Research Closed Head Injuries.

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1) Define CLOSED HEAD INJURIES clearly, in your own words.

2) Research Closed Head Injuries. FIND ONE RESEARCH article ( AN EXPERIMENT) done within the last 5 years that addresses Closed Head Injuries. The subjects of the study MUST be HUMANS. Summarize the article. [ PRINT OUT and include the article, stapled to the back of your original written work.] Papers without attached articles will receive NO credit. An Experiment is NOT an overview or summary!!

3) Based on your research, the text and lecture, list and describe the 3 of the most common causes of closed head injuries.

4) Describe and discuss 2 (two) things that YOU, personally could do to prevent closed head injuries for you and/or your family.

PLEASE NOTE THE FOLLOWING ITEMS:

1) Make sure you are finding RELIABLE RESEARCH sites that deal with CLOSED HEAD INJURIES.

2) This means that sites selling things or sites offering outlandish personal opinions are NOT appropriate.

3) We are EXCLUSIVELY looking for RESEARCH (in other words, an experiment) which means that encyclopedic sites, blogs, etc. are also NOT acceptable.

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Explanation & Answer

Hello😊 here is the document and the research article from which I sourced a summary. Let me know if you need further assistance.

Surname 1
Name
Instructor’s name
Course
Date
Closed Head Injuries
A closed head injury is a type of head injury resulting from a strike or impact from an object that
does not penetrate the skull. Therefore, the skull and the dura matter remain largely undamaged.
Some examples of closed head injuries are contusion and concussion.
Summary of an Experimental Research Article
Title: Benefits of Strict Rest after Acute Concussion: A Randomized Controlled Trial
Objective: The objective of the study was to investigate the effectiveness of recommending
strict rest after a concussion as a way of enhancing recovery.
Introduction
Over the past 10 years, there has been a 60% increase in visits to the emergency department (ED)
due to sports-related head injuries with concussions taking a huge fraction. When these patients
get discharged from the ED after a diagnosis of concussion, they are usually given strict
instructions to rest before resuming their activities.
The hypothesis was that patient who had been advised to have strict rest after the injury would
have much decreased mental and physical activity hence improved symptoms outcome and mean
neurocognitive balance compared to patient's recommended usual care.

Surname 2
Methods
Recruited patients were aged 11-22 years and had been presented to the ED within 24 hours of a
concussion. The patients were then taken through balance, neurocognitive, and symptom
assessments within the ED and in a randomized manner advised a strict rest of 5 days versus the
usual 1-2 day rest. Patients would fill a daily record of their mental and physical activity level
while recording their post-concussive symptoms. Balance and neurocognitive assessment were
done after 3 and 10 days since their injury
Results
A total of 99 patients participated with 88 competing for all the study procedures. 45 were
intervention while 43 were control. After being discharged, a 20% decrease in energy exertion
was reported in both groups.
Upon analyzing the balance and neurocognitive data, no clinically significant difference was
found between the two groups. However, a lower symptom resolution and more daily
postconcussive symptoms were reported among the intervention group participants.
Conclusion
The study found that a recommendation for strict rest after a concussion did not have any extra
benefits over the usual care. (Thomas et al. 1-10)

Surname 3
Main Causes of Closed Head Injuries
The main causes of Closed Head Injuries include:
Vehicular accidents – When people get involved in vehicle accidents, their head most likely
strikes an object such as the steering wheel. During this impact, the skull and the dura mater are
not necessarily damaged. However, the brain inside might get damaged due to a collision of the
brain with the inside of the skull. Aside from that, even if the head is not hit by an object, the
sheer force of a sudden stop of the vehicle can create the same situation. This is due to the fact
that as the vehicle is moving, the brain is also moving and sudden stop say due to the collision of
the vehicle with another, the brain keeps moving as inertia force dictates. Hence, it collides with
the inside of the skull and gets bruised (contusion) which might also lead to a brain hemorrhage.
Falls – when a person falls, their head might hit the ground, wall, or any other object in the path
of their fall. During the impact, they may experience contusion or brain hemorrhage without their
skull being necessarily being penetrated by an object.
Physical assaults – this can be as a result of a strike by an assailant using a blunt object of a fall
as a result of the confrontation. The fall or the strike from the blunt object might not penetrate
the skull but a sudden movement by the brain matter inside might get injured by the inside of the
skull resulting into contusion and brain injury (Marsh and Marsh 300-308).

To prevent closed head injuries, the following are some of the measures I would undertake:


Wearing seat belts and installing airbags in my vehicle and those of my family members.
With those measures in place, it means that we will be in a better situation to avoid

Surname 4
getting our heads injured in case of an accident. The seat belts will hold us in place while
the airbags will cushion our heads from hitting the vehicle’s hard parts.


Being keen on reading signs and warnings – Most places where one is susceptible to fall
have warning signs. For example, most swimming pool and water parks have signs
indicating slippery floors. To avoid head injuries due to fall, I would also wear and advise
my family members to always wear the appropriate gear when cycling or when
participating in certain sports.

Surname 5
Works Cited
Thomas, D. G. et al. "Benefits of Strict Rest after Acute Concussion: A Randomized Controlled
Trial." PEDIATRICS 135.2 (2015): 213-223. Web.
Marsh, W., and H. Marsh. "Management of Closed Head Injuries." Seminars in Respiratory
Medicine 3.04 (2008): 300-308. Web.


Benefits of Strict Rest After
Acute Concussion: A Randomized
Controlled Trial
Danny George Thomas, MD, MPHa, Jennifer N. Apps, PhDb, Raymond G. Hoffmann, PhDa, Michael McCrea, PhDc,
Thomas Hammeke, PhDb

To determine if recommending strict rest improved concussion recovery and
outcome after discharge from the pediatric emergency department (ED).

OBJECTIVES:

abstract

METHODS: Patients

aged 11 to 22 years presenting to a pediatric ED within 24 hours of concussion
were recruited. Participants underwent neurocognitive, balance, and symptom assessment in
the ED and were randomized to strict rest for 5 days versus usual care (1–2 days rest, followed
by stepwise return to activity). Patients completed a diary used to record physical and mental
activity level, calculate energy exertion, and record daily postconcussive symptoms.
Neurocognitive and balance assessments were performed at 3 and 10 days postinjury. Sample
size calculations were powered to detect clinically meaningful differences in postconcussive
symptom, neurocognitive, and balance scores between treatment groups. Linear mixed modeling
was used to detect contributions of group assignment to individual recovery trajectory.

RESULTS: Ninety-nine patients were enrolled; 88 completed all study procedures
(45 intervention, 43 control). Postdischarge, both groups reported a 20% decrease in energy
exertion and physical activity levels. As expected, the intervention group reported less school
and after-school attendance for days 2 to 5 postconcussion (3.8 vs 6.7 hours total, P , .05).
There was no clinically significant difference in neurocognitive or balance outcomes. However,
the intervention group reported more daily postconcussive symptoms (total symptom score
over 10 days, 187.9 vs 131.9, P , .03) and slower symptom resolution.
CONCLUSIONS: Recommending

strict rest for adolescents immediately after concussion offered no
added benefit over the usual care. Adolescents’ symptom reporting was influenced by
recommending strict rest.

Departments of aPediatrics, bPsychiatry and Behavioral Medicine, and cNeurology and Neurosurgery, Medical
College of Wisconsin, Milwaukee, Wisconsin

Dr Thomas developed the study concept and design, obtained funding, supervised the study,
acquired data, analyzed and interpreted data, and drafted and revised the manuscript; Dr Apps
assisted with study concept and design, supervised the study, provided technical support, analyzed
and interpreted data, and critically revised the manuscript; Dr Hoffmann assisted with study design,
analyzed data, provided statistical expertise, and critically revised the manuscript; Dr McCrea
assisted with study design, analyzed and interpreted data, provided technical support, and critically
revised the manuscript; Dr Hammeke assisted with study concept and design, supervised the study,
provided material and technical support, analyzed and interpreted data, and critically revised the
manuscript; and all authors approved the final manuscript as submitted.
This trial has been registered at www.clinicaltrials.gov (identifier NCT01101724).
www.pediatrics.org/cgi/doi/10.1542/peds.2014-0966
DOI: 10.1542/peds.2014-0966
Accepted for publication Nov 5, 2014

WHAT’S KNOWN ON THIS SUBJECT: Expert
consensus recommends rest after concussion
with stepwise return to activity. Animal and
retrospective human data suggest that early
mental and physical activity may worsen
outcome. There are no pediatric studies testing
the efficacy of recommending strict rest after
concussion.
WHAT THIS STUDY ADDS: Recommending strict
rest postinjury did not improve outcome and
may have contributed to increased symptom
reporting. Usual care (rest for 1–2 days with
stepwise return to activity) is currently the best
discharge strategy for pediatric mild traumatic
brain injury/concussion.

from http://pediatrics.aappublications.org/ by guest on November 10, 2017
PEDIATRICS Volume 135, numberDownloaded
2, February 2015

ARTICLE

Pediatric head trauma represents
a significant injury burden for
children, and emergency department
(ED) visits for sports-related
traumatic brain injury (TBI) have
increased 60% over the previous
10 years.1 Most of these patients are
discharged from the ED with
a diagnosis of concussion and are
instructed to rest. Rest
recommendations are motivated by
a concern for reinjury during
recovery from a concussion.2,3
Additionally, retrospective studies
and animal models demonstrate that
early physical and mental activity
can impair recovery.4–7 Because
human data on postinjury exertion is
limited, expert consensus
recommends 24 to 48 hours of rest
before beginning a stepwise return
to activity.8 Many clinicians
recommend a longer period of rest,
and some clinicians have advocated
“cocoon therapy,” which restricts
patients to several days in
a darkened room before slowly
returning to activity.9 To date, the
optimal period of rest after
concussion remains unknown.
We sought to investigate the
effectiveness of recommending 5 days
of strict rest compared with the usual
care of 24 to 48 hours of rest on
outcomes after discharge from the ED
with acute concussion. We
hypothesized that patients who were
recommended strict rest after injury
would have a greater decrease in
physical and mental activity and
improved mean neurocognitive,
balance, and symptom outcomes
compared with patients who were
recommended the usual care.

METHODS
Design and Procedures
The study was a prospective
randomized controlled trial of
patients presenting to the Children’s
Hospital of Wisconsin Emergency
Department and Trauma Center with
mild TBI/concussion (mTBI) between
May 2010 and December 2012 (see
study overview, Fig 1)...


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