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Chapter 28 - Outcomes and Prognosis

Published online by Cambridge University Press:  28 April 2020

By
Helen M. K. Gooday
Edited by
Peter C. Whitfield ,
Jessie Welbourne ,
Elfyn Thomas ,
Fiona Summers ,
Maggie Whyte  and
Peter J. Hutchinson
Peter C. Whitfield
Affiliation:
Derriford Hospital, Plymouth
Jessie Welbourne
Affiliation:
University Hospitals, Plymouth
Elfyn Thomas
Affiliation:
Derriford Hospital, Plymouth
Fiona Summers
Affiliation:
Aberdeen Royal Infirmary
Maggie Whyte
Affiliation:
Aberdeen Royal Infirmary
Peter J. Hutchinson
Affiliation:
Addenbrooke’s Hospital, Cambridge
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Summary

Brain injury remains a major cause of disability and death, especially in young people. In survivors, the extent of recovery depends largely on the severity of the injury. Residual disabilities include both cognitive and physical impairments with the most rapid recovery often occurring within the first 6 months after injury, but improvement may continue for years.

Outcome after TBI also depends on many other factors including patient and injury characteristics such as premorbid state (e.g. older age, comorbidities, personality, cognitive functioning), mechanism of trauma, presence and severity of extracranial injuries, patient response, quality of care and the social environment.

Type
Chapter
Information
Traumatic Brain Injury
A Multidisciplinary Approach
 , pp. 364 - 376
Publisher: Cambridge University Press
Print publication year: 2020

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References

Teasdale, G, Jennett, B. Assessment and prognosis of coma after head injury. Acta Neurochir 1976;34:45–55.CrossRefGoogle ScholarPubMed
Wedekind, C, Fischbach, R, Pakos, P, et al. Comparative use of magnetic resonance imaging and electrophysiologic investigation for prognosis of head injury. J Trauma 1999;47(1):44–9.CrossRefGoogle ScholarPubMed
Firsching, R, Woischneck, D, Klein, S, et al. Classification of severe head injury based on magnetic resonance imaging. Acta Neurochir. 2001;143:263–71.Google ScholarPubMed
Carpentier, A, Galanaud, D, Puybasset, L, et al. Early morphologic and spectroscopic magnetic resonance in severe traumatic brain injuries can detect ‘invisible brain stem damage’ and predict ‘vegetative states’. J Neurotrauma 2006;23(5):674–85.Google Scholar
Sidaros, A, Engberg, Aw, Sidaros, K, et al. Diffusion tensor imaging during recovery from severe traumatic brain injury and relation to clinical outcome: a longitudinal study. Brain 2008;131:559–72.CrossRefGoogle ScholarPubMed
Langares, A, Ramos, A, Perez-Nunez, A, et al. The role of MR imaging in assessing prognosis after severe and moderate head injury. Acta Neurochir (Wein) 2009;151(4):341–56.Google Scholar
Skandsen, T, Kvistad, KA, Solheim, O, et al. Prevalence and impact of diffuse axonal injury in patients with moderate and severe head injury: a cohort study of early magnetic resonance imaging findings and 1-year outcome. J Neurosurg 2010;113:556–63.Google Scholar
Skandsen, T, Kvistad, KA, Solheim, O, et al. Prognostic value of magnetic resonance imaging in moderate and severe head injury: a prospective study of early MRI and one-year outcome. J Neurotrauma 2011;28:691–9.Google Scholar
Haghbayan, H, Boutin, A, Laflamme, M, et al. The prognostic value of MRI in moderate and severe traumatic brain injury: a systematic review and meta-analysis. [Review]. Crit Care Med 2017;45(12):e1280–8.CrossRefGoogle ScholarPubMed
Yuh, EL, Mukherjee, P, Lingsma, HF, et al. MRI improves 3-month outcome prediction in mild traumatic brain injury. Ann Neurol 2013;73(2):224–35.CrossRefGoogle ScholarPubMed
Shendon, ME, Hamoda, HM, Schneiderman, JS, et al. A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury. Brain Imag Behav 2012;6(2):137–92.Google Scholar
Kothari, S. Prognosis after severe TBI: a practical, evidence based approach. In: Zasler, ND, Katz, DI, Zalfonte, RD, eds. Brain injury medicine, principles and practice. New York: Demos Medical Publishing; 2007.Google Scholar
Perel, P, Arango, M, Clayton, T, MRC CRASH trial Collaborators. Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients. BMJ 2008;336:425.Google Scholar
Jennett, B, Bond, M. Assessment of outcome after severe brain damage: a practical scale. Lancet 1975;1:480–4.Google Scholar
Jennett, B, Snoek, J, Bond, MR, Brooks, N. Disability after severe head injury: observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatr 1981;44:285–93.Google Scholar
Maas, AIR, Braakman, R, Schouten, HJA, Minderhoud, JM, Van Zomeren, AH. Agreement between physicians on assessment of outcome following severe head injury. J Neurosurg 1983;58:321–5.Google Scholar
Rappaport, M, Hall, KM, Hopkins, K, Belleza, T, DN, Cope. Disability Rating Scale for severe head trauma: coma to community. Arch Phys Med Rehabil 1982;63:118–23.Google Scholar
Mahoney, FI, Barthel, DW. Functional evaluation: the Barthel Index. Maryland State Med J 1965;14:61–5.Google Scholar
Uniform Data Systems. The functional independence measure. New York: State University of Buffalo; 1987.Google Scholar
Uniform Data System for Medical Rehabilitation. Guide for the uniform data state for medical rehabilitation (adult FIM), version 4.0. Buffalo: State University of New York at Buffalo; 1993.Google Scholar
Turner-Stokes, L. Goal attainment scaling (GAS) in rehabilitation: a practical guide. Clin Rehabil 2009;23:362–70.CrossRefGoogle ScholarPubMed
Hurn, J, Kneebone, I, Cropley, M. Goal setting as an outcome measure: a systematic review. Clin Rehabil 2006;20:756–72.Google Scholar
Maas, A, Marmarou, A, Murray, GD. Prognosis and clinical trial design in traumatic brain injury: the IMPACT study. J Neurotrauma 2007;24(2):232–8.CrossRefGoogle ScholarPubMed
Lingsma, HF, Roozenbeek, B, Steyerberg, EW, et al. Early prognosis in traumatic brain injury: from prophesies to predictions. Lancet Neurol 2010;9:543–54.Google Scholar
McMillan, R, Strang, I, Jennett, B. Head injuries in primary surgical wards in Scottish hospitals: Scottish head injury management study. Health Bull 1979;37:75–81.Google Scholar
Field, JH. Epidemiology of head injuries in England and Wales. London: Research Division, Department of Health and Social Security; 1975.Google Scholar
Bryden, J. How many head injuries? The epidemiology of post head injury disability. In: Wood, R, Eames, P, eds. Models of brain injury rehabilitation. Baltimore: Johns Hopkins University Press; 1989.Google Scholar
Kraus, JF. Epidemiology of head injury. In: Cooper, PL, ed. Head injury. 3rd edn. London: Williams and Wilkins; 1993.Google Scholar
Thornhill, S, Teasdale, GM, Murray, GD, et al. Disability in young people and adults one year after head injury: prospective cohort study. Br Med J 2000;320:1631–5.CrossRefGoogle ScholarPubMed
Maas, AIR, Stocchetti, N, Bullock, R. Moderate and severe traumatic brain injury in adults. Lancet 2008;7(8): 728–41.Google Scholar
Laureys, S, Celesia, GG, Cohadon, F, et al. Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Med 2010;8:68–71.Google Scholar
Monti, MM, Laureys, S, Owen, AM. The vegetative state. Br Med J 2010;341:292–6.Google Scholar
American Academy of Neurology. Practice parameter: assessment and management of patients in the persistent vegetative state. Neurology 1995;45:1015–18.Google Scholar
Giacino, J, Ashwal, S, Childs, N, et al. The minimally conscious state: definition and diagnostic criteria. Neurology 2002;58:349–53.Google Scholar
Coleman, MR, Davis, MH, Rodd, JM, et al. Towards the routine use of brain imaging to aid the clinical diagnosis of disorders of consciousness. Brain 2009;132(9):2541–52.Google Scholar
Bekinschtein, TA, Shalom, DE, Forcato, C, et al. Classical conditioning in the vegetative and minimally conscious state. Nat Neurosci 2009;12:1343–9.Google Scholar
Monti, MM, Vanhaudenhuyse, A, Coleman, MR, et al. Willful modulation of brain activity in disorders of consciousness. N Engl Med 2010;362:579–89.Google Scholar
Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state (part 2). N Engl J Med 1994;330 :1572–9.Google Scholar
Luaute, J, Maucort-Boulch, D, Tell, L, et al. Long-term outcomes of chronic minimally conscious and vegetative states. Neurology 2010;75(3):246–52.Google Scholar
Stender, JS, Gosseries, O, Bruno, MA, et al. Diagnostic precision of PET imaging and functional MRI in disorders of consciousness: a clinical validation study. Lancet 2014;384(9942):514–22.Google Scholar
van der Naalt, J. Prediction of outcome in mild to moderate head injury: a review. J Clin Exp Neuropsychol 2001;23:837–51.Google Scholar
Stein, SC. Outcome from moderate head injury. In: Narayan, RK, Wilberger, JE, Povlishock, JT, eds. Neurotrauma. New York: McGraw-Hill; 1996.Google Scholar
Sureyya, SS, Corrigan, J, Levin, HS, et al. Cognitive outcome following traumatic brain injury. J Head Trauma Rehabil 2009;24:430–8.Google Scholar
Andriessen, TM, Horn, J, Franschman, G, et al. Epidemiology, severity classification, and outcome of moderate and severe traumatic brain injury: a prospective multicenter study. J Neurotrauma 2011;28:2019–31.CrossRefGoogle ScholarPubMed
Mild Traumatic Brain Injury Committee American Congress of Rehabilitation Medicine, Head Injury Interdisciplinary Special Interest Group. Definition of mild traumatic brain injury. J Head Trauma Rehabil 1993;8 :86–7.Google Scholar
Williams, DH, Levin, HS, Eisenberg, HM. Mild head injury classification. Neurosurgery 1990;27:422–8.Google Scholar
Miller, H. Accident neurosis. Br Med J 1961;1:919.Google Scholar
Miller, H. Mental after-effects of head injury. Proc R Soc Med 1966;59:257–61.Google Scholar
Shulkla, D, Devi, BI. Mild traumatic brain injuries in adults. J Neurosci Rural Pract 2010;1(2):82–8.Google Scholar
Karr, JE, Areshenkoff, JE, Corson, N, et al. The neuropsychological outcomes of concussion: a systematic review of meta-analyses on the cognitive sequelae of mild traumatic brain injury. Neuropsychology 2014;28(3):321–36.Google Scholar
Gopinath, SP, Robertson, CS, Constant, CF, et al. Jugular venous desaturation and outcome after head injury. J Neurol Neurosurg Psychiatry 1994;57:717–23.CrossRefGoogle ScholarPubMed
McHugh, GS, Engel, DC, Butcher, I, et al. Prognostic value of secondary insults in traumatic brain injury: results from the IMPACT study. J Neurotrauma 2007;24(2):287–93.Google Scholar
Li, W, Risacher, S, McAllister, T, et al. Traumatic brain injury and age at onset of cognitive impairment in older adults. J Neurol 2016;263:1280–5.Google ScholarPubMed
Lye, TC, Shores, EA. Traumatic brain injury as a risk factor for Alzheimer’s disease: a review. Neuropsychol Rev 2000;10:115–29.CrossRefGoogle ScholarPubMed
Moretti, L, Cristofori, I, Weaver, SM, Chau, A, Portelli, JN, Grafman, J Cognitive decline in older adults with a history of traumatic brain injury Lancet Neurol 2012;11:1103–12.CrossRefGoogle ScholarPubMed
Johnson, VE, Stewart, W, Smith, DH. Traumatic brain injury and amyloid-β pathology: a link to Alzheimer’s disease? Nat Rev Neurosci 2010;11:361–70.Google Scholar
Fann, JR, Ribe, AR, Pedersen, HS, et al. Long-term risk of dementia among people with traumatic brain injury in Denmark: a population-based observational cohort study. Lancet Psychiatr, in press.Google Scholar
Godbolt, AK, Cancelliere, C, Hincapie, CA, et al. Systematic review of the risk of dementia and chronic cognitive impairment after mild traumatic brain injury: results of the international collaboration on mild traumatic brain injury prognosis. Arch Phys Med Rehabil 2014;95(3):S245–56.Google Scholar
Deckers, K, van Boxtel, MP, Schiepers, OJ, et al. Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies. Int J Geriatr Psychiatry 2015;30:234–46.Google Scholar
Washington, PM, Villapol, S, Burns, MP. Polypathology and dementia after brain trauma: does brain injury trigger distinct neurodegenerative diseases, or should they be classified together as traumatic encephalopathy? Exp Neurol 2016;275:381–8.Google Scholar
Walsh, S, Donnan, J, Fortin, Y, et al. A systematic review of the risk factors associated with the onset and natural progression of epilepsy. Neurotoxicology 2017;61:64–77.Google Scholar
Burke, JF, Stulc, JL, Skolarus, LE, et al. Traumatic brain injury may be an independent risk factor for stroke. Neurology 2013;81 :33–9.Google Scholar
Liao, C-C, Chou, Y-C, Yeh, C-C, et al. Stroke risk and outcomes in patients with traumatic brain injury: 2 nationwide studies. Mayo Clin Proc 2014;89:163–72.CrossRefGoogle ScholarPubMed
Jafari, S, Etminan, M, Aminzadeh, F, et al. Head injury and risk of Parkinson’s disease: a systematic review and meta-analysis. Mov Disord 2013;28:1222–9.Google Scholar
Gardner, RC, Burke, JF, Nettiksimmons, J, et al. Traumatic brain injury in later life increases risk for Parkinson’s disease. Ann Neurol 2015;77:987–95.Google Scholar
Crane, PK, Gibbons, LE. Association of traumatic brain injury with late-life neurodegenerative conditions and neuropathological findings. JAMA Neurol 2016;73:1062–9.Google Scholar
McMillan, TM, Teasdale, GM, Weir, CJ, et al. Death after head injury: the 13 year outcome of a case control study. J Neurol Neurosurg Psychiatry 2011;82:931–5.CrossRefGoogle ScholarPubMed
Teasdale, TW, Engberg, AW. Suicide after traumatic brain injury: a population study. J Neurol Neurosurg Psychiatry 2001;71:436–40.Google Scholar
Corsellis, JAN. Boxing and the brain. Br Med J 1989;289:105.Google Scholar
Corsellis, JAN, Bruton, CJ, Freeman-Browne, D. The aftermath of boxing. Psychol Med 1973;3:270.Google Scholar
Collins, MW, Iverson, GL, Gaetz, M, et al. Sport-related concussion. In: Zasler, ND, Katz, DI, Zalfonte, RD, eds. Brain injury medicine, principles and practice. New York: Demos Medical Publishing; 2007.Google Scholar
Asken, BM, Sullan, MJ, Snyder, AR, et al. Factors influencing clinical correlates of chronic traumatic encephalopathy (CTE): a review. Neuropsychol Rev 2016;26:340–63.Google Scholar
Stewart, W. Five minutes with … Willie Stewart: neuropathologist tells Anne Gulland of his footballers’ dementia risk study. BMJ 2018;360:88.Google Scholar
Coleman, M, Handler, M, Martin, C. Update on apolipoprotein E state of the art. Hosp Phys 1995;31:22–4.Google Scholar
Teasdale, GM, Nicoli, JA, Murray, G, et al. Association of apolipoprotein E polymorphism with outcome after head injury. Lancet 1997;350:1069–71.Google Scholar
Nathoo, N, Chetty, R, van Dellen, JR, Barnett, GH. Genetic vulnerability following traumatic brain injury: the role of apolipoprotein E. Mol Pathol 2003;56:132–6.Google Scholar
Zhou, W, Xu, D, Peng, X, et al. Meta-analysis of APOE4 allele and outcome after traumatic brain injury. J Neurotrauma 2008;25(4):279–90.Google Scholar
Kurowski, B, Martin, LJ, Wade, SL. Genetics and outcomes after traumatic brain injury (TBI): what do we know about pediatric TBI? J Pediatr Rehabil Med 2012;5(3):217–31.Google Scholar
Calvin, H, Mak, K, Wong, H, et al. Traumatic brain injury in the elderly: is it as bad as we think? Curr Transl Geriatr Exp Gerontol Rep 2012;1(3):171–8.Google Scholar
Ross, AM, Pitts, LH, Kobayashi, S. Prognosticators of outcome after major head injury in the elderly. J Neurosci Nurs 1992;24 :88–93.Google Scholar
Pentland, B, Jones, PA, Roy, CW, et al. Head injury in the elderly. Age Aging 1986;15:193–202.CrossRefGoogle ScholarPubMed
Rothweiler, B, Temkin, NR, Dikmen, SS. Ageing effect on psychosocial outcome in traumatic brain injury. Arch Phys Med Rehabil 1998;79:881–7.Google Scholar
Maurice-Williams, RS. Head injuries in the elderly. Br J Neurosurg 1999;13 :5–8.Google Scholar
Pruitt, BA Jr. Part 2: prognosis in penetrating brain injury. J Trauma 2001;51:S44–86.Google Scholar
Santiago, LA, Oh, BC, Dash, PK, et al. A clinical comparison of penetrating and blunt traumatic brain injuries. Brain Injury 2012;26(2):107–25.Google Scholar
Taber, KH, Warden, DL, Robin, A, et al. Blast-related traumatic brain injury: what is known? J Neuropsychiatr Clin 2006;18:141–5.Google Scholar
Elder, GA, Cristian, A. Blast-related mild traumatic brain injury: mechanisms of injury and impact on clinical care. Mount Sinai J Med 2009;76(2):111–18.Google Scholar
Goldstein, LE, Fisher, AM, Tagge, CA, et al. Chronic traumatic encephalopathy in blast- exposed military veterans and a blast neurotrauma mouse model. Sci Transl Med 2012;4(134):1–17.Google Scholar

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