Traumatic Brain Injury, Part I

458 Pages·2015·35.12 MB·English

by  Jordan Grafman and Andres M. Salazar (Eds.)

HANDBOOK OF CLINICAL
NEUROLOGY
Series Editors
MICHAEL J. AMINOFF, FRANC¸OIS BOLLER, AND DICK F. SWAAB
VOLUME 127
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ST LOUIS SYDNEY TORONTO 2015
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Foreword
Traumaticbraininjuries(TBI)areamongtheearliest describedillnessesaffectinghumanity.Theearliestavailable
medicaldocument,theEdwinSmithSurgicalPapyrus(c.26thcenturyBC),providesawrittendescriptionofseveral
neurologicdisordersfollowingwartimeheadinjuries.Becauseoftheimportanceoftheproblem,thepreviousseriesof
theHandbookofClinicalNeurology,editedbyVinkenandBruyn,includedvolumesdedicatedtothistopic.Unfor-
tunatelyTBIs,eventhoughpreventableinmanycases,continuetobethesinglemostfrequentcauseofdeathand
permanent disability in people aged 45 or less. Furthermore, there has been a surge of interest in this area due to
theincreasedincidenceofpost-traumaticstressdisorders(PTSD)andalsoofsport-relatedpostconcussiondisorders.
Therefore,thepresenttwovolumesoftheHandbookdealingwithTBIareparticularlytimely.
ThevolumesdealwithavarietyofTBI-relatedtopics.Theseincludeanimalmodels,geneticpredictorsofsuscep-
tibility,andanin-depthpresentationoftheepidemiologyandclassificationofTBI,aswellastheneuropathology,
neurophysiology,andcellularandmolecularbasisofinjuryandsubsequentrecovery.Laterchaptersdealwithbio-
markersofTBI,withconsiderableemphasisgiventoimagingandneurophysiologictechniques.Asectionexplores
indetailthepreventionandtreatmentofTBI.Thesadvarietyofclinicalsequelaeandthelong-termoutcomeofTBIin
adultsandchildrenarealsodiscussedindifferentchapters.Thevolumesconcludewithsectionsdedicatedtobrain
plasticityandtotheall-importanttopicoftheconductofclinicaltrials,includingthespecialethicalandregulatory
aspectsofTBIresearch.
Wehavebeenfortunatetohaveasvolumeeditorstwodistinguishedscholars,Dr.JordanGrafman,Directorof
BrainInjuryResearchattheRehabilitationInstituteofChicagoandProfessorinPhysicalMedicineandRehabilitation,
NorthwestUniversity,andDr.AndresSalazar,ChiefExecutiveOfficerandScientificDirectorofOncovirInc.Both
havebeenontheforefrontofTBIresearchformanyyears.Theyhaveassembledatrulyinternationalgroupofauthors
withacknowledgedexpertisetocontributetothesevolumes,whichareauthoritative,comprehensive,anduptodate.
TheavailabilityelectronicallyofthevolumesonElsevier’sScienceDirectsiteaswellasinprintformatshouldensure
theirreadyaccessibilityandfacilitatesearchesforspecificinformation.Wethankthevolumeeditorsandcontributors
forcreatingsuchaninvaluableresource.Asserieseditorswereadandcommentedoneachofthechapterswithgreat
interest. We are therefore confident that clinicians and researchers in many different medical disciplines will find
muchinthesevolumestoappealtothem.
Asalways,itisapleasuretoacknowledgeandthankElsevier,ourpublisher–andinparticularMichaelParkinsonin
Lochcarron,andMicaHaleyandKristiAndersoninSanDiego–fortheirunfailingandexpertassistanceinthedevel-
opmentandproductionofthesevolumes.
MichaelJ.Aminoff
Franc¸oisBoller
DickF.Swaab
Preface
Moderateandseveretraumaticbraininjury(TBI)remainsamajorpublichealthchallenge.Itaffectstheyoungand
elderly disproportionately, having a magnified societal impact early in life and during retirement. The consequent
cognitiveandbehavioralchangesafterTBIcanattimesbesubtleandunrecognized.MildTBI,whileresultinginless
severe–albeitveryreal–deficits,hasanimportantsocietalimpactbecauseofthenumberofindividualsaffected,and
stillunknownfactorspredisposesomewithmildTBItohaveahigherriskthanothersofdevelopingalate-lifeneu-
rodegenerativedisorder.Whilepreventivemeasuressuchastheuseofhelmetsandvehicularrestraintsmayreducethe
incidenceofsevereTBI,suchinjurywillnotbeeliminated.
Earlyinourcareers,bothofusbecameinvolvedinthestudyofVietnamveteranswithpenetratingtraumaticbrain
injury,andweappreciatedtheadvancesinacutecaremedicinethatenabledmanyofthoseveteranstosurvive.Major
advancesinourunderstandingofthebrain’sresponseto,andrecoveryfrom,injuryhavecontinuedinthepastfew
decadesbutgenerallyhavefailedtobetranslatedintoclinicalpractice.Thus,onemajormotivationforustoeditthese
twovolumesonTBIintheHandbookofClinicalNeurologyserieshasbeentheopportunitytohelpstrengthenthelink
betweenbasicscienceandclinicalmanagementinawaythatcaninformbothbenchscientistsandpractitioners.We
believewehaveaccomplishedthisgoalbyprovidingthereaderwithanupdatedreviewofemergingapproachestoTBI
research,clinicalmanagement,andrehabilitationofaffectedpatientsthatoffersnewanduniqueperspectivesonTBI.
Chaptersinthisvolumehavebeenwrittenbyleadersinthefield,andincludeepidemiologyandpathologicmech-
anismsofinjury,neuroprotection,functionalsequelae,predictionoflong-termoutcomes,andneuroplasticity,witha
strongemphasisoncurrentneurobiologicapproachestodescribingtheconsequencesandmechanismsofrecovery
fromTBI.Contemporaryinvestigationsonblastinjuryarepresented,highlightingthecontributionsthatwarmedicine
has made to TBI management over thepast century and demonstrating thatcombat-related TBI draws public and
scientificattentiontoTBIresearchandmanagement,oftenleadingtoincreasedsupportforresearchandadvances
inmedicalknowledgeandpractice.Therecognitionoftheriskforchronictraumaticencephalopathy,evenaftermild
sportsTBI,isanotherrecentdevelopmentthatislendingclaritytoourunderstandingofthelong-termconsequences
andrecoveryfromTBI,includingitslinktomorecommonneurodegenerativeconditionssuchasAlzheimerdisease.
Finally,thevolumesconcludewithchaptersthatdiscussthechallengesindesignofclinicaltrialsforneuroprotection
andrehabilitation,echoingathemethatisalsointroducedbyotherauthorsthroughoutthevolume.
It remains challenging to take time away from writing data-driven papers, grant writing, and other day-to-day
responsibilitiestowriteareviewchapter–evenifthechapterisonatopicdeartotheheart.Nevertheless,suchchapters
offer a unique opportunity to summarize an area of research and study and to advance hypotheses based on this
appraisal.Webelieveourcontributorsexemplifythisapproachandwegratefullyacknowledgetheircontributions.
ManyofuswhostudyandworkwithTBIpatientsknowthesacrificethatpatientsmaketocontributetoresearch
thatmayleadtofutureimprovementsinclinicalcare.Weareforeverindebtedtothemfortheirhelp,trust,anddevo-
tion. Finally, we thank our families for their support and patience in allowing us to prepare and complete these
volumes.
AndresM.Salazar,M.D.
JordanGrafman,Ph.D.
Contributors
B.Aarabi T.Buell
DepartmentofNeurosurgery,UniversityofMaryland, DepartmentofNeurosurgery,BaylorCollege
Baltimore,MD,USA ofMedicine,Houston,TX,USA
J.A.Aarabi
J.Cantor(deceased)
CapellaUniversity,Minneapolis,MN,USA
DepartmentofRehabilitationMedicine,MountSinai
SchoolofMedicine,NewYork,
M.P.Alexander
NY,USA
DepartmentofNeurology,HarvardMedicalSchool,
Boston,Concussion/TBIProgram,BethIsrael
S.I.Cohen
DeaconessMedicalCenter,Boston,andSpaulding
AcquiredBrainInjuryProgram,Braintree
HospitalCambridge,Cambridge,MA,USA
RehabilitationHospital,BraintreeandDepartmentof
PhysicalMedicineandRehabilitation,TuftsMedical
A.Bandak
School,Boston,MA,USA
IntegratedServicesGroupInc.,Potomac,MD,USA
F.A.Bandak V.Coronado
DepartmentofNeurology,F.EdwardHe´bertSchool CentersforDiseaseControlandPrevention,Atlanta,
ofMedicine,UniformedServicesUniversityofthe GA,USA
HealthSciences,BethesdaandIntegratedServices
GroupInc.,Potomac,MD,USA D.K.Cullen
PennCenterforBrainInjuryandRepairand
M.Beare
DepartmentofNeurosurgery,Universityof
DepartmentofNeurosciences,InovaFairfaxMedical
Pennsylvania,Philadelphia,PA,USA
Campus,FallsChurch,VA,USA
K.Dams-O’Connor
T.Bekinschtein
DepartmentofRehabilitationMedicine,MountSinai
DepartmentofPsychology,UniversityofCambridge,
SchoolofMedicine,NewYork,NY,USA
Cambridge,UK
S.Bhatnagar D.H.Daneshvar
DepartmentofPhysicalMedicineandRehabilitation, VABostonHealthCareSystem;CenterfortheStudy
SpauldingRehabilitationHospital,Veterans ofTraumaticEncephalopathy,Alzheimer’sDisease
Administration,BostonandHarvardMedicalSchool, Center,andDepartmentsofNeurologyandPathology,
Boston,MA,USA BostonUniversitySchoolofMedicine,Boston,
MA,USA
D.L.Brody
DepartmentofNeurology,WashingtonUniversity N.C.deLanerolle
SchoolofMedicine,St.Louis,MO,USA DepartmentofNeurosurgery,YaleUniversitySchoolof
Medicine,NewHaven,CT,USA
S.P.Broglio
NeuroSportResearchLaboratory,Michigan M.A.Dichter
NeuroSport,SchoolofKinesiology,Universityof DepartmentofNeurology,UniversityofPennsylvania,
Michigan,AnnArbor,MI,USA Philadelphia,PA,USA
xii CONTRIBUTORS
A-C.Duhaime K.M.Guskiewicz
DepartmentofNeurosurgery,MassachusettsGeneral MatthewGfellerSport-RelatedTBIResearch
Hospital,Boston,MA,USA Center,DepartmentofExerciseandSportScience,
UniversityofNorthCarolinaatChapelHill,ChapelHill,
J.M.Ecklund NC,USA
DepartmentofNeurosciences,InovaFairfaxMedical
Campus,FallsChurch,VA,USA
G.W.J.Hawryluk
DepartmentofNeurosurgery,UniversityofUtah,Salt
A.I.Faden LakeCity,UT,USA
Department of Anesthesiology and Center for
Shock, Trauma and Anesthesiology Research (STAR),
R.L.Hayes
National Study Center for Trauma and EMS,
BanyanBiomarkersInc.,Alachua,FL,USA
University of Maryland School of Medicine,
Baltimore, MD, USA
H.Hetherington
M.Faul DepartmentofNeurosurgery,YaleUniversitySchoolof
CentersforDiseaseControlandPrevention,Atlanta, Medicine,NewHaven,CT,USA
GA,USA
M.A.Iaccarino
S.S.K.Gaddam DepartmentofPhysicalMedicineandRehabilitation,
DepartmentofNeurosurgery,BaylorCollegeof SpauldingRehabilitationHospitalandHarvardMedical
Medicine,Houston,TX,USA School,Boston,MA,USA
R.I.Geddes
A.Jagoda
DepartmentofEmergencyMedicine,EmoryUniversity
DepartmentofEmergencyMedicine,MountSinai
SchoolofMedicine,Atlanta,GA,USA
SchoolofMedicineandBrainTraumaFoundation,
NewYork,NY,USA
J.T.Giacino
DepartmentofPhysicalMedicineandRehabilitation,
HarvardMedicalSchoolandSpauldingRehabilitation V.E.Johnson
Hospital,Boston,MA,USA PennCenterforBrainInjuryandRepairand
DepartmentofNeurosurgery,Universityof
J.Gilhooly Pennsylvania,Philadelphia,PA,USA
DepartmentofNeurosurgery,WalterReedNational
MilitaryMedicalCenter,Bethesda,MD,USA
D.I.Katz
DepartmentofNeurology,BostonUniversitySchool
E.Gleichgerrcht
ofMedicine,BostonandAcquiredBrainInjury
DepartmentofNeurology,MedicalUniversityofSouth
Program,BraintreeRehabilitationHospital,Braintree,
Carolina,Charleston,SC,USA
MA,USA
S.A.Goldberg
DepartmentofEmergencyMedicine,Brigham M.Lin
&Women’sHospital,Boston,MA,USA DepartmentofMolecularNeuroscience,Krasnow
InstituteforAdvancedStudy,GeorgeMason
W.A.Gordon University,Fairfax,VA,USA
DepartmentofRehabilitationMedicine,MountSinai
SchoolofMedicine,NewYork,NY,USA
G.Ling
DepartmentofNeurology,F.EdwardHe´bert
J.Grafman
SchoolofMedicine,UniformedServices
DepartmentofPhysicalMedicineandRehabilitation;
UniversityoftheHealthSciences,Bethesda,
DepartmentofPsychiatryandBehavioralSciences;
MD,USA
CognitiveNeurologyandAlzheimer’sDiseaseCenter,
NorthwesternUniversityMedicalSchooland
R.H.Lipsky
DepartmentofPsychology,NorthwesternUniversity,
DepartmentofNeurosciences,InovaHealthSystem,
Chicago,IL,USA
FallsChurch,VA,USA
CONTRIBUTORS xiii
D.J.Loane R.S.Rindler
DepartmentofAnesthesiologyandCenterforShock, EmoryUniversityHospital,NeurologicalSurgery,
TraumaandAnesthesiologyResearch(STAR),National Atlanta,GA,USA
StudyCenterforTraumaandEMS,Universityof
MarylandSchoolofMedicine,Baltimore,MD,USA C.S.Robertson
DepartmentofNeurosurgery,BaylorCollegeof
C.L.MacDonald
Medicine,Houston,TX,USA
DepartmentofNeurology,WashingtonUniversity
SchoolofMedicine,St.Louis,MO,USA
D.Rojanasarntikul
DepartmentofEmergencyMedicine,MountSinai
F.Manes
SchoolofMedicine,NewYork,NY,USAand
InstituteofCognitiveNeurology(INECO),andInstitute
ChulalongkornUniversity,Bangkok,
ofNeuroscience,FavaloroUniversity,BuenosAires,
Thailand
ArgentinaandUDP-INECOFoundationCoreon
Neuroscience(UIFCoN),DiegoPortalesUniversity,
Santiago,Chile A.M.Rosenbaum
ParkTerraceCareCenter,RegoPark,NY,USA
G.T.Manley
DepartmentofNeurologicalSurgeryandBrainand A.M.Salazar
SpinalInjuryCenter,UniversityofCalifornia,San OncovirInc.,Washington,DC,USA
Francisco,CA,USA
S.Schmitt
M.J.McGinn DepartmentofNeurology,UniversityofPennsylvania,
DepartmentofAnatomyandNeurobiology,Medical Philadelphia,PA,USA
CollegeofVirginiaCampusofVirginiaCommonwealth
University,Richmond,VA,USA
J.S.Shimony
DepartmentofRadiology,WashingtonUniversity
A.C.McKee
SchoolofMedicine,St.Louis,MO,USA
VABostonHealthCareSystem;CenterfortheStudyof
TraumaticEncephalopathy,Alzheimer’sDiseaseCenter,
A.Siu
andDepartmentsofNeurologyandPathology,Boston
DepartmentofNeurosurgery,GeorgeWashington
UniversitySchoolofMedicine,Boston,MA,USA
University,Washington,DC,USA
D.F.Meaney
D.H.Smith
DepartmentsofBioengineeringandNeurosurgery,
DepartmentsofBioengineeringandNeurosurgery,
UniversityofPennsylvania,Philadelphia,PA,USA
UniversityofPennsylvania,Philadelphia,
PA,USA
S.Mondello
DepartmentofNeurosciences,UniversityofMessina,
Messina,Italy E.A.Sribnick
DepartmentofEmergencyMedicine,EmoryUniversity
C.Mossop SchoolofMedicine,Atlanta,GA,USA
WalterReedNationalMilitaryMedicalCenter,
Bethesda,MD,USA D.G.Stein
DepartmentofEmergencyMedicine,Emory
A.M.Owen UniversitySchoolofMedicine,Atlanta,
BrainandMindInstitute,DepartmentofPsychology, GA,USA
UniversityofWesternOntario,London,Ontario,Canada
B.A.Stoica
J.T.Povlishock DepartmentofAnesthesiologyandCenterforShock,
DepartmentofAnatomyandNeurobiology, TraumaandAnesthesiologyResearch(STAR),
MedicalCollegeofVirginiaCampusofVirginia NationalStudyCenterforTraumaandEMS,
CommonwealthUniversity,Richmond, UniversityofMarylandSchoolofMedicine,
VA,USA Baltimore,MD,USA
xiv CONTRIBUTORS
T.Tsaousides R.Zafonte
DepartmentofRehabilitationMedicine,MountSinai DepartmentofPhysicalMedicineandRehabilitation,
SchoolofMedicine,NewYork,NY,USA SpauldingRehabilitationHospital,Massachusetts
GeneralHospital,BrighamandWoman’sHopsital,
J.vanderNaalt andHarvardMedicalSchool,Boston,
DepartmentofNeurology,UniversityMedicalCenter MA,USA
Groningen,UniversityofGroningen,TheNetherlands