OBJECTIVES: To understand the current status of appraisal of post-concussion syndrome disability and the reasons for the changes in re-appraisal opinions. METHODS: The cases that were judged as "post-concussion syndrome and ten-level disability" in the first appraisal and re-appraised for psychiatric impairment by the Academy of Forensic Science in 2019 were analyzed retrospectively. RESULTS: There were 75 cases, including 58 cases with pre-hospital emergency medical records, among which 39 cases were clearly recorded to be without a history of coma; 74 cases had emergency medical records, among which 44 cases were recorded of having a history of coma; 43 cases had follow-up medical records, among which 24 cases had a history of psychiatric follow-up. The most complained symptoms of the appraisee in appraisal and examination include headache, dizziness, poor sleep at night, irritability, memory loss, fatigue and inattention. The main reasons for the re-appraisal application include doubts about the history of coma, doubts about the credibility of mental symptoms, post-concussion syndrome didn't meet the disability criteria, and objections to the original appraisal procedure or the original appraisal agency. The appraisal opinions of a total of 47 cases were changed. Seven of them did not meet the disability criteria, and the main reason was that there was no clear history of coma and no head injury was admitted; the coma history of the 40 other cases had to be confirmed by the court before they can be clearly identified as disabilities. The reason was that the records about the history of coma were inconsistent or there were alterations and additional information. CONCLUSIONS In the past, the conditions for appraisal of post-concussion syndrome disability were too lax and must be further standardized and strictly controlled.
Brain Concussion/diagnosis* ; Craniocerebral Trauma ; Headache/psychology* ; Humans ; Mental Disorders ; Post-Concussion Syndrome/psychology* ; Retrospective Studies

OBJECTIVES: To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma. METHODS: According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory （NEO-FFI）. RESULTS: The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients （18.7%） of mild craniocerebral trauma （P<0.05）. Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences （P<0.05） in the patients of mild craniocerebral trauma with personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences （ P>0.05） in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma. CONCLUSIONS The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment.
Craniocerebral Trauma/pathology* ; Humans ; Personality ; Personality Disorders/psychology* ; Personality Inventory ; Psychotic Disorders/psychology*

OBJECTIVETo compare the clinical therapeutic effects differences between acupuncture at Suliao (GV 25) and Shuigou (GV 26) on promoting regain of consciousness from coma in severe craniocerebral injury.

METHODSBased on regular emergency treatments of neurosurgery, eighty-two cases of craniocerebral injury who were under stable condition were randomly divided into an observation group (42 cases) and a control group (40 cases). Suliao (GV 25) was selected as main aupoint, while Laogong (PC 8) and Yongquan (KI 1), etc. were selected as adjuvant acupoints and Neiguan (PC 6), Sanyinjiao (SP 6), Yifeng (TE 17) and Wangu (GB 12), etc. were selected as matching acupoints in the observation group where a strong needle manipulation was applied to improve the regain of consciousness. The main acupoint of Shuigou (GV 26) along with identical adjuvant acupoints and matching acupoints in the observation group were selected in the control group with identical strong needle manipulation. The treatment was given once a day in both groups, five times per week and ten times were considered as one session. The immediate clinical symptoms after acupuncture at Suliao (GV 25) and Shuigou (GV 26) were observed as well as Glasgow coma scale (GCS) before the treatment, after 45 days and 90 days of treatment to assess the resuscitation time and rate. Also the clinical efficacy was compared between both groups.

RESULTSThe occurrence rate of sneezing reflex was 85.7% (36/42) in the observation group, which was higher than 25.0% (10/40) in the control group (P < 0.01). The average resuscitation time was (64.6 +/- 19.4) days in the observation group, which was obviously shorter than (73.8 +/- 14. 6) days in the control group (P < 0.05). The resuscitation rate was 88.1% (37/42) in the observation group, which was similar to 75.0% (30/40) in the control group (P > 0.05). Compared before the treatment, GCS were both improved after the treatment in two groups (both P < 0.01). The 90-day GCS was 9.52 +/- 2.32 in the observation group, which was superior to 8.47 +/-2.14 in the control group (P < 0.05). The curative and markedly effective rate was 45.2% (19/42) in the observation group, which was superior to 22.5% (9/40) in the control group (P < 0.05).

CONCLUSIONThe effect of acupuncture at Suliao (GV 25) on improving regain of consciousness from coma in severe craniocerebral injury is positive. It could specifically improve sneezing reflex and stimulate respiratory center, which has more obvious effect than acupuncture at Shuigou (GV 26).

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Coma ; etiology ; physiopathology ; psychology ; therapy ; Consciousness ; Craniocerebral Trauma ; complications ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Youth violence is a public health and social issue of global concern. It will be helpful to reduce the incidence of youth violence if the risk factors and prediction methods can be fully comprehended. This paper summarized the risk factors of youth violence in the aspects of the individual factors, the social psychological factors and the biological factors. Meanwhile, the status of prediction and assessment of youth violence are reviewed, with expectation to reduce youth violence and contribute to further research.
Adolescent ; Adolescent Behavior/psychology* ; Age Factors ; Craniocerebral Trauma/psychology* ; Family/psychology* ; Female ; Forecasting ; Forensic Psychiatry ; Humans ; Interviews as Topic ; Juvenile Delinquency/statistics & numerical data* ; Male ; Models, Statistical ; Predictive Value of Tests ; Public Health ; Risk Assessment/methods* ; Risk Factors ; Socioeconomic Factors ; Violence/statistics & numerical data* ; Young Adult

OBJECTIVETo observe the therapeutic effect of continuous electroacupuncture at Neiguan (PC 6) on the basis of routine treatment of western medicine for arousing consciousness of comatose patinents with severe craniocerebral trauma.

METHODSFifty-six cases of severe cranio cerebral trauma patients whose scores of Glasgow Coma Scale (GCS) lower than 8 were randomly divided into an observation group (29 cases) and a control group (27 cases). Both groups were treated with routine western medicine. The observation group were additionally treated with continuous electroacupuncture at Neiguan (PC 6) as the main point. Arousal rate and time after one month and three months of two groups were observed, arousal rate and the total therapeutic effect of recovery of the patients with different types after three months were compared between two groups.

RESULTSThe arousal time of the observation group was (18.57 +/- 7.14) days and the arousal rate was 72.4% (21/29) after one month, while (24.60 +/- 5.00) days and 37.0% (10/27) in control group, respectively. They were suprior in observation group to those in control group (P < 0.01, P < 0.05); the arousal time was (25.04 +/- 16.68) days in the observation group after three months of treatment, also shorter than (37.90 +/- 16.94) days in control group (P < 0.05). The arousal rate of patients with diffuse axonal injury was significantly higher than that of patients with non-diffuse axonal injury in the observation group and patients with the same type in control group after one month (P < 0.05). The cured-markedly effective rate of 72.4% (21/29) in observation group was significantly higher than that of 37.0% (10/27) in control group (P < 0.05).

CONCLUSIONThe therapy of continunous electroacupuncture at Neiguan (PC 6) on the basis of routine western medicine has a better therapeutic effect for comatose patients with severe cranio cerebral trauma, especially for those with diffuse axonal injury.

Acupuncture Points ; Adolescent ; Adult ; Child ; Coma ; etiology ; psychology ; therapy ; Consciousness ; Craniocerebral Trauma ; complications ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the effects of mild head injury (HI) on the victims'intelligence by measuring their intelligence quotient (IQ).

METHODSThis cohort study was performed in Khatam-ol-Anbia Hospital, Zahedan, Iran and the IQs of 30 mild HI patients were measured right after the injury (IQ0) and six months later (IQ6). The IQs of 90 close relatives of the patients were also measured at the same period of time as the non-exposure group. The IQs were measured with Wechsler adult intelligence scale-revised (WAIS-R). The IQ0, IQ6 and their differences (IQ change) were compared in HI patients and their relatives using the Student's t test.

RESULTSThe mean IQ0 of the HI patients was similar to their relatives. The IQ6 of HI patients appeared to be less than those of their relatives. Moreover, the IQ6 of the HI patients appeared to be less than their initial scores. HI was associated with more decrease in IQ6 compared with IQ0 and the female subjects showed more decrease in IQ6 compared with their IQ0.

CONCLUSIONHI seems to be associated with decrease in IQ six months after the injury and it is more evident in female HI patients.

Adult ; Cohort Studies ; Craniocerebral Trauma ; psychology ; Female ; Humans ; Intelligence ; Iran ; Male

C1 lateral mass and C2 pedicle (C1LM-C2P) fixation is a relatively new technique for atlantoaxial stabilization. Complications from C1LM-C2P fixation have been rarely reported. The authors report unilateral rod migration into the posterior fossa as a rare complication after this posterior C1-C2 stabilization technique. A 23-year-old man suffered severe head trauma and cervical spine injury after vehicle accident. He was unconscious for 2 months and regained consciousness. He underwent C1LM-C2P fixation for stabilization of type II odontoid process fracture described by Harms. The patient recovered without a major complication. Twenty months after operation, brain computed tomogram performed at psychology department for disability evaluation showed rod migration into the right cerebellar hemisphere. The patient had mild occipital headache and dizziness only regarding the misplaced rod. He refused further operation for rod removal. To our knowledge, this complication is the first report regarding rod migration after Harms method. We should be kept in mind the possibility of rod migration, and C1LM-C2P fixation should be performed with meticulous technique and long-term follow-up.
Brain ; Consciousness ; Craniocerebral Trauma ; Disability Evaluation ; Dizziness ; Follow-Up Studies ; Headache ; Humans ; Odontoid Process ; Spine ; Unconscious (Psychology) ; Young Adult

OBJECTIVETo explore the effective methods for evaluating the consciousness and speech status of patients with special types of cerebral injuries.

METHODSA total of 96 patients with injury in the language center and in coma were treated with operative and correlated conventional therapies. Then their recovery status of consciousness and speech was observed.

RESULTSAll the patients were recovered to consciousness. Sixty-nine patients with aphasia were cured completely, but 7 patients were complicated with incomplete ataxic aphasia, 15 with incomplete sensory aphasia, and 5 with incomplete mixed aphasia.

CONCLUSIONSFor the patients with injury in the language center, evaluation of the conscious state with GCS scoring system has certain limitations and conscious behaviours are advantageous evidences to evaluate the consciousness recovery of the patients. The patients with conscious disturbance and injury in the language center should be considered to have aphasia.

Adult ; Aged ; Aphasia ; diagnosis ; Consciousness ; Craniocerebral Trauma ; psychology ; Female ; Glasgow Coma Scale ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Speech

OBJECTIVE: To explore the change of brain cognition function in severe head injury and the correlation between P300 in event-related potential (ERP) and intelligence quotient (IQ). METHODS: Auditory P300 was measured and intelligence quotient was tested by Wechsler Adult Intelligence Scale Revised in China (WAIS-RC) in 40 severe head injury patients. Auditory P300 was measured in 40 normal healthy people as control group. RESULTS: The latencies of P300 in severe head injury patients group were longer than in control group. There was a significant difference between the two groups (P< 0.01). There were significant negative correlations between P300 latency and VIQ and FIQ respectively (r=-0.335,-0.344, P<0.05). CONCLUSION ERP might be taken as an objective index for measuring the change of the brain cognition function in patients with severe head injury.
Adolescent ; Adult ; Aged ; Cognition ; Craniocerebral Trauma/psychology* ; Event-Related Potentials, P300 ; Female ; Humans ; Intelligence ; Male ; Middle Aged ; Reaction Time ; Trauma Severity Indices ; Wechsler Scales ; Young Adult

OBJECTIVE: To explore characteristics of the head traumatic children's intelligence. METHODS: The authors investigated 43 head trauma children and 50 normal children, using Wechser Intelligence Test (C-WISC). Data were analyzed by SPSS10.0 on computer. RESULTS Head trauma children had lower FIQ, VJQ, PIQ than normal children. Pervaded head trauma has more contribution to the damage of the children's intelligence.
Accidents, Traffic ; Adolescent ; Child ; Child Development ; Craniocerebral Trauma/psychology* ; Female ; Humans ; Intelligence ; Intelligence Tests ; Language ; Male ; Wechsler Scales