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Lancet Neurol. 2017 Oct;16(10):813-825. doi: 10.1016/S1474-4422(17)30279-X. Epub 2017 Sep 12.

The chronic and evolving neurological consequences of traumatic brain injury.

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Division of Psychology, University of Stirling, Stirling, UK. Electronic address:
Department of Neuropathology, Queen Elizabeth University Hospital, Glasgow, UK; Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK.
Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Department of Neurology and Center for Brain Injury and Repair, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Division of Psychology, University of Stirling, Stirling, UK.
Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
Department of Public Health, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands.


Traumatic brain injury (TBI) can have lifelong and dynamic effects on health and wellbeing. Research on the long-term consequences emphasises that, for many patients, TBI should be conceptualised as a chronic health condition. Evidence suggests that functional outcomes after TBI can show improvement or deterioration up to two decades after injury, and rates of all-cause mortality remain elevated for many years. Furthermore, TBI represents a risk factor for a variety of neurological illnesses, including epilepsy, stroke, and neurodegenerative disease. With respect to neurodegeneration after TBI, post-mortem studies on the long-term neuropathology after injury have identified complex persisting and evolving abnormalities best described as polypathology, which includes chronic traumatic encephalopathy. Despite growing awareness of the lifelong consequences of TBI, substantial gaps in research exist. Improvements are therefore needed in understanding chronic pathologies and their implications for survivors of TBI, which could inform long-term health management in this sizeable patient population.

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