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20 - Head injury and dementia

Published online by Cambridge University Press:  12 October 2009

Colin Smith
Affiliation:
Department of Neuropathology, University of Glasgow, UK; Department of Pathology, University of Edinburgh, UK
James A. R. Nicoll
Affiliation:
Department of Neuropathology, University of Glasgow, UK; Division of Clinical Neurosciences, University of Southampton, General Hospital, UK
David I. Graham
Affiliation:
Department of Neuropathology, University of Glasgow, UK
Margaret M. Esiri
Affiliation:
University of Oxford
Virginia M. -Y. Lee
Affiliation:
University of Pennsylvania School of Medicine
John Q. Trojanowski
Affiliation:
University of Pennsylvania School of Medicine
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Summary

Introduction

Traumatic brain injury remains a significant cause of morbidity and mortality throughout the world. In the United Kingdom more than 150,000 patients are admitted to hospital each year with a head injury. Of this group more than 80% are classified as having a mild head injury, as defined by the Glasgow Coma Scale (GCS). The GCS (Teasdale & Jennett 1974, 1976) provides a means of quantifying the level of consciousness after traumatic brain injury based on the clinical features of verbal performance, eye opening and motor response. Using this scale three levels of severity of head injury are defined; mild (score 13–15), moderate (score 9–12), and severe (score 3–8).

Approximately 1–2% of patients admitted to hospital after traumatic brain injury die as a consequence of their injuries. The majority of fatalities are within the severe head injury group, with 40% of the cases resulting in death at 6 months (Murray et al., 1999).

Among survivors of traumatic brain injury of all grades chronic disability may have a physical component although it is predominantly the cognitive and behavioural problems which provide the greatest challenge (Jennett et al., 1981). Outcome may be assessed by the Glasgow Outcome Scale (GOS) (Jennett & Bond 1975) which defines four outcome states; death/vegetative state, severe disability, moderate disability, and good recovery. The GOS is based predominantly on assessment of social reintegration after traumatic brain injury involving a structured questionnaire-based interview. This has recently been modified as the extended GOS (Teasdale et al., 1998).

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Publisher: Cambridge University Press
Print publication year: 2004

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  • Head injury and dementia
    • By Colin Smith, Department of Neuropathology, University of Glasgow, UK; Department of Pathology, University of Edinburgh, UK, James A. R. Nicoll, Department of Neuropathology, University of Glasgow, UK; Division of Clinical Neurosciences, University of Southampton, General Hospital, UK, David I. Graham, Department of Neuropathology, University of Glasgow, UK
  • Edited by Margaret M. Esiri, University of Oxford, Virginia M. -Y. Lee, University of Pennsylvania School of Medicine, John Q. Trojanowski, University of Pennsylvania School of Medicine
  • Book: The Neuropathology of Dementia
  • Online publication: 12 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526886.021
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  • Head injury and dementia
    • By Colin Smith, Department of Neuropathology, University of Glasgow, UK; Department of Pathology, University of Edinburgh, UK, James A. R. Nicoll, Department of Neuropathology, University of Glasgow, UK; Division of Clinical Neurosciences, University of Southampton, General Hospital, UK, David I. Graham, Department of Neuropathology, University of Glasgow, UK
  • Edited by Margaret M. Esiri, University of Oxford, Virginia M. -Y. Lee, University of Pennsylvania School of Medicine, John Q. Trojanowski, University of Pennsylvania School of Medicine
  • Book: The Neuropathology of Dementia
  • Online publication: 12 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526886.021
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Head injury and dementia
    • By Colin Smith, Department of Neuropathology, University of Glasgow, UK; Department of Pathology, University of Edinburgh, UK, James A. R. Nicoll, Department of Neuropathology, University of Glasgow, UK; Division of Clinical Neurosciences, University of Southampton, General Hospital, UK, David I. Graham, Department of Neuropathology, University of Glasgow, UK
  • Edited by Margaret M. Esiri, University of Oxford, Virginia M. -Y. Lee, University of Pennsylvania School of Medicine, John Q. Trojanowski, University of Pennsylvania School of Medicine
  • Book: The Neuropathology of Dementia
  • Online publication: 12 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526886.021
Available formats
×