Monthly Archives: August 2012

TMJ linked to chronic headache

TMJ pain is more common among people with chronic headache according to new research. When compared to adults without head pain, those with chronic daily headache or episodic headache were more likely to suffer from tempromandibular disorders. TMD symptoms were also more severe in patients who also suffered from headaches.

Brain injection could save lives

The lives of head-injury victims could be saved with an injection of nanoparticles moments after the injury occurs. Researchers found that the nanoparticles PEG-HCC can quickly stabilize the brain’s blood flow and help control destructive superoxide levels in the brain. The nanoparticles could help medics on the battlefield or in the emergency room, researchers suggest.

Cervical muscle area measurements following whiplash injuries

Whiplash injuries result in many changes within the spinal muscles. Researchers still do not fully understand the role of these muscle changes in whiplash symptoms. One recent study examined cervical (neck) muscle changes over time in order to determine whether muscle volume affected whiplash symptoms.

The study involved 48 patients who had been involved in vehicle collisions and had whiplash injuries. They were examined at 48 hours, 3 months, and 6 months following the initial injury. MRI cross-sectional muscle area measurements enabled the researchers to track muscle changes over time.

The study was performed to test the hypothesis that cervical muscle volume affects symptom severity following whiplash injuries. The researchers hypothesized that cervical muscle hypotrophy would be visible 6 months after the initial injury, and that it would correlate with an increase in persistent symptoms related to pain or inactivity.

However, the researchers found no significant changes in muscle area measurements over time, and no significant correlations between the measurements and clinical scores reflecting symptoms of pain or immobility. The results, they conclude, do not support the hypothesis that cervical muscle volume plays a major role in the development of symptoms following whiplash injuries.

Reference:

Ulbrich EJ, et al. Cervical muscle area measurements in whiplash patients: Acute, 3, and 6 months of follow-up. Journal of Magnetic Resonance Imaging 2012; doi: 10.1002/jmri.23769.

Do you have enough auto insurance? Probably not.

Really well done article in the New York Times about the ramifications of not having enough insurance coverage to protect themselves and their families.

Here’s a quote from the article:

Still, many of us will tell ourselves all sorts of stories about why this isn’t necessary. For instance, we may figure that no one is going to come after us beyond whatever minimum amount our insurance policy will pay. But if you’re at fault and don’t have enough insurance, the job of plaintiff’s lawyers is to track down both the assets you have now and the ones you may accrue later. They may keep an eye out for any future windfall long after any judgment and then try to use it to satisfy whatever you still owe.

The bottom line? For most people, an extra $25 per month will raise your liability limits from $50,000 to $1 million.

Know the symptoms of PTSD

PTSD is more common than people think in the civilian population. With the rash of shootings across the country, more people are being exposed to violence that would normally only be found in war zones.

This CNN article talks about the common symptoms of PTSD.

Brain injuries cause the brain to age more quickly

Brain injuries may accelerate the aging process of the brain, suggests the results of a new study from the University of Michigan. Previous research has linked concussions with lasting cognitive decline, and this latest study found that cognitive deficits were apparent in participants up to six years after the initial injury.

Researchers examined college students with and without a history of traumatic brain injuries. The students performed tests on a computer while researchers monitored their brain activity. Images taken during the test revealed that participants with a history of concussions had less brain activity during the tests than participants without a history of TBIs. The causes of these cognitive deficits are still unclear but researchers hypothesized that “concussive and subconcussive head impacts set about a cascade of pathological events” that accelerate declines in cognitive function associated with aging.

Students with a history of concussions also showed changes in postural sway and gait, confirming that brain injuries can impact motor control for years after the injury. Researchers suggest that after a concussion, people unconsciously modify their gait to a more conservative stance to prevent falling or injury. Unfortunately, reduced postural control could mean they’re  at an increased risk of falling as they age.

Although the previously concussed students were “highly-functioning” and exhibited no obvious signs of cognitive deficits, researchers suggested that these deficits could become more pronounced with age.

But getting a concussion when you’re young doesn’t guarantee you’ll have dementia later in life. Instead, lead author Steven Broglio told WXYZ that there is a probable dose response; in other words, the more concussions you sustain throughout your lifetime, the more likely you are to experience dementia or Alzheimer’s disease as you age.

Researchers say their next study will include people in their 20s, 40s, and 60s with a history of concussion. They hope to examine whether increasing effects of concussions are apparent with aging.

Reference

Broglio SP, Eckner JT, et al. Cognitive decline and aging: the role of concussive and subconcussive impacts. Exercise and Sport Sciences Reviews 2012; 40(3):138-144.

Preventing whiplash with education

Most people are unaware that using a properly adjusted head restraint can reduce your risk of whiplash injuries. Previous research found that 73% of drivers could not identify the safest position for head restraints, commonly called “head rests.”1

Recently, a team of researchers set out to determine whether a brief education program improved whiplash prevention awareness among a group of vehicle fleet managers.2 The researchers administered a short written survey both before and after a 30-minute presentation on whiplash prevention and whiplash injuries. The presentation was delivered to 27 fleet managers at a regional meeting held in British Columbia, Canada.

Respondents initially had little knowledge of the causes, effects, and prevention of whiplash. After the presentation, respondents showed improved awareness, along with reporting increased motivation to make changes based on this knowledge. The results indicate that improved education can be a valuable way to increase awareness of whiplash injuries and prevention.

Another recent study showed that patient education may also improve the prognosis of patients with whiplash.3 After education on neurophysiology, patients showed significant difference in kinesiophobia (the fear of movement or re-injury), self-rated disability, and other measurements related to whiplash knowledge. Patients also showed improvements in their pain-free movement capabilities following the educational presentation.

References

  1. McCreesh, K., S. Arthurs, S. Horgan, L. Keane and L. Meagher. “Vehicle head restraint positioning knowledge and behaviours in a sample of Irish drivers.” International Journal of Injury Control and Safety Promotion 2011; doi:10.1080/17457300.2011.628754.
  2. Desapriya E, et al. A brief educational program improves awareness regarding whiplash prevention among a cohort of vehicle fleet managers in British Columbia, Canada. Traffic Injury Prevention 2012;13(4):373-7.
  3. Oosterwijck J, Nijs J, Meeus M, Truijen S, Craps J, Van den Keybus N, Paul L. Pain neurophysiology education improves cognitions, pain thresholds, and movement performance in people with chronic whiplash: A pilot study. Journal of Rehabilitation Research and Development. 2011; 48 (1): 43-58.

 

Age weakens recovery from traumatic brain injuries

Age has long been known to be a strong prognostic factor affecting recovery from traumatic brain injury (TBI). Researchers recently undertook a study to evaluate the effect of various age thresholds on TBI outcome.

244 patients were assessed at 1 and 6 months following the initial injury. Of the participants, 144 had severe, 38 had moderate, and 62 patients had mild TBI. The researchers found that age was a significant predicting factor. Mortality at 1 month was significantly associated with advanced age. Other unfavorable outcomes also showed strong association with age increasing.

After statistical analysis, the researchers concluded that there is a stepwise increase in the odds of unfavorable outcomes, particularly for patients over the age of 40. These results are consistent with the findings of previous research, and adds to the knowledge surrounding the effect of age on recovery from traumatic brain injuries.

Dhandapani S, Manju D, Sharma B, and Mahapatra A. Prognostic significance of age in traumatic brain injury. Journal Neurosciences Rural Practice 2012;3(2):131-5.

Traumatic brain injury in elderly patients

Morbidity and mortality due to brain injury is a growing issue in the elderly population. Patients over the age of 70 have a substantially higher risk of mortality and morbidity following traumatic brain injuries, although the factors influencing such outcomes are not well understood.

A group of Italian researchers recently conducted a study to examine the main clinical characteristics affecting the outcome in patients aged over 70. They performed a retrospective analysis of 103 head-injury patients over the age of 70 who were treated between 2004 and 2009. They considered the following clinical variables: age, sex, type of TBI, pre-TBI use of anti-coagulants such as aspirin and warfarin, INR at admission, and GCS.

The most frequent cause of injury was accidental fall (65%), although traffic collision-related injuries were more likely in patients aged 70-75 years. Patients undergoing anticoagulant (CAW) treatments were more likely to be injured due to an accidental fall. Overall mortality rate was higher with elevated INR class, and was also related to the presence of t-SAH and subdural hematoma.

The results show that in patients over the age of 70, traumatic brain injuries are high-risk events, regardless of the cause or treatment specifics.

 Reference

Gaetani P, et al. Traumatic brain injury in the elderly: considerations in a series of 103 patients older than 70. Journal of Neurosurgical Sciences 2012;56(3):231-7.