severe traumatic brain injury (Glasgow Coma Scale score 70 mm Hg. Each blood flow velocity/BP recording was related to the presence or absence of middle cerebral artery territory brain parenchyma lesions on cranial CT performed within a close time frame. RESULTS: In controls, hypocapnia decreased coherence (0.0 to 0.20 Hz), increased phase shift (0.0 to 0.17 Hz), and decreased gain in the frequency range of 0.0 to 0.11 Hz but increased gain at frequencies of 0.20 to 0.25 Hz (P<0.01 for all frequency ranges reported). In patients with traumatic brain injury, 102 investigations were possible. Compared with controls, coherence was increased in the frequency range <0.03 Hz and between 0.13 and 0.25 Hz in both normocapnia and hypocapnia, irrespective of the CT findings. Gain was unchanged in normocapnia and in the absence of a CT lesion. Gain was decreased in hypocapnia at frequencies >0.12 Hz irrespective of the presence/absence of a CT lesion. Phase shift decreased rapidly between 0.06 and 0.13 Hz under hypocapnic conditions and under normocapnic conditions in the presence of a CT lesion (P< 0.01). CONCLUSIONS: Use of spontaneous fluctuations of blood flow velocity and BP to assess the cerebrovascular system dynamically requires consideration of the Paco2 level. In different conditions, including severe traumatic brain injury, the cerebrovascular system behaves linearly only in parts of the investigated frequency range.

Adolescent↗

PubMed2006

Continuous monitoring of cerebral metabolism in traumatic brain injury: a focus on cerebral microdialysis.

PURPOSE OF REVIEW: This review highlights recent advances in cerebral microdialysis as a tool for neurochemical monitoring of patients with traumatic brain injury. RECENT FINDINGS: Progress in microdialysis research has come from validation studies of microdialysis biomarkers and clinical outcome in large cohorts of traumatic brain injury patients and by combining microdialysis with other methods, such as positron emission tomography, magnetic resonance spectroscopy, brain tissue oximetry and electrophysiology. The combination of rapid-sampling microdialysis and electrocorticography has revealed complex, transient fluctuations of microdialysis glucose and lactate and depolarization-like events that may affect the secondary injury process. The use of microdialysis to monitor global cerebral metabolic events (related to intracranial hypertension or reduced cerebral perfusion pressure for example) as opposed to focal events in peri-lesional brain tissue need to be clearly distinguished and the microdialysis catheter location verified by neuroimaging to ensure proper data interpretation. Differences in microdialysis biomarker levels between grey and white matter following traumatic brain injury need clarification. SUMMARY: Microdialysis is established as a neurochemical research tool in neurointensive care, particularly in combination with other monitoring methods, and contributes to a growing knowledge of secondary injury mechanisms in traumatic brain injury. The value of microdialysis as a tool in routine neurointensive care decision-making remains unclear.

Brain Injuries↗

PubMed1993

Functional outcome following surgical excision of heterotopic ossification in patients with traumatic brain injury.

Increased osteogenesis, both in fracture healing and heterotopically, occurs in a significant percentage of patients with traumatic brain injury. Periarticular heterotopic ossification, especially in the hip and elbow joint, can cause functional loss of motion in patients with traumatic brain injury and interfere with activities of daily living. Seventeen patients with traumatic brain injury had periarticular heterotopic ossification resected in 20 joints (13 hips and seven elbows). Each joint was ankylosed prior to surgical resection (Brooker IV). In the immediate postoperative period, the average arc of motion was 85 degrees in the hips and 65 degrees in the elbows. At the final follow-up observation (average, 23 months), 17 of the 20 heterotopic ossification resected joints had maintained functional range of motion. Three joints in two patients reankylosed. Two additional patients had significant complications. In summary, surgical excision of periarticular heterotopic ossification in patients with traumatic brain injury can give satisfactory results, provided appropriate preoperative selection is done.

Adolescent↗

PubMed2001

Traumatic brain injury outcome: concepts for emergency care.

Injury to the brain is the leading factor in mortality and morbidity from traumatic injury. The devastating personal, social, and financial consequences of traumatic brain injury (TBI) are compounded by the fact that most people with TBI are young and previously healthy. From the emergency physician's standpoint, patients with severe TBI are those with a presenting Glasgow Coma Scale score of less than 9. Over the past 30 years, mortality from severe traumatic brain injury for those patients who survive to the hospital has been reduced by half from nearly 50% to approximately 25%. Because most of the pathologic processes that determine outcome are fully active during the first hours after TBI, the decisions of emergency care providers may be crucial. This review addresses new concepts and information in the pathophysiology of TBI and secondary brain injury and demonstrates how emergency management may be linked to neurologic outcome.

Brain↗

PubMed2003

Acute etomidate treatment reduces cognitive deficits and histopathology in rats with traumatic brain injury.

OBJECTIVE: To test the hypothesis that etomidate treatment improves functional, cognitive, and histologic outcome after experimental traumatic brain injury. DESIGN: Controlled animal study. SETTING: University research laboratory. SUBJECTS: Male Sprague-Dawley rats. INTERVENTIONS: Traumatic brain injury was produced by controlled cortical impact injury (4 m/sec, 2.6 mm of tissue deformation). Etomidate (2 mg/kg) was administered intravenously immediately before injury (n = 13) or 5 mins after injury (n = 12). Additional rats received saline treatment 5 mins after injury (n = 12) or served as sham controls (n = 10). MEASUREMENTS AND MAIN RESULTS: Rats were evaluated on beam balance and beam walk tasks on postoperative days 1-5 and then trained in the Morris water maze on postoperative days 14-18. On day 28, the rats were killed, and hippocampal CA1 and CA3 neuron counts and cortical lesion volume were measured in histologic brain sections. Preinjury etomidate attenuated beam balance deficits, water maze deficits, hippocampal CA3 neuronal loss, and cortical tissue loss but did not attenuate beam walk deficits or hippocampal CA1 neuronal loss. Postinjury etomidate attenuated water maze deficits, but it did not affect any other outcome measure. CONCLUSIONS: Administration of etomidate both before and after injury attenuates secondary injury resulting from traumatic brain injury, but the effect is more pronounced with pretreatment. The ineffectiveness of postinjury etomidate on motor and histologic tasks suggests a brief therapeutic treatment window in rats. However, the treatment window in humans is unknown. Lastly, postinjury etomidate did not exacerbate neurologic or histologic outcome.

Animals↗

PubMed2003

Inter-rater reliability and concurrent validity of walking speed measurement after traumatic brain injury.

OBJECTIVE: To assess the inter-rater reliability and concurrent validity of walking speed measurement after traumatic brain injury. DESIGN: Twelve subjects each completed five comfortably paced and five fast-paced walking trials. Walking speed was measured simultaneously by five observers using a stopwatch (clinical procedure) and by infrared timing gates (gold standard). SETTING: Brain injury rehabilitation unit. SUBJECTS: People with traumatic brain injury who could walk independently and were participating in a rehabilitation programme. MAIN OUTCOME MEASURES: Walking speed over a 10-metre distance. RESULTS: The inter-rater reliability of walking speed measured using a stopwatch was very high, with an intraclass correlation coefficient of at least 0.998 for both comfortable and fast-paced tests. Concurrent validity was excellent for comfortable and fast tests, with perfect correlations between the stopwatch and infrared timing gate measurement procedures. CONCLUSIONS: Physiotherapists can use a stopwatch as a reliable and valid measurement tool to quantify walking speed over a short distance at both comfortable and fast paces in people who have sustained traumatic brain injuries.

Adult↗

PubMed2006

Motor performance in physically well-recovered men with traumatic brain injury.

OBJECTIVE: The primary aim of this study was to compare the motor performance of physically well-recovered men with traumatic brain injury with that of healthy men. DESIGN: Cross-sectional study in a national rehabilitation centre. METHODS: Static and dynamic balance, agility and rhythm co-ordination of men with traumatic brain injury (n=34) and healthy controls (n=36) were assessed. Between-group differences in dynamic balance and agility were analysed by analysis of covariance and differences in static balance and rhythm co-ordination by logistic regression analysis. Cut-off points for clinical screening were determined by receiver operating characteristics analyses. RESULTS: Men with traumatic brain injury had impaired balance and agility compared with healthy men and in a rhythm co-ordination test they had difficulties in starting and sustaining simultaneous rhythmical movements of hands and feet. In receiver operating characteristics analyses a running figure-of-eight test (agility), tandem walking forwards (dynamic balance) and rhythm co-ordination test with fast tempo were found the most sensitive and specific for distinguishing between men with traumatic brain injury and the healthy men. CONCLUSIONS: The impairments in motor performance of physically well-recovered patients with traumatic brain injury were obvious. The results of this study extend the knowledge of problems in motor performance among patients with traumatic brain injury and provide further information for clinical rehabilitation.

Adult↗

PubMed2000

Oxidative stress following traumatic brain injury in rats: quantitation of biomarkers and detection of free radical intermediates.

Oxidative stress may contribute to many pathophysiologic changes that occur after traumatic brain injury. In the current study, contemporary methods of detecting oxidative stress were used in a rodent model of traumatic brain injury. The level of the stable product derived from peroxidation of arachidonyl residues in phospholipids, 8-epi-prostaglandin F(2alpha), was increased at 6 and 24 h after traumatic brain injury. Furthermore, relative amounts of fluorescent end products of lipid peroxidation in brain extracts were increased at 6 and 24 h after trauma compared with sham-operated controls. The total antioxidant reserves of brain homogenates and water-soluble antioxidant reserves as well as tissue concentrations of ascorbate, GSH, and protein sulfhydryls were reduced after traumatic brain injury. A selective inhibitor of cyclooxygenase-2, SC 58125, prevented depletion of ascorbate and thiols, the two major water-soluble antioxidants in traumatized brain. Electron paramagnetic resonance (EPR) spectroscopy of rat cortex homogenates failed to detect any radical adducts with a spin trap, 5,5-dimethyl-1-pyrroline N:-oxide, but did detect ascorbate radical signals. The ascorbate radical EPR signals increased in brain homogenates derived from traumatized brain samples compared with sham-operated controls. These results along with detailed model experiments in vitro indicate that ascorbate is a major antioxidant in brain and that the EPR assay of ascorbate radicals may be used to monitor production of free radicals in brain tissue after traumatic brain injury.

Animals↗

PubMed1979

Recovery of memory and learning functions following traumatic brain injury.

Twenty-four traumatically brain-injured males, of whom eight had sustained right-sided, eight left-sided, and eight bilateral or diffuse closed head injuries, took a battery of neuropsychological tests within the first six months, the second six months, the second year and the third year post injury. Performances on WAIS Digits Forward and Backward and Rey's Auditory-Verbal Learning Test were classified as within or below normal range. Comparisons were made (1) between time periods and tests and (2) between subgroups formed by severity, site of lesion, and age. The findings give an overall picture of wide performance variability with consistent improvement in immediate memory span and learning. Recovery varied with the specific nature of the tested function, task complexity, and severity of injury. Neither age, site of injury, not recency were associated with improvement.

Adult↗

PubMed2004

[Moderate hypothermia in traumatic brain injury: results of clinical trials].

The concept of neuroprotection' by hypothermia dates back to ancient times. This paper reviews the results of clinical trials using mild hypothermia (3235 degrees C) in patients with severe traumatic brain injury over the past decade. Induced hypothermia has been used in experimental models mostly to prevent or attenuate secondary neurological injury and has been used to provide neuroprotection in traumatic brain injury, both in animal models and clinical trials. Results from animal experiments largely confirm that hypothermia can provide protection for the injured brain; however, the results from clinical trials and from a number of meta-analyses have been conflicting. This paper reviews the evidence and explores possible reasons for the mixed results from clinical trials. Hypothermia is clearly effective in controlling intracranial hypertension. Early favourable results on neurological outcome and mortality were not confirmed in a subsequent multi-center trial. Subsequently, single-centre studies, with quicker induction of hypothermia and longer duration of cooling, again reported benefits on outcome. These differences may be explained by differences in study protocols (i.e. speed and duration of cooling, speed of re-warming), prevention of side effects and various supportive measures in the ICU. Although induced hypothermia appears to be a highly promising treatment in various forms of neurological injury including traumatic brain injury, the difficulties in realising its therapeutic potential are underscored by the negative results from a large multi-center trial. Routine usage of hypothermia in traumatic brain injury can not currently be recommended.

Brain Injuries↗

PubMed1999

Unexpected contribution of moderate traumatic brain injury to death after major trauma.

BACKGROUND: The cardiovascular reflex responses to injury and simple hemorrhage are coordinated in the central nervous system. Coincidental brain injury, which is present in 64% of trauma patients who die, could impair these homeostatic responses. The occurrence of hemorrhagic shock in the patient with head injury is also known to increase mortality. Therefore, there is a potential bidirectional interaction between traumatic brain injury and peripheral injury, which would result in an increased mortality when these two injuries coexist. Our objective was to test the hypothesis that moderate traumatic brain injury is an independent predictor of outcome in patients with multisystem trauma. METHODS: We carried out an analysis of the UK Trauma Audit and Research Network Database. Moderate traumatic brain injury was defined as an Abbreviated Injury Scale score of 3. The study population included 2,717 patients with multisystem injury: 378 patients had a moderate brain injury with peripheral injury, and 2,339 patients had extracranial injury alone. Mortality rates for both groups were compared at increasing injury severity. RESULTS: Moderate brain injury alone was associated with a mortality rate of 4.2%. However, when combined with extracranial injury, the risk of death was double that attributable to extracranial injury alone (odds ratio, 2.08; 95% confidence interval, 1.57-2.77). CONCLUSION: This study confirms that the coexistence of moderate traumatic brain injury with extracranial injury is associated with a doubling of the predicted mortality rate throughout the injury severity ranges studied.

Adolescent↗

PubMed1995

Comparison of the values of basic fibroblast growth factor determined by an immunoassay in the sera of patients with traumatic brain injury and enhanced osteogenesis and the effects of the same sera on the fibroblast growth in vitro.

In patients with severe traumatic brain injury, the early healing of fractures is accompanied by hypertrophic callus formation or heterotopic ossifications, which might even result in ankylosis of the affected joints. Analysis of the sera of patients with traumatic brain injury revealed post-traumatic dynamic changes of basic fibroblast growth factor immunoreactivity, similar to those observed during fracture healing associated with enhanced osteogenesis. The aim of this study was to determine whether such changes in basic fibroblast growth factor concentrations could be related to the phenomenon of enhanced osteogenesis. Basic fibroblast growth factor immunoreactivity was determined (using an IEMA kit) in the sera of patients with traumatic brain injury and bone fractures (n = 8) and in the sera of patients with either traumatic brain injury alone (n = 10) or bone fractures alone (n = 7), and the effects of these sera on L929 fibroblast growth were analysed in vitro. The results did not prove a causative relationship between the changes of basic fibroblast growth factor immunoreactivity and in vitro growth promoting effects of the sera. However, it is apparent that, in addition to changes in the growth-promoting activity and basic fibroblast growth factor concentration of serum, other as yet unknown post-traumatic changes can cause enhanced osteogenesis.

Adolescent↗

PubMed2005

A comparison of the Glasgow Coma Scale score to simplified alternative scores for the prediction of traumatic brain injury outcomes.

STUDY OBJECTIVE: The 15-point Glasgow Coma Scale (GCS) is extensively used in the initial evaluation of traumatic brain injury in emergency department (ED) settings. We hypothesized that the GCS might be unnecessarily complex and that a simpler scoring system might demonstrate similar accuracy in the prediction of traumatic brain injury outcomes. METHODS: We analyzed a prospectively maintained trauma registry of patients evaluated at our Level I trauma center from 1990 to 2002. We calculated the test performance of ED GCS scores relative to 4 clinically relevant traumatic brain injury outcomes (emergency intubation, neurosurgical intervention, brain injury, and mortality) using areas under their receiver operating characteristic (ROC) curves. We performed similar analyses for each of the 3 GCS components and for 2 simplified 3-point scores (simplified verbal score: oriented=2, confused conversation=1, inappropriate words or less=0; simplified motor score: obeys commands=2, localizes pain=1, withdrawal to pain or less=0). We then compared the test performance of each of these 5 to the total GCS score using a priori thresholds for clinically important differences. RESULTS: Each of the 3 GCS components alone and the 2 simplified 3-point scores demonstrated ROC areas within 9% of that of the GCS score for the 4 outcomes, with a median difference of 3.0% (interquartile range 1.6% to 4.5%). These differences were all below our a priori definitions of clinical importance. CONCLUSION: The 3 individual GCS components alone and two 3-point simplified scores demonstrated test performance similar to the total GCS score for the prediction of 4 clinically relevant traumatic brain injury outcomes. Despite the widespread use of the GCS for the initial evaluation of traumatic brain injury, this score may be unnecessarily complex for this indication.

Adolescent↗

PubMed1997

Survival and functional outcome of children requiring endotracheal intubation during therapy for severe traumatic brain injury.

OBJECTIVE: To determine the predictors of survival and functional outcome of pediatric patients with traumatic brain injury severe enough to require endotracheal intubation and mechanical ventilation. DESIGN: Retrospective, observational cohort study. SETTING: Pediatric intensive care unit (ICU) at a tertiary care children's hospital. PATIENTS: All children (n = 105) admitted over a 5-yr period with traumatic brain injury severe enough to require endotracheal intubation and mechanical ventilation. The median age was 43 months (range 1 month to 14 yrs). Of these children, 74% were male and 70% were white. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Variables studied included vital signs during the first 24 hrs of admission, Pediatric Risk of Mortality (PRISM) score, Glasgow Coma Score, duration of mechanical ventilation, and number of pediatric ICU and hospital days. Functional status was graded as normal, independent, partially dependent, or dependent in the areas of locomotion, self-care, and communication. This status was assessed at hospital discharge by chart review and at follow-up by telephone interview. The median Glasgow Coma Score was 6 (range 3 to 14) and the median PRISM score was 13 (range 1 to 51). There were 19 (18.1%) deaths, 17 in the pediatric ICU and two after hospital discharge. Of the patients who survived to hospital discharge, 39 (37.1%) patients were completely normal or independent, 42 (40%) patients were partially dependent, and seven (6.7%) patients were dependent in all three areas of function. Follow-up evaluations were available for 80 patients, with a median follow-up time of 24.5 months (range 8 to 70). Of the 78 patients who survived and were available for follow-up, the number who were functionally normal or independent increased to 69 (65.7%). At follow-up, there were eight (7.6%) patients remaining with partial dependency in at least one area of function while one (0.9%) patient continued to be dependent in all three areas of function. Mortality and dependent functional outcome were more likely in patients with younger age, lower Glasgow Coma Score, and higher PRISM score at hospital admission. Of the 27 patients with a Glasgow Coma Score of < or = 5, 11 (40.7%) survived with normal or independent functional status at follow-up. Of the 24 patients with PRISM scores of > 20, only five (20.8%) were functionally normal or independent at follow-up. The relative risk of a bad outcome for patients with a Glasgow Coma Score of < or = 5 and a PRISM score of > or = 20 was ten times higher than the group of patients with a Glasgow Coma Score of < or = 5 but a PRISM score of < 20. CONCLUSIONS: Children with severe traumatic brain injury who survive to hospital discharge will continue to improve in their functional status over the next few years. Although low Glasgow Coma Score is strongly associated with death or poor functional outcome after therapy for traumatic brain injury, many patients with Glasgow Coma Score of < or = 5 can survive with good function. PRISM scores add to the power of Glasgow Coma Score to predict survival and functional outcome in tracheally intubated pediatric patients with Glasgow Coma Score of < or = 5.

Activities of Daily Living↗

PubMed2005

Gender and environmental effects on regional brain-derived neurotrophic factor expression after experimental traumatic brain injury.

Alterations in brain-derived neurotrophic factor expression have been reported in multiple brain regions acutely after traumatic brain injury, however neither injury nor post-injury environmental enrichment has been shown to affect hippocampal brain-derived neurotrophic factor gene expression in male rats chronically post-injury. Studies have demonstrated hormone-related neuroprotection for female rats after traumatic brain injury, and estrogen and exercise both influence brain-derived neurotrophic factor levels. Despite recent studies suggesting that exposure post-traumatic brain injury to environmental enrichment improves cognitive recovery in male rats, we have shown that environmental enrichment mediated improvements with spatial learning are gender specific and only positively affect males. Therefore the purpose of this study was to evaluate the effect of gender and environmental enrichment on chronic post-injury cortical and hippocampal brain-derived neurotrophic factor protein expression. Sprague-Dawley male and cycling female rats were placed into environmental enrichment or standard housing after controlled cortical impact or sham surgery. Four weeks post-surgery, hippocampal and frontal cortex brain-derived neurotrophic factor expression were examined using Western blot. Results revealed significant increases in brain-derived neurotrophic factor expression in the frontal cortex ipsilateral to injury for males (P=0.03). Environmental enrichment did not augment this effect. Neither environmental enrichment nor injury significantly affected cortical brain-derived neurotrophic factor expression for females. In the hippocampus ipsilateral to injury brain-derived neurotrophic factor expression for both males and females was half (49% and 51% respectively) of that observed in shams housed in the standard environment. For injured males, there was a trend in this region for environmental enrichment to restore brain-derived neurotrophic factor levels to sham values. However, there were robust increases in hippocampal brain-derived neurotrophic factor expression ipsilateral to the injury for injured females in environmental enrichment compared with both sham and injured females placed in standard housing (P<or=0.005). In the hippocampus contralateral to injury, there were also significant injury-related increases in brain-derived neurotrophic factor expression for females (P<or=0.05) that were not further augmented by environmental enrichment. These results show significant, region-specific gender differences in brain-derived neurotrophic factor expression with both injury and environmental enrichment that may be important for recovery. However, these data do not support a critical role for brain-derived neurotrophic factor in environmental enrichment mediated improvements with spatial learning.

Actins↗

PubMed2004

Interpreting the meaning individuals ascribe to returning to work after traumatic brain injury: a qualitative approach.

OBJECTIVE: The purpose of this study was to describe, qualitatively, the meaning individuals ascribe to returning to work after traumatic injury to the brain. DESIGN: A qualitative multiple-case study design was used for this study to allow for flexibility during data collection and to support naturalistic generalizations. METHODS: A random sample of two participants was included in the study using snowball sampling. Semi-structured interviews and written documentation was used to collect data. Cross-case analysis was used to identify phenomenological themes. RESULTS: While defining the meaning of work, thematic analysis revealed three themes: (a) experience of finding work after injury, (b) experience of maintaining work and (c) independence related to work. CONCLUSION: The several important points that were identified throughout semi-structured interviews were how individuals subjectively and objectively define work, important points about personal experiences finding and maintaining work and the societal value individuals relate to work. Important themes found in this study could be addressed by intermittent long-term interventions following traumatic brain injury (TBI).

Adaptation, Psychological↗