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Acute trauma,head injury,

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https://www.readbyqxmd.com/read/30048325/decreased-risk-of-delirium-with-use-of-regional-analgesia-in-geriatric-trauma-patients-with-multiple-rib-fractures
#1
Kathleen M O'Connell, D Alex Quistberg, Robert Tessler, Bryce R H Robinson, Joseph Cuschieri, Ronald V Maier, Frederick P Rivara, Monica S Vavilala, Paul I Bhalla, Saman Arbabi
OBJECTIVE: The aim of this study was to examine the risk of delirium in geriatric trauma patients with rib fractures treated with systemic opioids compared with those treated with regional analgesia (RA). SUMMARY OF BACKGROUND DATA: Delirium is a modifiable complication associated with increased morbidity and mortality. RA may reduce the need for opioid medications, which are associated with delirium in older adults. METHODS: Cohort study of patients ≥65 years admitted to a regional trauma center from 2011 to 2016...
September 2018: Annals of Surgery
https://www.readbyqxmd.com/read/30041860/pediatric-trauma-associated-acute-respiratory-distress-syndrome-incidence-risk-factors-and-outcomes
#2
Amory de Roulet, Rita V Burke, Joanna Lim, Stephanie Papillon, David W Bliss, Henri R Ford, Jeffrey S Upperman, Kenji Inaba, Aaron R Jensen
BACKGROUND/PURPOSE: Acute Respiratory Distress Syndrome (ARDS) results in significant morbidity and mortality in pediatric trauma victims. The objective of this study was to determine risk factors and outcomes specifically related to pediatric trauma-associated ARDS (PT-ARDS). METHODS: A retrospective cohort (2007-2014) of children ≤18 years old from the American College of Surgeons National Trauma Data Bank (NTDB) was used to analyze incidence, risk factors, and outcomes related to PT-ARDS...
July 11, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/30001646/repetitive-head-injury-in-adolescent-mice-a-role-for-vascular-inflammation
#3
Limin Wu, Joon Y Chung, Shivani Saith, Lorenzo Tozzi, Erin M Buckley, Bharat Sanders, Maria A Franceschini, Sevda Lule, Saef Izzy, Josephine Lok, William J Edmiston, Lauren M McAllister, Sloane Mebane, Gina Jin, Jiaxi Lu, John S Sherwood, Sarah Willwerth, Suzanne Hickman, Joseph El Khoury, Eng H Lo, David Kaplan, Michael J Whalen
Repetitive mild traumatic brain injury during adolescence can induce neurological dysfunction through undefined mechanisms. Interleukin-1 (IL-1) contributes to experimental adult diffuse and contusion TBI models, and IL-1 antagonists have entered clinical trials for severe TBI in adults; however, no such data exist for adolescent TBI. We developed an adolescent mouse repetitive closed head injury (rCHI) model to test the role of IL-1 family members in post-injury neurological outcome. Compared to one CHI, three daily injuries (3HD) produced acute and chronic learning deficits and emergence of hyperactivity, without detectable gliosis, neurodegeneration, brain atrophy, and white matter loss at one year...
July 13, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/30001441/traumatic-brain-injury-in-the-pediatric-intensive-care-unit
#4
Elora Hussain
Head trauma is a leading cause of brain injury in children, and it can have profound lifelong physical, cognitive, and behavioral consequences. Optimal acute care of children with traumatic brain injury (TBI) requires rapid stabilization and early neurosurgical evaluation by a multidisciplinary team. Meticulous attention is required to limit secondary brain injury after the initial trauma. This review discusses pathophysiology, acute stabilization, and monitoring, as well as supportive and therapeutic measures to help minimize ongoing brain injury and optimize recovery in children with TBI...
July 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29982209/emotional-reserve-and-prolonged-post-concussive-symptoms-and-disability-a-swedish-prospective-1-year-mild-traumatic-brain-injury-cohort-study
#5
Christian Oldenburg, Anders Lundin, Gunnar Edman, Catharina Nygren Deboussard, Aniko Bartfai
OBJECTIVE: Prolonged post-concussive symptoms (PCS) affect a significant minority of patients withmild traumatic brain injury (mTBI). The aetiology is multifactorial depending on preinjury as well as peri-injury and postinjury factors. In this study, we examine outcome from an emotional reserve perspective. DESIGN: Prospective cohort study. SETTING: Patients were recruited from three emergency departments in major university hospitals in Stockholm, Sweden...
July 6, 2018: BMJ Open
https://www.readbyqxmd.com/read/29981606/mild-to-moderate-to-severe-what-drives-the-severity-of-ards-in-trauma-patients
#6
Pamela Daher, Pedro G Teixeira, Thomas B Coopwood, Lawrence H Brown, Sadia Ali, Jayson D Aydelotte, Brent J Ford, Adam S Hensely, Carlos V Brown
Acute respiratory distress syndrome (ARDS) is a complex inflammatory process with multifactorial etiologies. Risk factors for its development have been extensively studied, but factors associated with worsening severity of disease, as defined by the Berlin criteria, are poorly understood. A retrospective chart and trauma registry review identified trauma patients in our surgical intensive care unit who developed ARDS, defined according to the Berlin definition, between 2010 and 2015. The primary outcome was development of mild, moderate, or severe ARDS...
June 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29980817/acute-massive-and-submassive-pulmonary-embolism-preliminary-validation-of-aspiration-mechanical-thrombectomy-in-patients-with-contraindications-to-thrombolysis
#7
Massimo Pieraccini, Susanna Guerrini, Edoardo Laiolo, Alessio Puliti, Giandomenico Roviello, Leonardo Misuraca, Genni Spargi, Ugo Limbruno, Mauro Breggia, Morando Grechi
PURPOSE: The aim of this study is to assess the feasibility of aspiration mechanical thrombectomy in patients with massive and submassive pulmonary embolism (PE) and contraindications to thrombolysis. MATERIALS AND METHODS: Eighteen patients presenting massive (8/18) or submassive (10/18) PE were prospectively enrolled between October 2016 and November 2017. All the patients enrolled had contraindications to thrombolysis (haemorrhagic stroke n = 1, ischaemic stroke in the preceding 6 months n = 7, central nervous system damage or neoplasms n = 1, recent major trauma/surgery/head injury in the preceding 3 weeks n = 5, gastrointestinal bleeding within the last month n = 4)...
July 6, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29966779/delayed-intracerebral-haemorrhage-following-pseudoaneurysm-of-middle-meningeal-artery-rupture-case-report-literature-review-and-forensic-issues
#8
REVIEW
Eva Montanari, Gabriele Polonara, Roberto Montalti, Marco Vivarelli, Riccardo Antonio Ricciuti, Raffaele Giorgetti, Adriano Tagliabracci
Traumatic pseudoaneurysm of the middle meningeal artery (PMMA) is rare. Its rupture is associated with a high mortality rate, so an early diagnosis is recommended for this risky pathology. In the absence of a specific guideline, computed tomography (CT), digitalized subtraction angiography (DSA) and CT-angiography (CT-A) are proposed for its diagnosis. CT-A is the technique of choice even if it is almost never performed, especially in mild head injury. We herein report a rare case of a delayed rupture of PMMA, being analysed from a forensic point of view...
June 29, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29916991/risk-factors-for-early-reoperation-after-operative-treatment-of-acetabular-fractures
#9
Anthony Ding, Robert V OʼToole, Renan Castillo, Brad Reahl, Ryan Montalvo, Jason W Nascone, Marcus F Sciadini, Anthony R Carlini, Theodore T Manson
OBJECTIVES: To identify the risk factors for early reoperation after operative fixation of acetabular fractures. DESIGN: Retrospective evaluation. SETTING: Level I Trauma Center. PATIENTS: Seven hundred ninety-one patients with displaced acetabular fractures treated with open reduction and internal fixation (ORIF) from 2006 to 2015. Average follow-up was 52 weeks. MAIN OUTCOME MEASURES: Early reoperation after acetabular ORIF, defined as secondary procedure for infection or revision within 3 years of initial operation...
July 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29913815/distribution-of-concussion-related-symptoms-after-whiplash-injury-in-risk-strata
#10
Helge Kasch, Troels S Jensen
Background/aims The presence and severity of concussion related symptoms after acute whiplash injury are debatable. In this study we examine the distribution and development of the burden of concussion related symptoms in whiplash patients. Methods Consecutively 141 acute whiplash patients and 40 ankle injured controls were recruited from emergency units and were examined after 1 week, 1, 3, 6, 12 months obtaining neck/head VAS score, number-of-non-painful complaints, epidemiological, social, psychological data and neurological examination, active neck mobility, and furthermore muscle tenderness and pain response, strength and duration of neck muscles...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29905513/isolated-subdural-hematomas-in-mild-traumatic-brain-injury-part-1-the-association-between-radiographic-characteristics-and-neurosurgical-intervention
#11
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
https://www.readbyqxmd.com/read/29904601/incidence-and-risk-factors-for-complications-after-definitive-skeletal-fixation-of-lower-extremity-in-multiple-injury-patients-a-retrospective-chart-review
#12
Thananit Sangkomkamhang, Wilaiphorn Thinkhamrop, Bandit Thinkhamrop, Wongsa Laohasiriwong
Background : The management of multiple injuries is complex. Type and timing of treatment for lower extremity fractures is a controversial subject. Although many studies have demonstrated the safety and effectiveness of early treatment, others have suggested that early definitive stabilization may cause complications, especially with chest and head injuries. The aim of this study was to determine the complications and effects of timing of fixation, and investigate risk factors for complications in multiple injuries patients with lower extremity fractures...
2018: F1000Research
https://www.readbyqxmd.com/read/29895273/prevalence-of-acute-stress-disorder-among-road-traffic-accident-survivors-a-meta-analysis
#13
Wenjie Dai, Aizhong Liu, Atipatsa C Kaminga, Jing Deng, Zhiwei Lai, Jianzhou Yang, Shi Wu Wen
BACKGROUND: Road traffic accident (RTA), an unexpected traumatic event, may not only lead to death and serious physical injuries, but also could put survivors at an increased risk for a wide range of psychiatric disorders, particularly acute stress disorder (ASD). Early assessment of trauma-related psychological responses is important because acute trauma responses in the early post-traumatic period are among the robust predictors of long-term mental health problems. However, estimates of the prevalence of ASD among RTA survivors varied considerably across studies...
June 13, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29878909/neuroimaging-of-brain-trauma
#14
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...
August 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29801909/infantile-traumatic-brain-injury-with-a-biphasic-clinical-course-and-late-reduced-diffusion
#15
Nanako Takase, Noboru Igarashi, Hiromichi Taneichi, Kumi Yasukawa, Takafumi Honda, Hiromichi Hamada, Jun-Ichi Takanashi
Reduced diffusion in the subcortical white matter has been reported in some infants with traumatic brain injury (TBI), including abusive head trauma. However, the pathomechanisms of the lesions and clinical features are uncertain. We herein report two infants with TBI who presented with biphasic clinical courses and late reduced diffusion in the subcortical white matter, and reviewed seven clinically and radiologically similar patients with TBI. Their clinical features (secondary neurological symptoms on days 3 to 6) and radiological findings (normal diffusion on days 1 to 2, followed by reduced diffusion on days 3 to 6) are very similar to those observed in patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD)...
July 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29794235/prevalence-of-cerebral-microhemorrhage-following-chronic-blast-related-mild-traumatic-brain-injury-in-military-service-members-using-susceptibility-weighted-mri
#16
E Lotan, C Morley, J Newman, M Qian, D Abu-Amara, C Marmar, Y W Lui
BACKGROUND AND PURPOSE: Cerebral microhemorrhages are a known marker of mild traumatic brain injury. Blast-related mild traumatic brain injury relates to a propagating pressure wave, and there is evidence that the mechanism of injury in blast-related mild traumatic brain injury may be different from that in blunt head trauma. Two recent reports in mixed cohorts of blunt and blast-related traumatic brain injury in military personnel suggest that the prevalence of cerebral microhemorrhages is lower than in civilian head injury...
July 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29788111/acute-assessment-of-traumatic-brain-injury-and-post-traumatic-stress-after-exposure-to-a-deployment-related-explosive-blast
#17
Monty T Baker, John C Moring, Willie J Hale, Jim Mintz, Stacey Young-McCaughan, Richard A Bryant, Donna K Broshek, Jeffrey T Barth, Robert Villarreal, Cynthia L Lancaster, Steffany L Malach, Jose M Lara-Ruiz, William Isler, Alan L Peterson
Introduction: Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are two of the signature injuries in military service members who have been exposed to explosive blasts during deployments to Iraq and Afghanistan. Acute stress disorder (ASD), which occurs within 2-30 d after trauma exposure, is a more immediate psychological reaction predictive of the later development of PTSD. Most previous studies have evaluated service members after their return from deployment, which is often months or years after the initial blast exposure...
May 18, 2018: Military Medicine
https://www.readbyqxmd.com/read/29774195/development-of-delayed-acute-subdural-hematoma-after-mild-traumatic-brain-injury-a-case-report
#18
Soon O Hong, Dong Soo Kang, Min Ho Kong, Se Youn Jang, Jung Hee Kim, Kwan Young Song
We report a case involving the development of a delayed acute subdural hematoma (ASDH) after trauma, with the absence of any abnormal radiological and clinical findings at initial examination. A 54-year-old male visited the emergency department after a minor trauma. The patient only complained of mild headache after head injury. He presented no abnormal findings on neurological examination, and brain computed tomography (CT) did not show any intracranial lesion or skull fractures. However, he developed seizure with disorientation eight hours after trauma, and ASDH with midline shift was found during a follow-up CT...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29768334/a-case-report-of-b-lymphoblastic-lymphoma-with-brain-metastases-clinical-and-pathological-significance-of-head-trauma-misdiagnosis
#19
Jian Shi, Jale Manzo, Yiwu Zhou, Peter Agovino, Song Wu
INTRODUCTION: B lymphoblastic lymphoma (B-LBL) is a rare type of lymphoma that originates from precursor lymphocytes. B-BLB in adults with brain metastases is extremely rare as the disease mainly affects children and adults. Therefore, such a seldom-seen case can easily trigger a dispute regarding clinical diagnosis and treatment.This paper reports the case of a 22-year-old man hospitalized for a head injury that resulted from a physical altercation. Upon admission to the hospital, the patient was diagnosed with a diffuse axonal injury (DAI)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29757458/posttraumatic-headache-basic-mechanisms-and-therapeutic-targets
#20
REVIEW
Joshua Kamins, Andrew Charles
Frequent or continuous headache, often refractory to medical therapy, is a common occurrence after head trauma. In addition to being the most common acute symptom after traumatic brain injury (TBI), headache is also one of the most persistent and disabling symptoms. Different studies indicate that 18-58% of those suffering a TBI will have significant headache at 1 year following the trauma. In addition to being disabling on its own, posttraumatic headache (PTH) is a predictor of overall outcome after concussion...
June 2018: Headache
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