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Traumatic brain injury review

Alessandro Orlando, A Stewart Levy, Benjamin A Rubin, Allen Tanner, Matthew M Carrick, Mark Lieser, David Hamilton, Charles W Mains, David Bar-Or
OBJECTIVE Isolated subdural hematomas (iSDHs) are one of the most common intracranial hemorrhage (ICH) types in the population with mild traumatic brain injury (mTBI; Glasgow Coma Scale score 13-15), account for 66%-75% of all neurosurgical procedures, and have one of the highest neurosurgical intervention rates. The objective of this study was to examine how quantitative hemorrhage characteristics of iSDHs in patients with mTBI at admission are associated with subsequent neurosurgical intervention. METHODS This was a 3...
June 15, 2018: Journal of Neurosurgery
Jesús A Morales-Gómez, Everardo Garcia-Estrada, Jorge E Leos-Bortoni, Miriam Delgado-Brito, Luis E Flores-Huerta, Adriana A De La Cruz-Arriaga, Luis J Torres-Díaz, Ángel R Martínez-Ponce de León
OBJECTIVE Cranioplasty implants should be widely available, low in cost, and customized or easy to mold during surgery. Although autologous bone remains the first choice for repair, it cannot always be used due to infection, fragmentation, bone resorption, or other causes, which led to use of synthetic alternatives. The most frequently used allogenic material for cranial reconstructions with long-term results is polymethylmethacrylate (PMMA). Three-dimensional printing technology has allowed the production of increasingly popular customized, prefabricated implants...
June 15, 2018: Journal of Neurosurgery
Alessandro Orlando, A Stewart Levy, Benjamin A Rubin, Allen Tanner, Matthew M Carrick, Mark Lieser, David Hamilton, Charles W Mains, David Bar-Or
OBJECTIVE A paucity of studies have examined neurosurgical interventions in the mild traumatic brain injury (mTBI) population with intracranial hemorrhage (ICH). Furthermore, it is not understood how the dimensions of an ICH relate to the risk of a neurosurgical intervention. These limitations contribute to a lack of treatment guidelines. Isolated subdural hematomas (iSDHs) are the most prevalent ICH in mTBI, carry the highest neurosurgical intervention rate, and account for an overwhelming majority of all neurosurgical interventions...
June 15, 2018: Journal of Neurosurgery
D Jochems, L P H Leenen, F Hietbrink, R M Houwert, K J P van Wessem
INTRODUCTION: Central nervous system (CNS) related injuries and exsanguination have been the most common causes of death in trauma for decades. Despite improvements in haemorrhage control in recent years exsanguination is still a major cause of death. We conducted a prospective database study to investigate the current incidence of haemorrhage related mortality. MATERIALS AND METHODS: A prospective database study of all trauma patients admitted to an urban major trauma centre between January 2007 and December 2016 was conducted...
May 23, 2018: Injury
Karen Barlow, Michael M J Esser, Myra Veidt, Roslyn Boyd
Traumatic brain injury is common and yet effective treatments of the secondary brain injury are scarce. Melatonin is a potent, non-selective neuroprotective and anti-inflammatory agent that is showing promising results in neonatal brain injury. The aim of this study was to systematically evaluate the pre-clinical and clinical literature for the effectiveness of Melatonin to improve outcome after TBI. Using the systematic review protocol for animal intervention studies (SYRCLE) and Cochrane methodology for clinical studies, a search of English articles was performed...
June 14, 2018: Journal of Neurotrauma
Byung-Ho Yoon, In Keun Park, Yerl-Bo Sung
Purpose: Neurogenic myositis ossificans (NMO) in patients with traumatic spinal cord or brain injuries can cause severe joint ankylosis or compromise neurovascularture. The purpose of this study was to evaluate the clinical and radiological outcomes of and review considerations relevant to surgical resection of NMO of the hip joint. Materials and Methods: Six patients (9 hips) underwent periarticular NMO resection between 2015 and 2017. The medical records of these patients were retrospectively reviewed...
June 2018: Hip & Pelvis
Joseph Margolick, Charlotte Dandurand, Katrina Duncan, Wenjia Chen, David C Evans, Mypinder S Sekhon, Naisan Garraway, Donald E G Griesdale, Peter Gooderham, S Morad Hameed
BACKGROUND: Patients suffering from traumatic brain injury (TBI) are at increased risk of venous thromboembolism (VTE). However, initiation of pharmacological venous thromboprophylaxis (VTEp) may cause further intracranial hemorrhage. We reviewed the literature to determine the postinjury time interval at which VTEp can be administered without risk of TBI evolution and hematoma expansion. METHODS: MEDLINE and EMBASE databases were searched. Inclusion criteria were studies investigating timing and safety of VTEp in TBI patients not previously on oral anticoagulation...
June 13, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
William C Walker, Kayla J Nowak, Kimbra Kenney, Laura Manning Franke, Blessen C Eapen, Karen Skop, Harvey Levin, Amma A Agyemang, David F Tate, Elisabeth A Wilde, Sidney Hinds, Tracy L Nolen
OBJECTIVES: Determine if mild traumatic brain injury (mTBI) history is associated with balance disturbances. SETTING: Chronic Effects of Neurotrauma Consortium (CENC) centres. PARTICIPANTS: The CENC multi-centre study enrols post-9/11 era Service Members and Veterans with combat exposure. This sample (n = 322) consisted of enrolees completing initial evaluation by September 2016 at the three sites conducting computerized dynamic post-urography (CDP) testing...
June 12, 2018: Brain Injury: [BI]
Emily Nalder, Laura Hartman, Anne Hunt, Gillian King
There is a growing trend in traumatic brain injury (TBI) rehabilitation, and research, to focus on the processes of adaptation following the injury. Resiliency is an umbrella term describing the range of personal protective factors, environmental supports and resources, as well as self-regulatory processes, engaged in response to adversity. An affective, cognitive, and behavioural self-regulatory process model of resiliency in the workplace was adapted to suit the TBI context. Through a narrative review of the literature pertaining to brain injury rehabilitation, participation, and resilience, we substantiated the model, and explained how resiliency can frame research on life experiences following the injury...
June 12, 2018: Disability and Rehabilitation
Brandon Lucke Wold, Richard Nolan, Divine Nwafor, Linda Nguyen, Cletus Cheyuo, Ryan Turner, Charles Rosen, Robert Marsh
Posttraumatic Stress Disorder (PTSD) is a devastating condition that can develop after blast Traumatic Brain Injury (TBI). Ongoing work has been performed to understand how PTSD develops after injury. In this review, we highlight how PTSD affects individuals, discuss what is known about the physiologic changes to the hypothalamic pituitary axis and neurotransmitter pathways, and present an overview of genetic components that may predispose individuals to developing PTSD. We then provide an overview of current treatment strategies to treat PTSD in veterans and present new strategies that may be useful going forward...
2018: Journal of neuroscience and neuropharmacology
N O C Onyemaechi, O E Nwankwo, R A Ezeadawi
Background: The study aimed to describe the pattern of injuries among patients presenting at a tertiary care hospital in Enugu southeast Nigeria. Patients and Methods: A retrospective review of records of all injured patients seen in our hospital over a 12-month period was done. Results: A total of 789 patients had complete medical records and were included in the study. Road traffic accident (RTA) was the most common cause of injury. Lacerations/abrasions, fractures, and traumatic brain injury (TBI) were the most frequently seen injuries...
June 2018: Nigerian Journal of Clinical Practice
Michael H Bennett
This report is a product of the VA Evidence-based Synthesis Program. The purpose is to provide "timely and accurate syntheses of targeted healthcare topics …. to improve the health and healthcare of Veterans". The authors have made a comprehensive search and analysis of the literature and make recommendations to assist clinicians in dealing with veterans suffering from either traumatic brain injury (TBI) or post-traumatic stress disorder (PTSD). The report is timely and of great potential impact given the vigorous and lengthy debate among hyperbaric physicians and lay people determined to find an answer for the large numbers of veterans deeply affected with some combination of PTSD and post-concussion dysfunction...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
R Stolmeijer, H R Bouma, J G Zijlstra, A M Drost-de Klerck, J C Ter Maaten, J J M Ligtenberg
Introduction: Despite widespread and liberal use of oxygen supplementation, guidelines about rational use of oxygen are scarce. Recent data demonstrates that current protocols lead to hyperoxemia in the majority of the patients and most health care professionals are not aware of the negative effects of hyperoxemia. Method: To investigate the effects of hyperoxemia in acutely ill patients on clinically relevant outcomes, such as neurological and functional status as well as mortality, we performed a literature review using Medline (PubMed) and Embase...
2018: BioMed Research International
Hannah L Coyle, Jennie Ponsford, Kate E Hoy
The pathophysiology associated with mild traumatic brain injury (mTBI) includes neurometabolic and cytoskeletal changes that have been shown to impair structural and functional connectivity. Evidence that persistent neuropsychological impairments post injury are linked to structural and functional connectivity changes is increasing. However, to date the relationship between connectivity changes, heterogeneity of persistent symptoms and recovery post mTBI has been poorly characterised. Recent innovations in neuroimaging provide new ways of exploring connectivity changes post mTBI...
June 6, 2018: Neuroscience and Biobehavioral Reviews
Rachida Guennoun, Magalie Fréchou, Pauline Gaignard, Philippe Liere, Abdelhamid Slama, Michael Schumacher, Christian Denier, Claudia Mattern
Progesterone has been shown to be cerebroprotective in different experimental models of brain injuries and neurodegenerative diseases. The preclinical data provided great hope for its use in humans. The failure of Phase 3 clinical trials to demonstrate the cerebroprotective efficiency of progesterone in traumatic brain injury (TBI) patients emphasizes that different aspects of the design of both experimental and clinical studies should be reviewed and refined. One important aspect to consider is to test different routes of delivery of therapeutic agents...
June 6, 2018: Neuropharmacology
Christos Lazaridis, Craig G Rusin, Claudia S Robertson
Mortality or severe disability affects the majority of patients after severe traumatic brain injury (TBI). Adherence to the brain trauma foundation guidelines has overall improved outcomes; however, traditional as well as novel interventions towards intracranial hypertension and secondary brain injury have come under scrutiny after series of negative randomized controlled trials. In fact, it would not be unfair to say there has been no single major breakthrough in the management of severe TBI in the last two decades...
June 6, 2018: Neuropharmacology
Mark J Pandrich, Andreas K Demetriades
The biomechanical relationship between cranial and spinal structures makes concomitant injury likely. Concomitant cranio-spinal injuries are important to consider following trauma due to the serious consequences of a missed injury. The objective of this review was to estimate the prevalence of concomitant cranio-spinal injury in the adult trauma population. A systematic search of MEDLINE and EMBASE databases to identify observational studies reporting the prevalence of concomitant cranio-spinal injury in the general adult trauma population was conducted on 21 March 2017...
June 7, 2018: Neurosurgical Review
David B Douglas, Jonathan L Muldermans, Max Wintermark
PURPOSE OF REVIEW: The purpose of this review is to provide an update on advanced neuroimaging techniques in traumatic brain injury (TBI). We will focus this review on recent literature published within the last 18 months and the advanced neuroimaging techniques of perfusion imaging and diffusion tensor imaging (DTI). RECENT FINDINGS: In the setting of a moderate or severe acute closed head injury (Glasgow Coma Scale <13), the most appropriate neuroimaging study is a noncontrast computed tomography (CT) scan...
June 6, 2018: Current Opinion in Neurology
Emerson Wickwire, David M Schnyer, Anne Germain, Scott Williams, Christopher Lettieri, Ashlee McKeon, Steven Scharf, Ryan Stocker, Jennifer S Albrecht, Neeraj Badjatia, Amy Markowitz, Geoffrey Manley
A rapidly expanding scientific literature supports the frequent co-occurrence of sleep and circadian disturbances following mild traumatic brain injury (mTBI). Although many questions remain unanswered, the preponderance of evidence suggests that sleep and circadian disorders can result from mTBI. Among those with mTBI, sleep disturbances and clinical sleep and circadian disorders contribute to the morbidity and long-term sequelae across domains of functional outcomes and quality of life. Specifically, along with deterioration of neurocognitive performance, insufficient and disturbed sleep can precede, exacerbate, or perpetuate many of the other common sequelae of mTBI, including depression, post-traumatic stress disorder, and chronic pain...
June 7, 2018: Journal of Neurotrauma
Joanne Kacperski
Concussion, now most often referred to as mild traumatic brain injury in recent literature, is common in pediatrics, and headache is often the most common complaint post-injury. Although most children and adolescents recover within 1-2 weeks, some develop frequent and debilitating headaches that can last for months or longer. Most clinicians would agree on the importance of managing both acute and persistent posttraumatic headaches appropriately to speed recovery, minimize disability, maximize function, and improve quality of life, but there are no well-established guidelines to instruct physicians in doing so...
June 7, 2018: Paediatric Drugs
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