Traumatic Brain Injury: Emergency Management, Prevention of Secondary Injury, and Rehabilitation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Brain Injury".

Deadline for manuscript submissions: 20 August 2025 | Viewed by 5138

Special Issue Editors


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Guest Editor
Department of Neurology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, 811 Kaufmann Medical Building, 3471 Firth Avenue, Pittsburgh, PA 15213, USA
Interests: cerebral edema; traumatic brain injury; hemorrhagic stroke; intracerebral hemorrhage; neurointensive care

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Guest Editor
Department of Neurology, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
Interests: neuroemergencies; glucose control after stroke; traumatic brain injury; subarachnoid hemorrhage; neurocritical care

Special Issue Information

Dear Colleagues,

Traumatic brain injury (TBI) continues to be one of the top three leading causes of death and severe disability worldwide, which poses an enormous burden on families, caregivers, and the economy and health care systems. With the constantly aging population, especially in high-income countries, the incidence of falls resulting in TBI is expected to rise.

Improvements in emergency management, diagnostic tools, and neurocritical care, with special attention to secondary injuries and their differential diagnosis and neuromonitoring, as well as rehabilitation programs, have contributed to a better understanding of individual pathophysiology and outcomes after TBI. Multidimensional outcome assessment tools have been developed.

Clinicians and scientists are encouraged to submit original research papers or state-of-the-art reviews for this upcoming Special Issue focusing on aspects of acute management and neurocritical care of TBI patients, neuromonitoring, rehabilitation during the acute, subacute, and chronic phases, as well as outcome assessment after a TBI.

Dr. Katja E. Wartenberg
Prof. Dr. Lori Shutter
Guest Editors

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Keywords

  • traumatic brain injury
  • neuromonitoring
  • neurocritical care
  • neurorehabilitation
  • secondary injury
  • outcome
  • prognostication

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Published Papers (3 papers)

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Research

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25 pages, 9684 KiB  
Article
Retraining Dorsal Visual Pathways Improves Cognitive Skills After a Mild Traumatic Brain Injury
by Teri Lawton, John Shelley-Tremblay, Roland R. Lee and Ming-Xiong Huang
J. Clin. Med. 2025, 14(7), 2273; https://doi.org/10.3390/jcm14072273 - 26 Mar 2025
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Abstract
Background and Objectives: Currently, there are no proven solutions to remediate cognitive deficits in people with a mild traumatic brain injury (mTBI). One common issue is visual timing deficits, which may be due to processing deficits in dorsal visual pathways. Methods: This [...] Read more.
Background and Objectives: Currently, there are no proven solutions to remediate cognitive deficits in people with a mild traumatic brain injury (mTBI). One common issue is visual timing deficits, which may be due to processing deficits in dorsal visual pathways. Methods: This study investigates whether a new intervention (PATH) aimed at improving these visual timing deficits is more effective than conventional cognitive therapies that either remediate: (1) pattern discrimination deficits (ventral visual pathway): Orientation Discrimination (OD), or (2) working memory deficits using ReCollect task, for 10 subjects between the ages of 26–60 years old. This study tests the ability of three different cognitive therapies to improve the primary outcome: visual working memory (VWM), and secondary outcomes: processing speed, auditory working memory, and selective attention in mTBI subjects based on neuropsychological tests administered before and after 36 30-min training sessions Monday, Wednesday and Friday mornings. Results: On average, the PATH group exhibited a 35% improvement in VWM, compared to 15% for ReCollect and 5% for OD. A repeated-measures ANOVA found that improving dorsal stream function improved VWM significantly more than found after the other two interventions. The results reveal the importance of strengthening dorsal pathways more than conventional cognitive therapies to improve cognitive skills after mTBI. A biomarker, MagnetoEncephaloGraphy (MEG) brain recordings, using an N-Back task for subjects in treatment groups, verified these improvements as well. Conclusions: The data from this preliminary study are very promising for a new method improving the brain’s timing, more effective than conventional therapies, to improve cognitive deficits in mTBI patients. Full article
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20 pages, 4842 KiB  
Systematic Review
Neuropsychological Rehabilitation for Traumatic Brain Injury: A Systematic Review
by Carlos Ramos-Galarza and Jennifer Obregón
J. Clin. Med. 2025, 14(4), 1287; https://doi.org/10.3390/jcm14041287 - 15 Feb 2025
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Abstract
Background/Objectives: A traumatic brain injury (TBI) is a brain lesion caused by external or internal factors, resulting in cognitive, behavioral, physical, relational, and sensory sequelae, depending on the affected brain area and the severity of the injury. Within neuropsychological rehabilitation (NR), multiple methods [...] Read more.
Background/Objectives: A traumatic brain injury (TBI) is a brain lesion caused by external or internal factors, resulting in cognitive, behavioral, physical, relational, and sensory sequelae, depending on the affected brain area and the severity of the injury. Within neuropsychological rehabilitation (NR), multiple methods have been developed that are aimed at restoring, compensating, and substituting deteriorated cognitive functions resulting from a TBI. This systematic review aimed to identify the state of the scientific literature regarding the efficacy of NR methods in individuals with a TBI. Methods: Articles were analyzed in the SCOPUS and PUBMED databases. Initially, 5347 studies were found. After applying inclusion and exclusion criteria, 17 articles remained and were included in the data extraction process. Results: Of the seventeen included articles, eleven employed randomized or semi-randomized controlled trials, five were clinical studies, and one was a comparative study, in which the percentage of computerized NR methods was 58.82% in the experimental and clinical groups. In contrast, traditional methods constituted 35.3%, and the remaining 5.88% conducted holistic NR. Ninety percent of the methods employed in these investigations showed efficacy. Conclusions: While most of the evaluated NR methods demonstrated efficacy, the analysis of these findings should not be isolated from variables such as the etiology and phase of the TBI, the intervention duration, and the symptoms treated. Furthermore, the NR implementation must be adapted to the specific context of each patient. Full article
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11 pages, 623 KiB  
Commentary
Albumin in Normovolemic Fluid Management for Severe Traumatic Brain Injury: Controversies and Research Gaps
by Christian J. Wiedermann
J. Clin. Med. 2024, 13(18), 5452; https://doi.org/10.3390/jcm13185452 - 13 Sep 2024
Cited by 2 | Viewed by 3327
Abstract
Traumatic brain injury (TBI) is a significant public health issue characterized by high mortality rates and long-term complications. This commentary examines the controversial role of the use of albumin in the fluid management of patients with severe TBI. Despite its physiological benefits, the [...] Read more.
Traumatic brain injury (TBI) is a significant public health issue characterized by high mortality rates and long-term complications. This commentary examines the controversial role of the use of albumin in the fluid management of patients with severe TBI. Despite its physiological benefits, the clinical use of albumin remains controversial due to the fact that various studies have yielded mixed results. Serum albumin is important for maintaining normovolemia, primarily through its contribution to colloid osmotic pressure, which helps to retain fluid in the circulatory system. This review highlights the existing evidence, examines inconsistencies in guideline recommendations, and suggests future research directions to clarify the efficacy and safety of the use of albumin in maintaining normovolemia in patients with TBI. The review also discusses the potential benefits of small-volume resuscitation strategies for the management of acute kidney injury in TBI patients, drawing parallels with the management of septic acute kidney injury. The need for further well-designed randomized controlled trials and ethical considerations in studies regarding the use of hyperoncotic albumin in TBI management is emphasized. Full article
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