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Management of Mild Head Injury

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1. Can S100B Serum Biomarker Testing Reduce Head Computed Tomography Scanning in Children With Mild Traumatic Brain Injury? Full Text available with Trip Pro

and low positive predictive value, thus somewhat limiting its ability to reduce the number of CT scans and hospital costs. x 8 Ruan, S., Noyes, K., and Bazarian, J.J. The economic impact of S-100B as a pre-head CT screening test on emergency department management of adult patients with mild traumatic brain injury. J Neurotrauma . 2009 ; 26 : 1655–1664 In addition, many facilities may not have immediate access to the results of the test, with personal experience showing a turnaround time of 3 to 18 (...) Can S100B Serum Biomarker Testing Reduce Head Computed Tomography Scanning in Children With Mild Traumatic Brain Injury? Can S100B Serum Biomarker Testing Reduce Head Computed Tomography Scanning in Children With Mild Traumatic Brain Injury? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 5, Pages 456–458 Can S100B Serum Biomarker Testing Reduce Head Computed Tomography Scanning

2019 Annals of Emergency Medicine Systematic Review Snapshots

2. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Initial Management of Concussion/mTBI

concussion/mTBI (see Appendices & ), which may be influenced by psychosocial factors and psychological responses to the injury. Patients who screen positive should be managed and referred to specialist services, if needed, since these conditions commonly complicate recovery. Adapted from the Motor Accidents Authority NSW, Guidelines for Mild Traumatic Brain Injury following a Closed Head Injury (MAA, NSW, 2008). Providing Education After mTBI New Key Section Level of evidence A B C Updated Evidence 2.6 (...) Guideline for concussion/mild traumatic brain injury & persistent symptoms - Initial Management of Concussion/mTBI Initial Management of Concussion/mTBI // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Initial Management of Concussion/mTBI Whether a patient first presents to the Emergency Department (ED) or to the primary care

2018 Ontario Neurotrauma Foundation

3. Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Management of Persistent Symptoms

presentation and considered in the management strategies. Adapted from the Motor Accidents Authority NSW, Guidelines for Mild Traumatic Brain Injury following a Closed Head Injury (MAA, NSW, 2008). 5.3 B Persons with concussion/mTBI and identified factors typically associated with persistent symptoms (see Table ) should be considered for early referral to an interdisciplinary treatment clinic including a physician with expertise in concussion/mTBI where available or interdisciplinary formal network (...) Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Management of Persistent Symptoms General Recommendations Regarding Management of Persistent Symptoms // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age General Recommendations Regarding Management of Persistent Symptoms

2018 Ontario Neurotrauma Foundation

4. External validation of the Scandinavian guidelines for management of minimal, mild and moderate head injuries in children. Full Text available with Trip Pro

External validation of the Scandinavian guidelines for management of minimal, mild and moderate head injuries in children. Clinical decision rules (CDRs) aid in the management of children with traumatic brain injury (TBI). Recently, the Scandinavian Neurotrauma Committee (SNC) has published practical, evidence-based guidelines for children with Glasgow Coma Scale (GCS) scores of 9-15. This study aims to validate these guidelines and to compare them with other CDRs.A large prospective cohort (...) of children (< 18 years) with TBI of all severities, from ten Australian and New Zealand hospitals, was used to assess the SNC guidelines. Firstly, a validation study was performed according to the inclusion and exclusion criteria of the SNC guideline. Secondly, we compared the accuracy of SNC, CATCH, CHALICE and PECARN CDRs in patients with GCS 13-15 only. Diagnostic accuracy was calculated for outcome measures of need for neurosurgery, clinically important TBI (ciTBI) and brain injury on CT.The SNC

2018 BMC Medicine

5. Economic evaluation of the NET intervention versus guideline dissemination for management of mild head injury in hospital emergency departments. Full Text available with Trip Pro

Economic evaluation of the NET intervention versus guideline dissemination for management of mild head injury in hospital emergency departments. Evidence-based guidelines for the management of mild traumatic brain injury (mTBI) in the emergency department (ED) are now widely available, and yet, clinical practice remains inconsistent with the guidelines. The Neurotrauma Evidence Translation (NET) intervention was developed to increase the uptake of guideline recommendations and improve (...) the management of minor head injury in Australian emergency departments (EDs). However, the adoption of this type of intervention typically entails an upfront investment that may or may not be fully offset by improvements in clinical practice, health outcomes and/or reductions in health service utilisation. The present study estimates the cost and cost-effectiveness of the NET intervention, as compared to the passive dissemination of the guideline, to evaluate whether any improvements in clinical practice

2018 Implementation Science Controlled trial quality: predicted high

6. Clinical Practice Guideline on the Management of Rotator Cuff Injuries

Clinical Practice Guideline on the Management of Rotator Cuff Injuries View background material via the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 1 MANAGEMENT OF ROTATOR CUFF INJURIES CLINICAL PRACTICE GUIDELINE Adopted by the American Academy of Orthopaedic Surgeons Board of Directors March 11, 2019 Endorsed by: Please cite this guideline as: American Academy of Orthopaedic Surgeons. Management of Rotator Cuff Injuries Clinical Practice Guideline. https://www.aaos.org (...) /rotatorcuffinjuriescpg Published March 11, 2019 View background material via the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 2 Disclaimer This Clinical Practice Guideline was developed by an AAOS physician volunteer Clinical Practice Guideline development group based on a systematic review of the current scientific and clinical information and accepted approaches to management of rotator cuff injuries. This clinical practice guideline is not intended to be a fixed protocol, as some patients may

2020 American Academy of Orthopaedic Surgeons

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

to the original CPG. It provides best practice recommendations for the care of patients with a history of mTBI. While screening for and addressing co-occurring mental disorders is considered good clinical practice, specific guidance on management of co-occurring mental health conditions is beyond the scope of this VA/DoD Clinical Practice Guideline for the Management of Concussion-mild Traumatic Brain Injury February 2016 Page 13 of 133 CPG. Interested readers are referred to related VA/DoD CPGs (e.g (...) • Neurological deficit: motor or sensory • Double vision • Worsening headache • Cannot recognize people or disoriented to place • Slurred speech • Unusual behaviorVA/DoD Clinical Practice Guideline for the Management of Concussion-mild Traumatic Brain Injury February 2016 Page 23 of 133 Evaluating individuals in military operational settings who are exposed to potentially concussive events (e.g., blast, motor vehicle accidents, blow to the head) while in theater is strongly encouraged as soon as possible

2016 VA/DoD Clinical Practice Guidelines

8. Systematic Review - Relationship of Deployment-related Mild Traumatic Brain Injury to Posttraumatic Stress Disorder, Depressive Disorders, Substance Use Disorders, Suicidal Ideation, and Anxiety Disorders

Systematic Review - Relationship of Deployment-related Mild Traumatic Brain Injury to Posttraumatic Stress Disorder, Depressive Disorders, Substance Use Disorders, Suicidal Ideation, and Anxiety Disorders 4 March 2019 Prepared for: Department of Veterans Affairs Veterans Health Administration Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence Synthesis Program (ESP) Center Portland VA Medical Center Portland, OR Mark Helfand, MD, MPH, MS, Director (...) Relationship of Deployment-related Mild Traumatic Brain Injury to Posttraumatic Stress Disorder, Depressive Disorders, Substance Use Disorders, Suicidal Ideation, and Anxiety Disorders: A Systematic Review Authors: Principal Investigator: Nancy Greer, PhD Timothy J. Wilt, MD, MPH Co-Investigators: Princess Ackland, PhD, MSPH Roderick MacDonald, MS Nina Sayer, PhD Michele Spoont, PhD Brent Taylor, PhD Research Assistants: Lauren McKenzie, MPH Christina Rosebush, MPH Evidence Synthesis Program 4 Relationship

2019 Veterans Affairs Evidence-based Synthesis Program Reports

9. Evaluation of a targeted, theory-informed implementation intervention designed to increase uptake of emergency management recommendations regarding adult patients with mild traumatic brain injury: results of the NET cluster randomised trial. Full Text available with Trip Pro

intervention (Neurotrauma Evidence Translation (NET) intervention) was designed to increase the uptake of three clinical practice recommendations regarding the management of patients who present to Australian EDs with mild head injuries. The intervention involved local stakeholder meetings, identification and training of nursing and medical local opinion leaders, train-the-trainer workshops and standardised education materials and interactive workshops delivered by the opinion leaders to others within (...) Evaluation of a targeted, theory-informed implementation intervention designed to increase uptake of emergency management recommendations regarding adult patients with mild traumatic brain injury: results of the NET cluster randomised trial. Evidence-based guidelines for management of mild traumatic brain injury (mTBI) in the emergency department (ED) are now widely available; however, clinical practice remains inconsistent with these guidelines. A targeted, theory-informed implementation

2019 Implementation Science Controlled trial quality: predicted high

10. Early Management of Head Injury in Adults

Injury xii for Head CT Algorithm 4. Selection of Adults with Head Injury xiii for Imaging of the Cervical Spine Algorithm 5. Management of Adults Patient with xiv Mild Head Injury Requiring Urgent Surgery other than Cranial Surgery 1. INTRODUCTION 1 2. DEFINITION 3 3 CLASSIFICATION OF SEVERITY 5 4. DIFFERENTIAL DIAGNOSES 6 5. PRE-HOSPITAL CARE (PHC) 6 5.1 Assessment and General Treatment 6 5.2 Initial Management 7 5.3 Referral or Discharge at Primary Care Setting 9 5.4 Transportation 11 6. MANAGEMENT (...) Refer to hospital with neuro-trauma services * Refer to Algorithm 3 on Selection of Adults with Head Injury for Head CT. ** Refer to Recommendation 7 on Criteria of Patients with Mild Head Injury (MHI) who can be Safely Observed in ED. *** Refer to Recommendation 10 on Criteria for Admission of MHI Patients Post-observation in ED. CT = computed tomography; ED = Emergency Department xEarly Management of Head Injury in Adults ALGORITHM 2. TRIAGING OF ADULTS WITH SUSPECTED HEAD INJURY IN PRE-HOSPITAL

2015 Ministry of Health, Malaysia

11. Mild Head Injury Home Management

Mild Head Injury Home Management Mild Head Injury Home Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Mild Head Injury (...) Home Management Mild Head Injury Home Management Aka: Mild Head Injury Home Management , Mild Head Injury Discharge Instructions , Head Injury Precautions From Related Chapters II. Management Follow-up One week follow-up clinic (or immediately if warning signs occur as below) Consider clinic (sports medicine) ral precautions Avoid and sedating medications for 3 days Remain with a reliable companion for 24 hours Avoid driving for at least the first 24 hours (and until most significant symptoms have

2018 FP Notebook

12. Management of Mild Head Injury

Management of Mild Head Injury Management of Mild Head Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Management of Mild Head (...) Injury Management of Mild Head Injury Aka: Management of Mild Head Injury , Mild Traumatic Brain Injury , MTBI , Minor Head Injury , Mild Head Injury , Mild Head Trauma From Related Chapters II. Epidemiology Mild Traumatic Brain Injury (MTBI) accounts for 75% of the 1.7 Million people in U.S. who suffer TBI annually III. Criteria : 13-15 (at two hours) Loss of consciousness may have occurred with injury Awake and oriented with normal ination IV. History See Time and mechanism of injury Loss

2018 FP Notebook

13. The Incidence and Management of Moderate to Severe Head Injury. Full Text available with Trip Pro

The Incidence and Management of Moderate to Severe Head Injury. The comprehensive expansion of the Trauma Register of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie; TR-DGU) now enables, for the first time, studies on traumatic brain injury (TBI) with special attention to care processes, clinical course, and outcomes of treatment on discharge or transfer from the acute-care hospital.Retrospective analysis of patients documented in the TR-DGU in the period 2013-2017 who had (...) moderate to severe head injury as defined by the Abbreviated Injury Scale (AIS).In the period 2013-2017, 41 101 patients with moderate to severe TBI were treated in TR-DGU-associated hospitals in Germany (n = 605 hospitals), corresponding to 8220 cases per year and thus to a population-wide incidence of 10.1 cases per 100 000 persons per year. TBI was present as an isolated injury in 39.1% of cases. The mean age of the patients was 60 years (median; range 0-104 years), and the male-to-female ratio

2019 Deutsches Arzteblatt international

14. Mild fetal ventriculomegaly: diagnosis, evaluation, and management

Mild fetal ventriculomegaly: diagnosis, evaluation, and management Mild fetal ventriculomegaly: diagnosis, evaluation, and management Society for Maternal-Fetal Medicine (SMFM); Nathan S. Fox, MD; Ana Monteagudo, MD; Jeffrey A. Kuller, MD; Sabrina Craigo, MD; and Mary E. Norton, MD Thepracticeofmedicinecontinuestoevolveandindividualcircumstanceswillvary.Thisopinionre?ectsinformation available at the time of acceptance for publication and is neither designed nor intended to establish (...) .Papageorghiou AT, Thilaganathan B, Bilardo CM, et al. ISUOG interim guidance on ultrasound for Zika virus infection in pregnancy: information for healthcare professionals. Ultrasound Obstet Gynecol 2016;47:530-2. 29.Society for Maternal-Fetal Medicine (SMFM), Hughes BL, Gyam?- Bannerman C. Diagnosis and antenatal management of congenital cytomegalovirus infection. Am J ObstetGynecol 2016;214:B5-11. 30.American College of Obstetricians and Gynecologists. Cytomegalo- virus, parvovirus B19, varicella zoster

2019 Society for Maternal-Fetal Medicine

15. Trauma Bay Disposition of Infants and Young Children With Mild Traumatic Brain Injury and Positive Head Imaging. Full Text available with Trip Pro

Trauma Bay Disposition of Infants and Young Children With Mild Traumatic Brain Injury and Positive Head Imaging. To describe the disposition of infants and young children with isolated mild traumatic brain injury and neuroimaging findings evaluated at a level 1 pediatric trauma center, and identify factors associated with their need for ICU admission.Retrospective cohort.Single center.Children less than or equal to 4 years old with mild traumatic brain injury (Glasgow Coma Scale 13-15 (...) included ICU (48%), ward (38%), intermediate care unit and home (7% each). Overall, 1% required intubation, 4.3% seizure management, and 4.3% neurosurgical procedures; 15% were diagnosed with nonaccidental trauma. None of the ward/intermediate care unit patients were transferred to ICU. Median ICU/hospital length of stay was 2 days. Most patients (99%) were discharged home without neurologic deficits. The ICU subgroup included all patients with midline shift, 62% patients with intracranial hemorrhage

2019 Pediatric Critical Care Medicine

16. Intact mast cell content during mild head injury is required for development of latent pain sensitization: implications for mechanisms underlying post-traumatic headache. (Abstract)

Intact mast cell content during mild head injury is required for development of latent pain sensitization: implications for mechanisms underlying post-traumatic headache. Post-traumatic headache (PTH) is one of the most common, debilitating and difficult symptoms to manage after a traumatic head injury. While the mechanisms underlying PTH remain elusive, recent studies in rodent models suggest the potential involvement of calcitonin gene-related peptide (CGRP), a mediator of neurogenic (...) inflammation, and the ensuing activation of meningeal mast cells (MCs), pro-algesic resident immune cells that can lead to the activation of the headache pain pathway. Here, we investigated the relative contribution of MCs to the development of PTH-like pain behaviors in a model of mild closed head injury (mCHI) in male rats. We initially tested the relative contribution of peripheral CGRP signaling to the activation of meningeal MCs following mCHI using a blocking anti-CGRP monoclonal antibody. We

2019 Pain

17. Understanding the management of patients with head injury taking warfarin: who should we scan and when? Lessons from the AHEAD study. (Abstract)

Understanding the management of patients with head injury taking warfarin: who should we scan and when? Lessons from the AHEAD study. Anticoagulated patients represent an important and increasing proportion of the patients with head trauma attending the ED, but there is no international consensus for their appropriate investigation and management. International guidelines vary and are largely based on a small number of studies, which provide poor-quality evidence for the management of patients (...) warfarin than is currently recommended by most guidelines. Specifically, patients without any head injury-related symptoms and GCS score 15 have a reduced risk of adverse outcome and may not need to be scanned. We argue that there is evidence to support an individualised approach to decision to CT scan in mild head injuries on warfarin and that clinicians should feel able to discuss risks with patients and sometimes decide not to scan.© Author(s) (or their employer(s)) 2019. No commercial re-use. See

2018 Emergency Medicine Journal

18. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sport-Related Concussion/mTBI

for retirement from play: multiple concussion/mTBIs >3, increasing duration of symptoms, subsequent concussion/mTBIs requiring lesser force, inability to return to full-time school or work. 7,8 It should be noted that sport-related concussion/mTBI represents one area of study in the mTBI field. Given that the current guideline is not specific to sport-related injuries, the information and guidance included herein for acute and subacute management is limited. Thus, readers interested in further guidance (...) about how to proceed with progressive return to an activity/sport (see resource links in Appendix F). Further, as discussed above, differences exist between the nature of injuries sustained during sport compared with other types of injuries. Therefore, the application of clinical guidance for sport-related concussion/mTBI may not be appropriate for patients who have sustained other types of injuries. Assessment and Management of Sport-Related Concussion New Key Section Level of evidence A B C

2018 Ontario Neurotrauma Foundation

19. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Cognitive Difficulties

Compensatory Cognitive Training for Traumatic Brain Injury: Effects Over 1 Year. J Head Trauma Rehabil. 2015;30(6):391-401. Country: USA Design: Randomized Control Trial Quality Rating: PEDro: 6/11 Twamley EW, Jak AJ, Delis DC, Bondi MW, Lohr JB. Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for veterans with traumatic brain injury: pilot randomized controlled trial. J Rehabil Res Dev. 2014;51(1):59-70. Country: USA Design: Pilot Randomized Control Trial Quality Rating: PEDro: 6/11 (...) Storzbach D, Twamley EW, Roost MS, et al. Compensatory Cognitive Training for Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans With Mild Traumatic Brain Injury. J Head Trauma Rehabil. 2017;32(1):16-24. Country: USA Design: Randomized Control Trial Quality Rating: PEDro: 8/11 Theadom A, Mahon S, Barker-Collo S, et al. Enzogenol for cognitive functioning in traumatic brain injury: a pilot placebo-controlled RCT. Eur J Neurol. 2013;20(8):1135-1144. Country: New Zealand Design

2018 Ontario Neurotrauma Foundation

20. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Vestibular (Balance/ Dizziness) & Vision Dysfunction

C When the patient identifies a problem with hearing the following steps should be followed: Take a detailed patient history, including auditory history to rule out common causes of hearing complications. Perform an otologic examination, including otoscopy. Refer to audiology for hearing assessment if no other apparent cause is found. Adapted from the VA/DoD Management of Concussion/Mild Traumatic Brain Injury Clinical Practice Guideline (VA/DoD, 2016). 10.7 C There is no evidence to suggest (...) for or against the use of any particular modality for the treatment of tinnitus after concussion/mTBI. Taken from the VA/DoD Management of Concussion/Mild Traumatic Brain Injury Clinical Practice Guideline (VA/DoD, 2016). Vision Dysfunction New Key Section Level of evidence A B C Updated Evidence 10.9 C Vision changes can occur post-concussion and should be screened for (see Appendix ). If vision symptoms are reported, take an appropriate case history and complete a visual examination. 10.10 C When assessed

2018 Ontario Neurotrauma Foundation

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