Phoebe H Johnson-Black, Julia M Carlson, Paul M Vespa
{"title":"Traumatic brain injury and disorders of consciousness.","authors":"Phoebe H Johnson-Black, Julia M Carlson, Paul M Vespa","doi":"10.1016/B978-0-443-13408-1.00014-2","DOIUrl":null,"url":null,"abstract":"<p><p>Trauma is one of the most common causes of disorders of consciousness (DOC) worldwide. Traumatic brain injury (TBI) leads to heterogeneous, multifocal injury via focal brain damage and diffuse axonal injury, causing an acquired network disorder. Recovery occurs through reemergence of dynamic cortical and subcortical networks. Accurate diagnostic evaluation is essential toward promoting recovery and may be more challenging in traumatic than non-traumatic brain injuries. Standardized neurobehavioral assessment is the cornerstone for assessments in the acute, prolonged, and chronic phases of traumatic DOC, while structural and functional neuroimaging, tractography, nuclear medicine studies, and electrophysiologic techniques assist with differentiation of DOC states and prognostication. Prognosis for recovery is better for patients with TBI than those with non-traumatic brain injuries, and the timeline for recovery is longer. The majority of patients experience improvement in their DOC within the first year post-injury, but recovery can continue for five and even ten years after TBI. Pharmacologic therapy and device-related neuromodulation represent important areas for future research.</p>","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"207 ","pages":"75-96"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Handbook of clinical neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/B978-0-443-13408-1.00014-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Trauma is one of the most common causes of disorders of consciousness (DOC) worldwide. Traumatic brain injury (TBI) leads to heterogeneous, multifocal injury via focal brain damage and diffuse axonal injury, causing an acquired network disorder. Recovery occurs through reemergence of dynamic cortical and subcortical networks. Accurate diagnostic evaluation is essential toward promoting recovery and may be more challenging in traumatic than non-traumatic brain injuries. Standardized neurobehavioral assessment is the cornerstone for assessments in the acute, prolonged, and chronic phases of traumatic DOC, while structural and functional neuroimaging, tractography, nuclear medicine studies, and electrophysiologic techniques assist with differentiation of DOC states and prognostication. Prognosis for recovery is better for patients with TBI than those with non-traumatic brain injuries, and the timeline for recovery is longer. The majority of patients experience improvement in their DOC within the first year post-injury, but recovery can continue for five and even ten years after TBI. Pharmacologic therapy and device-related neuromodulation represent important areas for future research.
期刊介绍:
The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.