Marilyn Kraus, MD
Speaker at 2015 NABIS Conference on Brain Injury
Session Title 1: Pre-Conference course: Neuropsychiatry of TBI
During this course, the attendee will learn about
1. The neuropsychiatric approach to TBI during inpatient rehabilitation, including the use of appropriate assessments.
2. The role of neuropharmacology in managing the neuropsychiatric sequelae during the subacute and chronic phases of recovery.
3. Recognize the expected neuropsychiatric recovery during the first year after mild TBI.
4. Recognize appropriate neuropsychiatric management of the patient with persistent symptoms after concussion.
Neuropsychiatric disturbances, including cognitive deficits, emotional dysregulation, and behavioral problems, are common and functionally important consequences of traumatic brain injury. Careful evaluation and effective management of these posttraumatic neuropsychiatric disturbances facilitates rehabilitation and reduces barriers to activities and participation. In this workshop, heuristics for the evaluation, management, and further study of posttraumatic neuropsychiatric disturbances will be reviewed. Clinical case definitions of TBI, the clinical features of acute traumatic encephalopathy, and the neuropsychiatric sequelae of mild and moderate-to-severe TBI will be reviewed. Pre-injury, injury-related, and post-injury factors that influence the development and course of neuropsychiatric symptoms after TBI will be considered, and the importance of carefully considering the differential diagnosis of early and late post-injury neuropsychiatric disturbances will be highlighted. The faculty then will offer four lectures focused on the evaluation and management of the early and late neuropsychiatric features of mild TBI and of moderate-to-severe TBI. Finally, directions for future research that may address productively the challenges to TBI rehabilitation and recovery presented by neuropsychiatric disturbances will be addressed through discussion between faculty and participants.
Session Title 2: An integrated Strategy to neuropharmacologic management in traumatic brain injury
1) Provide an overview of the sequelae of traumatic brain injury with a focus on concussion
2) Provide a strategy for an approach to treatment planning
3) Review several agents that are examples of ‘multitaskers’ in detail with case examples
Summary: This talk will provide the frame work for an integrated approach to the treatment planning and management of the sequelae of TBI, with a focus on neuropharmacology and the rational for using ‘multitasker’ agents. This concept will be expanded upon during the talk and examples provided. While the content will often apply to all severities of TBI, concussion will be the focus.
Session Title 3: Case Study - Mild TBI
1. To understand relevant biologic and psychological factors in the diagnosis and treatment of mild TBI.
2. To understand the neurobiologic presently mechanisms presently known regarding mild TBI and their relevance to treatment and outcomes.
3. To discuss different etiologies and types of complicated mild TBI and how this relates to a focused approach to neurodiagnosis and treament.
A case presentation format will be utilized to discuss mild TBI related to differing etiologies and mechanisms of injury. This will include but not be limited to sports, falls, MVA, and repetitive blast exposure. An interdisciplinary panel of experts will discuss the important issues of neurodiagnosis, treatment, and followup necessary to achieve optimal outcomes.
Current Company Affiliation: Medstar National Rehabiliation Hospital Hospital
Speaker Bio: Marilyn F. Kraus, MD, is a subspecialty boarded neuropsychiatrist who has worked in the field of traumatic brain injury (TBI) for over twenty years, both clinically and in research. She is currently the Director of the Concussion Program for Medstar National Rehabilitation Hospital, and Program Director for the Brain Injury Medicine Fellowship at Georgetown University Hospital / National Rehabilitation Hospital (NRH). Dr. Kraus is also actively involved in developing the TBI Research Program, and has been involved with organizing a multi-institutional TBI Research Consortium in the DC area that includes Medstar-NRH, Georgetown, the DC Veterans Administration Hospital and specialized military research groups, whose mission is to promote inter-institutional research collaboration and foster novel research in the Greater DC area.
She also completed a research and clinical fellowship in Aging and Dementia at Johns Hopkins. She has numerous peer reviewed publications on TBI. Her research has focused the on assessment of neuropathology and neurobehavioral/cognitive function, as well as the role of neuropharmacology in recovery and management of TBI. Her work has included the use of amantadine in both acute and chronic TBI, as well as the role of different modalities - PET imaging, fMRI, diffusion tensor imaging and oculomotor studies - in the evaluation of TBI. She has been extensively involved in education, and has taught and supervised interdisciplinary trainees and is a frequent invited lecturer on TBI. Dr Kraus is a recent past Medical Director of the Traumatic Brain Injury Consult team, which is part of the inpatient acute polytrauma service at Walter Reed National Military Medical Center in Bethesda, MD.