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The diagnosis, prognosis, and treatment of mild traumatic brain injuries (mTBIs), such as concussions, are significant unmet medical issues. The kinetic forces that occur in mTBI adversely affect the cerebral vasculature, making cerebrovascular injury (CVI) a pathophysiological hallmark of mTBI. Given the importance of a healthy cerebrovascular system in overall brain function, CVI is likely to contribute to neurological dysfunction after mTBI. As such, CVI and related pathomechanisms may provide objective biomarkers and therapeutic targets to improve the clinical management and outcomes of mTBI. Despite this potential, until recently, few studies have focused on the cerebral vasculature in this context. This article will begin by providing a brief overview of the cerebrovascular system followed by a review of the literature regarding how mTBI can affect the integrity and function of the cerebrovascular system, and how this may ultimately contribute to neurological dysfunction and neurodegenerative conditions. We then discuss promising avenues of research related to mTBI biomarkers and interventions that target CVI, and conclude that a clinical approach that takes CVI into account could result in substantial improvements in the care and outcomes of patients with mTBI. [ABSTRACT FROM AUTHOR]

Interprofessional practice (IP)--ie, collaborative practice--involves interaction and knowledge-sharing between professionals from different disciplines in order to meet the needs of the patient. This approach to care is well suited to patients with pressure ulcers, whose complex and varying presentations require the monitoring and consultation of an IP team. A 44-year-old man with anoxic brain injury was admitted to a complex continuing care facility with 18 wounds, 17 of which were pressure ulcers. The patient was at high risk for further skin breakdown as a result of immobility, incontinence, impaired cognition, impaired sensation, low body weight, and positioning challenges secondary to contractures and spasticity. Wounds were located primarily around the patient's sacrum, trochanters, feet, and ankles. The care team included a physician, unit manager, clinical nurse educator, nurses, physiotherapist, occupational therapist, registered dietician, and pharmacist, all with varying roles related to wound care. The patient's wife was concerned about his overall health status and wanted to move him out of his room in a wheelchair to spend time with him. Using current best practices, the IP team implemented management strategies that facilitated wheelchair time during family visits; plus, all 18 wounds healed within 15 months of admission. The patient did not develop any new areas of skin breakdown. IP collaboration facilitated the problem-solving needed to meet the complex needs of this patient.