Brain Injury review

Traumatic brain injury is the leading cause of long term disability in children and adolescences, some of the major consequences associated with it include behavior and physical effects as well as more cognitive problems. One of the more common consequences is dizziness; this is reported in over eighty percent of patients suffering from traumatic brain injury in the initial days following the brain damage. There are many differences in research results that have investigated dizziness in brain injury sufferers.

There are many different types of dizziness associated with traumatic brain injury, these include but are not limited to light headedness, where the sufferer may feel like they are about to feint, this is often associated with a drop in blood pressure when postural is changed; Vertigo, related to the vestibular system;  psycho-physiological dizziness, this involves visual and space problems.
 

The best way of explaining dizziness is as damage to the sensory-motor interactions, which leads to a defect in motor function and in the function of the senses, so that the sufferer is unable to grasp relative orientation. Interestingly many people who suffer from traumatic brain injury have problems to describe their dizziness. There is therefore little information about the causes of non-vesticular dizziness following traumatic brain injury.
 

In an article in ‘brain injury’ Maskell and colleagues concluded that though the causes of the symptoms that lead to dizziness are well documented, there are great problems associated with the data known about the functional impact that dizziness causes in traumatic brain injury patients.

I read a really interesting article in the latest edition of Brain and development by Zannolli et al from Italy.
Global developmental delay is a serious social problem. It is often unrecognized and the phenotypes are inadequately studied. To investigate the phenotypes of children with aspecific central nervous system (CNS) impairment

(poor speech, maladaptive behavioral symptoms such as temper tantrums, aggressiveness, poor concentration and attention, impulsiveness, and mental retardation). Setting. Tertiary care hospital. Patients: Three children (two male siblings, and one unrelated girl). Methods: We used the results from clinical neurological evaluations; imaging and electrodiagnostic studies; metabolic and genetic tests; skin biopsies and bone mineral densitometry. All three children suffered from (A) global developmental delay, (B) osteopenia, and (C) identical skin defects. The skin ultrastructural abnormalities were abnormal keratin differentiation, consisting of hyperkeratosis and granular layer thickening; sweat gland abnormalities, consisting of focal, cytoplasmic clear changes in eccrine secretory cells; and melanocyte abnormalities, with both morphological changes (reduced number and size without evident dendritic processes), and functional changes (defects in the migration of melanosomes in the keratinocytes). These patients present a previously unrecognized syndrome. We retain useful to report this new association, to be recognized, in the next future, as a specific key-sign of a well-defined genetic defect.The full article can be found here Brain Development 

There is much evidence that age is a negative prognostic factor in traumatic brain injury, and that death following brain damage rises with age; in fact death is a near certainty for people who get a traumatic brain injury in their mid seventies. Even in the case of more moderate brain damage, elder people have a lower survival rate than is seen in younger people.

Mass lesions

Elderly people are much more likely to get traumatic mass lesions from moderate injuries, this often results in a permanent disabilities and lengthy, often permanent hospital stays. Additionally, older people are more likely to have post-concussional injuries a year after the occurance of their brain injury. These post-concussional symptoms often include apathy, impulsive behaviour, and depression.