Post head injury neurobehavioral sequelae: severity among alcoholics

Authors

  • Sunilkumar B. Sreemathyamma Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India
  • Prasanth Asher Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India
  • Palamkunnil T. Baburaj School of Behavioural Science, M. G. University, Kottayam, Kerala, India
  • Raja K. Kutty Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India
  • Sharmad Mohammed Haneefa Suharban Beevi Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India
  • Anilkumar Peethambaran Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India
  • Sureshkumar Kunjini Leela Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India

DOI:

https://doi.org/10.18203/2349-2902.isj20204143

Keywords:

Traumatic brain injury, Neurobehavioral sequelae, Chronic alcoholism

Abstract

Background: Alcohol use and traumatic brain injury (TBI) are closely linked public health problems. Alcohol intoxication is one of the major risk factor for TBI, and is a main determinant of prognosis in terms of mortality and functional outcome. The aim of the study is to find out the impact of alcoholism in the neurobehavioral outcome following TBI.

Methods: A total of 150 head injury patients were divided into two groups: alcoholics and non-alcoholics, and evaluated between six weeks to one year after injury using the revised neurobehavioral rating scale by Levin et al (NRS-R) for the evaluation of neurobehavioral sequelae and the outcome was compared between groups.

Results: The study showed significant difference between the groups indicating that the neurobehavioral sequelae were more in the chronic alcoholics group. In the comparison of individual factors, all except factors III (negative symptoms) and IV (mood and affect) were found to be significantly different. The factors I (executive), II (positive symptoms), V (oral and motor), and VI (not loading on any of the factors) were significant at 0.01 level.

Conclusions: Chronic alcoholism significantly increases the risk of developing neurobehavioral sequelae after traumatic brain injury.

 

References

Dewan MC, Rattani A, Gupta S, Baticulon RE, Hung YC, Punchak M, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2018;1-18.

National Crime Records Bureau Ministry of Home Affairs Government of India. Accidental Deaths and Suicides in India. 2014. Available at: https://ncrb.gov.in/en/accidental-deaths-suicides-in-india. Accessed on: 20 May 2020.

Weil ZM, Corrigan JD, Karelina K. Alcohol Use Disorder and Traumatic Brain Injury. Alcohol Res. 2018;39(2):171-80.

Lishman WA. Alcohol and the brain. Br J Psychiatry. 1990;156:635-44.

Weiss F, Porrino LJ. Behavioral Neurobiology of alcohol addition: Recent advances and challenges. J Neurosc. 2002;22:3332-7.

American Psychiatric Association, DSM-5 Task Force. Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). 2013. Available at: https://www.psychiatry.org/psychiatrists/practice/dsm. Accessed on: 20 May 2020.

McCauley SR, Levin HS, Vanier M, Mazaux JM, Boake C, Goldfader P, et al. The neurobehavioural rating scale-revised: sensitivity and validity in closed head injury assessment. J Neurol Neurosurg Psychiatr. 2001;71(5):643-51.

Likert R. A technique for the measurement of attitudes. Arch Psychol. 1932;22:140-55.

Scheenen ME, de Koning ME, van der Horn HJ, Roks G, Yilmaz T, van der Naalt J, et al. Acute Alcohol Intoxication in Patients with Mild Traumatic Brain Injury: Characteristics, Recovery, and Outcome. J Neurotrauma. 2016;33(4):339-45.

Harrison DA, Prabhu G, Grieve R, Harvey SE, Sadique MZ, Gomes M, et al. Risk Adjustment InNeurocritical care (RAIN)--prospective validation of risk prediction models for adult patients with acute traumatic brain injury to use to evaluate the optimum location and comparative costs of neurocritical care: A cohort study. Health Technol Assess. 2013;17(23):1-350.

Gururaj G. Epidemiology of traumatic Brain Injuries: Indian Scenario, Neurological research. 2002;24:1-5.

Brismar B, Engström A, Rydberg U. Head injury and intoxication: a diagnostic and therapeutic dilemma. Acta Chir Scand. 1983;149(1):11-4.

Ruff RM, Marshall LF, Klauber MR, Blunt BA, Grant I, Foulken MA, et al. Alcohol abuse and Neurological outcome of severally Head Injured. J Head Trauma Rehab. 1990;5:21-31.

Grzelczak AC, Ceccon A, Guetter CR, Pimentel SK. Revista do CBC v46n5-Inglês by cbc cirurgioes. Rev Col Bras Cir. 2019;46(5):25.

Rundhaug N, Moen K, Skandsen T, Schirmer-Mikalsen K, Lund SB, Hara S, Vik A. Moderate and severe traumatic brain injury: effect of blood alcohol concentration on Glasgow Coma Scale score and relation to computed tomography findings, J Neurosurg. 2015;122(1):211-8.

Tien HCN, Tremblay LN, Rizoli SB, Gelberg J, Chughtai T, Tikuisis P, et al. Association Between Alcohol and Mortality in Patients With Severe Traumatic Head Injury. Arch Surg. 2006;141(12):1185-91.

Lin HL, Lin TY, Soo KM, Chen CW, Kuo LC, Lin YK, Lee WC, Lin CL. The Effect of Alcohol Intoxication on Mortality of Blunt Head Injury. Bio Med Research Int. 2014;619231.

Arvin B, Neville LF, Barone FC, Feuerstein GZ. The role of inflammation and cytokines in brain injury. Neurosci Biobehav Rev. 1996;20(3):445-52.

Crews FT, Bechara R, Brown LA, Guidot DM, Mandrekar P, Oak S, et al. Cytokines and alcohol. Alcohol Clin Exp Res. 2006;30(4):720-30.

Sharp DJ, Beckmann CF, Greenwood R, Kinnunen KM, Bonnelle V, De Boissezon X, et al. Default Mode Network Functional and Structural Connectivity after Traumatic Brain Injury. Brain. 2011;134(8):2233-47.

Shum D, Gill H, Banks M, Maujean A, Griffin J, Ward H. Planning ability following moderate to severe traumatic brain injury: Performance on a 4-disk version of the Tower of London. Brain Impairment. 2009;10(3):320-4.

Rabinowitz AR, Levin HS. Cognitive sequelae of traumatic brain injury. Psychiatr Clin North Am. 2014;37(1):1.

Yudofsky SC, Silver JM, Hales RE. Pharmacologic management of aggression in the elderly. J Clin Psychiatr. 1990;51:22-8.

Anderson KE, Silver JM. Neurological and medical diseases and violence. In: Tardiff K, editor. Medical Management of the Violent Patient: Clinical Assessment and Therapy. New York: Marcel Dekker. 1999;87-124.

Rao V, Rosenberg P, Bertrand M, Salehinia S, Spiro J, Vaishnavi S, et al. Aggression after traumatic brain injury: Prevalence and correlates. J Neuropsychiatry Clin Neurosci. 2009;21:420-9.

Dikmen S, Corrigan JD, Levin HS, Machamer JMA, Stiers W, Weisskopf MG. Cognitive Outcome Following Traumatic Brain Injury. J Head Trauma Rehab. 2009;24(6):430-8.

Sparadeo FR, Gill D. Effects of prior alcohol use on head injury recovery. J Head Trauma Rehabil. 1989;4:75-81.

Dikmen SS, Machamer JE, Donovan DM, Winn HR, Temkin NR. Alcohol use before and after traumatic head injury. Ann Emerg Med. 1995;26:167-76. .

Moselhy HF, Georgious G, Khan A. Frontal lobe changes in alcoholism: Rev Lit Alcohol Alcoholism. 1997;(36):357-68.

Marlene OB, Ksenija M. Alcohol: Effects on Neurobehavioral Functions and the Brain. Neuropsychol Rev. 2007;17:239-57.

Harris GJ, Jaffin SK, Hodge SM, Kennedy D, Caviness VS, Marinkovic K, et al. Frontal white matter and cingulum diffusion tensor imaging deficits in alcoholism. Alcohol Clin Exp Res. 2008;32(6):1001-13.

Mikko L, Olli V, Savolainen L, Eila RT, Hilkka S, Hannu A, Jari T. A volumetric MRI study of the hippocampus in type 1 and 2 alcoholism. Behavioural brain Res. 2000;109:177-86.

Kelly MP, Johnson CT, Knoller N, Drubach DA, Winslow MM. Substance abuse, traumatic brain injury and neuropsychological outcome. Brain Inj. 1997;11:391-402.

Wilde EA, Bigler ED, Gandhi PV, Lowry CM, Blatter DD, Brooks J, et al. Alcohol abuse and traumatic brain injury: Quantitative magnetic resonance imaging and neuropsychological outcome. J Neurotrauma. 2004;21:137-47.

Turner AP, Williams RM, Bowen JD, Kivlahan DR, Haselkorn JK. Suicidal ideation in multiple sclerosis. Arch Phys Med Rehabil. 2006;87:1073-8.

Ponsford J, Tweedly L, Taffe J. The relationship between alcohol and cognitive functioning following traumatic brain injury. J Clin Exp Neuropsychol. 2013;35:103-12.

Downloads

Published

2020-09-23

Issue

Section

Original Research Articles