Brain Injury review

This article by J Donders and J Nienhuis from the mary Bed hospital in michigan takes a look at the realtionship between traumatic brain injury and the california verbal test.

The performance of 23 patients with moderate-severe traumatic brain injury on the California Verbal Learning Test, Second Edition (CVLT-II; Delis et al., 2000) was compared with that of 23 matched healthy controls to determine whether recall discriminability indices, which take into account both correct target recall and intrusive errors, would provide better diagnostic classification than traditional variables that are based exclusively on correct recall. Patients with traumatic brain injury recalled fewer correct words, and also made more intrusive errors, on CVLT-II short and long delay, free and cued recall trials (p < .02 for all variables after Stepdown Bonferroni correction). However, recall discriminability indices yielded a classification of clinical versus control participants (72%) that was not significantly different from one based on traditional variables (74%). We conclude that CVLT-II recall discriminability indices do not routinely provide an advantage over traditional variables in patients with traumatic brain injury.

The full article can be found via pubmed; Identifier number 17286892

This article on the relationship  of shoulder pain and traumatic brain injury is by J Leung et al from the royal rehabilitation centre in Sydney. 

OBJECTIVE: To determine the prevalence and characteristics of shoulder pain in people with traumatic brain injury participating in inpatient rehabilitation and to compare the clinical presentation with that of people with stroke.

DESIGN: A prospective comparative study.

SETTING: Six metropolitan rehabilitation units.

SUBJECTS: Eighty-seven people with traumatic brain injury and 52 people with stroke took part in the study.

MAIN MEASURES: Assessment of shoulder pain, range of motion, strength and function was conducted on admission and, for the subjects with traumatic brain injury, at discharge if rehabilitation exceeded two weeks.

RESULTS: The prevalence of shoulder pain in people with traumatic brain injury was 62%, which was comparable with the 69% of subjects with stroke that experienced shoulder pain (odds ratio 0.72, 95% confidence interval 0.34 -1.5). Fracture in the shoulder complex and passive shoulder external rotation range of motion were the best predictors for shoulder pain after traumatic brain injury. This was different from the subjects with stroke for which the best predictors were passive shoulder flexion range of motion and length of acute hospital stay.

CONCLUSION: There is a relatively high prevalence of shoulder pain after traumatic brain injury. Trauma to the shoulder complex contributes to shoulder pain after traumatic brain injury, making clinical presentation different from people with stroke. The findings support the need for greater attention in the management of shoulder pain after traumatic brain injury.

Pubmed number 17264111

The purpose of this investigation was to describe the causes, clinical pattern, and treatment of cerebral salt wasting syndrome in children with acute central nervous system injury. This retrospective study focused on patients 120 mEq/L), and volume depletion. Fourteen patients were identified with cerebral salt wasting syndrome, 12 after a neurosurgical procedure (8 brain tumor, 4 hydrocephalus) and 2 after severe brain trauma. In 11 patients the cerebral salt wasting syndrome was diagnosed during the first 48 hours of admission. Prevalence of cerebral salt wasting syndrome in neurosurgical children was 11.3/1000 surgical procedures. The minimum sodium was 122 +/- 7 mEq/L, the maximum urine osmolarity 644 +/- 59 mOsm/kgH(2)O. The maximum sodium supply was 1 mEq/kg/h (range, 0.1-2.4). The mean duration of cerebral salt wasting syndrome was 6 +/- 5 days (range 1-9). In conclusion, cerebral salt wasting syndrome can complicate the postoperative course of children with brain injury; it is frequently present after surgery for brain tumors and hydrocephalus and in patients with severe head trauma. Close monitoring of salt and fluid balance is essential to prevent severe neurologic and hemodynamic complications.

Pub med ID is 16996399