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Minor tBI

Tara Rhine, Shari L Wade, Nanhua Zhang, Huaiyu Zang, Stephanie Kennebeck, Lynn Babcock
OBJECTIVES: Care decisions for young children presenting to the emergency department (ED) with head injury are often challenging (e.g. whether to obtain neuroimaging). We sought to identify factors associated with acute management of children at-risk for clinically important traumatic brain injury (ciTBI) and describe symptom management. METHODS: Observational evaluation of children, ages 0-4years, presenting to a pediatric ED following minor head injury. Children with ≥1 risk element per the Pediatric Emergency Care Academic Research Network's decision rule were deemed "at-risk" for ciTBI...
January 31, 2018: American Journal of Emergency Medicine
Louise M Crowe, Stephen Hearps, Vicki Anderson, Meredith Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Ed Oakley, Stuart R Dalziel, Franz E Babl
OBJECTIVE: To prospectively compare the proportion of traumatic brain injuries (TBIs) that would be classified as 'mild' using different published definitions by applying published definitions of mild TBI to a large prospectively collected dataset and to examine the variability in the proportions included by various definitions. High rates of mild TBI in children makes it a major public health issue, however, there is a wide variation in how mild TBI is defined in literature and guidelines...
January 30, 2018: Archives of Physical Medicine and Rehabilitation
Donald C Olsen, Chelsea C Hays, Henry J Orff, Amy J Jak, Elizabeth W Twamley
PRIMARY OBJECTIVE: About 20% of Iraq and Afghanistan Veterans have sustained a traumatic brain injury (TBI), which can result in postconcussive symptoms and difficulty transitioning from the military to civilian employment and postsecondary education. To better inform programs help Veterans transition back into civilian life, we evaluated correlates of employment and postsecondary education enrolment among treatment-seeking Veterans with a history of TBI. RESEARCH DESIGN: A cross-sectional design, using an archival database of VA medical records, was used to answer these research questions...
January 25, 2018: Brain Injury: [BI]
Erkut N Kucukboyaci, Coralynn Long, Michelle Smith, Joseph F Rath, Tamara Bushnik
OBJECTIVE: To analyze the complex relationship between various social indicators that contribute to socioeconomic status and healthcare barriers. DESIGN: Cluster analysis of historical patient data obtained from inpatient visits. SETTING: Setting: Inpatient rehabilitation unit in a large, urban university hospital PARTICIPANTS: Adult patients receiving acute inpatient care, predominantly for closed head injury. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: We examined the membership of TBI patients in various "vulnerable group" (VG) clusters (e...
January 6, 2018: Archives of Physical Medicine and Rehabilitation
Galit Gincberg, Esther Shohami, Victoria Trembovler, Alexander G Alexandrovich, Philip Lazarovici, Uriel Elchalal
BACKGROUND AIMS: Human umbilical cord blood (HUCB) is an important source of stem cells for therapy of hematopoietic disorders and is a potential therapy for various neurological disorders, including traumatic brain injury (TBI). The expression of nerve growth factor (NGF) and its receptors TrkA, p75NTR and α9β1 integrin on an HUCB CD45+ pan-hematopoietic subpopulation was investigated in the context of its neurotherapeutic potential after TBI. METHODS: NGF and its receptors were detected on CD45+ cells by reverse transcriptase polymerase chain reaction, flow cytometry analysis and confocal microscopy...
February 2018: Cytotherapy
Thomas Beez, Hans-Jakob Steiger, Nima Etminan
BACKGROUND: The effectiveness of pharmacological strategies exclusively targeting secondary brain damage (SBD) following ischemic stroke, aneurysmal subarachnoid hemorrhage, aSAH, intracerebral hemorrhage (ICH), traumatic brain injury (TBI) and bacterial meningitis is unclear. This meta-analysis studied the effect of SBD targeted treatment on clinical outcome across the pathological entities. METHODS: Randomized, controlled, double-blinded trials on aforementioned entities with 'death' as endpoint were identified...
December 7, 2017: BMC Neurology
Megan Moore, Nathalia Jimenez, Janessa M Graves, Tessa Rue, Jesse R Fann, Frederick P Rivara, Monica S Vavilala
OBJECTIVE: To examine racial differences in mental health service utilization after hospitalization for traumatic brain injury (TBI) among children with Medicaid insurance. DESIGN AND MAIN MEASURES: Retrospective analysis of the MarketScan Multi-State Medicaid database from 2007 to 2012 was performed. Outpatient mental health service utilization (psychiatric and psychological individual and group services) was compared at TBI hospitalization, from discharge to 3 months and from 4 to 12 months after discharge, between children of non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, and "Other" racial groups...
November 29, 2017: Journal of Head Trauma Rehabilitation
Thomas M Woodcock, Tony Frugier, Tan Thanh Nguyen, Bridgette Deanne Semple, Nicole Bye, Matteo Massara, Benedetta Savino, Roberta Besio, Cristina Sobacchi, Massimo Locati, Maria Cristina Morganti-Kossmann
The atypical chemokine receptor ACKR2 promotes resolution of acute inflammation by operating as a scavenger receptor for inflammatory CC chemokines in several experimental models of inflammatory disorders, however its role in the brain remains unclear. Based on our previous reports of increased expression of inflammatory chemokines and their corresponding receptors following traumatic brain injury (TBI), we hypothesised that ACKR2 modulates neuroinflammation following brain trauma and that its deletion exacerbates cellular inflammation and chemokine production...
2017: PloS One
Carl Marincowitz, Fiona Lecky, William Townend, Aditya Borakati, Trevor Sheldon
BACKGROUND: The optimal management of minor head injured patients with brain injury identified by CT imaging is unclear. Some guidelines recommend routine hospital admission of GCS13-15 patients with traumatic brain (TBI) injury identified by CT imaging. Others argue that selected lower-risk patients can be discharged from the Emergency Department (ED). OBJECTIVE: To estimate the risk of death, neurosurgery and clinical deterioration minor head injured patients with TBI identified by CT imaging, and assess which factors affect the risk of these outcomes...
December 2017: Emergency Medicine Journal: EMJ
Anneliese Synnot, Marisa Chau, Veronica Pitt, Denise O'Connor, Russell L Gruen, Jason Wasiak, Ornella Clavisi, Loyal Pattuwage, Kate Phillips
BACKGROUND: Skeletal muscle spasticity is a major physical complication resulting from traumatic brain injury (TBI), which can lead to muscle contracture, joint stiffness, reduced range of movement, broken skin and pain. Treatments for spasticity include a range of pharmacological and non-pharmacological interventions, often used in combination. Management of spasticity following TBI varies from other clinical populations because of the added complexity of behavioural and cognitive issues associated with TBI...
November 22, 2017: Cochrane Database of Systematic Reviews
Navneet Singh, Ash Singhal
INTRODUCTION: Pediatric head trauma is one of the commonest presentations to emergency departments. Over 90% of such head injuries are considered mild, but still present risk acute clinical deterioration and longer term morbidity. Identifying which children are at risk of clinically important brain injuries remains challenging and much of the data on minor head injuries is based on the adult population. CHALLENGES IN PEDIATRICS: Children, however, are different, both anatomically and in terms of mechanism of injury, to adults and, even within the pediatric group, there are differences with age and stage of development...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Marie Manfiotto, Carmine Mottolese, Alexandru Szathmari, Pierre-Aurelien Beuriat, Olivier Klein, Matthieu Vinchon, Edouard Gimbert, Thomas Roujeau, Didier Scavarda, Michel Zerah, Federico Di Rocco
INTRODUCTION: Decompressive craniectomy (DC) is a lifesaving procedure but is associated to several post-operative complications, namely cerebrospinal fluid (CSF) dynamics impairment. The aim of this multicentric study was to evaluate the incidence of such CSF alterations after DC and review their impact on the overall outcome. MATERIAL AND METHODS: We performed a retrospective multicentric study to analyze the CSF disorders occurring in children aged from 0 to 17 years who had undergone a DC for traumatic brain injury (TBI) in the major Departments of Pediatric Neurosurgery of France between January 2006 and August 2016...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Sara M Lippa, Tracey A Brickell, Jason M Bailie, Louis M French, Jan E Kennedy, Rael T Lange
OBJECTIVE: Examine effects of diagnostically relevant posttraumatic stress disorder (PTSD) symptoms, mild traumatic brain injury (TBI) severity, and associated bodily injury severity on postconcussion symptom reporting in female service members (SM) compared with a matched sample of male SM. SETTING: Six US military medical treatment facilities. PARTICIPANTS: A total of 158 SM (79 females, 79 males) evaluated within 30 months after mild TBI...
October 27, 2017: Journal of Head Trauma Rehabilitation
Navneet Singh, Ash Singhal
The published version of this article unfortunately contained an error.An error in the Abstract was introduced during corrections stage when a "Conclusion" section appended is from a different article and was not provided from authors.
October 7, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Melloney L M Wijenberg, Sven Z Stapert, Jeanine A Verbunt, Jennie L Ponsford, Caroline M Van Heugten
BACKGROUND: A minority of patients with mild traumatic brain injury (mTBI) experience a persistent symptom complex also known as post-concussion syndrome. Explanations for this syndrome are still lacking. OBJECTIVE: To investigate if the fear avoidance model, including catastrophizing thoughts and fear avoidance behaviour, poses a possible biopsychosocial explanation for lingering symptoms and delay in recovery after traumatic brain injury (TBI) with special focus on mTBI...
2017: Brain Injury: [BI]
Victoria M Scicluna, Mohammed K Ali, Rebecca D Pentz, David W Wright, Neal W Dickert
BACKGROUND: Community consultation (CC) is required for research in emergency settings using an exception from informed consent (EFIC) in the United States, but uncertainty persists regarding best CC practices. There is ongoing debate about whom to include in CC, specifically, whether to prioritize geographically defined communities or individuals with connections to the condition. Understanding the impact of personal disease experience on views of EFIC research is important for designing CC and interpreting its results...
April 2017: AJOB Empirical Bioethics
Mieszko Olczak, Justyna Niderla-Bielińska, Magdalena Kwiatkowska, Dorota Samojłowicz, Sylwia Tarka, Teresa Wierzba-Bobrowicz
MAPT is a neuronal protein that plays an important role in axonal stabilization, neuronal development, and neuronal polarity. MAPT release into the CSF and blood has been interpreted as indicative of axonal injury as its elevated levels were observed in olympic boxers even after a mild head trauma suggesting minor CNS injuries. In our study we wanted to check the potential relevance of MAPT examination for forensic purposes. The study was carried out using cases of head injury group and cases of sudden death (cardiopulmonary failure, no injuries of the head - control group) provided by forensic pathologists at the Department of Forensic Medicine, Medical University of Warsaw...
November 2017: Forensic Science International
Shiyao Gao, Raj G Kumar, Stephen R Wisniewski, Anthony Fabio
OBJECTIVE: To characterize racial/ethnic and insurance disparities in the utilization of healthcare services among US adults with traumatic brain injury (TBI). METHODS: The PubMed database was used to search for articles that directly examined the association between race/ethnicity and insurance disparities and healthcare utilization among patients with TBI. Eleven articles that met the criteria and were published between June 2011 and June 2016 were finally included in the review...
September 18, 2017: Journal of Head Trauma Rehabilitation
Renana Gelernter, Giora Weiser, Eran Kozer
BACKGROUND: Large studies which developed decision rules for the use of Computed tomography (CT) in children with minor head trauma excluded children with late presentation (more than 24h). OBJECTIVE: To assess the prevalence of significant traumatic brain injury (TBI) on CT in infants with head trauma presenting to the emergency department (ED) more than 24h from the injury. METHODS: A retrospective chart review of infants less than 24 months old referred for head CT because of traumatic brain injury from January 2004 to December 2014 in Assaf-Harofeh medical center was conducted...
September 11, 2017: Injury
Stefania Schiavone, Margherita Neri, Luigia Trabace, Emanuela Turillazzi
Pharmacological interventions for traumatic brain injury (TBI) are limited. Together with parvalbumin (PV) loss, increased production of reactive oxygen species (ROS) by the NADPH oxidase NOX enzymes represents a key step in TBI. Here, we investigated the contribution of NOX2-derived oxidative stress to the loss of PV immunoreactivity associated to TBI, performing immunohistochemistry for NOX2, 8-hydroxy-2'-deoxyguanosine (8OHdG) and PV on post mortem brain samples of subjects died following TBI, subjects died from spontaneous intracerebral hemorrhage (SICH) and controls (CTRL)...
August 18, 2017: Scientific Reports
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