A Retrospective Review on Post Traumatic Agitation Predictors in Hospitalized Patients with Acute Traumatic Brain Injury

Objectives: To determine if socio-demographic, medical and radiological variables have an impact on the risk of developing post-traumatic agitation in patients with mild complex to severe Traumatic Brain Injury (TBI). In addition, determine prognosis using the Extended Glasgow Outcome Scale (GOS-E), length of stay (LOS) and orientation at discharge of agitated patients with TBI.Methods: A retrospective observational study of all 778 patients admitted to the Montreal General Hospital, a tertiary specialized trauma centre, following a TBI that occurred between 2013 and 2015. Data was collected from the national trauma registry and TBI program database. Independent variables collected were socio-demographic, clinical, and neurological information. Dependent variables were LOS in days, non-pharmacological treatment, GOS-E at discharge, and discharge destination.Results: 55 patients (7.1%) suffered from post-traumatic agitation. The group with agitation had a significantly higher proportion of men, psychiatric history and suffered in a greater proportion a moderate TBI. The median GCS was significantly lower and post traumatic amnesia was longer in subjects with agitation. A higher percentage of patients with agitation were transferred to long-term care (LTC) facilities

Pitch and Rhythm Perception and Verbal Short-Term Memory in Acute Traumatic Brain Injury

Music perception deficits are common following acquired brain injury due to stroke, epilepsy surgeries, and aneurysmal clipping. Few studies have examined these deficits following traumatic brain injury (TBI), resulting in an under-diagnosis in this population. We aimed to (1) compare TBI patients to controls on pitch and rhythm perception during the acute phase; (2) determine whether pitch and rhythm perception disorders co-occur; (3) examine lateralization of injury in the context of pitch and rhythm perception; and (4) determine the relationship between verbal short-term memory (STM) and pitch and rhythm perception. Music perception was examined using the Scale and Rhythm tests of the Montreal Battery of Evaluation of Amusia, in association with CT scans to identify lesion laterality. Verbal short-term memory was examined using Digit Span Forward. TBI patients had greater impairment than controls, with 43% demonstrating deficits in pitch perception, and 40% in rhythm perception. Deficits were greater with right hemisphere damage than left. Pitch and rhythm deficits co-occurred 31% of the time, suggesting partly dissociable networks. There was a dissociation between performance on verbal STM and pitch and rhythm perception 39 to 42% of the time (respectively), with most individuals (92%) demonstrating intact verbal STM, with impaired pitch or rhythm perception. The clinical implications of music perception deficits following TBI are discussed