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Related Concept Videos

Acute Kidney Injury I: Introduction01:22

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Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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The Vestibular System01:29

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The vestibular system is a set of inner ear structures that provide a sense of balance and spatial orientation. This system is comprised of structures within the labyrinth of the inner ear, including the cochlea and two otolith organs—the utricle and saccule. The labyrinth also contains three semicircular canals—superior, posterior, and horizontal—that are oriented on different planes.
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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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A Mouse Model of Single and Repetitive Mild Traumatic Brain Injury
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Vestibular dysfunction in acute traumatic brain injury.

Hani J Marcus1,2, Heidi Paine1, Matthew Sargeant2

  • 1Imperial College Healthcare NHS Trust, London, UK.

Journal of Neurology
|June 16, 2019
PubMed
Summary

Traumatic brain injury (TBI) often causes vestibular issues like dizziness and imbalance. Acute TBI reveals common vestibular signs, but patients frequently underreport symptoms, complicating diagnosis.

Keywords:
ConcussionDizzinessHead injuryHead traumaVertigo

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Area of Science:

  • Neuroscience
  • Vestibular System Research
  • Traumatic Brain Injury Studies

Background:

  • Traumatic brain injury (TBI) is a leading cause of disability, with vestibular dysfunction affecting 50% of patients long-term.
  • Cryptogenic vestibular diagnoses in chronic TBI impede effective treatment.
  • Understanding acute TBI vestibular features is crucial for clarifying chronic TBI diagnoses.

Purpose of the Study:

  • To define the spectrum of vestibular diagnoses in acute TBI.
  • To investigate the relationship between vestibular symptoms and signs in acute TBI.
  • To explore the hypothesis that chronic adaptive brain mechanisms uncouple vestibular symptoms from signs.

Main Methods:

  • Screened 111 adult Major Trauma Ward admissions for vestibular symptoms and signs.
  • Referred 96 patients (87%) with subjective dizziness or objective imbalance for assessment.
  • Assessed 47 patients for specific vestibular diagnoses, including Benign Paroxysmal Positional Vertigo (BPPV) and acute peripheral unilateral vestibular loss.

Main Results:

  • Subjective dizziness and/or objective imbalance were reported by 87% of acute TBI patients.
  • Gait ataxia was the most frequent sign (62%), with 50% of these patients denying imbalance.
  • Common diagnoses included BPPV (38%), acute peripheral unilateral vestibular loss (19%), and migraine (34%).

Conclusions:

  • Vestibular signs are prevalent in acute TBI, with gait ataxia being common.
  • Patients frequently underreport vestibular symptoms, suggesting TBI affects perceptual mechanisms.
  • The disconnect between symptoms and signs in TBI necessitates acute, prospective, mechanistic studies for accurate diagnosis and treatment.