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Change in Headache Suffering and Predictors of Headache after Mild Traumatic Brain Injury: A Population-Based, Controlled, Longitudinal Study with Twelve-Month Follow-Up.

https://arctichealth.org/en/permalink/ahliterature300860
Source
J Neurotrauma. 2019 Aug 02; :
Publication Type
Journal Article
Date
Aug-02-2019
Author
Lena H Nordhaug
Mattias Linde
Turid Follestad
Øystein Njølstad Skandsen
Vera Vik Bjarkø
Toril Skandsen
Anne Vik
Author Affiliation
1Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Source
J Neurotrauma. 2019 Aug 02; :
Date
Aug-02-2019
Language
English
Publication Type
Journal Article
Abstract
Headache attributed to traumatic injury to the head (HAIH) is claimed to be the most common sequela following mild traumatic brain injury (MTBI), but epidemiological evidence is scarce. We explored whether patients with MTBI had an increase in headache suffering following injury compared with controls. We also studied predictors of headache. The Trondheim MTBI follow-up study is a population-based, controlled, longitudinal study. We recruited patients exposed to MTBI and controls with minor orthopedic injuries from a trauma center and a municipal outpatient clinic, and community controls from the surrounding population. Information on headache was collected through questionnaires at baseline, and 3 and 12 months post-injury. We used a generalized linear mixed model to investigate the development of headache over time in the three groups, and logistic regression to identify predictors of headache. We included 378 patients exposed to MTBI, 82 trauma controls, and 83 community controls. The MTBI-group had a larger increase in odds of headache from baseline to the first 3 months post-injury than the controls, but not from baseline to 3-12 months post-injury. Predictors for acute HAIH were female sex and pathological imaging findings on computed tomography (CT) or magnetic resonance imaging (MRI). Predictors for persistent HAIH were prior MTBI, being injured under the influence of alcohol, and acute HAIH. Patients who experience HAIH during the first 3 months post-injury have a good chance to improve before 12 months post-injury. Female sex, imaging findings on CT or MRI, prior MTBI, and being injured under the influence of alcohol may predict exacerbation of headache.
PubMed ID
31195890 View in PubMed
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Cognitive Reserve Moderates Cognitive Outcome After Mild Traumatic Brain Injury.

https://arctichealth.org/en/permalink/ahliterature308825
Source
Arch Phys Med Rehabil. 2020 01; 101(1):72-80
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2020
Author
Jonas Stenberg
Asta K Håberg
Turid Follestad
Alexander Olsen
Grant L Iverson
Douglas P Terry
Rune H Karlsen
Simen B Saksvik
Migle Karaliute
John A N Ek
Toril Skandsen
Anne Vik
Author Affiliation
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurosurgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Source
Arch Phys Med Rehabil. 2020 01; 101(1):72-80
Date
01-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Brain Concussion - psychology
Case-Control Studies
Cognitive Dysfunction - psychology
Cognitive Reserve
Female
Humans
Linear Models
Longitudinal Studies
Male
Post-Concussion Syndrome - psychology
Risk factors
Abstract
To investigate whether cognitive reserve moderates differences in cognitive functioning between patients with mild traumatic brain injury (MTBI) and controls without MTBI and to examine whether patients with postconcussion syndrome have lower cognitive functioning than patients without postconcussion syndrome at 2 weeks and 3 months after injury.
Trondheim MTBI follow-up study is a longitudinal controlled cohort study with cognitive assessments 2 weeks and 3 months after injury.
Recruitment at a level 1 trauma center and at a general practitioner-run, outpatient clinic.
Patients with MTBI (n=160) according to the World Health Organization criteria, trauma controls (n=71), and community controls (n=79) (N=310).
A cognitive composite score was used as outcome measure. The Vocabulary subtest was used as a proxy of cognitive reserve. Postconcussion syndrome diagnosis was assessed at 3 months with the British Columbia Postconcussion Symptom Inventory.
Linear mixed models demonstrated that the effect of vocabulary scores on the cognitive composite scores was larger in patients with MTBI than in community controls at 2 weeks and at 3 months after injury (P=.001). Thus, group differences in the cognitive composite score varied as a function of vocabulary scores, with the biggest differences seen among participants with lower vocabulary scores. There were no significant differences in the cognitive composite score between patients with (n=29) and without (n=131) postconcussion syndrome at 2 weeks or 3 months after injury.
Cognitive reserve, but not postconcussion syndrome, was associated with cognitive outcome after MTBI. This supports the cognitive reserve hypothesis in the MTBI context and suggests that persons with low cognitive reserve are more vulnerable to reduced cognitive functioning if they sustain an MTBI.
PubMed ID
31562876 View in PubMed
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The epidemiology of mild traumatic brain injury: the Trondheim MTBI follow-up study.

https://arctichealth.org/en/permalink/ahliterature291547
Source
Scand J Trauma Resusc Emerg Med. 2018 Apr 27; 26(1):34
Publication Type
Journal Article
Date
Apr-27-2018
Author
Toril Skandsen
Cathrine Elisabeth Einarsen
Ingunn Normann
Stine Bjøralt
Rune Hatlestad Karlsen
David McDonagh
Tom Lund Nilsen
Andreas Nylenna Akslen
Asta Kristine Håberg
Anne Vik
Author Affiliation
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. toril.skandsen@ntnu.no.
Source
Scand J Trauma Resusc Emerg Med. 2018 Apr 27; 26(1):34
Date
Apr-27-2018
Language
English
Publication Type
Journal Article
Abstract
Mild traumatic brain injury (MTBI) is a frequent medical condition, and some patients report long-lasting problems after MTBI. In order to prevent MTBI, knowledge of the epidemiology is important and potential bias in studies should be explored. Aims of this study were to describe the epidemiological characteristics of MTBI in a Norwegian area and to evaluate the representativeness of patients successfully enrolled in the Trondheim MTBI follow-up study.
During 81 weeks in 2014 and 2015, all persons aged 16-60 years, presenting with possible MTBI to the emergency department (ED) at St. Olavs Hospital, Trondheim University Hospital or to Trondheim municipal outpatient ED, were evaluated for participation in the follow-up study. Patients were identified by CT referrals and patient lists. Patients who were excluded or missed for enrolment in the follow-up study were recorded.
We identified 732 patients with MTBI. Median age was 28 years, and fall was the most common cause of injury. Fifty-three percent of injuries occurred during the weekend. Only 29% of MTBI patients were hospitalised. Study specific exclusion criteria were present in 23%. We enrolled 379 in the Trondheim MTBI follow-up study. In this cohort, Glasgow Coma Scale score was 15 at presentation in 73%; 45% of patients were injured under the influence of alcohol. Patients missed for inclusion were significantly more often outpatients, females, injured during the weekend, and suffering violent injuries, but differences between enrolled and not enrolled patients were small.
Two thirds of all patients with MTBI in the 16-60 age group were treated without hospital admission, patients were often young, and half of the patients presented during the weekend. Fall was the most common cause of injury, and patients were commonly injured under the influence of alcohol, which needs to be addressed when considering strategies for prevention. The Trondheim MTBI follow-up study comprised patients who were highly representative for the underlying epidemiology of MTBI.
Notes
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PubMed ID
29703222 View in PubMed
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Factors Affecting Caregiver Burden 1 Year After Severe Traumatic Brain Injury: A Prospective Nationwide Multicenter Study.

https://arctichealth.org/en/permalink/ahliterature275466
Source
J Head Trauma Rehabil. 2015 Nov-Dec;30(6):411-23
Publication Type
Article
Author
Unn Sollid Manskow
Solrun Sigurdardottir
Cecilie Røe
Nada Andelic
Toril Skandsen
Elin Damsgård
Sølve Elmståhl
Audny Anke
Source
J Head Trauma Rehabil. 2015 Nov-Dec;30(6):411-23
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Analysis of Variance
Brain Injuries - diagnosis - nursing - therapy
Caregivers - psychology
Checklist
Chronic Disease
Cohort Studies
Continuity of Patient Care
Female
Follow-Up Studies
Glasgow Coma Scale
Humans
Injury Severity Score
Long-Term Care
Male
Middle Aged
Multivariate Analysis
Norway
Prospective Studies
Regression Analysis
Risk assessment
Statistics, nonparametric
Time Factors
Treatment Outcome
Young Adult
Abstract
To assess burden in the caregivers of patients with severe traumatic brain injury (TBI) 1 year postinjury, related to caregiver's demographic data and social network, patient's demographic data, injury severity, and functional status.
Prospective national multicenter study. Self-report from caregivers, patient data collected from the national cohort on patients with severe TBI.
92 caregivers.
The Caregiver Burden Scale (CBS).
Total caregiver burden was reported high in 16% of caregivers and moderate in 34%. The mean total burden index was 2.12, indicating a moderate burden. Caregivers reported highest scores on the General strain index, followed by the Disappointment index. Poor social network, feeling loneliness, and caring for patients with severe disability were significant predictors of higher burden in univariate analyses (P
PubMed ID
25119652 View in PubMed
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Frequency and prognostic factors of olfactory dysfunction after traumatic brain injury.

https://arctichealth.org/en/permalink/ahliterature301779
Source
Brain Inj. 2018; 32(8):1021-1027
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
2018
Author
Mette Bratt
Toril Skandsen
Thomas Hummel
Kent G Moen
Anne Vik
Ståle Nordgård
Anne-S Helvik
Author Affiliation
a Department of Otorhinolaryngology , St. Olavs University Hospital , Trondheim , Norway.
Source
Brain Inj. 2018; 32(8):1021-1027
Date
2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Aged
Brain Injuries, Traumatic - complications - psychology
Cross-Sectional Studies
Female
Follow-Up Studies
Head - diagnostic imaging
Humans
Logistic Models
Male
Middle Aged
Olfaction Disorders - diagnosis - epidemiology - etiology
Prognosis
Quality of Life
Retrospective Studies
Statistics, nonparametric
Tomography Scanners, X-Ray Computed
Young Adult
Abstract
To assess the frequency and factors associated with posttraumatic olfactory dysfunction, including anosmia, in a follow-up of patients with moderate and severe traumatic brain injury (TBI).
The setting was a cross-sectional study of patients that were consecutively included in the Trondheim TBI database, comprising injury-related variables. Eligible participants 18-65 years were contacted 9-104 months post trauma and asked olfactory-related questions. Those reporting possible posttraumatic change of olfaction were invited to further examination using the Sniffin' Sticks panel.
Of 211 eligible participants, 182 (86.3%) took part in telephone interviews and 25(13.7%) were diagnosed with olfactory dysfunction. 60% of these, or 8.2% of all participants, had anosmia. In age-adjusted logistic regression analyses, fall (OR 2.5, 95% CI 1.0-6.2), skull base fracture (OR 2.9, 95% CI 1.2-7.1) and cortical contusion(s) (OR 6.0, 95% CI 2.1-17.3) were associated with olfactory dysfunction. In an analysis of anosmia, fall (OR 3.4, 95% CI 1.1-10.6) and cortical contusion(s) (OR 19.7, 95% CI 2.5-156.0) were associated with the outcome.
Of the study participants 13.7% had olfactory dysfunction and 8.2% had anosmia. Higher age, trauma caused by fall and CT displaying skull base fracture and cortical contusion(s) were related to olfactory dysfunction.
PubMed ID
29741969 View in PubMed
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Functional Recovery and Life Satisfaction in the First Year After Severe Traumatic Brain Injury: A Prospective Multicenter Study of a Norwegian National Cohort.

https://arctichealth.org/en/permalink/ahliterature271858
Source
J Head Trauma Rehabil. 2015 Jul-Aug;30(4):E38-49
Publication Type
Article
Author
Audny Anke
Nada Andelic
Toril Skandsen
Rein Knoph
Tiina Ader
Unn Manskow
Solrun Sigurdardottir
Cecilie Røe
Source
J Head Trauma Rehabil. 2015 Jul-Aug;30(4):E38-49
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Brain Injuries - physiopathology - psychology - therapy
Female
Humans
Male
Middle Aged
Norway
Personal Satisfaction
Prospective Studies
Quality of Life
Recovery of Function
Time Factors
Young Adult
Abstract
(1) To examine the impact of demographic and acute injury-related variables on functional recovery and life satisfaction after severe traumatic brain injury (sTBI) and (2) to test whether postinjury functioning, postconcussive symptoms, emotional state, and functional improvement are related to life satisfaction.
Prospective national multicenter study.
Level 1 trauma centers in Norway.
163 adults with sTBI.
Functional recovery between 3 and 12 months postinjury measured with Glasgow Outcome Scale Extended, Rivermead Postconcussion Symptoms Questionnaire, Hospital Anxiety and Depression Scale, and satisfaction with life situation.
60% of cases experienced functional improvement from 3 to 12 months postinjury. Multivariate logistic regression analysis revealed that discharge to a rehabilitation department from acute care (odds ratio [OR] = 2.14; P 65 years), low education, better functional outcome, and the absence of depressive and postconcussion symptoms were significant (P
PubMed ID
25033035 View in PubMed
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Incidence and mortality of moderate and severe traumatic brain injury in children: A ten year population-based cohort study in Norway.

https://arctichealth.org/en/permalink/ahliterature301924
Source
Eur J Paediatr Neurol. 2019 May; 23(3):500-506
Publication Type
Journal Article
Date
May-2019
Author
Mari Olsen
Anne Vik
Tom Ivar Lund Nilsen
Oddvar Uleberg
Kent Gøran Moen
Oddrun Fredriksli
Espen Lien
Torun Gangaune Finnanger
Toril Skandsen
Author Affiliation
Clinic of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway. Electronic address: mari.olsen@ntnu.no.
Source
Eur J Paediatr Neurol. 2019 May; 23(3):500-506
Date
May-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Brain Injuries, Traumatic - epidemiology
Child
Child, Preschool
Cohort Studies
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Norway - epidemiology
Retrospective Studies
Abstract
In this study we wanted to estimate population-based rates of incidence and mortality of moderate and severe traumatic brain injury (TBI) in children in one specific region in Norway.
In the region there are seven acute care hospitals (ACHs) in addition to a Level 1 trauma centre. Of 702 869 inhabitants (2014), 145 395 were children aged 0-16 years. Data were collected during ten years (2004-2014). All children aged 0-16 years with moderate (Glasgow Coma Scale [GCS] score 9-13) or severe (GCS score = 8) TBI admitted to the Level 1 trauma centre were prospectively included. Children treated outside the Level 1 trauma centre were retrospectively included from the ACHs. Children who died from TBI prehospitally were included from the National Cause of Death Registry. Poisson regression was used to estimate incidence rate ratios (with a 95% confidence interval) comparing age, sex, and time periods.
A total of 71 children with moderate or severe TBI were identified. Crude incidence rates were 2·4 (95% CI 1·7-3·3) for moderate and 2·5 (95% CI 1·8-3·4) for severe TBI per 100 000 person-years (py). Mortality rate from TBI was 1·2 (95% CI 0·7-1·9) per 100 000 py, and 88% were prehospital deaths.
The incidence rates and mortality of moderate and severe TBI were low compared to international reports. Most likely explained by successful national prevention of TBI.
PubMed ID
30879962 View in PubMed
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Incidence of Mild Traumatic Brain Injury: A Prospective Hospital, Emergency Room and General Practitioner-Based Study.

https://arctichealth.org/en/permalink/ahliterature301538
Source
Front Neurol. 2019; 10:638
Publication Type
Journal Article
Date
2019
Author
Toril Skandsen
Tom Lund Nilsen
Cathrine Einarsen
Ingunn Normann
David McDonagh
Asta Kristine Haberg
Anne Vik
Author Affiliation
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Source
Front Neurol. 2019; 10:638
Date
2019
Language
English
Publication Type
Journal Article
Abstract
Background: There are no recent estimates of incidence rates of mild traumatic brain injury (MTBI) from Norway. Moreover, reported incidence rates rarely comprise cases of MTBI evaluated in the primary care setting. In this study, we utilized existing data collected as part of the recruitment to a large, follow-up study of patients with MTBI. We estimated the incidence rate of MTBI, including patients who visited outpatient clinics, in the age group 16-59 years in a Norwegian region. Methods: During 81 weeks in 2014 and 2015, all persons aged 16-59 years, presenting with possible MTBI to the emergency department (ED) at St. Olavs Hospital, Trondheim University Hospital or to the general practitioner (GP)-run Trondheim municipal outpatient ED, were evaluated for a diagnosis of MTBI. Patients were identified by computerized tomography (CT) referrals and patient lists. Patients referred to acute CT from their primary GP with suspicion of MTBI were also recorded. This approach identified 732 patients with MTBI. Age- and sex-specific incidence rates of MTBI were calculated using population figures from the regional catchment area. Results: Overall incidence of MTBI in people between 16 and 59 years was 302 per 100,000 person-years (95% confidence interval 281-324). The incidence rate was highest in the age group 16-20 years, where rates were 835 per 100,000 person-years in males and 726 in females. Conclusion: The overall incidence rate of MTBI was lower than expected from existing estimates. Like other reports, the incidence was highest in the late teens.
PubMed ID
31275229 View in PubMed
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The Influence of Traumatic Axonal Injury in Thalamus and Brainstem on Level of Consciousness at Scene or Admission: A Clinical Magnetic Resonance Imaging Study.

https://arctichealth.org/en/permalink/ahliterature288239
Source
J Neurotrauma. 2018 Feb 09;
Publication Type
Article
Date
Feb-09-2018
Author
Hans Kristian Moe
Kent Gøran Moen
Toril Skandsen
Kjell Arne Kvistad
Steven Laureys
Asta Håberg
Anne Vik
Source
J Neurotrauma. 2018 Feb 09;
Date
Feb-09-2018
Language
English
Publication Type
Article
Abstract
The aim of this study was to investigate how traumatic axonal injury (TAI) lesions in the thalamus, basal ganglia, and brainstem on clinical brain magnetic resonance imaging (MRI) are associated with level of consciousness in the acute phase in patients with moderate to severe traumatic brain injury (TBI). There were 158 patients with moderate to severe TBI (7-70 years) with early 1.5T MRI (median 7 days, range 0-35) without mass lesion included prospectively. Glasgow Coma Scale (GCS) scores were registered before intubation or at admission. The TAI lesions were identified in T2*gradient echo, fluid attenuated inversion recovery, and diffusion weighted imaging scans. In addition to registering TAI lesions in hemispheric white matter and the corpus callosum, TAI lesions in the thalamus, basal ganglia, and brainstem were classified as uni- or bilateral. Twenty percent of patients had TAI lesions in the thalamus (7% bilateral), 18% in basal ganglia (2% bilateral), and 29% in the brainstem (9% bilateral). One of 26 bilateral lesions in the thalamus or brainstem was found on computed tomography. The GCS scores were lower in patients with bilateral lesions in the thalamus (median four) and brainstem (median five) than in those with corresponding unilateral lesions (median six and eight, p?=?0.002 and 0.022). The TAI locations most associated with low GCS scores in univariable ordinal regression analyses were bilateral TAI lesions in the thalamus (odds ratio [OR] 35.8; confidence interval [CI: 10.5-121.8], p?
PubMed ID
29334825 View in PubMed
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Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted.

https://arctichealth.org/en/permalink/ahliterature271960
Source
Behav Neurol. 2015;2015:845491
Publication Type
Article
Date
2015
Author
Cecilie Røe
Toril Skandsen
Unn Manskow
Tiina Ader
Audny Anke
Source
Behav Neurol. 2015;2015:845491
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Brain Injuries - epidemiology - mortality - therapy
Female
Follow-Up Studies
Humans
Male
Norway - epidemiology
Outcome Assessment (Health Care)
Prognosis
Trauma Severity Indices
Abstract
The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based prediction, from the Medical Research Council (MRC). Methods. Prospective, national multicenter study including patients with severe TBI = 65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic) (age, GCS score, and pupil reactivity to light), as well as with additional CT findings (CRASH CT). Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7) years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR) for mortality was 2.65. Unfavorable outcome (GOSE
Notes
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PubMed ID
26688614 View in PubMed
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18 records – page 1 of 2.