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21. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury

Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury Clinical Practice Guidelines CATHERINE C. QUATMAN-YATES, PT , DPT , PhD • AIRELLE HUNTER-GIORDANO, PT , DPT KATHY K. SHIMAMURA, PT , DPT , NCS, OCS, CSCS, FAAOMPT • ROB LANDEL, PT , DPT , FAPTA BARA A. ALSALAHEEN, PT , PhD • TIMOTHY A. HANKE, PT , PhD • KAREN L. McCULLOCH, PT , PhD, FAPTA Physical Therapy Evaluation and Treatment After Concussion/ Mild Traumatic Brain Injury Clinical Practice Guidelines (...) experi- enced a recent potential concussive event for signs of medical emergency or severe pathology (eg, more serious brain injury, medical conditions, or cervical spine injury) that warrant further evaluation by other health care providers. Referral for fur- ther evaluation should be made as indicated (FIGURE 1). Differential Diagnosis A Physical therapists must evaluate for potential signs and symptoms of an undiagnosed concussion in patients who have experienced a concussive event but have

2020 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

22. Guidelines for the Management of Severe Traumatic Brain Injury (4th edition)

for management decisions, may be considered to reduce mortality and improve outcomes at 3 and 6 mo post-injury. a AVDO 2 , arteriovenous oxygen content difference; CPP, cerebral perfusion pressure; CT, computed tomography; GCS, Glasgow Coma Scale; ICP, intracranial pressure; SBP, systolic blood pressure; TBI, traumatic brain injury. b Bold: New or revised recommendations. TABLE 2. Updated Monitoring Recommendations , Topic Recommendations Intracranial pressure monitoring Level IIB • Management of severe TBI (...) mortality. Advanced cerebral monitoring Level III • Jugular bulb monitoring of AVDO 2 , as a source of information for management decisions, may be considered to reduce mortality and improve outcomes at 3 and 6 mo post-injury. a AVDO 2 , arteriovenous oxygen content difference; CPP, cerebral perfusion pressure; CT, computed tomography; GCS, Glasgow Coma Scale; ICP, intracranial pressure; SBP, systolic blood pressure; TBI, traumatic brain injury. b Bold: New or revised recommendations. TABLE 3. Updated

2016 Congress of Neurological Surgeons

23. Management of Concussion-mild Traumatic Brain Injury (mTBI)

) • Any alteration in mental state at the time of the injury (e.g., confusion, disorientation, slowed thinking, alteration of consciousness/mental state) • Neurological deficits (e.g., weakness, loss of balance, change in vision, praxis, paresis/plegia, sensory loss, aphasia) that may or may not be transient • Intracranial lesion External forces may include any of the following events: the head being struck by an object, the head striking an object, the brain undergoing an acceleration/deceleration (...) Management of Concussion-mild Traumatic Brain Injury (mTBI) VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF CONCUSSION-MILD TRAUMATIC BRAIN INJURY Department of Veterans Affairs Department of Defense QUALIFYING STATEMENTS The Department of Veterans Affairs and the Department of Defense guidelines are based upon the best information available at the time of publication. They are designed to provide information and assist decision making. They are not intended to define a standard

2016 VA/DoD Clinical Practice Guidelines

24. Management of Traumatic Brain Injury

) (BOOST 2). www.clinicaltrials.gov/show/ NCT00974259. Aries, M. J., M. Czosnyka, K. P. Budohoski, L. A. Steiner, A. Lavinio, A. G. Kolias, P. J. Hutchinson, K. M. Brady, D. K. Menon, J. D. Pickard and P. Smielewski. 24Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury. Crit Care Med 40(8): 2456-2463. 2012 Hlatky, R., A. B. Valadka and C. S. Robertson. Intracranial pressure response to induced hypertension: role of dynamic pressure autoregulation. Neurosurgery 57 (...) (5): 917-923; discussion 917-923. 2005 Howells, T., K. Elf, P. A. Jones, E. Ronne-Engstrom, I. Piper, P. Nilsson, P. Andrews and P. Enblad. Pressure reactivity as a guide in the treatment of cerebral perfusion pressure in patients with brain trauma. J Neurosurg 102(2): 311-317. 2005 Lazaridis, C., S. M. DeSantis, P. Smielewski, D. K. Menon, P. Hutchinson, J. D. Pickard and M. Czosnyka. Patient- specific thresholds of intracranial pressure in severe traumatic brain injury. J Neurosurg 120(4): 893

2015 American College of Surgeons

25. Brain injury rehabilitation in adults

period of loss of or a decreased level of consciousness y any loss of memory for events immediately before or after the injury y any alteration in mental state at the time of the injury (confusion, disorientation, slowed thinking, etc) y neurological deficits (weakness, loss of balance, change in vision, praxis, paresis/plegia, sensory loss, aphasia, etc) that may or may not be transient, or y intracranial lesion. Brain injury rehabilitation in adults| 3 1.3.3 BRAIN INj URy SEVERITy Long term (...) MTBI, ie with associated skull fractures or intracranial lesions may have significant cognitive deficits. 27, 28 2 ++ 2 ++ 2 ++ 3 2 ++ 2 + Brain injury rehabilitation in adults| 11 False positives on cognitive testing can be a problem. Effort tests have been developed for use in psychometric examinations which evaluate whether a patient’s poor score on cognitive testing is likely to represent a false positive due to poor effort. A number of such tests have been developed but no recommendation can

2013 SIGN

26. Alcohol related brain injury (ARBI). A guide for general practitioners and other health workers

Alcohol related brain injury (ARBI). A guide for general practitioners and other health workers Drug and Alcohol Services South Australia Alcohol Related Brain Injury (ARBI) A guide for general practitioners and other health workers The assessment needs to occur at least six weeks after alcohol withdrawal in the context of abstinence and proper nutrition. Repeat assessment at three months is recommended, as significant recovery in functioning can occur during this time and up to 12 months after (...) -motor problems (impaired eye-hand coordination and perception-related tasks). Assessment Psychometric assessment by a registered psychologist can help in determining the nature and extent of the ARBI symptoms and how they may impact on daily functioning and treatment. ARBI refers to the physiological and biochemical changes in the brain associated with regular, prolonged and excessive use of alcohol. Injury to the brain is caused by thiamine deficiency due to poor nutrition and alcohol-related

2014 Clinical Practice Guidelines Portal

27. Routine imaging of the preterm neonatal brain

infants born at or before 31+6 weeks gestation. For preterm neonates born between 32+0 to 36+6 weeks gestation, routine head ultrasound is recommended only in presence of risk factors for intracranial hemorrhage or ischemia. Brain imaging in the first 7 to 14 days post-birth is advised to detect most germinal matrix and intraventricular hemorrhages. Repeat imaging at 4 to 6 weeks of age is recommended to detect white matter injury. Keywords: Computed tomography (CT); Germinal matrix hemorrhage (GMH (...) Routine imaging of the preterm neonatal brain Routine brain imaging to detect injuries affecting preterm infants is used to predict long-term outcomes and identify complications that might necessitate an intervention. Although magnetic resonance imaging may be indicated in some specific cases, head ultrasound is the most widely used technique and, because of portability and ease of access, is the best modality for routine imaging. Routine head ultrasound examination is recommended for all

2020 Canadian Paediatric Society

28. Evidence-based approaches to the management of cognitive and behavioral impairments following pediatric brain injury

, Rosenfeld JV, Anderson VA. Selective changes in executive functioning ten years after severe childhood traumatic brain injury. Dev. Neuropsychol. 36(5),578–595 ( 2011 ). , 5 Alzaga AG, Cerdan M, Varon J. Therapeutic hypothermia. Resuscitation 70,369–380 ( 2007 ). , 6 Sahuquillo J, Vilalta A. Cooling the injured brain: does moderate hypothermia influence the pathophysiology of traumatic brain injury. Curr. Pharm. Des. 13,2310–2322 ( 2007 ). , , 7 Jiang J, Yang X. Current status of cerebral protection (...) , and complications of hypothermia. Crit. Care Med. 37(7),186–202 ( 2009 ).▪▪ Provides suggestions as to why results regarding hypothermia may be inconsistent across studies. , 14 Servadei F, Compagnone C, Sahuquillo J. The role of surgery in traumatic brain injury. Curr. Opin. Crit. Care 13,163–168 ( 2007 ). , 15 Valadka AB, Robertson CS. Surgery of cerebral trauma and associated critical care. Neurosurgery 61(Suppl. 1) 203–220; discussion 220–221 ( 2007 ). , 16 Thomale UW, Graetz D, Vajkoczy P, Sarrafzadeh

2013 Clinical Practice Guidelines Portal

29. Mild traumatic brain injury Full Text available with Trip Pro

Mild traumatic brain injury Mild traumatic brain injury - Vos - 2012 - European Journal of Neurology - Wiley Online Library The full text of this article hosted at iucr.org is unavailable due to technical difficulties.

2012 European Academy of Neurology

30. Organizational Guideline for the Delivery of Stereotactic Radiosurgery for Brain Metastasis in Ontario

Organizational Guideline for the Delivery of Stereotactic Radiosurgery for Brain Metastasis in Ontario Guideline 21-4 A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Organizational Guideline for the Delivery of Stereotactic Radiosurgery for Brain Metastasis in Ontario A. Sahgal, S. Kellett, M. Ruschin, J. Greenspoon, M. Follwell, J. Sinclair, J. Perry, O. Islam and the Stereotactic Radiosurgery for Brain Metastasis Guideline Development Group Report (...) S, Ruschin M, Greenspoon J, Follwell M, Sinclair J, Perry J, Islam O and the Stereotactic Radiosurgery for Brain Metastasis Guideline Development Group. Organizational Guideline for the Delivery of Sterotactic Radiosurgery for Brain Metastasis in Ontario. Toronto (ON): Cancer Care Ontario; 2019 August 27. Program in Evidence-Based Care Guideline No.: 21-4. Copyright This report is copyrighted by Cancer Care Ontario; the report and the illustrations herein may not be reproduced without

2019 Cancer Care Ontario

31. Acute Kidney Injury (AKI)

. Continuous RRT should preferably be offered to patients who are haemodynamically unstable or have acute brain injury or cerebral oedema. (2B) Guideline 9.2 - Choice of membrane and fluids We recommend that: ? dialysers with a biocompatible membrane should be used for IHD and CRRT. (1C) ? bicarbonate should be the preferred buffer for dialysate and replacement fluid in continuous renal replacement therapy (CRRT) techniques. (1C) ? fluids used for continuous or intermittent haemodialysis, haemofiltration (...) Acute Kidney Injury (AKI) Clinical Practice Guideline Acute Kidney Injury (AKI) Authors: Dr Suren Kanagasundaram – Chair Consultant Nephrologist, Newcastle upon Tyne Hospitals NHS Foundation Trust Honorary Clinical Senior Lecturer, Institute of Cellular Medicine, Newcastle University Professor Caroline Ashley Renal Pharmacist, Royal Free Hospital Dr Sheetal Bhojani Consultant Paediatrician with Special Interest in Nephrology, University Hospital Wishaw, NHS Lanarkshire Ms Alma Caldwell Patient

2019 Renal Association

32. Drug-Induced Liver Injury

Drug-Induced Liver Injury EASL Clinical Practice Guidelines: Drug-induced liver injury q European Association for the Study of the Liver ? Summary Idiosyncratic (unpredictable) drug-induced liver injury is one of the most challenging liver disorders faced by hepatologists, because of the myriad of drugs used in clinical practice, avail- able herbs and dietary supplements with hepatotoxic potential, the ability of the condition to present with a variety of clinical (...) andpathologicalphenotypesandthecurrentabsenceofspeci?c biomarkers. This makes the diagnosis of drug-induced liver injury an uncertain process, requiring a high degree of aware- ness of the condition and the careful exclusion of alternative aetiologies of liver disease. Idiosyncratic hepatotoxicity can be severe, leading to a particularly serious variety of acute liver failure for which no effective therapy has yet been developed. These Clinical Practice Guidelines summarize the available evi- dence on risk factors, diagnosis, management and risk

2019 European Association for the Study of the Liver

33. Obstetric Management of Patients with Spinal Cord Injuries

transections. Afferent stimuli come from distention of a hollow viscus (eg, the bladder, bowel, or uterus) and from the skin below the level of the lesion or of the genital areas. Signs and Symptoms The inhibitory response from cerebral vasomotor centers causes vasodilation above the level of injury, with symptoms including pounding headache, flushing, nasal congestion, nausea, anxiety, malaise, and a prickling sensation in the skull; signs include sweating, blushing, skin blotching, piloerection, tremor (...) Obstetric Management of Patients with Spinal Cord Injuries Obstetric Management of Patients with Spinal Cord Injuries | ACOG Clinical Guidance Journals & Publications Patient Education Topics Featured Clinical Topics Hi, Featured Clinical Topics Clinical Guidance Obstetric Management of Patients with Spinal Cord Injuries Committee Opinion Number 808 May 2020 Jump to Resources Share By reading this page you agree to ACOG's Terms and Conditions. . Nearly half (47.6%) occur in persons between

2020 American College of Obstetricians and Gynecologists

34. ACR–ASNR–SPR Practice Parameter for the Performance and Interpretation of Magnetic Resonance Imaging (MRI) of the Brain

imaging of traumatic brain injury. Radiol Clin North Am 2012;50:15-41. 39. Burgess RE, Kidwell CS. Use of MRI in the assessment of patients with stroke. Curr Neurol Neurosci Rep 2011;11:28-34. 40. Vernooij MW, van der Lugt A, Ikram MA, et al. Prevalence and risk factors of cerebral microbleeds: the Rotterdam Scan Study. Neurology 2008;70:1208-1214. 41. Kidwell CS, Chalela JA, Saver JL, et al. Comparison of MRI and CT for detection of acute intracerebral hemorrhage. JAMA 2004;292:1823-1830. 42 (...) Practice Parameter for the Performance of Cervicocerebral Magnetic Resonance Angiography [MRA].) 3. Congenital disorders and anatomical abnormalities including the evaluation of brain maturation [23-26]. 4. Congenital or acquired neurodegenerative disorders [14,27-30]. 5. Congenital or acquired hydrocephalus [31,32]. 6. Metabolic disorders [33,34]. 7. Trauma [35-38]. a. Certain benefits over computed tomography (CT), such as detection of diffuse axonal injury. b. Post-traumatic brain injury. c

2019 American Society of Neuroradiology

35. ACR–ASNR Practice Parameter for the Performance of Computed Tomography (CT) of the Brain

. 2007;62(5):404-415. 2. Hijaz TA, Cento EA, Walker MT. Imaging of head trauma. Radiol Clin North Am. 2011;49(1):81-103. 3. Jacobs B, Beems T, van der Vliet TM, Diaz-Arrastia RR, Borm GF, Vos PE. Computed tomography and outcome in moderate and severe traumatic brain injury: hematoma volume and midline shift revisited. J Neurotrauma. 2011;28(2):203-215. 4. Miller MT, Pasquale M, Kurek S, et al. Initial head computed tomographic scan characteristics have a linear relationship with initial intracranial (...) possible. CT of the brain is superior to magnetic resonance imaging (MRI) for the evaluation of osseous structures, acute intracranial hemorrhage, and the detection of calcification, which can be important for the identification of an abnormality or for refinement of a differential diagnosis. CT of the brain is sufficient and diagnostic in many clinical circumstances such as in acute trauma, nontraumatic intracranial hemorrhage, evaluation of shunt malfunction, and selected postoperative follow-up

2019 American Society of Neuroradiology

36. ACR–ASNR Practice Parameter for Brain PET/CT Imaging Dementia Res. 17 – 2015 - 2019

to, the following: 1. Assessment of progressive dementia: Although AD is the most common cause of dementia in the elderly, several other neurodegenerative conditions exist that may be responsible for progressive dementia in the individual patient. FDG-PET can identify the underlying characteristic brain regional patterns of cerebral hypometabolism and can thereby distinguish AD from other degenerative processes such as FTD [17]. 4 / Brain Dementia PET/CT Imaging PRACTICE PARAMETER ? 2. Assessment (...) ACR–ASNR Practice Parameter for Brain PET/CT Imaging Dementia Res. 17 – 2015 - 2019 PRACTICE PARAMETER Brain Dementia PET/CT Imaging / 1 The American College of Radiology, with more than 30,000 members, is the principal organization of radiologists, radiation oncologists, and clinical medical physicists in the United States. The College is a nonprofit professional society whose primary purposes are to advance the science of radiology, improve radiologic services to the patient, study

2019 American Society of Neuroradiology

37. Appropriate Use Criteria: Imaging of the Brain

is considered medically necessary for diagnosis and management when the results of imaging will impact treatment decisions. IMAGING STUDY - CT or MRI brain Trauma Trauma Does not apply to patients with bleeding diatheses or intracranial shunts in whom advanced imaging may be performed when the results will impact management decisions. ADULT Advanced imaging is considered medically necessary in the initial evaluation of head trauma when a mechanism of injury has been identified and ANY of the following (...) of the Guidelines 4 Administrative Guidelines 5 Ordering of Multiple Studies 5 Simultaneous Ordering of Multiple Studies 5 Repeated Imaging 5 Pre-Test Requirements 6 History 6 Imaging of the Brain 7 General Information/Overview 7 Scope 7 Technology Considerations 7 Definitions 8 Clinical Indications 9 Congenital and Developmental Conditions 9 Ataxia, congenital or hereditary 9 Developmental delay (Pediatric only) 9 Congenital cerebral anomalies 10 Infection 10 Infection 10 Inflammatory Conditions 11 Multiple

2019 AIM Specialty Health

38. Anticonvulsant Prophylaxis and Steroid Use in Adults With Metastatic Brain Tumors

to increased intracranial pressure and edema secondary to brain metastases. It is recommended for patients who are symptomatic from metastatic disease to the brain that a starting dose of dexamethasone 4 to 8 mg/d be considered. Patients with brain metastases with moderate to severe symptoms related to mass effect Level 3: Corticosteroids are recommended to provide temporary symptomatic relief of symptoms related to increased intracranial pressure and edema secondary to brain metastases. If patients (...) Anticonvulsant Prophylaxis and Steroid Use in Adults With Metastatic Brain Tumors Anticonvulsant Prophylaxis and Steroid Use in Adults With Metastatic Brain Tumors: ASCO and SNO Endorsement of the Congress of Neurological Surgeons Guidelines | Journal of Clinical Oncology Search in: Menu Article Tools ASCO SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.18.02085 Journal of Clinical Oncology - published online before print

2019 American Society of Clinical Oncology Guidelines

39. EANM-EAN recommendations for the use of brain 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in neurodegenerative cognitive impairment and dementia: Delphi consensus Full Text available with Trip Pro

EANM-EAN recommendations for the use of brain 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in neurodegenerative cognitive impairment and dementia: Delphi consensus European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain 18F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus - Nobili - 2018 - European Journal of Neurology - Wiley Online Library Search (...) within Search term Search term The full text of this article hosted at iucr.org is unavailable due to technical difficulties. EAN Guidelines/CME Article Free Access European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain 18 F‐fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus Corresponding Author E-mail address: Department of Neuroscience (DINOGMI), University of Genoa

2018 European Academy of Neurology

40. Policy Prevention of Sports-related Orofacial Injuries

millimeter thickness might reduce the incidence of concussion injuries from a blow to the jaw by positioning the jaw to absorb the impact forces which, without it, would be transmitted through the skull base to the brain. 55 The American Society for Testing and Materials ( ASTM) classifies mouthguards by three categories 56 : 1. Type I – Custom-fabricated mouthguards are produced on a dental model of the patient’s mouth by either the vacuum-forming or heat-pressure lamination technique. 39 The ASTM (...) : A historical review. Br J Sports Med 2002;36(6):410-27. AMERICAN ACADEMY OF PEDIATRIC DENTISTRY ORAL HEALTH POLICIES 91 54. Deogade SC, Dube G, Sumathi K, Dube P, Katare U, Katare D. Sports dentistry and mouthguards. Brit J Med Med Res 2016;11(6):1-10. 55. Winters J, DeMont R. Role of mouthguards in reducing mild traumatic brain injury/concussion incidence in high school athletes. Gen Dent 2014;62(3):34-8. 56. American Society for Testing and Materials. ASTM F697- 16. Standard practice for care and use

2018 American Academy of Pediatric Dentistry

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