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Traumatic brain injury 

Traumatic brain injury
Chapter:
Traumatic brain injury
Author(s):

David J. Sharp

, Simon Fleminger

, and Jane Powell

DOI:
10.1093/med/9780199655946.003.0039
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date: 05 June 2020

Traumatic brain injury (TBI) is a common cause of cognitive impairment. Direct impact and acceleration/deceleration forces produce focal and diffuse patterns of brain injury. These have a complex relationship with behavior. Attention, executive function, memory, and speed of information processing are commonly affected. Neuroimaging demonstrates the location of brain injury, which informs the likelihood persistent cognitive problems. Patients with significant injuries should be managed in specialist trauma centres acutely, where neurosurgical intervention is available. TBI patients are heterogeneous, making the assessment and management of cognitive impairment complex. A multidisciplinary approach should be taken to rehabilitation, with behavioural and pharmacological treatments considered. Patients often have other problems, including psychiatric, sleep, and endocrine impairments. These may interact with cognitive function in complex ways, and treatment of these coexisting problems can often improve cognitive function. Recent neuroscientific advances offer the promise of a more stratified and effective approach to future cognitive treatment.

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