Chronic impact of traumatic brain injury on outcome and quality of life: a narrative review

Critical Care, 2016 · DOI: 10.1186/s13054-016-1318-1 · Published: May 27, 2016

Simple Explanation

Traumatic brain injury (TBI), traditionally viewed as a short-term event, can lead to lasting, sometimes lifelong, consequences affecting survivors and their families, with significant social and economic costs. Evaluating the impact of TBI is challenging due to co-existing injuries, limitations of assessment scales, and difficulties in patient cooperation, highlighting the complexity of outcome assessment. Research explores the connections between structural brain damage and functional impairment using advanced neuro-imaging, seeking to identify potential targets for future therapies and improved outcomes.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Narrative Review

Key Findings

1
TBI survivors often experience white matter degradation, neuronal loss, protein misfolding, and persistent neuroinflammation, contributing to long-term disabilities.
2
TBI is identified as a risk factor for neurodegenerative diseases like Alzheimer's, linked to the accumulation of amyloid-β peptides and aberrant tau protein.
3
Inflammatory responses in the brain after TBI can persist for years, with chronic microglial activation closely associated with neuropathology.

Research Summary

Traumatic brain injury (TBI) can result in long-term consequences, affecting physical, cognitive, and psychological well-being, impacting daily life, and incurring significant social and economic costs. The review highlights the challenges in assessing outcomes after TBI due to co-existing injuries and the limitations of current assessment scales, emphasizing the need for comprehensive evaluation methods. The paper underscores the importance of understanding the biological mechanisms of TBI, including white matter degradation, protein misfolding, and chronic inflammation, to develop effective therapies and improve long-term outcomes.

Practical Implications

Improved Diagnostic Tools

Develop and implement more sensitive and comprehensive diagnostic tools to accurately assess the long-term consequences of TBI, including mild cases.

Targeted Therapies

Focus on developing targeted therapies that address the underlying biological mechanisms of TBI, such as neuroinflammation and protein misfolding, to improve long-term outcomes.

Comprehensive Rehabilitation

Establish organized systems of care that provide prolonged and appropriate rehabilitation, linking professional help with family assistance, to minimize the long-term consequences of TBI.

Study Limitations

1
The review is based on a narrative approach, rather than a systematic literature review, potentially introducing selection bias.
2
Data on the prevalence of people living with the consequences of TBI are limited, especially in countries like India and China.
3
Outcome assessment after TBI is complex, with co-existing injuries and pre-existing conditions potentially confounding the evaluation of the pure effects of head injury.

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