Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Preface to second edition
- 1 Definition, clinical features and neuroanatomical basis of dementia
- 2 Important anatomical landmarks in the brain in dementia
- 3 Practical approach to pathological diagnosis
- 4 Morphometric methods and dementia
- 5 Safety precautions in laboratories involved with dementia diagnosis and research
- 6 Molecular diagnosis of dementia
- 7 Neuropathology of the ageing brain
- 8 Neuroimaging Alzheimer's disease
- 9 Alzheimer's disease
- 10 Down's syndrome and Alzheimer's disease
- 11 Sporadic tauopathies: Pick's disease, corticobasal degeneration, progressive supranuclear palsy and argyrophilic grain disease
- 12 Hereditary tauopathies and idiopathic frontotemporal dementias
- 13 Vascular dementias
- 14 Familial and sporadic cerebral amyloid angiopathies associated with dementia and the BRI dementias
- 15 Parkinson's disease, dementia with Lewy bodies, multiple system atrophy and the spectrum of diseases with α-synuclein inclusions
- 16 Huntington's disease
- 17 Human prion diseases
- 18 Alcoholism and dementia
- 19 Hydrocephalus and dementia
- 20 Head injury and dementia
- 21 Infectious (and inflammatory) diseases causing dementia
- 22 Schizophrenia and its dementia
- 23 Other diseases that cause dementia
- 24 Transgenic mouse models of neurodegenerative disease
- Appendix: Dementia brain banks
- Index
20 - Head injury and dementia
Published online by Cambridge University Press: 12 October 2009
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Preface to second edition
- 1 Definition, clinical features and neuroanatomical basis of dementia
- 2 Important anatomical landmarks in the brain in dementia
- 3 Practical approach to pathological diagnosis
- 4 Morphometric methods and dementia
- 5 Safety precautions in laboratories involved with dementia diagnosis and research
- 6 Molecular diagnosis of dementia
- 7 Neuropathology of the ageing brain
- 8 Neuroimaging Alzheimer's disease
- 9 Alzheimer's disease
- 10 Down's syndrome and Alzheimer's disease
- 11 Sporadic tauopathies: Pick's disease, corticobasal degeneration, progressive supranuclear palsy and argyrophilic grain disease
- 12 Hereditary tauopathies and idiopathic frontotemporal dementias
- 13 Vascular dementias
- 14 Familial and sporadic cerebral amyloid angiopathies associated with dementia and the BRI dementias
- 15 Parkinson's disease, dementia with Lewy bodies, multiple system atrophy and the spectrum of diseases with α-synuclein inclusions
- 16 Huntington's disease
- 17 Human prion diseases
- 18 Alcoholism and dementia
- 19 Hydrocephalus and dementia
- 20 Head injury and dementia
- 21 Infectious (and inflammatory) diseases causing dementia
- 22 Schizophrenia and its dementia
- 23 Other diseases that cause dementia
- 24 Transgenic mouse models of neurodegenerative disease
- Appendix: Dementia brain banks
- Index
Summary
Introduction
Traumatic brain injury remains a significant cause of morbidity and mortality throughout the world. In the United Kingdom more than 150,000 patients are admitted to hospital each year with a head injury. Of this group more than 80% are classified as having a mild head injury, as defined by the Glasgow Coma Scale (GCS). The GCS (Teasdale & Jennett 1974, 1976) provides a means of quantifying the level of consciousness after traumatic brain injury based on the clinical features of verbal performance, eye opening and motor response. Using this scale three levels of severity of head injury are defined; mild (score 13–15), moderate (score 9–12), and severe (score 3–8).
Approximately 1–2% of patients admitted to hospital after traumatic brain injury die as a consequence of their injuries. The majority of fatalities are within the severe head injury group, with 40% of the cases resulting in death at 6 months (Murray et al., 1999).
Among survivors of traumatic brain injury of all grades chronic disability may have a physical component although it is predominantly the cognitive and behavioural problems which provide the greatest challenge (Jennett et al., 1981). Outcome may be assessed by the Glasgow Outcome Scale (GOS) (Jennett & Bond 1975) which defines four outcome states; death/vegetative state, severe disability, moderate disability, and good recovery. The GOS is based predominantly on assessment of social reintegration after traumatic brain injury involving a structured questionnaire-based interview. This has recently been modified as the extended GOS (Teasdale et al., 1998).
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- The Neuropathology of Dementia , pp. 457 - 471Publisher: Cambridge University PressPrint publication year: 2004