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https://www.readbyqxmd.com/read/28319470/symptomatic-acute-on-chronic-subdural-hematoma-a-clinicopathological-study
#1
Rudy J Castellani, Gruschenka Mojica-Sanchez, Gary Schwartzbauer, David S Hersh
The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion...
March 18, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#2
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28099375/routine-neurosurgical-consultation-is-not-necessary-in-mild-blunt-traumatic-brain-injury
#3
Paul R Lewis, Casey E Dunne, James D Wallace, Jason B Brill, Richard Y Calvo, Jayraan Badiee, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
BACKGROUND: The Brain Trauma Foundation guidelines provide indications for neurosurgical intervention in traumatic brain injury (TBI) with moderate or severe intracranial hemorrhage (ICH). In TBI patients with less severe ICH, the utility of neurosurgical consultation remains unclear. We sought to determine if routine neurosurgical consultation is necessary for mild blunt TBI patients with ICH. METHODS: A retrospective cohort study was conducted on 500 consecutive blunt TBI patients aged 15 years or older with Glasgow Coma Scale score of ≥13 and ICH on initial head computed tomography admitted to a Level I trauma center over 28 months...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28038986/differential-effects-of-minocycline-on-microglial-activation-and-neurodegeneration-following-closed-head-injury-in-the-neonate-rat
#4
L A Hanlon, R Raghupathi, J W Huh
The role of microglia in the pathophysiology of injury to the developing brain has been extensively studied. In children under the age of 4 who have sustained a traumatic brain injury (TBI), markers of microglial/macrophage activation were increased in the cerebrospinal fluid and were associated with worse neurologic outcome. Minocycline is an antibiotic that decreases microglial/macrophage activation following hypoxic-ischemia in neonatal rodents and TBI in adult rodents thereby reducing neurodegeneration and behavioral deficits...
April 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28028451/diagnostic-and-clinical-management-of-skull-fractures-in-children
#5
Christoph Arneitz, Maria Sinzig, Günter Fasching
OBJECTIVE: The indications of routine skull X-rays after mild head trauma are still in discussion, and the clinical management of a child with a skull fracture remains controversial. The aim of our retrospective study was to evaluate our diagnostic and clinical management of children with skull fractures following minor head trauma. METHODS: We worked up the medical history of all consecutive patients with a skull fracture treated in our hospital from January 2009 to October 2014 and investigated all skull X-rays in our hospital during this period...
2016: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/27882255/tip-of-an-iceberg-skull-fracture-as-an-adult-presentation-of-encephalocraniocutaneous-lipomatosis
#6
Sinead Culleton, Christen D Barras, Hamed Asadi, Seamus Looby, Paul Brennan, Hong Kuan Kok
The severity of seizures presenting to the emergency department ranges from benign to life threatening. There are also a wide number of possible etiologies. Computed tomography (CT) emergency imaging may be required at presentation to elucidate a possible cause and assess signs of intracranial trauma. This case describes a serious seizure episode in a young man while on holiday. A CT brain showed a skull fracture as a consequence of seizure-related head trauma but unexpectedly there were image findings consistent with encephalocraniocutaneous lipomatosis...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27858189/ambulatory-or-inpatient-management-of-mild-tbi-in-children-a-post-concussion-analysis
#7
Danielle S Wendling-Keim, Adriana König, Hans-Georg Dietz, Markus Lehner
BACKGROUND: Diagnosis and treatment of children with mild traumatic brain injury (mTBI) remain a challenge since initial signs and symptoms do not always indicate the severity of the trauma. Therefore, guidelines regarding the decision upon imaging methods and ambulatory or hospitalized treatment are needed. The goal of our study was to investigate if the standard that was allied from the PECARN rules and is applied in this study can ensure that patients with clinically important brain injury are recognized and leads to outcomes with a low complication rate, a high patient satisfaction and minimal post-concussion syndrome incidence...
November 17, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27798539/pediatric-minor-traumatic-brain-injury-with-intracranial-hemorrhage-identifying-low-risk-patients-who-may-not-benefit-from-icu-admission
#8
Erin Comer Burns, Beech Burns, Craig D Newgard, Amber Laurie, Rongwei Fu, Theresa Graif, Casey S Ward, Abbie Bauer, David Steinhardt, Laura M Ibsen, David M Spiro
BACKGROUND: Pediatric patients with any severity of traumatic intracranial hemorrhage (tICH) are often admitted to intensive care units (ICUs) for early detection of secondary injury. We hypothesize that there is a subset of these patients with mild injury and tICH for whom ICU care is unnecessary. OBJECTIVES: To quantify tICH frequency and describe disposition and to identify patients at low risk of inpatient critical care intervention (CCI). METHODS: We retrospectively reviewed patients aged 0 to 17 years with tICH at a single level I trauma center from 2008 to 2013...
October 28, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27741077/acute-outcomes-of-isolated-pneumocephali-in-children-after-minor-blunt-head-trauma
#9
Ashley Blanchard, Keven I Cabrera, Nathan Kuppermann, Peter S Dayan
OBJECTIVES: We aimed to determine the prevalence of and adverse outcomes caused by pneumocephali in children with minor blunt head trauma who had no other intracranial injuries (ie, isolated pneumocephali). METHODS: We conducted a secondary analysis of a public use dataset from a multicenter prospective study of pediatric minor head trauma. We included children younger than 18 years with Glasgow Coma Scale (GCS) scores of 14 or 15 and non-trivial mechanisms of injury who had cranial computed tomographies obtained...
October 6, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27695534/posttraumatic-delayed-tension-pneumocephalus-rare-case-with-review-of-literature
#10
REVIEW
Vivek Kumar Kankane, Gaurav Jaiswal, Tarun Kumar Gupta
Pneumocephalus is commonly seen after head and facial trauma, ear infections, and tumors of the skull base or neurosurgical interventions. In tension pneumocephalus, the continuous accumulation of intracranial air is thought to be caused by a "ball valve" mechanism. In turn, this may lead to a mass effect on the brain, with subsequent neurological deterioration and signs of herniation. Tension pneumocephalus is considered a life-threatening, neurosurgical emergency burr-hole evacuation was performed and he experienced a full recovery...
October 2016: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/27682431/closed-head-experimental-traumatic-brain-injury-increases-size-and-bone-volume-of-callus-in-mice-with-concomitant-tibial-fracture
#11
Rhys D Brady, Brian L Grills, Jarrod E Church, Nicole C Walsh, Aaron C McDonald, Denes V Agoston, Mujun Sun, Terence J O'Brien, Sandy R Shultz, Stuart J McDonald
Concomitant traumatic brain injury (TBI) and long bone fracture are commonly observed in multitrauma and polytrauma. Despite clinical observations of enhanced bone healing in patients with TBI, the relationship between TBI and fracture healing remains poorly understood, with clinical data limited by the presence of several confounding variables. Here we developed a novel trauma model featuring closed-skull weight-drop TBI and concomitant tibial fracture in order to investigate the effect of TBI on fracture healing...
September 29, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27679447/modeling-and-optimization-of-airbag-helmets-for-preventing-head-injuries-in-bicycling
#12
Mehmet Kurt, Kaveh Laksari, Calvin Kuo, Gerald A Grant, David B Camarillo
Bicycling is the leading cause of sports-related traumatic brain injury. Most of the current bike helmets are made of expanded polystyrene (EPS) foam and ultimately designed to prevent blunt trauma, e.g., skull fracture. However, these helmets have limited effectiveness in preventing brain injuries. With the availability of high-rate micro-electrical-mechanical systems sensors and high energy density batteries, a new class of helmets, i.e., expandable helmets, can sense an impending collision and expand to protect the head...
April 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27618590/epidemiology-of-pediatric-traumatic-brain-injury-in-a-dense-urban-area-served-by-a-helicopter-trauma-service
#13
Ciaran S Hill, Aaron L McLean, Mark H Wilson
OBJECTIVE: Pediatric traumatic brain injury is the most common cause of death and a major cause of morbidity in children and young adults worldwide. Despite this, our understanding of epidemiological factors relating to this type of injury is incomplete. The objective of this study was to explore a variety of factors relating to these injuries including mechanism, timing of emergency response, prehospital management, radiological diagnosis, neurosurgical care, and final outcomes. METHODS: A retrospective review of all pediatric traumas attending a single large, densely populated urban area within a 2-year period was undertaken, and all cases with significant pediatric traumatic brain injury, as defined by a computed tomography scan showing an intracranial injury, were included for further analysis...
September 9, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27604723/impact-acceleration-model-of-diffuse-traumatic-brain-injury
#14
Sarah C Hellewell, Jenna M Ziebell, Jonathan Lifshitz, M Cristina Morganti-Kossmann
The impact acceleration (I/A) model of traumatic brain injury (TBI) was developed to reliably induce diffuse traumatic axonal injury in rats in the absence of skull fractures and parenchymal focal lesions. This model replicates a pathophysiology that is commonly observed in humans with diffuse axonal injury (DAI) caused by acceleration-deceleration forces. Such injuries are typical consequences of motor vehicle accidents and falls, which do not necessarily require a direct impact to the closed skull. There are several desirable characteristics of the I/A model, including the extensive axonal injury produced in the absence of a focal contusion, the suitability for secondary insult modeling, and the adaptability for mild/moderate injury through alteration of height and/or weight...
2016: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27586099/functional-outcomes-of-motor-vehicle-crash-head-injuries-in-pediatric-and-adult-occupants
#15
Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Gretchen Baker, Andrea N Doud, Ryan T Barnard, Joel D Stitzel, Mark R Zonfrillo
OBJECTIVE: The objective of the study was to develop a disability-based metric for motor vehicle crash (MVC) injuries, with a focus on head injuries, and compare the functional outcomes between the pediatric and adult populations. METHODS: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank-Research Data System (NTDB-RDS) for the top 95% most frequently occurring Abbreviated Injury Scale (AIS) 3, 4, and 5 head injuries in NASS-CDS 2000-2011...
September 2016: Traffic Injury Prevention
https://www.readbyqxmd.com/read/27432678/imaging-of-head-trauma
#16
REVIEW
Sandra Rincon, Rajiv Gupta, Thomas Ptak
Imaging is an indispensable part of the initial assessment and subsequent management of patients with head trauma. Initially, it is important for diagnosing the extent of injury and the prompt recognition of treatable injuries to reduce mortality. Subsequently, imaging is useful in following the sequelae of trauma. In this chapter, we review indications for neuroimaging and typical computed tomography (CT) and magnetic resonance imaging (MRI) protocols used in the evaluation of a patient with head trauma. We review the role of CT), the imaging modality of choice in the acute setting, and the role of MRI in the evaluation of patients with head trauma...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27430465/trauma
#17
REVIEW
Thierry A G M Huisman, Andrea Poretti
Traumatic brain and spine injury (TBI/TSI) is a leading cause of death and lifelong disability in children. The biomechanical properties of the child's brain, skull, and spine, the size of the child, the age-specific activity pattern, and variance in trauma mechanisms result in a wide range of age-specific traumas and patterns of brain and spine injuries. A detailed knowledge about the various types of primary and secondary pediatric head and spine injuries is essential to better identify and understand pediatric TBI/TSI, which enhances sensitivity and specificity of diagnosis, will guide therapy, and may give important information about the prognosis...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27428914/multidisciplinary-team-treatment-of-penetrating-head-and-neck-trauma
#18
Lili Li, Hongxing Li, Kongbin Yang
Penetrating head and neck trauma could cause significant mortality because of many important structures located in the brain and neck. Although high-velocity penetrating brain injury is often reported, reports of low-velocity, combined head and neck penetrating injury are rare. Hereby, the authors present a case of an old man who had encountered a serious accident, a 29-cm iron fork penetrated into his neck, through the skull base and into brain. After treatment by multidisciplinary team, the patient was in rehabilitation...
September 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27402215/abusive-head-trauma-an-epidemiological-and-cost-analysis
#19
Scott Boop, Mary Axente, Blakely Weatherford, Paul Klimo
OBJECTIVE Research on pediatric abusive head trauma (AHT) has largely focused on clinical presentation and management. The authors sought to review a single-institution experience from a public health perspective to gain a better understanding of the local population affected, determine overall incidence and seasonal trends, and provide details on the initial hospitalization, including extent of injuries, neurosurgical interventions, and hospital charges. METHODS All cases of AHT involving patients who presented to Le Bonheur Children's Hospital (LBCH) from 2009 through 2014 were identified...
November 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27399454/175%C3%A2-safety-of-anticoagulation-for-the-treatment-of-cerebral-venous-sinus-thrombosis-in-adult-trauma-patients
#20
David S Hersh, Erik Hayman, Bizhan Aarabi, Deborah Stein, Cara Diaz, Jennifer Massetti, Gary Thomas Schwartzbauer
INTRODUCTION: Cerebral venous sinus thrombosis (CVST) is a potentially devastating neurological outcome of closed head trauma. Current guidelines recommend anticoagulation in adults with spontaneous CVST. Although intracranial hemorrhage resulting from a sinus thrombosis is not considered a contraindication to treatment, less is known regarding the treatment of CVST in patients with acute traumatic brain injury, who often have intracranial hemorrhages unrelated to the thrombosis. METHODS: A prospectively collected database at a level 1 trauma center was retrospectively reviewed...
August 2016: Neurosurgery
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