Traumatic Brain Injury: Current Treatment and Future Options

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 1252

Special Issue Editor


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Guest Editor
Department of Neurosurgery, Neurocenter of the Southern Switzerland, Ente Ospedaliero Cantonale, CH-2900 Lu-gano, Switzerland
Interests: neurosurgical anatomy; skull base surgery; endoscopic surgery; neuro-oncological surgery; neurovascular surgery; spine surgery; machine learning; enhanced recovery after surgery; global neurosurgery

Special Issue Information

Dear Colleagues,

Traumatic brain injury (TBI) presents a significant global health challenge; however, its critical aspects, such as a reliable pathophysiological classification and targeted treatments, still lack sufficient data. While there has been a surge in TBI-related publications, the translation of these research findings into clinical practice remains frustratingly slow.

Encouragingly, substantial international efforts offer hope for significant advancements in TBI diagnostics and patient care. Given its interdisciplinary nature, TBI spans multiple medical specialties, ranging from emergency medicine and intensive care to rehabilitation and psychiatry. Consequently, reports on scientific progress in this field are dispersed across various journals, each with its own narrow focus, complicating efforts to grasp the full scope of TBI medicine and emerging trends.

The rapid evolution of technical solutions in laboratory medicine, imaging, and neurophysiology has yielded new tools with numerous potential clinical applications. Few medical domains demand personalized medicine and the integration of artificial intelligence more than TBI, given its complexity as an individual disease. Despite the proliferation of innovative technologies and their potential applications, everyday TBI care has seen minimal progress over the past two decades and still heavily relies on the subjective experience and judgment of treating clinicians.

This Special Issue aims to provide an up-to-date review of TBI for all the healthcare professionals who meet and treat TBI patients at various levels and across different facilities. The focus of this Special Issue is on clinically relevant recent developments and emerging trends, with the aim of providing the reader with a good understanding of the current state of TBI medicine.

Dr. Ismail Zaed
Guest Editor

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Keywords

  • traumatic brain injury
  • trauma
  • biomarkers
  • post-traumatic outcome
  • epidemiology

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Published Papers (2 papers)

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Research

14 pages, 827 KiB  
Article
Clinical, Neuroimaging, and Genetic Markers Associated with Cognitive and Functional Outcomes After Traumatic Brain Injury
by Khrystyna Duve, Svitlana Shkrobot, Pavlo Petakh, Valentyn Oksenych and Oleksandr Kamyshnyi
J. Clin. Med. 2025, 14(8), 2796; https://doi.org/10.3390/jcm14082796 - 18 Apr 2025
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Abstract
Background: Traumatic brain injury (TBI) is a major cause of long-term disability worldwide, often leading to progressive cognitive and functional impairments. This study aimed to investigate the underlying factors contributing to long-term deterioration in TBI patients. Methods: We conducted a comprehensive [...] Read more.
Background: Traumatic brain injury (TBI) is a major cause of long-term disability worldwide, often leading to progressive cognitive and functional impairments. This study aimed to investigate the underlying factors contributing to long-term deterioration in TBI patients. Methods: We conducted a comprehensive evaluation of 145 patients aged 18–66 years with a documented history of TBI and ongoing cognitive and behavioral deficits. Assessments included neuroimaging, laboratory tests, genetic analysis, and standardized tools such as the Montreal Cognitive Assessment (MoCA) and the Barthel Index. Results: Structural brain abnormalities, including ventricular enlargement and gliosis, were observed in a substantial portion of the cohort. Persistent neuroinflammatory markers were also identified. Genetic analysis revealed a significant association between cognitive decline and polymorphisms in the ACE and PON1 genes. Patients carrying these variants were more likely to exhibit reduced cognitive performance and greater functional limitations. Conclusion: These findings suggest that genetic predisposition, chronic neuroinflammation, and structural brain damage collectively contribute to long-term outcomes following TBI. This highlights the potential of genetic and imaging biomarkers in identifying high-risk individuals and supports the need for personalized approaches to diagnosis, monitoring, and treatment in chronic TBI management. Full article
(This article belongs to the Special Issue Traumatic Brain Injury: Current Treatment and Future Options)
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23 pages, 1202 KiB  
Article
Balance Performance After Mild Traumatic Brain Injury in Children and Adolescents: Instrumented BESS in the Acute Situation and Over Time
by Nils K. T. Schönberg, Johanna Wagner, Korbinian Heinrich, Ida Kandler, Tobias Graf, Rieke Böddeker, Lea Zinke, Nicole Fabri, Julia Wilke, Florian Hoffmann, A. Sebastian Schröder, Anne-Sophie Holler, Alexandra Fröba-Pohl, Oliver Muensterer, Doreen Huppert, Matthias Hösl, Florian Heinen and Michaela V. Bonfert
J. Clin. Med. 2025, 14(5), 1666; https://doi.org/10.3390/jcm14051666 - 28 Feb 2025
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Abstract
Background: Mild traumatic brain injury (mTBI) in the pediatric population is a significant public health concern, often associated with persistent post-concussion symptoms, including postural instability. Current tools for assessing postural control, such as the Balance Error Scoring System (BESS), lack integration with [...] Read more.
Background: Mild traumatic brain injury (mTBI) in the pediatric population is a significant public health concern, often associated with persistent post-concussion symptoms, including postural instability. Current tools for assessing postural control, such as the Balance Error Scoring System (BESS), lack integration with objective metrics. Incorporating force plate sensors into BESS assessments may enhance diagnostic accuracy and support return-to-play or sports decisions. This study evaluates postural performance in children with mTBI compared to controls using an instrumented BESS and examines recovery trajectories after mTBI. Methods: This prospective, longitudinal study included 31 children with mTBI (12.01 ± 3.28 years, 20 females) and 31 controls (12.31 ± 3.27 years, 18 females). Postural control was assessed using an instrumented BESS protocol during standing on a ground reaction force plate at three timepoints: within 72 h post injury (T1), at two weeks (T2), and three months after trauma (T3). Posturographic parameters derived from the displacement of the center of pressure included the ellipse area, path length, and mean velocity in the anterior–posterior and medio–lateral directions. Symptom burden was monitored using the Post-Concussion Symptom Inventory (PCSI). Results: The BESS total scores did not differ significantly between the groups at any timepoint. A significant reduction in BESS errors over time was observed exclusively in the two-legged stance on a soft surface (p = 0.047). The instrumented BESS revealed higher body swaying in the mTBI group compared to controls, particularly under demanding conditions. Significant between-group differences were most frequently observed in single-leg soft surface (38% of comparisons) and two-legged soft surface stances (29%). In those cases, path length and mean velocity differed between groups, respectively. Ellipse area did not show significant differences across conditions. Conclusions: An instrumented BESS has the potential to enhance the detection of subtle postural deficits in pediatric mTBI patients. Specifically, more demanding conditions with altered sensory-proprioceptive input and path length as an outcome measure should be focused on. This study underscores the need for tailored and age-appropriate objective and quantitative balance assessments to improve diagnostic precision in pediatric mTBI populations. Full article
(This article belongs to the Special Issue Traumatic Brain Injury: Current Treatment and Future Options)
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