The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole. Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 373
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
INDEX
A
Abbreviated Injury Scale (AIS), 41, 45, 60,
Adult traumatic brain injury, epidemiology of, 59–102
Afghanistan. See Operation Enduring Freedom
Aggressive behavior, 289–291
primary studies, 289–290
secondary studies, 290–291
summary and conclusion, 293
Alcohol abuse. See Drug and alcohol abuse disorders
Alzheimer's disease (AD). See Dementia of the Alzheimer type
Amnesia. See Posttraumatic amnesia
Amyotrophic lateral sclerosis (ALS), 254–255
secondary studies, 254
summary and conclusion, 255
Animal studies, 104
Anxiety disorders, 281–289
primary studies, 281–283
secondary studies, 283–284
summary and conclusion, 284
B
Behavioral Outcome of Head Injury, 134–136
Biology of traumatic brain injury, 19–57
basic mechanisms of explosive injuries, 31–41
classification according to biomechanics of injury, 27–28
classification according to extent of pathology, 25–27
pathobiology of traumatic brain injury, 19–25
severity scoring of blast injuries and traumatic brain injury, 41–45
summary of pathobiology of traumatic brain injury, 29
therapeutics and traumatic brain injury, 28–29
traumatic brain injuries relevant to the military, 30–31
Biomarkers, 25
Biomechanics of injury, 27–28
closed injury, 27–28
penetrating and perforating injuries, 28
Bipolar disorder, 269.
See also Mood disorders
OCR for page 374
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
Blast-induced neurotrauma (BINT), 36–41
diffuse brain injury, 41
experimental and clinical studies of, 8–9, 370–371
penetrating traumatic brain injury, 40–41
primary blast-induced neurotrauma, 37–40
recommendations concerning, 370–371
severity scoring of, 45
Brain injury severity, 63–64
severity distributions, 64
Brain tumors and traumatic brain injury, 350–363
primary studies, 350–354
secondary studies, 354–355
summary and conclusions, 355
Brief Traumatic Brain Injury Screen, 8, 44–45, 370
C
Canadian Study of Health and Aging (CSHA), 129–130
Case-control studies, 109–110
nested, 110
Case-fatality rates (CFRs), 68
Categories of associations, 112–113
inadequate/insufficient evidence to determine whether an association exists, 113
limited/suggestive evidence of an association, 112
limited/suggestive evidence of no association, 113
sufficient evidence of a casual relationship, 112
sufficient evidence of an association, 112
Caveness. See W.F. Caveness studies of Korean War veterans
Classification according to biomechanics of injury, 27–28
closed injury, 27–28
penetrating and perforating injuries, 28
Classification according to extent of pathology, 25–27
pathologic features of diffuse traumatic brain injury, 26–27
pathologic features of focal traumatic brain injury, 25–26
Cohort studies, 117–172
Bryant and Harvey studies, 133–134, 155–156
general limitations of, 117–118
Jennett (Oxford, Rotterdam, Cardiff, and Manchester) studies, 137–138, 163–164
military studies, 118–127
one type of observational-study design, 108–109
population-based, 127–133
Roberts (Oxford, UK) studies, 138–140, 162–163
of sports-related traumatic brain injury, 140–165
University of Washington longitudinal traumatic brain injury studies, 134–137, 156–162
Computed tomography (CT), of brain lesions, 60
Conclusions and recommendations, 367–372
OCR for page 375
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
Cross-sectional studies, 110
D
Dementia of the Alzheimer type, 237–242
primary study, 237–238
secondary studies, 238–240
Dementia pugilistica (DP), 243–246
secondary studies, 244–245
summary and conclusions, 245–246
Diabetes insipidus, 231.
See also Endocrine disorders
Diffuse traumatic brain injury, 26–27, 41
Diffusion-tensor imaging (DTI), 21–22
Dilantin Prophylaxis of Post-Traumatic Seizures, 134–136
Dizziness, 218.
See also Postconcussion symptoms
Dose-response relationships, in inferring causality, 107–108
Drug and alcohol abuse disorders, 291
secondary studies, 291
summary and conclusions, 293
Dynamic loading, 27–28
E
E.A. Walker's studies of head-injured veterans
from World War I, 119, 143
from World War II, 119–121, 144–145
Endocrine disorders, 227–236
diabetes insipidus, 231
growth hormone insufficiency, 231–232
hypopituitarism, 231
primary studies, 227–230
secondary studies, 230–231
summary and conclusions, 231–232
Epidemiologic studies, 105
Epidemiology of adult traumatic brain injury, 59–102
brain injury severity, 63–64
gross severity of traumatic brain injury, 59–60
incidence of traumatic brain injury, 61–63
outcome scores and predictors, 60
recurrent traumatic brain injury, 67–68
risk factors for traumatic brain injury, 64–67
scales and scoring systems used to describe traumatic brain injury, 59
summary, 69
traumatic brain injury and short-term outcomes, 68–69
OCR for page 376
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
Experimental studies
in penetrating traumatic brain injury, 40–41
in primary blast-induced neurotrauma, 37–39
F
Finnish studies, 121, 145
Focal traumatic brain injury, 25–26
Functional status, 312–313
Functioning of relatives, 313–314
G
Generalized anxiety disorder (GAD), 281.
See also Anxiety disorders
Glasgow Coma Scale (GCS), 42–43, 59–60
eye opening, 42–43
motor response, 43
overall score, 43
in scoring severity of TBI, 42–43
verbal response, 43
Glasgow Outcome Scale (GOS), 60, 69–70
Growth hormone insufficiency, 231–232.
See also Endocrine disorders
Gulf War and Health, previous volumes in series, 1–2, 13–14
H
"Healthy-warrior effect," 109
Hematomas, 25–26
Hypopituitarism, 231.
See also Endocrine disorders
I
Incidence of traumatic brain injury, 61–63
mortality, 62
prevalence, 62–63
time trends, 61–62
Inclusion criteria, 110–111
exposure assessment, 111
methodologic rigor, 111
outcome (health effect) assessment, 111
Independent living, 310, 315
Injury Severity Score (ISS), 41
Intracranial meningioma. See Brain tumors and traumatic brain injury
Iraq War. See Operation Iraqi Freedom
OCR for page 377
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
Irritability. See Postconcussion symptoms
K
Korean War veterans, W.F. Caveness studies of, 123, 147
L
Leisure activities, 311–312
Limitations of the studies, 4–5, 113–114
Lou Gehrig's disease. See Amyotrophic lateral sclerosis
M
Mania, 269.
See also Mood disorders
Mayo Classification System, 43
Mechanisms of explosive injuries, 31–33
blast-induced neurotrauma, 36–41
general medical effects, 33–36
physics, 31–33
Memory impairment. See Postconcussion symptoms
Military Acute Concussion Evaluation (MACE), 45,
Military studies, cohorts, 118–127
Finnish, 121, 145
of head-injured Bavarian World War I veterans, 119, 143
of head-injured World War II veterans, 119–121, 144–145
of Korean War veterans, 123, 147
Teuber's cohort, 121–122, 146
Vietnam Experience Study, 125–127, 150
Vietnam Head Injury Study (VHIS), 124–125, 148–149
Millennium Cohort Study, 16
Mood disorders, 266–275
primary studies, 266–268
secondary studies, 268–269
summary and conclusion, 269
Mortality and traumatic brain injury, 333–349.
See also Premature mortality
in civilian populations, 334–336
in military populations, 333–334
primary studies, 333–336
secondary studies, 336–338
summary and conclusions, 339
Motor response, in the Glasgow Coma Scale, 43
Multiple sclerosis, 251–253
primary study, 251
secondary study, 251
OCR for page 378
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
summary and conclusion, 251–252
N
National Institutes of Health, Traumatic Coma Databank (TCDB), 132–133
Nested case-control studies, 110, 266
Neurocognitive outcomes, 173–196
closed head injury, 181–193
penetrating brain injury, 173–180
Neurodegenerative diseases, 237–255
amyotrophic lateral sclerosis, 254–255
dementia of the Alzheimer’s type, 237–242
dementia pugilistica, 243–246
multiple sclerosis, 251–253
parkinsonism, 246–250
Neurologic outcomes, 197–263
endocrine disorders, 227–236
neurodegenerative diseases, 237–255
ocular and visual motor deterioration, 224–226
postconcussion symptoms, 210–223
seizure disorders, 197–209
O
Observational-study designs
case-control studies, 109–110
cohort studies, 108–109
cross-sectional studies, 110
standardized mortality studies, 109
Ocular and visual motor deterioration, 224–226
primary studies, 224
secondary studies, 224–225
summary and conclusion, 225
Operation Enduring Freedom (OEF), 1, 3, 13, 15, 30
Operation Iraqi Freedom (OIF), 1, 3, 13, 15, 30
Overpressure effects, on surrounding materials and unprotected persons, 32–33
P
Parkinsonism, 246–250
primary studies, 246–247
secondary studies, 248
summary and conclusion, 248
Pathobiology of traumatic brain injury, 19–25
OCR for page 379
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
Pathologic features
of diffuse traumatic brain injury, 26–27
of focal traumatic brain injury, 25–26
Pathology Scoring System (PSS), 42, 45
Patient Characteristics and Head Injury Outcome, 134–136
Patient Health Questionnaire (PHQ-15), 211
Penetrating traumatic brain injury
from blast-induced neurotrauma, 40–41
clinical studies, 41
experimental studies, 40–41
Persian Gulf War Veterans Act, 1, 13
Physics, of the mechanisms of explosive injuries, 31–33
Population-based studies, cohorts, 127–133
Canadian Study of Health and Aging (CSHA), 129–130, 153
community-based study of injuries in the Aquitaine, France, 128–129, 152
Rochester Epidemiology Project, 127–128, 150–151
Traumatic Brain Injury Model Systems (TBIMS), 130–132, 153–154
Traumatic Coma Databank (TCDB), 132–133, 154–155
Postconcussion symptoms (PCSs), 210–223
primary studies, 210–217
secondary studies, 217
summary and conclusions, 217–218
Postdeployment testing, recommendations concerning, 9–10, 372
Posttraumatic epilepsy. See Seizure disorders
Posttraumatic ischemia, 24
Predeployment testing, recommendations concerning, 9–10, 372
Predictors, of outcomes, 60
Premature mortality. See Mortality and traumatic brain injury
Prevalence
of traumatic brain injury (disability), 62–63
Primary blast-induced neurotrauma, 37–40
clinical studies, 39–40
experimental studies, 37–39
Psychiatric outcomes, 265–300
aggressive behaviors, 289–291
anxiety disorders, 281–289
drug and alcohol abuse disorders, 291
mood disorders, 266–275
suicide, 276–280
Psychotic disorders, 292–296
primary studies, 292
secondary studies, 292
summary and conclusions, 293
Punch-drunk syndrome, 243
OCR for page 380
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
R
Recommendations, 7–10, 370–372
experimental and clinical studies of blast-induced neurotrauma, 8–9, 370–371
predeployment and postdeployment testing, 9–10, 372
registry control groups, 9, 371–373
scoring of severity of blast-induced neurotrama, 7–8, 370
Recurrent traumatic brain injury, 67–68
Red Cross Wound Classification (RCWC), 42
Registry. See Traumatic Brain Injury Veterans Health Registry
Registry control groups, recommendations concerning, 9, 371–373
Risk factors for traumatic brain injury, 64–67
external causes of traumatic brain injury, 66
military exposures, 66–67
Rochester Epidemiology Project, 127–128
S
Scope of the report, 15
Scores, of outcomes, 59–60
Scoring of severity of blast-induced neurotrama, recommendations concerning, 7–8, 370
Seizure disorders, 197–209
primary studies, 197–200
secondary studies, 200–202
summary and conclusion, 202–203
Severity-of-injury index (SII), 42
Severity of brain injury, 63–64
scoring of BINT, 45
scoring of blast injuries, 41–42
scoring of traumatic brain injury, 42–45
Short-term outcomes, traumatic brain injury and, 68–69
case-fatality rates, 68
disposition at the end of acute care, 69
Social functioning, 301–331
primary studies of civilian populations, 303–307
primary studies of military populations, 301–303
secondary studies, 307–314
summary and conclusions, 314–327
Social relationships, 310–311
Spallation, 32–33
Sports-related traumatic brain injury, 140–165, 183-186
boxing, 141–142, 165
football, 140–141, 164
soccer, 142
Standardized mortality studies, 109
OCR for page 381
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
Strength of the evidence
categories of associations, 112–113
considerations in assessing, 112–113
Suicide, 276–280
primary studies, 276
secondary studies, 277
summary and conclusions, 277–278
T
Teuber's cohort, 121–122, 146
Therapeutics, and traumatic brain injury, 28–29
Time trends, in incidence of traumatic brain injury, 61–62
Traumatic Brain Injury Model Systems (TBIMS), 130–132, 153–154
Traumatic Brain Injury Veterans Health Registry, 9
U
Unemployment, long-term, 314–315.
See also Functional status
V
Valproate Prophylaxis of Post-Traumatic Seizures, 135–136
Verbal response, in the Glasgow Coma Scale, 43
Vertigo, positional, 139
Veterans Programs Enhancement Act, 1, 13
Vietnam Experience Study (VES), 125–127, 150
Vietnam Head Injury Study (VHIS), 124–125, 148–149
W
Walker. See E.A. Walker's studies of head-injured veterans
Walter Reed Army Institute of Research, Blast Injury Subjective Score, 42
Walter Reed Army Medical Center, 3, 14
W.F. Caveness studies of Korean War veterans, 123, 147
World Health Organization, Collaborating Task Force on Mild Traumatic Brain Injury, 2, 14
OCR for page 382
Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury
This page intentionally left blank.
