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severe trauma brain injury

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https://www.readbyqxmd.com/read/28430697/abusive-head-trauma-and-mortality-an-analysis-from-an-international-comparative-effectiveness-study-of-children-with-severe-traumatic-brain-injury
#1
Nikki Miller Ferguson, Ajit Sarnaik, Darryl Miles, Nadeem Shafi, Mark J Peters, Edward Truemper, Monica S Vavilala, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Patrick M Kochanek
OBJECTIVES: Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. DESIGN: First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28429407/spinal-cord-injury-induces-widespread-chronic-changes-in-cerebral-white-matter
#2
Tero Ilvesmäki, Eerika Koskinen, Antti Brander, Teemu Luoto, Juha Öhman, Hannu Eskola
Traumatic spinal cord injuries (SCIs) lead to axonal damage at the trauma site, as well as disconnections within the central nervous system. While the exact mechanisms of the long-term pathophysiological consequences of SCIs are not fully understood, it is known that neuronal damage and degeneration are not limited to the direct proximity of the trauma. Instead, the effects can be detected even in the cerebrum. We examined SCI-induced chronic brain changes with a case-control design using 32 patients and 70 control subjects...
April 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28429381/the-structural-connectome-of-children-with-traumatic-brain-injury
#3
Marsh Königs, L W Ernest van Heurn, Roel Bakx, R Jeroen Vermeulen, J Carel Goslings, Bwee Tien Poll-The, Marleen van der Wees, Coriene E Catsman-Berrevoets, Jaap Oosterlaan, Petra J W Pouwels
This study aimed to investigate the impact of mild to severe pediatric TBI on the structural connectome. Children aged 8-14 years with trauma control (TC) injury (n = 27) were compared to children with mild TBI and risk factors for complicated TBI (mild(RF+) , n = 20) or moderate/severe TBI (n = 16) at 2.8 years post-injury. Probabilistic tractography on diffusion tensor imaging data was used in combination with graph theory to study structural connectivity. Functional outcome was measured using neurocognitive tests and parent and teacher questionnaires for behavioral functioning...
April 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28429236/the-course-of-headache-in-patients-with-moderate-to-severe-headache-due-to-mild-traumatic-brain-injury-a-retrospective-cross-sectional-study
#4
Chang-Ki Hong, Jin-Yang Joo, Yu Shik Shim, Sook Young Sim, Min A Kwon, Yong Bae Kim, Joonho Chung
BACKGROUND: Little is known about the long-term course of headache in patients with moderate-to-severe headache due to traumatic brain injury (TBI). We evaluated the course of headache in patients with moderate-to-severe headache due to mild TBI. METHODS: Since September 2009, patients with TBI prospectively rated their headache using a numeric rating scale (NRS). From the database containing 935 patients with TBI between September 2009 and December 2013, 259 patients were included according to following criteria: (1) newly onset moderate-to-severe headache (NRS ≥ 4) due to head trauma; (2) age ≥ 15 years; (3) Glasgow Coma Scale ≥ 13; (4) transient loss of consciousness ≤ 30 min; and (5) radiographic evaluation, such as computed tomography or magnetic resonance image...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28422895/diffusion-tensor-tractography-for-detection-of-concomitant-traumatic-brain-injury-in-patients-with-traumatic-spinal-cord-injury
#5
Sung Ho Jang, Sang Ho Ahn, Yun Woo Cho, Ji Woon Lim, Ik Tae Cho
OBJECTIVES: We investigated concomitant traumatic brain injury in patients with traumatic spinal cord injury (TSCI) who had head trauma history, using diffusion tensor tractography (DTT). DESIGN: Retrospective survey. PARTICIPANTS: We recruited 14 consecutive patients with TSCI and coexisting head trauma history at the time of TSCI and 30 control subjects. METHODS: The corticospinal tract (CST), corticoreticulospinal tract (CRT), cingulum, and fornix were reconstructed using DTT, and DTT parameters (fractional anisotropy and fiber volume) and configuration were estimated...
January 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28419114/h-fabp-a-new-biomarker-to-differentiate-between-ct-positive-and-ct-negative-patients-with-mild-traumatic-brain-injury
#6
Linnéa Lagerstedt, Juan José Egea-Guerrero, Alejandro Bustamante, Joan Montaner, Ana Rodríguez-Rodríguez, Amir El Rahal, Natacha Turck, Manuel Quintana, Roser García-Armengol, Carmen Melinda Prica, Elisabeth Andereggen, Lara Rinaldi, Asita Sarrafzadeh, Karl Schaller, Jean-Charles Sanchez
The majority of patients with mild traumatic brain injury (mTBI) will have normal Glasgow coma scale (GCS) of 15. Furthermore, only 5%-8% of them will be CT-positive for an mTBI. Having a useful biomarker would help clinicians evaluate a patient's risk of developing intracranial lesions. The S100B protein is currently the most studied and promising biomarker for this purpose. Heart fatty-acid binding protein (H-FABP) has been highlighted in brain injury models and investigated as a biomarker for stroke and severe TBI, for example...
2017: PloS One
https://www.readbyqxmd.com/read/28416561/requirements-for-and-current-provision-of-rehabilitation-services-for-children-after-severe-acquired-brain-injury-in-the-uk-a-population-based-study
#7
Louise Hayes, Simon Shaw, Mark S Pearce, Rob J Forsyth
OBJECTIVES: Survival with brain injury is an outcome of severe illness that may be becoming more common. Provision for children in this situation has received little attention. We sought to estimate rates of severe paediatric acquired brain injury (ABI) requiring rehabilitation and to describe current provision of services for these children in the UK. METHODS: This study conducted an analysis of Hospital Episode Statistics data between April 2003 and March 2012, supplemented by a UK provider survey completed in 2015...
April 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28406438/u-s-trends-of-ed-visits-for-pediatric-traumatic-brain-injuries-implications-for-clinical-trials
#8
Cheng Chen, Junxin Shi, Rachel M Stanley, Eric A Sribnick, Jonathan I Groner, Henry Xiang
Our goal in this paper was to use the 2006-2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of annual patient number, patient demographics and hospital characteristics of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments (EDs); and to use the same database to estimate the available sample sizes for various clinical trials of pediatric TBI cases. National estimates of patient demographics and hospital characteristics were calculated for pediatric TBI...
April 13, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28400228/keen-s-point-for-external-ventricular-drainage-in-traumatic-brain-injury-patients-an-uncommon-indication-for-an-old-technique
#9
Kevin T Huang, Vamsidhar Chavakula, William B Gormley
BACKGROUND: In cases of severe traumatic brain injury (TBI), cerebrospinal fluid (CSF) diversion though an external ventricular drain (EVD) is a proven method to assist in the control of elevated intracranial pressure (ICP). Under normal circumstances, the EVD is placed in a frontal location. However, in cases of multifocal intracranial injury and swelling, collapse of the frontal horns of the lateral ventricles leads to frequent failure of frontal CSF drainage. In this series we describe the utility of the Keen's point EVD as a safe alternative to maintain continuous CSF diversion for patients in whom frontal drainage is not feasible...
April 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28398926/early-systolic-dysfunction-following-traumatic-brain-injury-a-cohort-study
#10
Vijay Krishnamoorthy, Ali Rowhani-Rahbar, Edward F Gibbons, Frederick P Rivara, Nancy R Temkin, Crystal Pontius, Kevin Luk, Morgan Graves, Danielle Lozier, Nophanan Chaikittisilpa, Taniga Kiatchai, Monica S Vavilala
OBJECTIVE: Prior studies have suggested that traumatic brain injury may affect cardiac function. Our study aims were to determine the frequency, longitudinal course, and admission risk factors for systolic dysfunction in patients with moderate-severe traumatic brain injury. DESIGN: Prospective cohort study. SETTING: Level 1 trauma center. MEASUREMENTS: Transthoracic echocardiogram within 1 day and over the first week after moderate-severe traumatic brain injury; transthoracic echocardiogram within 1 day after mild traumatic brain injury (comparison group)...
April 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28396009/molecular-mechanisms-of-brain-derived-neurotrophic-factor-in-neuro-protection-recent-developments
#11
REVIEW
Hailin Zhao, Azeem Alam, Chun-Yin San, Shiori Eguchi, Qian Chen, Qingquan Lian, Daqing Ma
Neuronal cell injury, as a consequence of acute or chronic neurological trauma, is a significant cause of mortality around the world. On a molecular level, the condition is characterized by widespread cell death and poor regeneration, which can result in severe morbidity in survivors. Potential therapeutics are of major interest, with a promising candidate being brain-derived neurotrophic factor (BDNF), a ubiquitous agent in the brain which has been associated with neural development and may facilitate protective and regenerative effects following injury...
April 7, 2017: Brain Research
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#12
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries. OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach. METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma"...
April 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28389734/-intensive-care-treatment-of-traumatic-brain-injury-in-multiple-trauma-patients-decision-making-for-complex-pathophysiology
#13
H Trimmel, G Herzer, H Schöchl, W G Voelckel
Traumatic brain injury (TBI) and hemorrhagic shock due to uncontrolled bleeding are the major causes of death after severe trauma. Mortality rates are threefold higher in patients suffering from multiple injuries and additionally TBI. Factors known to impair outcome after TBI, namely hypotension, hypoxia, hypercapnia, acidosis, coagulopathy and hypothermia are aggravated by the extent and severity of extracerebral injuries. The mainstays of TBI intensive care may be, at least temporarily, contradictory to the trauma care concept for multiple trauma patients...
April 7, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28389109/problem-solving-following-traumatic-brain-injury-in-adolescence-associations-with-functional-outcomes
#14
Shari L Wade, Amy E Cassedy, Lauren E Fulks, H Gerry Taylor, Terry Stancin, Michael W Kirkwood, Keith O Yeates, Brad G Kurowski
OBJECTIVE: To examine the association of problem solving with functioning in youth with traumatic brain injury (TBI). DESIGN: Cross-sectional evaluation of pre-treatment data from a randomized clinical trial. SETTING: Four children's hospitals and one general hospital, with level 1 trauma units. PARTICIPANTS: Youth, ages 11 to 18, who sustained moderate or severe TBI in the past 18 months (n = 133). MAIN OUTCOME AND MEASURES: Problem-solving skills were assessed using the Social Problem Solving Inventory (SPSI) and the Dodge Social Information Processing Short Stories (SIP-SR)...
April 4, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28387644/medical-necessity-of-routine-admission-of-children-with-mild-traumatic-brain-injury-to-the-intensive-care-unit
#15
Jared D Ament, Krista N Greenan, Patrick Tertulien, Joseph M Galante, Daniel K Nishijima, Marike Zwienenberg
OBJECTIVE Approximately 475,000 children are treated for traumatic brain injury (TBI) in the US each year; most are classified as mild TBI (Glasgow Coma Scale [GCS] Score 13-15). Patients with positive findings on head CT, defined as either intracranial hemorrhage or skull fracture, regardless of severity, are often transferred to tertiary care centers for intensive care unit (ICU) monitoring. This practice creates a significant burden on the health care system. The purpose of this investigation was to derive a clinical decision rule (CDR) to determine which children can safely avoid ICU care...
April 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28385926/critical-care-air-transport-team-severe-traumatic-brain-injury-short-term-outcomes-during-flight-for-operation-iraqi-freedom-operation-enduring-freedom
#16
L Renee Boyd, J Borawski, J Lairet, A T Limkakeng
INTRODUCTION: Our understanding of the expertise and equipment required to air transport injured soldiers with severe traumatic brain injuries (TBIs) continue to evolve. METHODS: We conducted a retrospective chart review of characteristics, interventions required and short-term outcomes of patients with severe TBI managed by the US Air Force Critical Care Air Transport Teams (CCATTs) deployed in support of Operation Iraqi Freedom and Operation Enduring Freedom between 1 June 2007 and 31 August 2010...
April 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28385104/prolonged-cerebrospinal-fluid-neurofilament-light-chain-increase-in-patients-with-post-traumatic-disorders-of-consciousness
#17
Sergio Bagnato, Luigi M E Grimaldi, Giorgio Di Raimondo, Antonino Sant'Angelo, Cristina Boccagni, Vittorio Virgilio, Maria Andriolo
The mechanisms involved in secondary brain injury after the acute phase of severe traumatic brain injury (TBI) are largely unknown. Ongoing axonal degeneration, consequent to the initial trauma, may lead to secondary brain injury. To test this hypothesis, we evaluated the cerebrospinal fluid (CSF) level of neurofilament light chain (NF-L), a proposed marker of axonal degeneration, in ten patients who developed a severe disorder of consciousness after a TBI, including seven in a minimally conscious state and three with unresponsive wakefulness syndrome (time since brain injury 309 ± 169 days)...
April 7, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28384927/inflammation-and-outcome-in-traumatic-brain-injury-does-gender-effect-on-survival-and-prognosis
#18
Taraneh Naghibi, Mina Mohajeri, Faramarz Dobakhti
INTRODUCTION: Traumatic Brain Injury (TBI) accounts for the majority of trauma deaths and there has been increased interest in the understanding the role of prognostic factors. C-Reactive Protein (CRP) level increases rapidly in response to trauma. AIM: Aim of the present study was to indicate the role of CRP as a predictor of outcome in TBI patients based on their gender category. MATERIALS AND METHODS: A prospective cohort study in a surgical Intensive Care Unit (ICU) in one of the Zanjan University of Medical Science hospital was designed...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383469/the-neurovascular-complexity-index-as-a-potential-indicator-of-traumatic-brain-injury-severity-a-case-series-study
#19
Jeffrey T Howard, Jud C Janak, Vladislav Bukhman, Claudia Robertson, Iurii Frolov, Corinne D Nawn, Alicia M Schiller, Victor A Convertino
BACKGROUND: Multimodal monitoring of brain physiology following a traumatic brain injury (TBI) shows promise as a strategy to improve management and outcomes of TBI patients within civilian and military trauma. Valid and reliable measures of different aspects of brain physiology following a TBI could prove critical to accurately capturing these changes. METHODS: Using a case-series design with a healthy control group comparison, we evaluated a new proprietary algorithm called the neurovascular complexity index (NCI) using transcranial Doppler to noninvasively obtain measures of cerebral blood flow variability (CBFV)...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28382259/traumatic-tension-pneumocephalus-two-cases-and-comprehensive-review-of-literature
#20
REVIEW
Promod Pillai, Rohit Sharma, Larami MacKenzie, Eugene F Reilly, Paul R Beery, Thomas J Papadimos, Stanislaw Peter A Stawicki
Although traumatic pneumocephalus is not uncommon, it rarely evolves into tension pneumocephalus (TP). Characterized by the presence of increasing amounts of intracranial air and concurrent appearance or worsening neurological symptoms, TP can be devastating if not recognized and treated promptly. We present two cases of traumatic TP and a concise review of literature on this topic. Two cases of traumatic TP are presented. In addition, a literature search revealed 20 additional cases, of which 18 had sufficient information for inclusion...
January 2017: International Journal of Critical Illness and Injury Science
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