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Life
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Traumatic Brain Injury (TBI)
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Traumatic Brain Injury (TBI)

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (30 November 2025) | Viewed by 27453

Special Issue Editors

Dr. Seyed Ahmad Naseri Alavi

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Guest Editor
Department of Neurosurgery, School of Medicine, Emory University, Atlanta, GA 30033, USA
Interests: neurosurgery; spine; neuroscience; traumtic brain injury; spinal cord injury; trauma; brain tumor
Dr. Andrew J. Kobets

E-Mail Website
Guest Editor
Neurological Surgery and Pediatrics, Neurosurgical Director, Montefiore Craniofacial Center, Co-Director, Surgical Neuro-Oncology, Children's Hospital at Montefiore, 3316 Rochambeau Avenue, 2nd Floor, Bronx, NY 10467, USA
Interests: traumatic brain injury; pediatric cranial trauma; hydrocephalus; craniofacial deformities; brain and spine tumors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The purpose of this Special Issue is to collect the most recent and innovative findings on both basic and clinical aspects of Traumatic Brain Injury (TBI) in the field of Neurosurgery. TBI is the leading cause of morbidity and mortality in young adults, impacting not only the patients' quality of life (QoL) but also burdening additional costs on family members and guardians. Significant efforts have been made to reduce pain, disability, and mortality rates and improve function following TBI. However, numerous questions regarding the prognosis and treatment of TBI patients have not been precisely addressed, and many remain controversial. Therefore, further comprehensive research in both basic and clinical areas is needed to develop new drugs, imaging techniques, surgical methods, prognosis prediction, rehabilitation, and quality of life improvements. All papers, clinical or not, should focus on mechanisms, molecules, interactions, modalities, prognosis, new drugs, treatment, and QoL.

Dr. Seyed Ahmad Naseri Alavi
Dr. Andrew J. Kobets
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neurosurgery
  • neuroscience
  • Traumatic Brain Injury
  • TBI
  • head injury
  • imaging
  • prognosis
  • labaratory findings
  • quality of life

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Published Papers (8 papers)

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Research

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18 pages, 1141 KB  
Article
Recovery from Post-Traumatic Amnesia During Inpatient Rehabilitation: A Retrospective Cohort Study
by Tay Kai Wen Elvina, Lim Gek Hsiang and Chua Karen
Life 2026, 16(2), 221; https://doi.org/10.3390/life16020221 - 28 Jan 2026
Abstract
Background: Traumatic brain injury (TBI) is a global healthcare problem, and post-traumatic amnesia (PTA) is a known predictor of long-term and societal outcomes. However, factors influencing PTA recovery during the inpatient rehabilitation phase remain underexplored, particularly in Asian populations. Objective: To identify factors [...] Read more.
Background: Traumatic brain injury (TBI) is a global healthcare problem, and post-traumatic amnesia (PTA) is a known predictor of long-term and societal outcomes. However, factors influencing PTA recovery during the inpatient rehabilitation phase remain underexplored, particularly in Asian populations. Objective: To identify factors associated with PTA duration and emergence during inpatient rehabilitation and examine their impact on functional outcomes. Materials and Methods: We conducted a retrospective, single-center cohort study over a 7-year period among patients with acute TBI who were admitted to an inpatient rehabilitation hospital. Outcomes included PTA emergence and duration, discharge Functional Independence Measure (FIM), rehabilitation length of stay, and Glasgow Outcome Scale (GOS) at ≥1 year. Results: A total of 100 patients were analyzed. In an adjusted Cox regression, age ≥ 55 years (Hazard Ratio [HR] 0.47) and non-infective medical complications during rehabilitation (HR 0.31) were associated with reduced likelihood of PTA emergence, while mild admission GCS (13–15; HR 4.80) and epidural hemorrhage (EDH) (HR 2.00) were associated with PTA emergence. PTA non-emergence was associated with approximately a 20-point lower discharge FIM total score (adjusted model, p < 0.001). A PTA duration of ≥90 days was associated with a lower total discharge FIM score by approximately 45 points compared with those with a PTA duration of <28 days (p < 0.001). PTA emergence was associated with better GOS at ≥1 year (odds ratio [OR] 3.92, p = 0.02). Conclusion: Both acute injury characteristics and intra-rehabilitation factors were associated with PTA recovery functional outcomes. PTA emergence, beyond PTA duration, was strongly associated with discharge functional status and long-term global outcome, supporting the clinical value of PTA in prognostication, rehabilitation planning, and goal setting. Full article
(This article belongs to the Special Issue Traumatic Brain Injury (TBI))
13 pages, 3641 KB  
Article
Biomechanical Investigation of Head Injuries Caused by Baseball Bat Strikes with Different Bat Sizes and Velocities: A Finite Element Simulation Study
by Han Zhang, Jin Yang, Luyi Guo, Jiani Sun, Shangxiao Li and Weiya Hao
Life 2026, 16(1), 9; https://doi.org/10.3390/life16010009 - 20 Dec 2025
Viewed by 405
Abstract
Objective: Traumatic brain injury (TBI) represents a significant clinical problem, with the biomechanical mechanisms of striking from different blunt instruments remaining unclear. This study aims to quantitatively evaluate TBI severity under blunt strikes and to assess the effects of strike velocity and blunt [...] Read more.
Objective: Traumatic brain injury (TBI) represents a significant clinical problem, with the biomechanical mechanisms of striking from different blunt instruments remaining unclear. This study aims to quantitatively evaluate TBI severity under blunt strikes and to assess the effects of strike velocity and blunt instrument size on biomechanical responses to provide a finite element approach for investigating injury mechanisms and informing clinical diagnosis. Methods: A head finite element model incorporating an outer cortical-cancellous-inner cortical bone structure was developed and verified against a previous cadaveric impact study. Strike velocities and blunt instrument parameters, obtained from experiments in which a long bat (LB) and a short bat (SB) were used to strike a dummy head, were applied as the loading conditions in the finite element simulation. Kinetic energy (KE), internal energy (IE), impact force, von Mises stress on skull, intracranial pressure (ICP), and Head3ms acceleration were analyzed as indicators of injury severity. Results: Simulated force and ICP responses agreed with cadaveric experimental data within a 9.8% error. With increasing strike velocity (10–30 m/s), KE, IE, impact force, ICP, and Head3ms all rose, while von Mises stress evolved from localized to dispersed distribution. Head3ms reached an injury threshold of 80 g at a strike velocity of 10 m/s, and ICP peaks for LB and SB exceeded the brain injury threshold (235 kPa, ≈1760 mmHg) at 12 m/s and 14 m/s, respectively. At the same velocity, LB generated higher KE, IE, impact force, ICP and Head3ms than SB. At 30 m/s, LB generated 390 J KE and 29.0 kN peak force, which were 50.0% and 11.1% higher than those of SB (260 J, 26.1 kN). Conclusion: This study reveals that increasing strike velocity and employing a larger blunt instrument elevate biomechanical responses, resulting in von Mises stress transitioning from localized concentration to multipolar dispersion. Specifically, when striking the head with the LB at velocities exceeding 12 m/s or with the SB exceeding 14 m/s, the impacts indicate a severely life-threatening level. These findings deepen our understanding of the mechanisms of blunt TBI. The constructed and validated finite element model can be repeatedly used for computer simulations of TBI under various blunt striking conditions, providing a scientific basis for clinical diagnosis and surgical planning. Full article
(This article belongs to the Special Issue Traumatic Brain Injury (TBI))
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20 pages, 4901 KB  
Article
A Diffusion Tensor Imaging Study: Relation of Wisconsin Card Sorting Covariates to White Matter Abnormalities in Traumatic Brain Injury
by Aditya Prashant Kamble, Angel Liu, Dean Choi and Joseph Wu
Life 2025, 15(10), 1633; https://doi.org/10.3390/life15101633 - 20 Oct 2025
Viewed by 725
Abstract
New brain imaging modalities and neuropsychological testing tools are used to study neuronal changes in brain injuries such as mild traumatic brain injury (mTBI). Here we utilized diffusion tensor imaging (DTI) parameters and Wisconsin Card Sorting Test (WCST) variables to investigate patients with [...] Read more.
New brain imaging modalities and neuropsychological testing tools are used to study neuronal changes in brain injuries such as mild traumatic brain injury (mTBI). Here we utilized diffusion tensor imaging (DTI) parameters and Wisconsin Card Sorting Test (WCST) variables to investigate patients with chronic mTBI. Neuropsychological assessments for mTBI evaluate impairments across a broad spectrum of executive functions. Our study aims to examine the relationship between fractional anisotropy (FA) and WCST covariates in patients with chronic mTBI. We hypothesize that patients who suffered chronic mTBI have significantly reduced FA in frontal white matter regions in association with significant deviation from standard percentile scores in WSCT. Utilizing multi-linear regression models alongside analyzing DTI scans, WCST covariates were linearly regressed to produce positive and negative contrasts to identify specific regions of interest (ROIs) with reduced FA. Results show that WCST covariates (such as percentile perseverative responses (Ep), non-perseverative responses (Enp), and conceptual response (CResp)) significantly deviate beyond standard percentile scores and correlate with lower FA in white matter regions in the frontal cortex, demonstrating executive function deficits. These frontal regions include the inferior frontal, superior frontal, and corpus callosum (CC), correlated with greater errors in WCST percentile scores. This study investigates the correlation between WCST covariates and DTI parameters as valuable tools in the diagnosis and prognosis of persistent cognitive impairment for patients with a history of chronic traumatic brain injury. Full article
(This article belongs to the Special Issue Traumatic Brain Injury (TBI))
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13 pages, 597 KB  
Article
Assessment of the Sex Hormone Profile and Its Predictive Role in Consciousness Recovery Following Severe Traumatic Brain Injury
by Seyed Ahmad Naseri Alavi, Sajjad Pourasghary, Amir Rezakhah, Mohammad Amin Habibi, Aydin Kazempour, Ata Mahdkhah and Andrew Kobets
Life 2025, 15(3), 359; https://doi.org/10.3390/life15030359 - 25 Feb 2025
Cited by 2 | Viewed by 1537
Abstract
Introduction: Traumatic brain injuries (TBIs) are conditions affecting brain function caused by blunt or penetrating forces to the head. Symptoms may include confusion, impaired consciousness, coma, seizures, and focal or sensory neurological motor injuries. Objective: This study evaluated sex hormone profiles and their [...] Read more.
Introduction: Traumatic brain injuries (TBIs) are conditions affecting brain function caused by blunt or penetrating forces to the head. Symptoms may include confusion, impaired consciousness, coma, seizures, and focal or sensory neurological motor injuries. Objective: This study evaluated sex hormone profiles and their predictive role in returning consciousness after severe traumatic brain injury. Materials and Methods: We included 120 patients with TBIs and collected comprehensive information about each patient, including the cause of the trauma, age, gender, Glasgow Coma Scale (GCS) score, Injury Severity Score (ISS), and neuroradiological imaging data. The ISS was used to assess the severity of the trauma. At the same time, the lowest GCS score was recorded either before sedation and intubation in the emergency room or by emergency medical services personnel. For female participants, samples were collected during the luteal phase of the menstrual cycle (days 18 to 23). Results: The mean age of male patients was 33.40 years, ranging from 23 to 45 years, while female patients had an average age of 34.25 years, ranging from 25 to 48 years. The primary cause of injury for both genders was motor vehicle accidents. In male patients, testosterone levels were significantly higher in those classified as responsive (RC) compared to those non-responsive (NRC), with levels of 2.56 ± 0.47 ng/mL versus 0.81 ± 0.41 ng/mL (p = 0.003). A cut-off point of 1.885 ng/mL for testosterone levels in males was established, achieving a sensitivity and specificity of 86.7% and 86.7%, respectively. In female patients, progesterone levels were elevated in those who regained consciousness, measuring 1.80 ± 0.31 ng/mL compared to 0.62 ± 0.31 ng/mL (p = 0.012). A cut-off point of 1.335 ng/mL for progesterone levels in females was determined, with a sensitivity and specificity of 93.3% and 86.7%, respectively. Conclusions: We can conclude that sex hormone levels in the acute phase of TBIs can vary between males and females. Notably, serum testosterone levels in males and progesterone levels in females with TBIs are significant prognostic factors for assessing the likelihood of regaining consciousness after such injuries. These findings underscore the importance of considering sex hormone profiles in TBI recovery prognosis. Full article
(This article belongs to the Special Issue Traumatic Brain Injury (TBI))
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Review

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31 pages, 1898 KB  
Review
Traumatic Brain Injury: Novel Experimental Approaches and Treatment Possibilities
by Kristina Pilipović, Tamara Janković, Jelena Rajič Bumber, Andrej Belančić and Jasenka Mršić-Pelčić
Life 2025, 15(6), 884; https://doi.org/10.3390/life15060884 - 30 May 2025
Cited by 2 | Viewed by 8041
Abstract
Traumatic brain injury (TBI) remains a critical global health issue with limited effective treatments. Traditional care of TBI patients focuses on stabilization and symptom management without regenerating damaged brain tissue. In this review, we analyze the current state of treatment of TBI, with [...] Read more.
Traumatic brain injury (TBI) remains a critical global health issue with limited effective treatments. Traditional care of TBI patients focuses on stabilization and symptom management without regenerating damaged brain tissue. In this review, we analyze the current state of treatment of TBI, with focus on novel therapeutic approaches aimed at reducing secondary brain injury and promoting recovery. There are few innovative strategies that break away from the traditional, biological target-focused treatment approaches. Precision medicine includes personalized treatments based on biomarkers, genetics, advanced imaging, and artificial intelligence tools for prognosis and monitoring. Stem cell therapies are used to repair tissue, regulate immune responses, and support neural regeneration, with ongoing development in gene-enhanced approaches. Nanomedicine uses nanomaterials for targeted drug delivery, neuroprotection, and diagnostics by crossing the blood–brain barrier. Brain–machine interfaces enable brain-device communication to restore lost motor or neurological functions, while virtual rehabilitation and neuromodulation use virtual and augmented reality as well as brain stimulation techniques to improve rehabilitation outcomes. While these approaches show great potential, most are still in development and require more clinical testing to confirm safety and effectiveness. The future of TBI therapy looks promising, with innovative strategies likely to transform care. Full article
(This article belongs to the Special Issue Traumatic Brain Injury (TBI))
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15 pages, 1446 KB  
Review
Visual Dysfunctions in Mild Traumatic Brain Injury: A Focus on Accommodative System Impairments
by Nawaf M. Almutairi
Life 2025, 15(5), 744; https://doi.org/10.3390/life15050744 - 6 May 2025
Viewed by 2988
Abstract
Background: Mild traumatic brain injury (mTBI) is a prevalent neurological condition that results in various physical, emotional, and cognitive impairments. The most common are visual impairments, which affect vision’s perceptual, motor, and sensory aspects. Objective: This paper analyzes the pathophysiology of [...] Read more.
Background: Mild traumatic brain injury (mTBI) is a prevalent neurological condition that results in various physical, emotional, and cognitive impairments. The most common are visual impairments, which affect vision’s perceptual, motor, and sensory aspects. Objective: This paper analyzes the pathophysiology of mild traumatic brain injury (mTBI) and its effects on visual and oculomotor functions, focusing on the deficits of the accommodative system and their underlying mechanism. Findings: mTBI frequently causes diffuse axonal injury, resulting in abnormalities of the neurometabolic cascade that impact the brain’s visual regions. Accommodative anomalies, including insufficiency, infacility, and spasm, are markedly more common in mTBI patients than in the general population. These deficiencies present as a notable delay in accommodation response, diminished peak velocity, and compromised dynamic responses, possibly due to sensory and motor disturbances. Conclusions: Accommodation disorder is a significant but under-examined component of visual sequelae related to mTBI. Future research should concentrate on the sensory and motor factors contributing to these deficiencies to enhance diagnostic precision and customize rehabilitative strategies. Full article
(This article belongs to the Special Issue Traumatic Brain Injury (TBI))
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25 pages, 1535 KB  
Review
Traumatic Brain Injury and Artificial Intelligence: Shaping the Future of Neurorehabilitation—A Review
by Seun Orenuga, Philip Jordache, Daniel Mirzai, Tyler Monteros, Ernesto Gonzalez, Ahmed Madkoor, Rahim Hirani, Raj K. Tiwari and Mill Etienne
Life 2025, 15(3), 424; https://doi.org/10.3390/life15030424 - 7 Mar 2025
Cited by 10 | Viewed by 12451
Abstract
Traumatic brain injury (TBI) is a leading cause of disability and death globally, presenting significant challenges for diagnosis, prognosis, and treatment. As healthcare technology advances, artificial intelligence (AI) has emerged as a promising tool in enhancing TBI rehabilitation outcomes. This literature review explores [...] Read more.
Traumatic brain injury (TBI) is a leading cause of disability and death globally, presenting significant challenges for diagnosis, prognosis, and treatment. As healthcare technology advances, artificial intelligence (AI) has emerged as a promising tool in enhancing TBI rehabilitation outcomes. This literature review explores the current and potential applications of AI in TBI management, focusing on AI’s role in diagnostic tools, neuroimaging, prognostic modeling, and rehabilitation programs. AI-driven algorithms have demonstrated high accuracy in predicting mortality, functional outcomes, and personalized rehabilitation strategies based on patient data. AI models have been developed to predict in-hospital mortality of TBI patients up to an accuracy of 95.6%. Furthermore, AI enhances neuroimaging by detecting subtle abnormalities that may be missed by human radiologists, expediting diagnosis and treatment decisions. Despite these advances, ethical considerations, including biases in AI algorithms and data generalizability, pose challenges that must be addressed to optimize AI’s implementation in clinical settings. This review highlights key clinical trials and future research directions, emphasizing AI’s transformative potential in improving patient care, rehabilitation, and long-term outcomes for TBI patients. Full article
(This article belongs to the Special Issue Traumatic Brain Injury (TBI))
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Other

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10 pages, 1724 KB  
Case Report
Ruptured Posterior Cerebral Artery Dissecting Aneurysm After Trauma: A Case Report and Literature Review
by Chun-Han Chang, Yuan-Yun Tseng and Tao-Chieh Yang
Life 2026, 16(1), 34; https://doi.org/10.3390/life16010034 - 25 Dec 2025
Viewed by 370
Abstract
Posterior cerebral artery (PCA) aneurysms are rare, accounting for less than 2% of intracranial aneurysms. Among them, dissecting aneurysms frequently occur in the P2 segment. Traumatic PCA aneurysms are extremely uncommon and usually reported in pediatric or young adults following high-energy injuries. We [...] Read more.
Posterior cerebral artery (PCA) aneurysms are rare, accounting for less than 2% of intracranial aneurysms. Among them, dissecting aneurysms frequently occur in the P2 segment. Traumatic PCA aneurysms are extremely uncommon and usually reported in pediatric or young adults following high-energy injuries. We report the case of a 43-year-old woman who sustained a ruptured left PCA P2 dissecting aneurysm with subarachnoid hemorrhage, accompanied by an L2 unstable burst fracture after a high-speed motor vehicle collision. Initial neuroimaging revealed diffuse basal cistern hemorrhage with more predominance at the left side ambient cistern and a fusiform aneurysm with a superimposed saccular component along its anterior portion of left PCA P2 segment. The patient underwent endovascular treatment with a flow-diverting stent and stent-assisted coiling, achieving complete obliteration, followed by lumbar minimally invasive spinal surgery (MISS). The patient recovered without neurological deficits and remained fully independence at a one-year follow-up. Traumatic PCA dissecting aneurysms pose a diagnostic challenge due to their rarity and potential for delayed clinical manifestation, yet they carry a substantial risk of morbidity and rebleeding if untreated. Early recognition through detailed vascular imaging and timely reconstructive endovascular intervention are essential to preventing secondary hemorrhage and optimizing clinical outcomes. This case underscores the need for heightened suspicion for vascular injury in patients with significant craniovertebral trauma. Full article
(This article belongs to the Special Issue Traumatic Brain Injury (TBI))
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