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Chapter 34 - Management of neurobehavioral sequelae oftraumatic brain injury in the emergency department

from Section 5. - Special populations

Published online by Cambridge University Press:  05 April 2013

By
Andy Jagoda  and
Silvana Riggio
Edited by
Leslie S. Zun
Edited in association with
Lara G. Chepenik  and
Mary Nan S. Mallory
Leslie S. Zun
Affiliation:
Department of Emergency Medicine, Mt Sinai Hospital, Chicago
Lara G. Chepenik
Affiliation:
Yale University School of Medicine
Mary Nan S. Mallory
Affiliation:
University of Louisville, School of Medicine
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Summary

Neurobehavioral sequelae after concussion may have both somatic and neuropsychiatric components. The impact of injury on neurotransmitter function is poorly defined but clearly could provide a biological explanation for some of the behavioral changes seen after traumatic brain injury (TBI). Chronic traumatic encephalopathy has been associated with both repeat concussion and with genetic predisposition. Before focusing on the neurobehavioral complaints of the patient who has sustained a concussion, a comprehensive history and physical exam is required. The history focuses on the events preceding and succeeding the concussion. The use of neurocognitive testing in athletes before and after injury has contributed to our understanding of postconcussive cognitive performance. Cognitive and physical rest are key components to recovery. Recognizing the possibility of a mild (mTBI) patient developing neurobehavioral sequelae, education is a key component of the discharge process.

Keywords

psychosissafety evaluationemergency departmentpsychiatric illnesspsychiatric patientdepressionacute treatment processde-escalation
Type
Chapter
Information
Behavioral Emergencies for the Emergency Physician , pp. 251 - 259
Publisher: Cambridge University Press
Print publication year: 2013

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