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Acute trauma,head injury,

Kent P Hymel, Ming Wang, Vernon M Chinchilli, Wouter A Karst, Douglas F Willson, Mark S Dias, Bruce E Herman, Christopher L Carroll, Suzanne B Haney, Reena Isaac
BACKGROUND: Evidence-based, patient-specific estimates of abusive head trauma probability can inform physicians' decisions to evaluate, confirm, exclude, and/or report suspected child abuse. OBJECTIVE: To derive a clinical prediction rule for pediatric abusive head trauma that incorporates the (positive or negative) predictive contributions of patients' completed skeletal surveys and retinal exams. PARTICIPANTS AND SETTING: 500 acutely head-injured children under three years of age hospitalized for intensive care at one of 18 sites between 2010 and 2013...
December 11, 2018: Child Abuse & Neglect
Clara Karton, T Blaine Hoshizaki
Head impacts that transfer mechanical energy to the skull and create brain injuries have unique dynamic responses and brain tissue trauma characteristics. The magnitude of the impact energy and how it is transmitted creates three-dimensional linear and rotational accelerations of the head, resulting in unique strains on brain tissue. Biomechanical investigations of head injuries in contact sports have historically focused on attenuating energy transfer to the skull and brain. Typically, severe life-threatening events are caused by high-energy impact events that result in anatomic damage...
2018: Handbook of Clinical Neurology
Alexander Lin, Molly Charney, Martha E Shenton, Inga Katharina Koerte
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder associated with repetitive head impact exposure, such as that resulting from sports-related concussive and subconcussive brain trauma. Currently, the only way to diagnose CTE is by using neuropathologic markers obtained postmortem. To diagnose CTE earlier, so that possible treatment interventions may be employed, there is a need to develop noninvasive in vivo biomarkers of CTE. Neuroimaging provides promising biomarkers for the diagnosis of CTE and may also help elucidate pathophysiologic changes that occur with chronic sports-related brain injury...
2018: Handbook of Clinical Neurology
Asif K Suri, Michael L Lipton
Computed tomography (CT) and magnetic resonance imaging (MRI) have revolutionized the assessment of traumatic brain injury (TBI) by permitting rapid detection and localization of acute intracranial injuries. In concussion, the most common presentation of sports-related head trauma, CT and MRI are unrevealing. This normal appearance of the brain on standard neuroimaging, however, belies the structural and functional pathology that underpins concussion-related symptoms and dysfunction. Advances in neuroimaging have expanded our ability to gain insight into this microstructural and functional brain pathology...
2018: Handbook of Clinical Neurology
Henrik Zetterberg, Bengt Winblad, Charles Bernick, Kristine Yaffe, Marek Majdan, Gunilla Johansson, Virginia Newcombe, Lars Nyberg, David Sharp, Olli Tenovuo, Kaj Blennow
Traumatic brain injury (TBI) is clinically divided into a spectrum of severities, with mild TBI being the least severe form and a frequent occurrence in contact sports, such as ice hockey, American football, rugby, horse riding and boxing. Mild TBI is caused by blunt non-penetrating head trauma that causes movement of the brain and stretching and tearing of axons, with diffuse axonal injury being a central pathogenic mechanism. Mild TBI is in principle synonymous with concussion; both have similar criteria in which the most important elements are acute alteration or loss of consciousness and/or post-traumatic amnesia following head trauma and no apparent brain changes on standard neuroimaging...
November 27, 2018: Journal of Internal Medicine
Vivek Kumar Kankane, Tarun Kumar Gupta
Aim: Delayed intracerebral tension pneumatocele (DITP) is an uncommon cause of raised intracranial pressure following trauma. However, it can cause herniation syndrome due to a sudden increase in intracranial pressure which requires emergent intervention. Pneumocephalus is a complication of head injury in 3.9%-9.7% of the cases. The accumulation of intracranial air can be acute (<72 h) or delayed (≥72 h). Method: When intracranial air causes intracranial hypertension and has a mass effect with neurological deterioration, it is called tension pneumocephalus...
October 2018: Asian Journal of Neurosurgery
Askin Esen Hasturk, Emre Cemal Gokce, Erdal Resit Yilmaz, Bahriye Horasanli, Oya Evirgen, Nazli Hayirli, Hilal Gokturk, Imge Erguder, Belgin Can
Purpose: The aim of the present study was to investigate the effect of etanercept (ETA) on histopathological and biochemical changes after traumatic brain injury (TBI) in rats. Materials and Methods: Thirty-six male Wistar albino rats were distributed into three groups ( n = 12 each). Control group rats were not subjected to trauma. Trauma group rats were subjected to TBI only. ETA group rats were subjected to TBI plus ETA (5 mg/kg intraperitoneal [i.p.]). The groups were further subdivided into those sacrificed in the hyperacute stage (1 h after TBI) (control-1, trauma-1, and ETA-1 groups) and the acute stage (6 h after TBI) (control-6, trauma-6, and ETA-6 groups)...
October 2018: Asian Journal of Neurosurgery
Fernando Mayor Basto, Patrick Lyden
Therapeutic hypothermia (TH) is a potent neuroprotective therapy in experimental cerebral ischemia, with multiple effects at several stages of the ischemic cascade. In animals, TH is so powerful that all preclinical stroke studies require strict temperature control. In humans, multiple clinical studies documented powerful protection with TH after accidental neonatal hypoxic-ischemic injury and global cerebral ischemia with return of spontaneous circulation after cardiac arrest. National and international guidelines recommend TH for selected survivors of global ischemia, with profound benefits seen...
2018: Handbook of Clinical Neurology
Aditya Safaya, Ashraf Elzaine, Min Li Xu, Jorge Con, Kartik Prabhakaran, Gary Lombardo
No abstract text is available yet for this article.
April 1, 2018: American Surgeon
Silvia Farkašová Iannaccone, Alžbeta Ginelliová, Ivana Šantová, Marián Šanta, Daniel Farkaš, Radoslav Morochovič, Lucia Fröhlichová, Vladimír Balik
Spinal subdural hematoma is a rare and potentionally life-threatening condition associated with trauma and other pathological conditions. In this paper we report the autopsy findings of a 64 year old male who was repeatedly hospitalized with traumatic head injuries in the past. In this case spinal subdural hematoma was diagnosed post-mortem and later comfirmed by ante-mortem CT scan revaluation. Keywords: intracranial subdural hematoma - recurrent spinal subdural hematoma - diffuse axonal injury - autopsy findings...
2018: Soudní Lékarství
Rachel M Nygaard, Ashley P Marek
BACKGROUND: Our aim was to examine the US trauma population before and after the Affordable Care Act (ACA), specifically examining racial disparities in insurance status as well as access to post-hospitalization care in the trauma population. MATERIALS AND METHODS: The National Trauma Data Bank was queried for all non-burn patients age 18 to 64. The patient data was grouped into pre-ACA (2012-2013) and post-ACA (2014-2015). Regression analysis was controlled for age, sex, race (when applicable), type of injury (blunt vs penetrating), ISS, shock, head injury, and mechanical ventilation and clustered by hospital...
November 14, 2018: Journal of Racial and Ethnic Health Disparities
Aditya Safaya, Ashraf Elzaine, Min Li Xu, Jorge Con, Kartik Prabhakaran, Gary Lombardo
No abstract text is available yet for this article.
April 1, 2018: American Surgeon
I-Lin Hsu, Chung-Yi Li, Da-Chen Chu, Li-Chien Chien
Traumatic head injuries occur frequently in Taiwan, having catastrophic consequences for the victims, their families, and society as a whole. However, little is known about the risk factors at the population level in Taiwan. The primary aim of this study was to obtain more information on these variables and their relationships. Another aim was to analyze the effects of independent variables such as sex, age, residency, pre-existing conditions, mechanisms of injury, associated injuries, and severity on the probability of in-hospital death...
November 4, 2018: International Journal of Environmental Research and Public Health
Valentin Rausch, Sebastian Wegmann, Michael Hackl, Tim Leschinger, Wolfram F Neiss, Martin Scaal, Lars P Müller, Kilian Wegmann
BACKGROUND: Acute injuries to the anterior medial collateral ligament (AMCL) can occur due to valgus trauma or during other dislocating events to the elbow. AMCL lesions are often associated with bony lesions, such as radial head fractures or fractures of the coronoid process. We analyzed the insertion of the AMCL on the sublime tubercle in relation to surrounding osseous structures. We aimed to increase the understanding of the involvement of the AMCL in bony lesions to the sublime tubercle...
October 31, 2018: Journal of Shoulder and Elbow Surgery
H Khalayleh, G Lin, H Kadar Sfarad, M Mostafa, N Abu Abed, A Imam, A P Zbar, E Mavor
BACKGROUND: There is debate concerning the need for specialist neurosurgical transfer of patients presenting to Level II trauma centers with a minimal head injury (Glasgow Coma Scale ≥13) and a small non-progressive intracranial bleeding (ICB). METHODS: A retrospective chart analysis was performed assessing the outcomes of adult patients presenting with a minor traumatic ICB on initial CT scan (minimal subarachnoid hemorrhage; small-width subdural hematoma without shift; punctate cerebral contusion)...
October 25, 2018: World Journal of Surgery
Christ Ordookhanian, Paul E Kaloostian
A young adult, 18 years of age, presented to the emergency department with severe traumatic brain injury (TBI) resulting from a bicycle versus vehicle head-on collision. The patient initially presented in a promising condition but quickly deteriorated into a state of unconsciousness with no meaningful responses to stimuli or coordinated voluntary movement. Stat computed tomography (CT) revealed a large, right-sided, acute epidural hematoma (EDH) with mass-effect and a severe midline shift indicative of immediate surgery...
August 20, 2018: Curēus
S Fitzpatrick, P Leach
The management of head trauma in children from suspected abuse is multidisciplinary. The primary role of neurosurgeons is to manage the acute clinical situation. They also have a secondary role in assisting others to determine the cause of the injury and prevent recurrences. This article aims to guide the trainee neurosurgeon on management of this patient group according to current literature.
October 24, 2018: British Journal of Neurosurgery
Marcello Covino, Emanuele Gilardi, Alberto Manno, Benedetta Simeoni, Veronica Ojetti, Chiara Cordischi, Evelina Forte, Luigi Carbone, Simona Gaudino, Francesco Franceschi
INTRODUCTION: Well recognized guidelines are available for the use of cranial computed tomography (CCT) in traumatic patients, while no definitely accepted standards exists to for CCT in patients without history of head injury. The aim of this study is to propose an easy clinical score to stratify the need of CCT in emergency department (ED) patients with suspect non-traumatic intracranial pathology. METHODS: We retrospectively evaluated patients presenting to the ED for neurological deficit, postural instability, acute headache, altered mental status, seizures, confusion, dizziness, vertigo, syncope, and pre-syncope...
September 19, 2018: American Journal of Emergency Medicine
Mary Matthews, Peter Richman, Scott Krall, Kimberly Leeson, K Tom Xu, Albert L Gest, Osbert Blow
BACKGROUND: Recurrent CT imaging is believed to significantly increase lifetime malignancy risk. We previously reported that high acuity, admitted trauma patients who received a whole-body CT in the emergency department (ED) had a history of prior CT imaging in 14% of cases. The primary objective of this study was to determine the CT imaging history for trauma patients who received a whole-body CT but were ultimately deemed safe for discharge directly home from the ED. METHODS: This was a retrospective cohort study conducted at an academic ED...
October 16, 2018: BMC Emergency Medicine
Hansen Deng, John K Yue, Beata Durcanova, Javid Sadjadi
Alcohol intoxication is a common risk factor of traumatic brain injury (TBI) and carries a significant health-care burden on underserved patients. Patients with chronic alcohol use may suffer a spectrum of bleeding diatheses from hepatic dysfunction not well studied in the context of TBI. A feared sequela of TBI is the development of coagulopathy resulting in worsened intracranial bleeding. We report the clinical course of an intoxicated patient found down with blunt head trauma and concurrent alcoholic cirrhosis who was awake and responsive in the field...
October 2018: Journal of Neurosciences in Rural Practice
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