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use of corticosteroids in head trauma

Franck Jolivet, Armelle Diquélou, Catherine Trumel, Simon Privat, Olivier Dossin
BACKGROUND: Among coagulation disorders, primary fibrinogen deficiency is very rare in dogs. It is divided into hypofibrinogenemia, afibrinogenemia and dysfibrinogenemia. Afibrinogenemia has been described in three dogs. There are, however, no published case reports of primary hypofibrinogenemia in dogs. CASE PRESENTATION: A 1.5 year-old male German Pointer dog was evaluated for a locked-jaw syndrome associated with eye protrusion which appeared after a minor head trauma...
June 19, 2017: BMC Veterinary Research
Massimo Ralli, Giuseppe Nola, Luca Sparvoli, Giovanni Ralli
Enlarged vestibular aqueduct (EVA) syndrome is a common congenital inner ear malformation characterized by a vestibular aqueduct with a diameter larger than 1.5 mm, mixed or sensorineural hearing loss that ranges from mild to profound, and vestibular disorders that may be present with a range from mild imbalance to episodic objective vertigo. In our study, we present the case of a patient with unilateral enlarged vestibular aqueduct and bilateral endolymphatic hydrops (EH). EH was confirmed through anamnestic history and audiological exams; EVA was diagnosed using high-resolution CT scans and MRI images...
2017: Case Reports in Otolaryngology
Maud Stenberg, Lars-Owe D Koskinen, Per Jonasson, Richard Levi, Britt-Marie Stålnacke
OBJECTIVE: To study: (i) acute computed tomography (CT) characteristics and clinical outcome; (ii) clinical course and (iii) Corticosteroid Randomisation after Significant Head Injury acute calculator protocol (CRASH) model and clinical outcome in patients with severe traumatic brain injury (sTBI). METHODS: Initial CT (CTi ) and CT 24 hours post-trauma (CT24 ) were evaluated according to Marshall and Rotterdam classifications. Rancho Los Amigos Cognitive Scale-Revised (RLAS-R) and Glasgow Outcome Scale Extended (GOSE) were assessed at three months and one year post-trauma...
2017: Brain Injury: [BI]
Diederik van de Beek, Matthijs Brouwer, Rodrigo Hasbun, Uwe Koedel, Cynthia G Whitney, Eelco Wijdicks
Meningitis is an inflammation of the meninges and subarachnoid space that can also involve the brain cortex and parenchyma. It can be acquired spontaneously in the community - community-acquired bacterial meningitis - or in the hospital as a complication of invasive procedures or head trauma (nosocomial bacterial meningitis). Despite advances in treatment and vaccinations, community-acquired bacterial meningitis remains one of the most important infectious diseases worldwide. Streptococcus pneumoniae and Neisseria meningitidis are the most common causative bacteria and are associated with high mortality and morbidity; vaccines targeting these organisms, which have designs similar to the successful vaccine that targets Haemophilus influenzae type b meningitis, are now being used in many routine vaccination programmes...
November 3, 2016: Nature Reviews. Disease Primers
Mark D Murphey, Catherine C Roberts, Jenny T Bencardino, Marc Appel, Erin Arnold, Eric Y Chang, Molly E Dempsey, Michael G Fox, Ian Blair Fries, Bennett S Greenspan, Mary G Hochman, Jon A Jacobson, Douglas N Mintz, Joel S Newman, Zehava S Rosenberg, David A Rubin, Kirstin M Small, Barbara N Weissman
Osteonecrosis of the hip (Legg-Calvé-Perthes) is a common disease, with 10,000-20,000 symptomatic cases annually in the United States. The disorder affects both adults and children and is most frequently associated with trauma and corticosteroid usage. The initial imaging evaluation of suspected hip osteonecrosis is done using radiography. MRI is the most sensitive and specific imaging modality for diagnosis of osteonecrosis of the hip. The clinical significance of hip osteonecrosis is dependent on its potential for articular collapse...
February 2016: Journal of the American College of Radiology: JACR
Okan Ozkunt, Kerim Sarıyılmaz, Mustafa Sungur, Ferhat Ilen, Fatih Dikici
INTRODUCTION: Femoral head avascular necrosis is caused by disruption of the blood supply of the femoral head, which finally results in hip dysfunction. Non traumatic osteonecrosis may related with corticosteroid use, alcohol abuse, SLE, hemoglobinopathies or exposure to cytotoxic agents. But avascular necrosis of the femoral head (ANFH) due to heroin use is a rare condition. We report a patient with bilateral ANFH due to heroin use treated by simultaneous bilateral hip arthroplasty. PRESENTATION OF CASE: 37 year-old male patient presented with bilateral hip pain that had been occurring for four years...
2015: International Journal of Surgery Case Reports
John A Staples, Jin Wang, Brianna Mills, Nancy Temkin, Mark C Zaros, Gregory J Jurkovich, Frederick P Rivara
OBJECTIVE: To examine the performance of the Corticosteroid Randomization After Significant Head injury (CRASH) trial prognostic model in older patients with traumatic brain injury. SETTING: The National Study on Costs and Outcomes of Trauma cohort, established at 69 hospitals in the United States in 2001 and 2002. PARTICIPANTS: Adults with traumatic brain injury and an initial Glasgow Coma Scale score of 14 or less. DESIGN: The CRASH-CT model predicting death within 14 days was deployed in all patients...
September 2016: Journal of Head Trauma Rehabilitation
Silvia Soare, Jean-Marc Foletti, Audrey Gallucci, Charles Collet, Laurent Guyot, Cyrille Chossegros
INTRODUCTION: Blindness is a rare and severe complication of craniofacial trauma. The management of acute orbital compartment syndrome (AOCS) is not well defined and there is no standard treatment. Our objective was to find indications for orbital decompression, the best time for treatment, and the appropriate techniques. MATERIALS AND METHODS: A literature review was made from articles published between 1994 and 2014 in the PubMed database, on the emergency treatment of AOCS...
September 2015: Journal of Cranio-maxillo-facial Surgery
Zhenhua He, Qiang Li, Jingmin Yuan, Xinding Zhang, Ruiping Gao, Yanming Han, Wenzhen Yang, Xuefeng Shi, Zhengbo Lan
PURPOSE: Traumatic optic neuropathy (TON) is a serious complication of head trauma, with the incidence rate ranging from 0.5% to 5%. The two treatment options widely practiced for TON are: (i) high-dose corticosteroid therapy and (ii) surgical decompression. However, till date, there is no consensus on the treatment protocol. This study aimed to evaluate the therapeutic efficacy of transcranial decompression of optic canal in TON patients. METHODS: A total of 39 patients with visual loss resulting from TON between January 2005 and June 2013 were retrospectively reviewed for preoperative vision, preoperative image, visual evoked potential (VEP), surgical approach, postoperative visual acuity, complications, and follow-up results...
July 2015: Clinical Neurology and Neurosurgery
Ishaan Swarup, Yuo-Yu Lee, Peter Movilla, Mark P Figgie
Osteonecrosis of the femoral head is a pathologic condition that commonly affects young patients and requires treatment with total hip arthroplasty (THA). The most common factors associated with osteonecrosis in young patients have not been previously described in the literature. A retrospective study was conducted to describe the most common factors associated with osteonecrosis in patients aged 35 or younger requiring a primary THA. This study included 235 patients and found that the most common factor associated with osteonecrosis was corticosteroid use (61%), followed by idiopathic causes (11%), trauma (9%), other causes (8%), haemoglobinopathies (7%), and alcoholism (3%)...
May 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Charalampos G Zalavras, Jay R Lieberman
Osteonecrosis of the femoral head may lead to progressive destruction of the hip joint. Although the etiology of osteonecrosis has not been definitely delineated, risk factors include corticosteroid use, alcohol consumption, trauma, and coagulation abnormalities. Size and location of the lesion are prognostic factors for disease progression and are best assessed by MRI. The efficacy of medical management of osteonecrosis with pharmacologic agents and biophysical modalities requires further investigation. Surgical management is based on patient factors and lesion characteristics...
July 2014: Journal of the American Academy of Orthopaedic Surgeons
Zoia Stoica, Daniela Dumitrescu, M Popescu, Ioana Gheonea, Mihaela Gabor, N Bogdan
Avascular necrosis of the femoral head (AVN) is an increasingly common cause of musculoskeletal disability, and it poses a major diagnostic and therapeutic challenge. Although patients are initially asymptomatic, AVN usually progresses to joint destruction, requiring total hip replacement, usually before the fifth decade. Avascular necrosis is characterized by osseous cell death due to vascular compromise. Avascular necrosis of bone results generally from corticosteroid use, trauma, pancreatitis, alcoholism, radiation, sickle cell disease, infiltrative diseases (e...
January 2009: Current Health Sciences Journal
Eugène Mutijima, Viviane De Maertelaer, Manu Deprez, Michel Malaise, Jean-Philippe Hauzeur
The pathogenesis of nontraumatic osteonecrosis (ON) remains unclear. Some studies have suggested that nontraumatic ON is attributed to increased osteocytic apoptosis. To test this hypothesis, a controlled study must compare the apoptosis of osteocytes and osteoblasts in cases of ON and osteoarthritis (OA). To assess either the localized or diffuse patterns of this increased osteocytic and osteoblastic apoptosis, we evaluated both the proximal and distal regions of necrotic areas. Femoral heads resected for total hip prosthesis were included for this study...
December 2014: Clinical Rheumatology
Stephen Honeybul, Kwok M Ho
OBJECT: To assess the impact that injury severity has on complications in patients who have had a decompressive craniectomy for severe traumatic brain injury (TBI). METHODS: This prospective observational cohort study included all patients who underwent a decompressive craniectomy following severe TBI at the two major trauma hospitals in Western Australia from 2004 to 2012. All complications were recorded during this period. The clinical and radiological data of the patients on initial presentation were entered into a web-based model prognostic model, the CRASH (Corticosteroid Randomization After Significant Head injury) collaborators prediction model, to obtain the predicted risk of an unfavourable outcome which was used as a measure of injury severity...
September 2014: Injury
Stephen Honeybul, Kwok M Ho, Christopher R P Lind, Grant R Gillett
OBJECT: The goal in this study was to assess the validity of the corticosteroid randomization after significant head injury (CRASH) collaborators prediction model in predicting mortality and unfavorable outcome at 18 months in patients with severe traumatic brain injury (TBI) requiring decompressive craniectomy. In addition, the authors aimed to assess whether this model was well calibrated in predicting outcome across a wide spectrum of severity of TBI requiring decompressive craniectomy...
May 2014: Journal of Neurosurgery
Tevfik Yılmaz, Metehan Akça, Yahya Turan, Hakan Ocak, Kağan Kamaşak, Mehmet Yildirim
Corticosteroids are extensively used in treatment of many diseases. In neurosurgery practice, dexamethasone (DEX) is commonly used particularly in cerebral edema secondary to brain tumors, head trauma, and central nervous system infections. There are some uncertainties surrounding the secure use of DEX in patients with epilepsy or seizures induced by diseases of the central nervous system such as head trauma and brain tumors. Despite its extensive use, the effect of DEX on epileptiform activity is unclear. In this study the effect of DEX on epileptiform activity was investigated in rats...
March 20, 2014: Brain Research
Martina Santarsieri, Christian Niyonkuru, Emily H McCullough, Julie A Dobos, C Edward Dixon, Sarah L Berga, Amy K Wagner
Despite significant advances in the management of head trauma, there remains a lack of pharmacological treatment options for traumatic brain injury (TBI). While progesterone clinical trials have shown promise, corticosteroid trials have failed. The purpose of this study was to (1) characterize endogenous cerebrospinal fluid (CSF) progesterone and cortisol levels after TBI, (2) determine relationships between CSF and serum profiles, and (3) assess the utility of these hormones as predictors of long-term outcomes...
April 15, 2014: Journal of Neurotrauma
Almutez Gharaibeh, Howard I Savage, Roberta W Scherer, Morton F Goldberg, Kristina Lindsley
BACKGROUND: Traumatic hyphema is the entry of blood into the anterior chamber (the space between the cornea and iris) subsequent to a blow or a projectile striking the eye. Hyphema uncommonly causes permanent loss of vision. Associated trauma (e.g. corneal staining, traumatic cataract, angle recession glaucoma, optic atrophy, etc.) may seriously affect vision. Such complications may lead to permanent impairment of vision. Patients with sickle cell trait/disease may be particularly susceptible to increases of elevated intraocular pressure...
December 3, 2013: Cochrane Database of Systematic Reviews
George Kwok Chu Wong, Jeremy Teoh, Janice Yeung, Emily Chan, Eva Siu, Peter Woo, Timothy Rainer, Wai Sang Poon
We aimed to test prognostic models (the Trauma Injury Severity Score, International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury, and Corticosteroid Randomisation After Significant Head Injury models) for 14-day mortality, 6-month mortality, and 6-month unfavorable outcome in a cohort of trauma patients with traumatic brain injury (TBI) in Hong Kong. We analyzed 661 patients with significant TBI treated in a regional trauma centre in Hong Kong over a 3-year period. The discriminatory power of the models was assessed as the area under the receiver operating characteristic curve...
December 2013: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Magnus Olivecrona, Zandra Olivecrona
Based on the Corticosteroid Randomisation after Significant Head Injury (CRASH) trial database, a prognosis calculator has been developed for the prediction of outcome in an individual patient with a head injury. In 47 patients with severe traumatic brain injury (sTBI) prospectively treated using an intracranial pressure (ICP) targeted therapy, the individual prognosis for mortality at 14 days and unfavourable outcome at 6 months was calculated and compared with the actual outcome. An overestimation of the risk of mortality and unfavourable outcome was found...
July 2013: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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