Individual Differences following TBI apoE4+ (N=27) apoE4- (N=42) Unconscious for >1 week 77.8% 38.1%* Dysarthria 63.0% 33.3%* Overall Function: excellent 3.7% 31.0%* * p < .05Friedman et al. (1999). Neurology, 52(2), 244-250.
Secondary Injury• All brain damage does not occur at the moment of impact (primary injury) but evolves over the ensuing hours and days (secondary injury).• The injured brain is extremely vulnerable to hypotension, hypoxia, and increased intracranial pressure which are causes of secondary injury.
Absence of evidence ≠ Evidence of absence • “There is insufficient reliable evidence to make recommendations on the use of mannitol in the management of patients with traumatic brain injury.” • “There is no evidence that barbiturates improve outcomes in people with acute brain injury.”Wakai et al. (2008). Cochrane Database of Systematic Reviews, 10.1002/14651858.CD001049.pub4.Roberts & Sydenham (2012). Cochrane Database of Systematic Reviews, 10.1002/14651858.CD000033.pub2.