The field of traumatic brain injury has evolved since the time of the Civil War in response to the needs of patients with injuries and disabilities resulting from war. The Department of Veterans Affairs and the Defense and Veterans Brain Injury Center have been in the forefront of the development of the interdisciplinary approach to the rehabilitation of soldiers with traumatic brain injury, particularly those injured from the recent conflicts in Iraq and Afghanistan. The objectives of this literature review are to examine how the casualties resulting from major wars in the past led to the establishment of the current model of evaluation and treatment of traumatic brain injury and to review how the field has expanded in response to the growing cohort of military service members and veterans with TBI.
[Show abstract][Hide abstract] ABSTRACT: The U.S. Veterans Health Administration established the Polytrauma System of Care (PSC) in response to the growing need for Traumatic Brain Injury (TBI) and polytrauma rehabilitation services for our returning war heroes. The unique and complex patterns of injuries sustained during the conflicts in Iraq and Afghanistan have resulted in significant physical, cognitive, and psychological impairments which require an extraordinary level of specialized training and skill provided by the PSC interdisciplinary team. The PSC offers a holistic, coordinated, and comprehensive continuum of polytrauma/brain injury rehabilitation. These services range from intensive inpatient rehabilitation to residential and outpatient programs designed to address all facets of combat injury. These services are available to Veterans and service members across the nation and have been involved in the direct care of tens of thousands of combat injured personnel. This article provides an overview of services and new initiatives created by the PSC to provide the best care for our Veterans and service members.
[Show abstract][Hide abstract] ABSTRACT: The ongoing wars in Iraq and Afghanistan and terrorist activity worldwide have been associated with an increased incidence of blast injuries. While blast injuries share similarities with blunt or penetrating traumatic injuries, there are unique mechanistic elements of blast injury that create increased vulnerability to damage of specific organs. This review highlights the mechanism of blast-related injury, describes the common sequelae of blast exposure that may impact rehabilitation care, and summarizes the intervention strategies for these blast-related sequelae.
[Show abstract][Hide abstract] ABSTRACT: Concussion management is an individualized process and therefore can be confusing to patients, parents, and other caregivers. There are guidelines to assist in identifying concussion symptoms and suggest return-to-play plans, but each patient deserves a unique approach to their injury. This chapter reviews the potential long-term complications of concussion, including chronic traumatic encephalopathy, chronic headaches, and neurocognitive dysfunction. It also explores the possible management options for concussed children and adolescents, many of which are emerging and somewhat experimental. Long-term psychosocial concerns are addressed. The ethics of return-to-play are also discussed.
Pediatric and Adolescent Concussion, 01/2012: pages 195-208; , ISBN: 978-0-387-89544-4
Kristina G. Witcher, Daniel S. Eiferman, Jonathan P. Godbout
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