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However, elderly patients with severe trauma often do not meet the standard TTA criteria due to normal age-related changes and reduced physiologic capacities. For example, older adults have a less profound tachycardic response to hemorrhage, pain, or anxiety following trauma. This explains why mortality increases in the elderly above a heart ...
The brain volume decreases roughly 5% per decade after forty. It is currently unclear why brain volume decreases with age. However, a few causes may include cell death, decreased cell volume, and changes in synaptic structure.
More than 50% of patients who suffer from a traumatic brain injury will develop psychiatric disturbances. [6] Although precise rates of anxiety after brain injury are unknown, a 30-year follow-up study of 60 patients found 8.3% of patients developed a panic disorder, 1.7% developed an anxiety disorder, and 8.3% developed a specific phobia. [ 7 ]
[6] [7] Regional volume reduction is not uniform; some brain regions shrink at a rate of up to 1% per year, whereas others remain relatively stable until the end of the life-span. [8] The brain is very complex, and is composed of many different areas and types of tissue, or matter.
Regions of the brain associated with stress and post-traumatic stress disorder [131] A meta-analysis of structural MRI studies found an association with reduced total brain volume, intracranial volume, and volumes of the hippocampus, insula cortex, and anterior cingulate. [132] Much of this research stems from PTSD in those exposed to the ...
The hippocampus is a principal target site for GCs and therefore experiences a severity of neuronal damage that other areas of the brain do not. [30] In severe trauma patients, especially those with post-traumatic stress disorder, the medial prefrontal cortex is volumetrically smaller in size than normal and is hyporesponsive when performing ...
One group examined slices of brain from patients having had multiple mild traumatic brain injuries and found changes in the cells' cytoskeletons, which they suggested might be due to damage to cerebral blood vessels. [22] Increased exposure to concussions and subconcussive blows is regarded as the most important risk factor.
It is suitable for patients with moderate to severe traumatic brain injury. The WPTAS is the most common post-traumatic amnesia scale used in Australia and New Zealand. [32] An abbreviated version has been developed to assess patients with mild traumatic brain injury, the Abbreviated Westmead PTA Scale (AWPTAS). [33]