INDEX

A

Abbreviated Injury Scale (AIS), 41, 45, 60,

Adult traumatic brain injury, epidemiology of, 59102

Afghanistan. See Operation Enduring Freedom

Aggressive behavior, 289291

primary studies, 289290

secondary studies, 290291

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), 254255

secondary studies, 254

summary and conclusion, 255

Animal studies, 104

Anxiety disorders, 281289

primary studies, 281283

secondary studies, 283284

summary and conclusion, 284

B

Behavioral Outcome of Head Injury, 134136

Biology of traumatic brain injury, 1957

basic mechanisms of explosive injuries, 3141

classification according to biomechanics of injury, 2728

classification according to extent of pathology, 2527

pathobiology of traumatic brain injury, 1925

severity scoring of blast injuries and traumatic brain injury, 4145

summary of pathobiology of traumatic brain injury, 29

therapeutics and traumatic brain injury, 2829

traumatic brain injuries relevant to the military, 3031

Biomarkers, 25

Biomechanics of injury, 2728

closed injury, 2728

penetrating and perforating injuries, 28

Bipolar disorder, 269.

See also Mood disorders



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



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
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 373

OCR for page 373
374 GULF WAR AND HEALTH 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 373
INDEX 375 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 373
376 GULF WAR AND HEALTH 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 373
INDEX 377 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 373
378 GULF WAR AND HEALTH 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 373
INDEX 379 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 373
380 GULF WAR AND HEALTH 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 373
INDEX 381 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 373