Frontiers in Traumatic Brain Injury
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Winter 1997
Volume 8, Number 1
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Abstracts
of this issue appear
below. Send e-mail or call 303-788-4010 to order a printed copy.
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 Abstracts
Neuroimaging: Current Approaches to
Diagnosis and Management
Erin C. Prenger, DO
Neuroimaging has become an integral
part of the assessment and management of patients with
Traumatic Brain Injury (TBI). Evaluation of a patient
with neuroimaging will continue throughout his/her
hospital stay and will play an important role in
management of care during the early evolution of brain
injury. Neuroimaging also plays an important part in the
evaluation and assessment during rehabilitation as well
as provide information related to the patient’s
prognosis.
Acute Care of Severe Traumatic Brain Injury
John H. McVicker, MD
Improved trauma systems have
resulted in increasing numbers of critically
brain-injured patients with potential for good outcomes.
Evidence-based guidelines help standardize optimal
therapy for these patients. Better understanding of the
pathophysiology of brain injury has increased emphasis on
maximizing cerebral perfusion to prevent secondary
ischemic insult. Pharmacologic brain protection from
lipid peroxidation is being intensely studied. Most
promising may be the pharmacologic inhibition of
excitotoxic amino acids, specifically glutamate.
Early Rehabilitation and Medical
Complications Following Severe Traumatic Brain Injury
Thomas E. Balazy, MD
The secondary neurological and
medical complications of traumatic brain injury usually
affect multiple body systems that can compromise a
patient’s recovery process. Ultimate outcome
requires early intervention by a coordinated
multi-disciplinary team. This review discusses the
benefits of acute neurorehabilitation on a specialty unit
that maximizes brain healing and minimizes medical
complications.
Neuromedical Aspects of Mild
Traumatic Brain Injury
David L. Reinhard, MD
Mild Traumatic Brain Injury (MTBI)
is associated with a diverse array of neuromedical
sequelae. Patients who have experienced head trauma may
complain of persistent post-concussive symptoms which go
undetected by routine physical examination and
traditional diagnostic testing. Consequently, this
patient population is often a source of frustration for
health care professionals. This article reviews some of
the common sequelae of this challenging, clinical entity.
Mild Traumatic Brain Injury: Acute
Neurobehavioral Treatment,
Donald Gerber, PsyD, James C. Berry, PhD, James C. Schraa, PsyD.
A model that outlines the factors
contributing to the genesis of the post concussive
syndrome (PCS) and the rational for early intervention to
prevent the development of persistent PCS is reviewed.
Neuropharmacological Approaches to
Frontal Brain Dysfunction
Alan H. Weintraub, MD.
Psychosocially disabling
neurobehavioral syndromes are often the result of frontal
brain dysfunction following trauma. The pathophysiologic
and anatomical correlates of these conditions are
important considerations for both prognosis and
rehabilitation treatment planning. A conceptual framework
for approaching these disorders with adjunctive
neuropharmacologic interventions will be presented.
Traumatic Brain Injury and the
Vegetative State
Mark P. Cilo, MD.
Severe traumatic brain injury (TBI)
may lead to the vegetative state. This is an uncommon
condition compatible with long and expensive survival.
Improvement frequently occurs and requires treatment in
an acute brain injury rehabilitation setting. Other
states of minimal responsivity and early signs of
improvement must be identified. Intensive and
comprehensive care by a multi-disciplinary team
experienced in TBI rehabilitation facilitates the complex
process of neurological recovery. Pharmacological
management may accelerate and amplify functional gains.
An optimistic approach to the vegetative patient and
their family is encouraged.
Surveillance and Follow-up of
Persons with Traumatic Brain Injury in Colorado,
Gale Whiteneck, PhD, Richard Hoffman, MD, MPH, C.A.
Brooks, MSHA, Barbara Gabella, MSPH.
Craig Hospital is working
collaboratively with the Colorado Department of Public
Health and Environment and the Centers for Disease
Control to design, implement and evaluate a statewide
population-based follow-up system for persons surviving
traumatic brain injury. Approximately 1,300 persons will
be selected each year from more than 3,000 adult Coloradoans hospitalized with TBI to participate in an
interview to determine health status, service
utilization, quality of life and other long-term
outcomes. This three-year project will produce not only a
process for follow-up in the state of Colorado, but a
model for other states, agencies, and organizations.
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