J Neurotrauma. 2009 December; 26(12): 23832402. 1Departments of Psychiatry and Behavioral Sciences, Rehabilitation Medicine, and Epidemiology, University of Washington, Seattle, Washington. 2Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania. 3Model Systems Knowledge Translation Center, Center for Technology and Disability Studies, University of Washington, Seattle, Washington. Address correspondence to: Jesse R. Fann, M.D., M.P.H., Department of Psychiatry and Behavioral Sciences, Box 356560, University of Washington, Seattle, WA 98195. E-mail:Email: fann/at/u.washington.edu The aim of this systematic review was to critically evaluate the evidence on interventions for depression following traumatic brain injury (TBI) and provide recommendations for clinical practice and future research. We reviewed pharmacological, other biological, psychotherapeutic, and rehabilitation interventions for depression following TBI from the following data sources: PubMed, CINAHL, PsycINFO, ProQuest, Web of Science, and Google Scholar. We included studies written in English published since 1980 investigating depression and depressive symptomatology in adults with TBI; 658 articles were identified. After reviewing the abstracts, 57 articles met the inclusion criteria. In addition to studies describing interventions designed to treat depression, we included intervention studies in which depressive symptoms were reported as a secondary outcome. At the end of a full review in which two independent reviewers extracted data, 26 articles met the … Continue reading →

Updated 30 December 2013 Traumatic Brain Injury - what Schumi is going through Head injury or Traumatic Brain Injury (TBI) occurs when a sudden physical assault on the head causes damage to the brain. The damage can be focal, confined to one area of the brain. Seven-times Formula One world champion Michael Schumacher was in a 'critical' condition on Monday 30 December 2013 after suffering head injuries in a skiing accident in the French Alps resort of Meribel. Doctors operated on the 44-year-old German for the second time during the night, according to the websites of German daily Bild. Bild said doctors had drilled holes in his skull to reduce internal pressure, without citing its sources. The retired motor racing star fell while skiing off-piste on Sunday morning. "He suffered head trauma with coma that needed prompt neurosurgical treatment ...He remains in a critical condition," Schumacher's agent Sabine Kehm said in a statement. Chief anesthesiologist professor Jean-Francois Payen said: "It was an impact on his right side with high speed. He could not answer questions after the accident." "We can say he is fighting for his life. We judge him to be in a very serious situation. We cannot tell … Continue reading →

Schumacher is fighting for his life in intensive care after falling and hitting his head on a rock in the French Alpine resort of Meribel World-renowned neurosurgeon Munchi Choksey has described the brain injuries racing legend Michael Schumacher could have suffered during his skiing accident. The Formula I motor racing legend is fighting for his life in intensive care following the incident in the French Alpine resort of Meribel yesterday morning. The 44-year-old's head hit a rock following an off-piste fall. Following Schumacher's accident, an emergency evacuation airlifted him off the slopes by helicopter while still conscious. The hospital he was taken to confirmed he is in a coma and is rated as being in a critical condition. Choksey, who practices at University Hospitals Coventry & Warwickshire, told The Mirror that controlling any bleeding in or around the brain was vital following major head injuries. The treatment depends very much on the nature of the bleeding and the particular compartment it has occurred in," he said. You can have bleeding inside the brain itself, which tends to be present from the time of the injury. Usually the patient is unlikely to be conscious. Go here to see the original: Michael … Continue reading →

STORY HIGHLIGHTS (CNN) -- They thought the tonsil surgery would help her. She feared she'd never wake up. Now, a 13-year-old girl once known for smiling, giggling and dropping off her sister every day at kindergarten lies motionless in a California hospital bed, hooked up to machines that doctors say are the only thing keeping her heart beating. There have been days of prayers and protests for Jahi McMath. There was a fierce court battle as a devastated family fought to keep her on life support and doctors argued she had already died. The case drew national attention and fueled debate. Doctors and a judge have declared her brain dead and said there's no chance Jahi will come back to life. A deadline loomed Monday as a judge had said the hospital could disconnect the machines after 5 p.m. (8 p.m. ET). But shortly before Jahi could have been cut off, that same judge extended his order to 5 p.m. (8 p.m. ET) on January 7. "This child was sitting on death row," said family attorney Christopher Dolan. "This was a facility that was hell bent on ending this child's life today, and a court stepped in." Children's Hospital Oakland … Continue reading →

A leading neurosurgeon has admitted that the treatment given to Michael Schumacher suggests his injuries are very serious and worse than first thought. "Following blunt trauma, which is what you would term his injury, the brain swells and that swelling contained within the rigid box of the skull can cause dangerous pressure on the vital structure to the brain," Dr Chris Chandler, consultant neurosurgeon at King's College Hospital told Sky News. "That brain swelling needs to be controlled. The fact that the German is in an induced coma suggests a number of possible scenarios. "He could have suffered a diffuse injury to his brain which can then result in brain swelling," said Chandler. "He could have sustained some sort of brain haemorrhage and if there was a blood clot within his brain or on the surface of his brain underneath his skull, that might need to be removed. "Sometimes there is nothing actually to remove but you put in an intracranial pressure monitor, which basically is an operation that requires drilling a hole in the skull and putting a fine probe inside. Or if there is diffuse swelling of the brain, sometimes surgeons remove a large piece of the skull … Continue reading →

By Elizabeth Landau, CNN updated 3:40 PM EST, Mon December 30, 2013 STORY HIGHLIGHTS (CNN) -- Formula 1 driver Michael Schumacher suffered severe head trauma in a skiing accident and arrived at a French hospital in a coma. To promote healing after Sunday's accident, doctors are keeping the German driver in a medically induced coma and lowered his body temperature, said Dr. Jean-Francois Payen, chief anesthesiologist at University Hospital Center of Grenoble, France, where the driver is being treated. Traumatic brain injury causes the brain to swell, just like the inflammation that happens when you injure an elbow or knee. But because the brain is trapped inside your skull, pressure on the brain increases and restricts a lot of critical functions, such as blood supply, said Dr. David Wright, director of emergency neurosciences in the Department of Emergency Medicine at the Emory University School of Medicine. "You're worried because the skull is a closed space," said Dr. Nicholas Schiff, professor of neurology and neuroscience at Weill Cornell Medical College. "As the brain starts to expand, the only place it has to go is down and out, and you damage the brain stem. You can die. You can create a lot … Continue reading →