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Traumatic head injury

Stephanie M Wolahan, Mayumi L Prins, David L McArthur, Courtney R Real, David A Hovda, Neil A Martin, Paul M Vespa, Thomas C Glenn
BACKGROUND: The objective was to investigate the impact of targeting tight glycemic control (4.4-6.1 mM) on endogenous ketogenesis in severely head-injured adults. METHODS: The data were prospectively collected during a randomized, within-patient crossover study comparing tight to loose glycemic control, defined as 6.7-8.3 mM. Blood was collected periodically during both tight and loose glycemic control epochs. Post hoc analysis of insulin dose and total nutritional provision was performed...
October 19, 2016: Neurocritical Care
Chia-Ying Kuo, Hung-Yi Chiou, Jia-Wei Lin, Shin-Han Tsai, Mau-Roung Lin, Yung-Hsiao Chiang, Chien-Min Lin, Shu-Fen Chu, Tsan-Hon Liou, Wen-Ta Chiu
Objective Bicycle riding is increasingly popular in Taiwan, but the number of cyclists injured and cyclists' death rate are both increasing. The aim of this study was to investigate the different characteristics and clinical outcomes of traffic-accident related head injuries to cyclists in urban and rural areas. Methods Records of 812 patients (533 urban and 279 rural) admitted to 27 hospitals in Taipei City and Hualien County as the result of a traumatic head injury while bicycling between 1998 and 2013 were retrieved for study...
October 18, 2016: Traffic Injury Prevention
Sungbae Moon, Suk Hee Lee, Hyun Wook Ryoo, Jong Kun Kim, Jae Yun Ahn, Sung Jin Kim, Jae Cheon Jeon, Kyung Woo Lee, Ae Jin Sung, Yun Jeong Kim, Dae Ro Lee, Byung Soo Do, Sin Ryul Park, Jin-Seok Lee
OBJECTIVE: This study investigated the preventable death rate in Daegu, South Korea, and assessed affecting factors and preventable factors in order to improve the treatment of regional trauma patients. METHODS: All traumatic deaths between January 2012 and December 2012 in 5 hospitals in Daegu were analyzed by panel review, which were classified into preventable and non-preventable deaths. We determined the factors affecting trauma deaths and the preventable factors during trauma care...
December 2015: Clin Exp Emerg Med
Michael R Hamblin
Photobiomodulation (PBM) describes the use of red or near-infrared light to stimulate, heal, regenerate, and protect tissue that has either been injured, is degenerating, or else is at risk of dying. One of the organ systems of the human body that is most necessary to life, and whose optimum functioning is most worried about by humankind in general, is the brain. The brain suffers from many different disorders that can be classified into three broad groupings: traumatic events (stroke, traumatic brain injury, and global ischemia), degenerative diseases (dementia, Alzheimer's and Parkinson's), and psychiatric disorders (depression, anxiety, post traumatic stress disorder)...
December 2016: BBA Clinical
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
Enrico Bellato, Roberto Rotini, Alessandro Marinelli, Enrico Guerra, Shawn W O'Driscoll
BACKGROUND: Chronic coronoid deficiency can occur subsequent to coronoid fracture malunion/nonunion or to coronoid hypoplasia or dysplasia resulting from injury during development. Several surgical options have been described to treat this difficult condition, but results are equivocal. We hypothesized that a modified coronoid reconstruction using a radial head osteochondral graft could restore elbow stability and congruity and that a technique involving rigid internal fixation would promote graft union...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Eugene T H Ek, Sophia K Paul, Robert N Hotchkiss
BACKGROUND: The role of elbow contracture release in the very young is unclear, with existing studies reporting conflicting results. This study evaluated the long-term results after open elbow contracture release in patients aged younger than 18 years. METHODS: Between 1994 and 2012, 32 patients underwent open elbow contracture release at a mean age of 13.8 years (range, 5-18 years), and their outcomes were reviewed. The primary cause was traumatic in 30 patients (4 radial head/neck fractures, 5 intra-articular distal humeral fractures, 11 extra-articular distal humeral fractures, 10 complex fracture-dislocations), and the mean time from the index injury to contracture release was 16...
October 14, 2016: Journal of Shoulder and Elbow Surgery
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
Cody S Olsen, Andrea M Thomas, Michael Singleton, Anna M Gaichas, Tracy J Smith, Gary A Smith, Justin Peng, Michael J Bauer, Ming Qu, Denise Yeager, Timothy Kerns, Cynthia Burch, Lawrence J Cook
BACKGROUND: Despite evidence that motorcycle helmets reduce morbidity and mortality, helmet laws and rates of helmet use vary by state in the U.S. METHODS: We pooled data from eleven states: five with universal laws requiring all motorcyclists to wear a helmet, and six with partial laws requiring only a subset of motorcyclists to wear a helmet. Data were combined in the Crash Outcome Data Evaluation System's General Use Model and included motorcycle crash records probabilistically linked to emergency department and inpatient discharges for years 2005-2008...
December 2016: Injury Epidemiology
Ramona Sturm, David Heftrig, Katharina Mörs, Nils Wagner, Kerstin Kontradowitz, Katrin Jurida, Ingo Marzi, Borna Relja
OBJECTIVE: Phagocytizing leukocytes (granulocytes and monocytes) play a fundamental role in immunological defense against pathogens and clearance of cellular debris after tissue injury due to trauma. According to the "two-hit hypothesis", phagocytes become primed due to/after trauma. Subsequently, a secondary stimulus may lead to their exaggerated response. This immune dysfunction can result in serious infectious complications, also depending on trauma injury pattern. Here, we investigated the phagocytizing capacity of leukocytes, and its correlation to trauma injury pattern...
September 29, 2016: Immunobiology
Joaquín Valle Alonso, Francisco Javier Fonseca Del Pozo, Manuel Vaquero Álvarez, Elisa Lopera Lopera, Marisol Garcia Segura, Ricardo García Arévalo
BACKGROUND AND OBJECTIVE: To compare two scales for assessment of patients with mild head injury. The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) according to their diagnostic accuracy in patients attending an emergency department, and to determine the most important predictive values. METHOD: Cross-sectional study in a first-level Hospital in the period of January 2011 to January 2013. Patients with mild head injury criteria were included. All the patients underwent a computed tomography (CT) of the head as part of internal protocol and the CCHR and NOC criteria were recorded for each patient...
October 10, 2016: Medicina Clínica
Rafet Özay, Erhan Türkoğlu, Bora Gürer, Habibullah Dolgun, Oya Evirgen, Berrin İmge Ergüder, Nazlı Hayırlı, Levent Gürses, Zeki Şekerci, Erdal Reşit Yılmaz
BACKGROUND: The development of secondary brain injury via oxidative stress after traumatic brain injury (TBI) is well known. Decorin inactivates Transforming growth factor-β1 (TGF-β1), complement system (CS) and Tumor necrosis factor-α (TNF-α) which are related the oxidative stress and apoptosis. Consequently, the aim of the present study was to evaluate the role of Decorin (DC) on TBI. METHODS: A total of 24 male rats were used and divided into four groups as follows; control, trauma, DC, and methylprednisolone (MP)...
October 12, 2016: World Neurosurgery
Robert T Granata, Edward M Castillo, Gary M Vilke
BACKGROUND: Patients presenting to the emergency department (ED) with altered mental status and alcohol intoxication can clinically resemble patients with an intracranial hemorrhage. Although intracranial hemorrhage is quickly excluded with a head computed tomographic (CT) scan, it is common practice to defer imaging and allow the patient to metabolize to spare ED resources and minimize radiation exposure to the patient. Although this reduces unnecessary scans, it may delay treatment in patients with occult intracranial hemorrhage, which some fear may increase morbidity and mortality...
September 30, 2016: American Journal of Emergency Medicine
Ian H Stanley, Thomas E Joiner, Craig J Bryan
Research has demonstrated a robust link between traumatic brain injuries (TBIs) and suicide risk. Yet, few studies have investigated factors that account for this link. Utilizing a clinical sample of deployed military personnel, this study aimed to examine a serial meditation model of anger and depression in the association of mild TBI and suicide risk. A total of 149 military service members referred for evaluation/treatment of a suspected head injury at a military hospital participated in the present study (92...
October 7, 2016: Journal of Psychiatric Research
Georgios F Hadjigeorgiou, Ranjodh Singh, Panagiotis Stefanopoulos, Adamantios Petsanas, Fivos G Hadjigeorgiou, Kostas Fountas
Pneumorrachis (PR) is characterized by the presence of air within the spinal canal. It can be classified descriptively into internal or intradural and external or epidural. The causes of PR can be divided as iatrogenic, nontraumatic and traumatic. In the present study, a comprehensive literature search was conducted to identify all previous cases of PR after an isolate head injury. Two additional cases were also reported. We concluded, that PR after isolated head injuries is a rare but likely an underdiagnosed entity...
October 11, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Ashley Blanchard, Keven I Cabrera, Nathan Kuppermann, Peter S Dayan
OBJECTIVES: We aimed to determine the prevalence of and adverse outcomes caused by pneumocephali in children with minor blunt head trauma who had no other intracranial injuries (ie, isolated pneumocephali). METHODS: We conducted a secondary analysis of a public use dataset from a multicenter prospective study of pediatric minor head trauma. We included children younger than 18 years with Glasgow Coma Scale (GCS) scores of 14 or 15 and non-trivial mechanisms of injury who had cranial computed tomographies obtained...
October 6, 2016: Pediatric Emergency Care
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]
Alexandra L Clark, Lisa Delano-Wood, Scott F Sorg, Madeleine L Werhane, Karen L Hanson, Dawn M Schiehser
No known studies have directly examined white matter microstructural correlates of cognitive fatigue post-TBI in a Veteran sample. We therefore investigated the relationship between cognitive fatigue and white matter integrity in Veterans with history of mild to moderate TBI (mmTBI). 59 Veterans (TBI = 34, Veteran Controls [VCs] = 25]) with and without history of mmTBI underwent structural 3T DTI scans and completed questionnaires related to cognitive fatigue and psychiatric symptoms. Tractography was employed on six regions of interest, including the anterior and posterior limbs of the internal capsule; genu; body and splenium of the corpus callosum; and cingulum bundle...
October 6, 2016: Brain Imaging and Behavior
Emily White, Cristina Pinar, Crystal Bostrom, Alicia Meconi, Brian Ross Christie
Mild traumatic brain injury (mTBI) is becoming recognized as a significant concern in modern society. In particular, juveniles are being increasingly seen as a vulnerable time period for mTBI, as this is the final developmental period for the brain and typically involves robust synaptic reorganization and axonal myelination. Another issue that is being hotly debated is whether mTBI differentially impacts the male and female brain. To examine the impact of mTBI in the juvenile brain, we measured hippocampal synaptic plasticity using a closed-head mTBI model in male and female Long-Evans rats (25-28 days of age) at either one hour, one day, seven days, or 28 days post-injury...
October 12, 2016: Journal of Neurotrauma
Ahmad S Alobaidi, Ammar Al-Hassani, Ayman El-Menyar, Husham Abdelrahman, Mazin Tuma, Hassan Al-Thani, Mohammed A Aldosari
BACKGROUND: Femur fracture (FF) is a common injury, and intramedullary nailing (IMN) is the standard surgical fixation. However, the time of intervention remains controversial. We aimed to describe the reamed IMN (rIMN) timing and hospital outcomes in trauma patients presenting with FF. MATERIALS AND METHODS: A retrospective analysis was conducted for all patients admitted with FF and they underwent fixation at level 1 trauma unit between January 2010 and January 2012...
July 2016: International Journal of Critical Illness and Injury Science
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