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Title Concussion and traumatic encephalopathy : causes, diagnosis, and management / edited by Jeff Victoroff, Erin D. Bigler
Published Cambridge, United Kingdom ; New York, NY, USA : Cambridge University Press, 2019
©2019

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Description 1 online resource (xxi, 824 pages)
Series Cambridge medicine
Cambridge medicine (Series)
Contents Cover -- Half-title -- Title page -- Copyright information -- Dedication -- Table of contents -- Guiding Apophthegm -- List of Contributors -- Preface -- Acknowledgments -- Introduction -- Salve, Elephant! -- Knowledge Versus Opinion -- I. Insufficient Empirical Investigation -- Forward March -- What Needs to be Done Right Now? -- Basic Research -- Translational Research: The Hope for Biomarkers -- Clinical Research to Determine the Risk Factors of Worse Outcome and Traumatic Encephalopathy, and the Modifiable Factors That Protect the Brain -- II. Lack of a Meaningful Outcome Measure -- III. Misplaced Faith in a Dated Conceptual Trichotomy -- IIIA. An Organic/Psychological Dichotomy Does Not Seem Consistent With What We Know About Brains -- IIIB. Which One of These Changes is Not Organic? -- IIIB1. A Dichotomy Between Imaginary and Intentional Complaints Does Not Seem Consistent With What We Know About Brains -- IIIB2. A Dichotomy Between Imaginary and Intentional Complaints is Not Clinically Diagnosable -- IV. Misplaced Faith in Flawed Modes of Inquiry -- IV.A. Misplaced Faith in Authority -- IV.B. Misplaced Faith in Consensus -- The Wisdom of Crowds? -- IV.C. Misplaced Faith in Cognitive Testing -- IV.C.1. Is There a Subgroup of CBI Survivors who Have Persistently Reduced Cognitive Test Scores? And if That is So, is That Because of the CBI or Something Else? -- Meta-Analysis -- IV.C.2. Are Cognitive Tests a Good Way to Assess Brain Function? -- V. Bias, Temperament, and Conflicts of Interest -- The Author's Bias -- Anger at Maximizers -- Tolerance of Minimizers -- Commencement -- References -- Part I What Is a Concussion? -- 1 What Is a Concussive Brain Injury? -- Part I: A Brief History of the Idea of Concussion -- What (if Anything) did Hippocrates Think About Concussion? -- Beyond the Hippocratics -- 1600-1700 -- 1700-1800: Running in Place
1800-1900: A Certain Undefinable Something, or Cause of Evil -- Experimental Concussion -- The Arrival of the Microscope: Long Delayed but Brilliantly Disruptive -- The Traumatic Impact of Traumatic Neurosis -- Clarity at the Very Cusp of the New Century -- 1900-1925: The Decline and Fall of a Coherent Idea -- Factor 1: A Rapid Increase in CBIs -- Factor 2: The Expansion of Payments for Disability -- Factor 3: The Popularity of Psychological Explanations -- The Fallacy of Benignity -- Attorneys and the Invention of Mild Traumatic Brain Injury -- The Reason Why -- Progress -- 1930 and Beyond -- The Great Divide -- Part II: A Brief Introduction to What Concussive Brain Injury Does to the Brain -- Shear, Stretch, and Axonal Jeopardy -- The "Neurometabolic Cascade" Hypothesis -- Inflammation -- Gene Expression -- Altered Protein Degradation, Toxic Accumulation, and Neurodegeneration -- Proton Magnetic Resonance Spectroscopy -- Functional MRI Studies -- If a Tree Falls in a Forest ... -- The Imponderability of Mildness -- Imagining "Recovery" -- Diagnostic Semantics -- Part III: Efforts to Define Concussion by Means of "Consensus" -- Conclusion -- References -- 2 Epidemiology of Concussive Brain Injury -- Antelogium -- What Counts? -- Introduction and Apologia2 -- Epidemiology of TBI in the United States: Deconstructing the CDC Pyramid -- The Three Question Marks -- Risk Factors for TBI -- Age -- Sex -- Race/Ethnicity -- Cause -- Risk of Recurrence -- Military Concussion -- Understanding the Concussion-PTSD Relationship -- The Myth of Missing Traumatic Memory -- How Common is PTSD After CBI? -- Why is Concussion so Strongly Associated with PTSD? -- The Epidemiology of Sports-Related Concussion -- Barriers to Knowledge Regarding Sports-Related Concussions -- How Many People Play Sports? -- How Many Sport-Related Concussions Occur?
Risk Factors for Sports-Related Concussions: Age, Sex, Recurrence, and Activity -- Age-Related Differences in Vulnerability to Sports-Related Concussions -- Sex-Related Differences in Vulnerability to Sports-Related Concussions -- Recurrence -- Activity-Related Differences in Vulnerability to Sports-Related Concussions -- Brief Observations Regarding Several Popular Sports -- All-Terrain Vehicle (ATV) Riding -- Baseball -- Basketball -- Bicycling -- Boxing -- Cheerleading -- Equestrian Sports -- Football and the Sophistry of the "Concussion Threshold" -- Concussive Brain Injuries Classified as Non-Concussions -- Ice Hockey -- Karate/Taekwondo/Mixed Martial Arts (MMA) -- Lacrosse -- Rodeo -- Rugby -- Skateboarding -- Skiing and Snowboarding -- Soccer -- Wrestling -- Legal Implication of Sports-Related Concussion -- Prevalence of Concussion-Related Disability -- Cost -- Conclusion -- References -- 3 The Pathophysiology of Concussive Brain Injury -- Introduction -- External Force and the Metabolic Cascade: From Biomechanical to Biochemical -- Measuring and Monitoring the Post-Concussive Metabolic Imbalance: Energy Metabolism and the Role of N-Acetyl Aspartate -- Gene Modulation After Concussion: Visualizing the Post-Concussive Melee -- Post-Concussion Brain Vulnerability and the Second Impact Syndrome -- Further Clinical Implications -- Key Issues for Future Studies -- References -- 4 What Happens to Concussed Animals? -- Introduction -- Experiments with Abrupt External Force -- What this Chapter will Defer -- Five Serious Problems With Animal Models (and the Other Four) -- Problem 1: We Do Not Know What Force Best Approximates Typical Human Concussion -- Problem 2: We Usually Hit the Wrong Thing in the Wrong Way -- Popular (But Flawed) Experimental Models of Concussive Brain Injury -- Six Models -- Problem 3: Animals Cannot Tell us How They Feel
Problem 4: The Behaviors Assessed are Neither Ecologically Valid nor Comparable to Human Behaviors -- Problem 5: Nobody Wants to Care for a Brain-Injured Mouse -- Problem 7: Rodents Don't Get "Alzheimer's Disease" -- Single, Double, Triple -- For Better or for Worse? -- Problem 8: Rodents Fix Themselves, in Part, by Making New Neurons -- Neurogenesis Helps Overcome the Deleterious Effects of TBI -- Problem 9: The Limits of the Accessorized Human Eye -- What Experimental Studies With Non-Human Animals Reveal -- 1. Animal CBI Immediately Triggers Competing Waves of Harmful and Helpful Brain Change -- 2. Animal CBI Tends to Disproportionately Hurt the Very Brain Cells Known to Mediate Human Post-Concussive Problems -- Why is the Hippocampus so Fragile? -- 3. Concussion (aka, "mTBI") Sometimes Kills Neurons -- Moderate and Severe -- How About "Mild" Injuries? Answering the Sometimes Question -- So What? -- A Mild Concussive Brain Injury is One in Which no Biological Signaling Attempts to Trigger Reactive Neurogenesis -- Sickly Cells -- Missed Connections -- Wayward Genes -- Medium- to Long-Term Change: The Data -- With Regard to Brain Change -- Conclusion -- Afterword: In Praise of Fact Finders -- References -- 5 What Happens to Concussed Humans? -- Pre-Antelogium -- Commonly Observed Post-CBI Problems -- What this Chapter Will Not Do -- A Dozen Reasons Why There is Still a Debate -- Considering Each in Turn -- 1. The Question Does Not Lend Itself to Clinico pathological Correlation Studies -- 2. There is Ongoing Resistance to Willis's 1664 Reflection That Brains Mediate Mental Functions -- 3. It is Doubtful That the Animal Experiments Accurately Mimic Human Concussion -- 4. Despite Garrod's 1908 Insight [11], Individuality Remains Hard to Accommodate in Western Medical Nosology -- 5. Access to Accurate Baseline Data is Rare
6. Detecting Persistent Change Requires Effort -- 7. Recovery is Not Objectively Verifiable -- 8. Some Patients Generate Barriers to Understanding Concussion's True Effects Because They Deny, Imagine, Inflate, or Invent Their Symptoms -- 9. Powerful Socioeconomic Forces are Arrayed Against Patients with Persistent Complaints -- 10. Opinions Harden in the Face of Uncertainty -- 11. It Would Be Unethical to Conduct a Definitive Experiment to Answer the Question: To What... -- Antelogium: The Dear Leader Experiment2 -- 12. No Single Method Assesses Outcome With Reliability and Ecological Validity -- 13. No Systematic Critical Review of Human Outcome Data has Been Published -- Empirical Data From Human Studies -- Introduction to, and for, Humans -- The Basis for Selection of the Tabulated Peer-Reviewed Articles -- At What Moment Post-Injury Should One Assess Outcome? -- What Was the Medical Problem Called? -- Age Range -- Number -- Rejecting Tunnel Visions -- Avoiding a Seductive Mistake -- Sven's Admonitions -- Sven's Admonition Number 1: Please Do Not Judge the Effect of a Disease by Comparing Groups With and Without That Disease -- Sven's Admonition Number 2: Please Stop Predicting Long-Term Outcome -- What Each Table Offers -- Pre-Emptively Curbing Enthusiasm -- The Effect of Controlling for Suspected (Rarely Verified) Pre-Morbid Neurobehavioral Conditions -- The Tables -- Analytic Comments Regarding Table 5.3: Uncontrolled Studies of Concussion Survivors -- Approaching Table 5.4 -- Analytic Comments Regarding Table 5.4: Comparing Concussion Survivors With Healthy Persons -- Cognitive Outcomes -- Symptomatic Outcomes -- Approaching Table 5.5 -- Narrative Comments Regarding Table 5.5: Comparisons of Concussion Survivors With Survivors of Other Injuries -- Cognitive Outcomes -- Symptomatic Outcomes
Summary Concussion and Traumatic Encephalopathy is a ground breaking text that offers neurologists, neuropsychologists, psychologists, and physiatrists the first comprehensive reconceptualization of concussive brain injury in 100 years. During the twentieth century, progress in understanding concussion was hamstrung by resistance to the observation that many survivors suffer long-term sequelae, and by the lack of advanced neuroimaging technologies. As a result, the potentially immense impact of concussion on global health was largely overlooked. The last decade has witnessed a dramatic renaissance in concussion science. We are just beginning to fathom the implications for society. Informed by twenty-first century advances, this new text updates the definition, epidemiology, pathophysiology, late effects, and promising therapies for concussion. Multiple experts have collaborated to summarize the latest scientific evidence in an engaging way and provide the reader with the first paradigm shifting textbook of this new era
Bibliography Includes bibliographical references and index
Notes Online resource; title from digital title page (viewed on May 21, 2019)
Subject Brain -- Concussion.
Brain Concussion
Chronic Traumatic Encephalopathy
Brain -- Concussion.
Form Electronic book
Author Victoroff, Jeffrey Ivan, editor.
Bigler, Erin D., 1949- editor.
LC no. 2018000312
ISBN 9781107073951
1107073952
9781139696432
1139696432