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severe trauma brain injury

Chung-Ching Chio, Mao-Tsun Lin, Ching-Ping Chang, Hung-Jung Lin
BACKGROUND: Transforming growth factor-beta 1 (TGF-β1) regulates many processes after traumatic brain injury (TBI). Both Neuro AiD(™) (MLC601) and Astragaloside (AST) attenuate microglia activation in rats with TBI. The purpose of this study was to investigate whether MLC601 or AST improves output of TBI by affecting microglial expression of TGF-β1. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (120 in number) were used to investigate the contribution of TGF-β1-containing microglia in the MLC601-mediated or the AST-mediated neuroprotection in the brain trauma condition using lateral fluid-percussion injury...
October 19, 2016: European Journal of Clinical Investigation
Vigneswaran Veeramuthu, Vairavan Narayanan, Norlisah Ramli, Aditya Hernowo, Vicknes Waran, Mark W Bondi, Lisa Delano-Wood, Dharmendra Ganesan
OBJECTIVE: To evaluate the extent of persistent neuropsychological impairment in patients with complicated versus uncomplicated mild traumatic brain injury (mTBI). METHODS: 61 patients with mTBI (GCS 13 to 15) were prospectively recruited, categorized according to baseline CT findings, and underwent neuropsychological assessment at initial admission (n=61) as well as at 6 month follow-up (n=30). A paired t-test, Cohen's d effect size calculation, and repeated measure ANOVA were used to establish the differences between the groups in terms of their neuropsychological performance...
October 14, 2016: World Neurosurgery
Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Sarit Shimony-Kanat, Julie Benbenishty
OBJECTIVE: To characterize trauma-related falls in infants and toddlers aged 0 to 3 years over a 4-year period and develop a risk stratification model of causes of fall injuries. METHODS: Data on falls of 0 to 3 year olds from 2009 to 2012 were identified from a Jerusalem tertiary hospital trauma registry (N = 422) and the National Trauma Registry of Israel (N = 4,131). RESULTS: Almost half of falls occurred during the first year of life, and 57% of the children were Jewish...
October 4, 2016: Pediatric Emergency Care
Megan J Leonhard, Dagan A Wright, Rongwei Fu, David P Lehrfeld, Kathleen F Carlson
BACKGROUND: Traumatic brain injury (TBI) greatly contributes to morbidity and mortality in the pediatric population. We examined potential urban/rural disparities in mortality amongst Oregon pediatric patients with TBI treated in trauma hospitals. METHODS: We conducted a retrospective study of children ages 0-19 using the Oregon Trauma Registry for years 2009-2012. Geographic location of injury was classified using the National Center for Health Statistics Urban/Rural Classification Scheme...
December 2015: Injury Epidemiology
Daisuke Kudo, Shigeki Kushimoto, Atsushi Shiraishi, Hiroshi Ogura, Akiyoshi Hagiwara, Daizoh Saitoh
PURPOSE: The purpose of this study was to determine whether preinjury medication with antithrombotic agents was related to an increase in hemostatic interventions in patients with severe trauma without traumatic brain injury. METHODS: Consecutive trauma patients who were admitted to the emergency departments of the study hospitals with an injury severity score ≥16 were enrolled in this retrospective, observational, multicenter study of coagulation in the acute phase of severe trauma...
October 5, 2016: American Journal of Emergency Medicine
Stephen S Humble, Laura D Wilson, John W McKenna, Taylor C Leath, Yanna Song, Mario A Davidson, Jesse M Ehrenfeld, Oscar D Guillamondegui, Pratik P Pandharipande, Mayur B Patel
OBJECTIVE: To determine risk factors associated with tracheostomy placement after severe traumatic brain injury (TBI) and subsequent outcomes among those who did and did not receive a tracheostomy. METHODS: This retrospective cohort study compared adult trauma patients with severe TBI (n = 583) who did and did not receive tracheostomy. A multivariable logistic regression model assessed the associations between age, sex, race, insurance status, admission GCS, AIS (Head, Face, Chest) and tracheostomy placement...
October 14, 2016: Brain Injury: [BI]
Stefan Candefjord, Johan Winges, Ahzaz Ahmad Malik, Yinan Yu, Thomas Rylander, Tomas McKelvey, Andreas Fhager, Mikael Elam, Mikael Persson
Traumatic brain injury is the leading cause of death and severe disability for young people and a major public health problem for elderly. Many patients with intracranial bleeding are treated too late, because they initially show no symptoms of severe injury and are not transported to a trauma center. There is a need for a method to detect intracranial bleedings in the prehospital setting. In this study, we investigate whether broadband microwave technology (MWT) in conjunction with a diagnostic algorithm can detect subdural hematoma (SDH)...
October 13, 2016: Medical & Biological Engineering & Computing
Ana Luiza Zaninotto, Jessica Elias Vicentini, Davi Jorge Fontoura Solla, Tatiana Tateishi Silva, Vinicius Monteiro de Paula Guirado, Fabrício Feltrin, Mara Cristina Souza de Lucia, Manoel Jacobsen Teixeira, Wellingson Silva Paiva
OBJECTIVE: Diffuse axonal injury (DAI) is prevalent in traumatic brain injury (TBI), and is often associated with poor outcomes and cognitive impairment, including memory deficits. Few studies have explored visual memory after TBI and its relationship to executive functioning. Executive functioning is crucial for remembering an object's location, operating devices, driving, and route finding. We compared visual memory performance via the Rey-Osterrieth Complex Figure (ROCF) test 6 and 12 months after DAI...
October 11, 2016: Acta Neuropsychiatrica
Ranabir Pal, Ashok Munivenkatappa, Amit Agrawal, Geetha R Menon, Sagar Galwankar, P Rama Mohan, S Satish Kumar, B V Subrahmanyam
BACKGROUND: A reliable prediction of outcome for the victims of traumatic brain injury (TBI) on admission is possible from concurrent data analysis from any systematic real-time registry. OBJECTIVE: To determine the clinical relevance of the findings from our TBI registry to develop prognostic futuristic models with readily available traditional and novel predictors. MATERIALS AND METHODS: Prospectively collected data using predesigned pro forma were analyzed from the first phase of a trauma registry from a South Indian Trauma Centre, compatible with computerized management system at electronic data entry and web data entry interface on demographics, clinical, management, and discharge status...
July 2016: International Journal of Critical Illness and Injury Science
Naranpurev Mendsaikhan, Tsolmon Begzjav, Ganbold Lundeg, Martin W Dünser
CONTEXT: The epidemiology and outcome of critical illness in Mongolia remain undefined. AIM: The aim of this study was to evaluate the epidemiology and outcome of critical illness in Mongolia. SETTINGS AND DESIGN: This is a multicenter, prospective, observational cohort study including 19 Mongolian centers. MATERIALS AND METHODS: Demographic, clinical, and outcome data of patients >15 years admitted to the Intensive Care Units (ICUs) were collected during a 6-month period...
July 2016: International Journal of Critical Illness and Injury Science
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
Tony Rosen, Sunday Clark, Elizabeth M Bloemen, Mary R Mulcare, Michael E Stern, Jeffrey E Hall, Neal E Flomenbaum, Mark S Lachs, Soumitra R Eachempati
INTRODUCTION: While geriatric trauma patients have begun to receive increased attention, little research has investigated assault-related injuries among older adults. Our goal was to describe characteristics, treatment, and outcomes of geriatric assault victims and compare them both to geriatric victims of accidental injury and younger assault victims. PATIENTS AND METHODS: We conducted a retrospective analysis of the 2008-2012 National Trauma Data Bank. We identified cases of assault-related injury admitted to trauma centers in patients aged ≥60 using the variable "intent of injury...
September 3, 2016: Injury
C Ganos, M J Edwards, K P Bhatia
Traumatic injury to the nervous system may account for a range of neurologic symptoms. Trauma location and severity are important determinants of the resulting symptoms. In severe head injury with structural brain abnormalities, the occurrence of trauma-induced movement disorders, most commonly hyperkinesias such as tremor and dystonia, is well recognized and its diagnosis straightforward. However, the association of minor traumatic events, which do not lead to significant persistent structural brain damage, with the onset of movement disorders is more contentious...
2017: Handbook of Clinical Neurology
Kai Oliver Jensen, Leonhard Held, Andrea Kraus, Frank Hildebrand, Philipp Mommsen, Ladislav Mica, Guido A Wanner, Peter Steiger, Rudolf M Moos, Hans-Peter Simmen, Kai Sprengel
BACKGROUND: Although under discussion, induced hypothermia (IH) is an established therapy for patients with cardiac arrest or traumatic brain injuries. The influences on coagulopathy and bleeding tendency in severely injured patients (SIP) with concomitant traumatic brain injury are most widely unclear. Therefore, the aim of this study was to quantify the effect of mild IH in SIP with concomitant severe traumatic brain injuries on transfusion rate and mortality. METHODS: In this retrospective multi-centre study, SIP from three European level-1 trauma centres with an ISS ≥16 between 2009 and 2011 were included...
October 6, 2016: European Journal of Medical Research
Elham Shafiei, Esmaeil Fakharian, Abdollah Omidi, Hossein Akbari, Ali Delpisheh
BACKGROUND: It is well-known that severe brain injury can make people susceptible to psychological symptoms. However, mild traumatic brain injury (MTBI) is still open for discussion. OBJECTIVES: This study aimed to compare psychological symptoms of MTBI patients with those without MTBI considering demographic auxiliary variables. PATIENTS AND METHODS: This prospective cohort study was conducted on 50 MTBI patients and 50 healthy subjects aged 15 - 65 years...
June 2016: Archives of Trauma Research
Alison Halstrom, Ellen MacDonald, Claire Neil, Glenn Arendts, Daniel Fatovich, Melinda Fitzgerald
Traumatic brain injury (TBI) encompasses a broad range of injury mechanisms and severity. A detailed determination of TBI severity can be a complex challenge, with current clinical tools sometimes insufficient to tailor a clinical response to a spectrum of patient needs. Blood biomarkers of TBI may supplement clinical assessments but currently available biomarkers have limited sensitivity and specificity. While oxidative stress is known to feature in damage mechanisms following TBI, investigation of blood biomarkers of oxidative stress has been limited...
September 30, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Deepak Kumar Gupta, Ajay Bisht, Priyam Batra, Purva Mathur, Ashok Kumar Mahapatra
BACKGROUND: The management of traumatic brain injury (TBI) aims to maintain the normal cerebral perfusion in spite of the mass lesions that may occur (haematoma, contusion, and oedema). The monitoring of the intracranial pressure (ICP) is a step in that direction. The intra-parenchymal catheters have the lowest incidence of infection compared to intra-ventricular/subdural catheters with reliable and accurate pressure recordings. The major disadvantage of the intra-parenchymal catheters is the cost, especially in developing nations...
October 2016: Asian Journal of Neurosurgery
Hakan Aylanç, Filiz Tütüncüler, Necdet Süt
BACKGROUND: This study was to determine whether pituitary dysfunction occurs after head trauma in children or not and which axis is affected more; to define the association of pituitary dysfunction with the severity of head trauma and duration time after the diagnosis of head trauma. MATERIALS AND METHODS: In this study, 24 children who were diagnosed with head trauma were evaluated regarding pituitary dysfunction. In all cases, after 12 h fasting, serum cortisol, fT3, fT4, thyroid-stimulating hormone, prolactin, insulin-like growth factor-1, serum sodium, urine density, follicle-stimulating hormone, luteinizing hormone, in female cases E2, in male cases, TT levels were determined...
October 2016: Journal of Neurosciences in Rural Practice
Vineet Kumar Kamal, Deepak Agrawal, Ravindra Mohan Pandey
INTRODUCTION: Traumatic brain injury (TBI) is a leading cause of mortality, morbidity, disability, and socioeconomic losses in the Indian subcontinent. However, for policymaking and research, there is a lack of reliable and larger data in our settings. AIMS AND OBJECTIVES: To evaluate and describe the epidemiological, clinical characteristics, and outcomes of patients with TBI in a Level 1 Trauma Center in India. MATERIALS AND METHODS: In this retrospective study, all patients with moderate or severe TBI, based on emergency department Glasgow Coma Scale, admitted to neurosurgery Intensive Care Unit (ICU) during May 2010-July 2012 were evaluated to provide detailed information on TBI-related variables and outcomes using descriptive statistics...
October 2016: Journal of Neurosciences in Rural Practice
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