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management of acute severe traumatic brain injury

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https://www.readbyqxmd.com/read/27911071/severe-brain-injury-in-massachusetts-assessing-the-continuum-of-care
#1
Laura Lorenz, Gabrielle Katz
Acquired brain injury (ABI) is a major public health problem in Massachusetts (Hackman et al, 2014) and includes traumatic brain injury (TBI), stroke, ABI-related infectious diseases, metabolic disorders affecting the central nervous system (brain and spinal cord), and brain tumor. Advances in emergency medical care and neurosurgery mean that more people are surviving severe traumatic brain injury (Trexler et al, 2014). Yet many patients with severe TBI in particular, are not receiving inpatient services after initial treatment (Hackman et al, 2014; CDC, 2014) or later that are known to be effective (Malec & Kean, 2015; Lewis & Horn, 2015; BI Commission, 2011; Kolakowsky-Hayner et al, 2000; Interviews)...
December 10, 2015: Issue Brief
https://www.readbyqxmd.com/read/27893148/osteopathic-manipulative-treatment-for-somatic-dysfunction-after-acute-severe-traumatic-brain-injury
#2
Adrienne McCallister, Christopher Brown, Michael Smith, Hugh Ettlinger, Gerard A Baltazar
Somatic dysfunction caused by traumatic brain injury (TBI) may be managed by osteopathic manipulative treatment (OMT). In this case report, the authors describe 2 patients with severe TBI who were each treated with OMT in a level-1 regional trauma center. Both patients received OMT beginning in the acute care phase of injury. Somatic dysfunction improved during the course of treatment, and no adverse effects of OMT were noted. More comprehensive research may clarify the efficacy and adverse effects of OMT as part of multimodal acute care of patients with severe TBI...
December 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27886876/complications-in-the-management-of-patients-with-spine-trauma
#3
REVIEW
Geoffrey Stricsek, George Ghobrial, Jefferson Wilson, Thana Theofanis, James S Harrop
More than 50% of patients diagnosed with acute, traumatic spinal cord injury will experience at least 1 complication during their hospitalization. Age, severity of neurological injury, concurrent traumatic brain injury, comorbid illness, and mechanism of injury are all associated with increasing risk of complication. More than 75% of complications will occur within 2 weeks of injury. The complications associated with SCI carry a significant risk of morbidity and mortality; their early identification and management is critical in the care of the SCI patient...
January 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27857999/do-age-and-anticoagulants-affect-the-natural-history-of-acute-subdural-hematomas
#4
Brandon P Lucke-Wold, Ryan C Turner, Darnell Josiah, Chelsea Knotts, Sanjay Bhatia
Acute subdural hematoma is a serious complication following traumatic brain injury. Large volume hematomas or those with underlying brain injury can cause mass effect, midline shift, and eventually herniation of the brain. Acute subdural hematomas in the young are associated with high-energy trauma and often have underlying contusions, while acute subdural hematomas in the elderly are associated with minor trauma and an absence of underlying contusions, even though the elderly are more likely to be on anticoagulants or anti-platelet therapy...
2016: Arch Emerg Med Crit Care
https://www.readbyqxmd.com/read/27720843/hospital-based-health-care-after-traumatic-brain-injury
#5
David Salisbury, Simon J Driver, Megan Reynolds, Monica Bennett, Laura B Petrey, Anne Marie Warren
OBJECTIVE: To investigate trends of hospital-based health care utilization after admission to a Level 1 trauma center following acute traumatic brain injury (TBI). DESIGN: Retrospective review. SETTING: Large urban trauma hospital and a hospital council data registry consisting of 88 member institutions (>150 hospitals) covering 15,000 square miles. PARTICIPANTS: All patients admitted to a Level I trauma center between January 2006 - June 2014 who experienced an acute TBI based on ICD-9 coding...
October 6, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27695379/hyperglycemia-a-predictor-of-death-in-severe-head-injury-patients
#6
Simin Babaie Kafaki, Kamaledin Alaedini, Ashkan Qorbani, Leila Asadian, Kaveh Haddadi
OBJECTIVES: Management of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperglycemia in patients with traumatic head injury admitted to the intensive care unit (ICU). METHODS: This prospective study included adults with traumatic primary brain injury with a Glasgow coma score of ≤8 necessitating mechanical ventilation treated in the period 2012-2015...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
https://www.readbyqxmd.com/read/27692109/age-related-injury-patterns-in-spanish-trauma-icu-patients-results-from-the-retrauci
#7
Juan Antonio Llompart-Pou, Mario Chico-Fernández, Marcelino Sánchez-Casado, Fermín Alberdi-Odriozola, Francisco Guerrero-López, María Dolores Mayor-García, Javier González-Robledo, María Ángeles Ballesteros-Sanz, Rubén Herrán-Monge, Rafael León-López, Lucía López-Amor, Ana Bueno-González
BACKGROUND: Injury patterns may differ in trauma patients when age is considered. This information is relevant in the management of trauma patients and for planning preventive measures. METHODS: We included in the study all patients admitted for traumatic disease in the participating ICUs from November 23(rd), 2012 to July 31(st), 2015 with complete records. Data on epidemiology, injury patterns, severity scores, acute management, resources utilisation and outcome were recorded and compared in the following groups of age: ≤55years (young adults), 56-65 years (adults), 66-75 years (elderly), >75years (very elderly)...
September 2016: Injury
https://www.readbyqxmd.com/read/27676786/healthcare-pathway-after-sever-traumatic-brain-injury-about-a-tunisian-population
#8
Soumaya Boudokhane, Amine Kalai, Aymen Haj Salah, Houda Migaou, Sana Salah, Anis Jellad, Mourad Gahbiche, Zohra Ben Salah Frih
OBJECTIVE: The aim of our study was to determine the demographic characteristics and the pathway of severe traumatic brain injury (STBI) victims in the Tunisian population. MATERIAL/PATIENTS AND METHODS: Our study included 26 patients victims of STBI hospitalized in intensive care unit, among 450 traumatic head injuries admitted to the Teaching Hospital of Fattouma Bourguiba in Monastir during the year 2014. The studied parameters were: demographic characteristics of the population, circumstances of the accident, transport modalities to the hospital, assessments of the injury types, duration of coma, length of hospitalization in the Intensive Care Unit (ICU) and finally the discharge mode after the ICU stay (transfer to neurosurgery ward, to rehabilitation unit, or home discharged)...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27622712/management-and-outcome-of-traumatic-epidural-hematoma-in-41%C3%A2-infants-and-children-from-a-single-center
#9
H Binder, M Majdan, T M Tiefenboeck, A Fochtmann, M Michel, S Hajdu, W Mauritz, J Leitgeb
BACKGROUND: Traumatic brain injury (TBI) is a frequent cause of mortality and acquired neurological impairment in children. HYPOTHESIS: We hypothese that due to adequate treatment of EDH in children and adolescence excellent clinical and functional outcome can be reached. PURPOSE: To evaluate retrospectively our treatment process of EDH and to elucidate the relationship between trauma mechanism, injury pattern, radiological presentation, subsequent therapy and functional outcome...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27604735/animal-models-of-posttraumatic-seizures-and-epilepsy
#10
Alexander V Glushakov, Olena Y Glushakova, Sylvain Doré, Paul R Carney, Ronald L Hayes
Posttraumatic epilepsy (PTE) is one of the most common and devastating complications of traumatic brain injury (TBI). Currently, the etiopathology and mechanisms of PTE are poorly understood and as a result, there is no effective treatment or means to prevent it. Antiepileptic drugs remain common preventive strategies in the management of TBI to control acute posttraumatic seizures and to prevent the development of PTE, although their efficacy in the latter case is disputed. Different strategies of PTE prophylaxis have been showing promise in preclinical models, but their translation to the clinic still remains elusive due in part to the variability of these models and the fact they do not recapitulate all complex pathologies associated with human TBI...
2016: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27604725/a-porcine-model-of-traumatic-brain-injury-via-head-rotational-acceleration
#11
D Kacy Cullen, James P Harris, Kevin D Browne, John A Wolf, John E Duda, David F Meaney, Susan S Margulies, Douglas H Smith
Unique from other brain disorders, traumatic brain injury (TBI) generally results from a discrete biomechanical event that induces rapid head movement. The large size and high organization of the human brain makes it particularly vulnerable to traumatic injury from rotational accelerations that can cause dynamic deformation of the brain tissue. Therefore, replicating the injury biomechanics of human TBI in animal models presents a substantial challenge, particularly with regard to addressing brain size and injury parameters...
2016: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27548472/long-term-anesthetic-dependent-hypoactivity-after-repetitive-mild-traumatic-brain-injuries-in-adolescent-mice
#12
Bridgette D Semple, Raha Sadjadi, Jaclyn Carlson, Yiran Chen, Duan Xu, Donna M Ferriero, Linda J Noble-Haeusslein
Recent evidence supports the hypothesis that repetitive mild traumatic brain injuries (rmTBIs) culminate in neurological impairments and chronic neurodegeneration, which have wide-ranging implications for patient management and return-to-play decisions for athletes. Adolescents show a high prevalence of sports-related head injuries and may be particularly vulnerable to rmTBIs due to ongoing brain maturation. However, it remains unclear whether rmTBIs, below the threshold for acute neuronal injury or symptomology, influence long-term outcomes...
2016: Developmental Neuroscience
https://www.readbyqxmd.com/read/27468498/-role-of-vagoinsular-and-enteric-endocrine-systems-in-acute-gastroduodenal-erosion-and-ulcers-formation-in-severe-combined-traumatic-brain-injury-depending-on-the-combination-of-damage
#13
F I Alyev
347 patients were analyzed and role of vagoinsular and enteric endocrine systems in acute gastroduodenal erosion and ulcers formation in severe traumatic brain injury were assessed depending on the combination of TBI with various organs and systems damage. It was revealed that activation ofvagoinsular and enteric endocrine systems due to microcirculatory disorders and hypoxia associated with severe TBI plays a crucial role in increasing the frequency of manifestations of erosions and ulcers in gastroduodenal mucosa...
March 2016: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/27466829/conversational-topics-discussed-by-individuals-with-severe-traumatic-brain-injury-and-their-communication-partners-during-sub-acute-recovery
#14
Sophie Brassel, Belinda Kenny, Emma Power, Elise Elbourn, Skye McDonald, Robyn Tate, Brian MacWhinney, Lyn Turkstra, Audrey Holland, Leanne Togher
PRIMARY OBJECTIVE: To investigate the nature and patterns of conversational topics discussed by individuals with severe TBI and familiar communication partners at 3 and 6 months post-injury, and to examine changes occurring in conversational topics during sub-acute recovery. RESEARCH DESIGN: Qualitative content analysis was used to explore the nature of topics and generate conversational themes. Topic analysis provided an understanding of conversational topic management by identifying patterns of topic initiation and maintenance...
2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27450515/memantine-reduced-cell-death-astrogliosis-and-functional-deficits-in-an-in-vitro-model-of-repetitive-mild-traumatic-brain-injury
#15
Gwen B Effgen, Barclay Morrison
Clinical studies suggest that athletes with a history of concussion may be at risk for additional mild traumatic brain injury (mTBI), and repetitive exposure to mTBI acutely increases risk for more significant and persistent symptoms and increases future risk for developing neurodegenerative diseases. Currently, symptoms of mTBI are managed with rest and pain medication; there are no drugs approved by the Food and Drug Administration (FDA) that target the biochemical pathology underlying mTBI to treat or prevent acute and long-term effects of repetitive mTBI...
August 8, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27399524/326%C3%A2-cerebral-contusions-catalysts-and-counteractants
#16
Joseph Carnevale, David J Segar, Benjamin Drapcho, Cody Doberstein, John F Morrison, Wael Asaad
INTRODUCTION: Annually in the United States, an estimated 1.7 million people experience traumatic brain injury (TBI), resulting in 1.4 million emergency department visits, 270 000 hospitalizations, and 53 000 deaths. The most common mass lesions associated with TBI are hematomas and contusions. Currently, there is no proven treatment protocol for contusion management. This retrospective study seeks to provide a more comprehensive assessment of the hemorrhagic progressions of contusions (HPC) by analyzing the rate at which contusions blossom depending on a variety of factors...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27397065/targeted-temperature-management-in-spontaneous-intracerebral-hemorrhage-a-systematic-review
#17
Marlene Fischer, Alois Schiefecker, Peter Lackner, Raimund Helbok, Ronny Beer, Bettina Pfausler, Erich Schmutzhard, Gregor Broessner
Fever is common in neurocritical care patients and is associated with poor outcome. Targeted temperature management (TTM), i.e. therapeutic hypothermia or controlled normothermia, after acute brain injury has been studied as a neuroprotectant for several decades. In contrast to pharmacological agents with specific targets TTM affects multiple pathophysiological mechanisms and is primarily thought to attenuate secondary brain injury. Most promising results have been obtained from experimental studies on cerebral ischemia or traumatic brain injury showing beneficial effects of hypothermia on structural and functional outcome...
July 3, 2016: Current Drug Targets
https://www.readbyqxmd.com/read/27393190/neurosurgical-treatment-variation-of-traumatic-brain-injury-evaluation-of-acute-subdural-hematoma-management-in-belgium-and-the-netherlands
#18
Thomas A van Essen, Godard C W de Ruiter, Kuan H Kho, Wilco C Peul
Several recent global traumatic brain injury (TBI) initiatives rely on practice variation in diagnostic and treatment methods to answer effectiveness questions. One of these scientific dilemmas, the surgical management of the traumatic acute subdural hematoma (ASDH) might be variable among countries, among centers within countries, and even among neurosurgeons within a center, and hence be amenable for a comparative effectiveness study. The aim of our questionnaire, therefore, was to explore variations in treatment for ASDH among neurosurgeons in similar centers in a densely populated geographical area...
August 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27339615/pharmacologic-neuroprotection-for-functional-outcomes-after-traumatic-brain-injury-a-systematic-review-of-the-clinical-literature
#19
REVIEW
Shaun E Gruenbaum, Alexander Zlotnik, Benjamin F Gruenbaum, Denise Hersey, Federico Bilotta
INTRODUCTION: Traumatic brain injury (TBI) is a major cause of death and disability worldwide. The deleterious effects of secondary brain injury may be attenuated by early pharmacological therapy in the emergency room and intensive care unit (ICU). Current medical management of acute TBI is primarily supportive, aimed at reducing intracranial pressure (ICP) and optimizing cerebral perfusion. There are no pharmacological therapies to date that have been unequivocally demonstrated to improve neurological outcomes after TBI...
September 2016: CNS Drugs
https://www.readbyqxmd.com/read/27319802/serum-concentrations-of-ubiquitin-c-terminal-hydrolase-l1-and-glial-fibrillary-acidic-protein-after-pediatric-traumatic-brain-injury
#20
Stefania Mondello, Firas Kobeissy, Annarita Vestri, Ronald L Hayes, Patrick M Kochanek, Rachel P Berger
Objective reliable markers to assess traumatic brain injury (TBI) and predict outcome soon after injury are a highly needed tool for optimizing management of pediatric TBI. We assessed serum concentrations of Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-Terminal Hydrolase-L1 (UCH-L1) in a cohort of 45 children with clinical diagnosis of TBI (Glasgow Coma Scale [GCS] 3-15) and 40 healthy subjects, evaluated their associations with clinical characteristics and outcomes, and compared their performance to previously published data on two well-studied blood biomarkers, S100B and MBP...
2016: Scientific Reports
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