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TBI Potpourri:  Update 2011 Michael R. Yochelson, MD VP of Medical Affairs Medical Director, Brain Injury Programs October 27, 2011 NRH/ReMeD/BIADC Joint Conference  An Overview of Brain Injury:  25 Years of Experience
Topics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SLEEP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Circadian Rhythm Dysfunction
SLEEP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SLEEP ,[object Object],[object Object],[object Object],[object Object],[object Object]
SLEEP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SLEEP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SLEEP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FATIGUE ,[object Object],[object Object],[object Object]
FATIGUE ,[object Object],[object Object],[object Object]
FATIGUE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PSYCHOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object]
PSYCHOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PSYCHOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PSYCHOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NEURO-ENDOCRINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NEURO-ENDOCRINE ,[object Object],[object Object],[object Object],[object Object]
SPORTS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SPORTS: Symptoms of Concussion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SPORTS:   When to return to play  ,[object Object],Rehab Stage Functional Exercise Objective No activity Complete physical & cognitive rest. Recovery Light Aerobic Walk, stationary bike, swim. <70% max pred HR. No resistance exercise.  Increase HR Sport specific exercise Skating drill (ice hockey), running drills (soccer). No head impact activities. Add movement Non-contact training drills More complex training drills (e.g., passing drills). May begin progressive resistance training. Exercise, coordination, cognitive load Full contact practice AFTER medical clearance, participate in normal training activities. Restore confidence; assessment of functional skills by coaching staff Return to play Normal game play.
BLAST INJURY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],US & UK CASUALTIES IN IRAQ & AFGHANISTAN http://www.defense.gov/news/casualty.pdf Accessed on September 6, 2011 http:// www.mod.uk/DefenceInternet/FactSheets/ Accessed on October 2, 2011
BLAST RELATED TBI: Incidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TBI vs PTSD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TBI vs PTSD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TBI vs PTSD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The real potpourri ,[object Object],[object Object],[object Object]
The real potpourri ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The real potpourri ,[object Object],[object Object],[object Object],[object Object]
The real potpourri ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The real potpourri ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The real potpourri ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The real potpourri ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The real potpourri
The real potpourri
CONCLUSIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
QUESTIONS?

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TBI Potpourri: Update 2011

Editor's Notes

  1. Somnolence (or &amp;quot; drowsiness &amp;quot;) is a state of near- sleep , a strong desire for sleep, or sleeping for unusually long periods (cf. hypersomnia ). It has two distinct meanings, referring both to the usual state preceding falling asleep, and the chronic condition referring to being in that state independent of a circadian rhythm . Somnolence goes back to the Latin &amp;quot;somnus&amp;quot; meaning &amp;quot;sleep.“ Fatigue (also called exhaustion , lethargy , languidness , languor , lassitude , and listlessness ) is a state of awareness describing a range of afflictions, usually associated with physical and/or mental weakness, though varying from a general state of lethargy to a specific work-induced burning sensation within one&apos;s muscles. Physical fatigue is the inability to continue functioning at the level of one&apos;s normal abilities. [1] [2] [3] It is widespread in everyday life, but usually becomes particularly noticeable during heavy exercise . Mental fatigue, on the other hand, rather manifests in somnolence (sleepiness). Fatigue is considered a symptom , as opposed to a medical sign , because it is reported by the patient instead of being observed by others. Fatigue and ‘feelings of fatigue’ are often confused.