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https://www.readbyqxmd.com/read/30334071/the-role-of-coagulopathy-on-clinical-outcome-following-traumatic-brain-injury-in-children-analysis-of-66-consecutive-cases-in-a-single-center-institution
#1
Guilherme Gozzoli Podolsky-Gondim, Luciano Lopes Furlanetti, Dinark Conceição Viana, Matheus Fernando Manzolli Ballestero, Ricardo Santos de Oliveira
INTRODUCTION: Head injury is a significant economic, social, and medical problem in developing countries and remains one of the leading causes of pediatric morbidity and mortality. The association of traumatic brain injury and coagulopathy in children is linked with an increase in mortality and poor functional outcomes. However, its impact on long-term outcome has not been discussed in the literature so far. OBJECTIVES: The aim of this paper was to investigate the effect of coagulopathy diagnosed by routine laboratory tests on neurological outcome following traumatic brain injury in children...
October 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/30276652/conservative-and-operative-management-of-iatrogenic-craniocerebral-disproportion-a-case-based-review
#2
Thomas Beez, Christopher Munoz-Bendix, Sebastian Alexander Ahmadi, Martina Messing-Jünger, Hans-Jakob Steiger, Andreas Röhrig
INTRODUCTION: Craniocerebral disproportion (CCD) can occur as a sequela after shunting in early infancy. It can be understood as a disorder closely related to slit ventricle syndrome and chronic overdrainage syndrome. Here, we present two exemplary cases and summarize the pathophysiological, diagnostic, and therapeutic approaches to CCD. CLINICAL PRESENTATION: Two premature babies underwent shunting for posthemorrhagic hydrocephalus and presented in later childhood with recurrent episodes of symptomatic raised intracranial pressure (ICP) at 2 and 8 years of age, respectively...
October 2, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/30267207/telemetry-in-intracranial-pressure-monitoring-sensor-survival-and-drift
#3
Nicolas Hernandez Norager, Alexander Lilja-Cyron, Carsten Reidies Bjarkam, Sara Duus, Marianne Juhler
BACKGROUND: Telemetric intracranial pressure (ICP) monitoring enable long-term ICP monitoring on patients during normal day activities and may accordingly be of use during evaluation and treatment of complicated ICP disorders. However, the benefits of such equipment depend strongly on the validity of the recordings and how often the telemetric sensor needs to be re-implanted. This study investigates the clinical and technical sensor survival time and drift of the telemetric ICP sensor: Raumedic Neurovent-P-tel...
September 29, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/30265194/a-clinical-decision-rule-to-predict-intracranial-hypertension-in-severe-traumatic-brain-injury
#4
Aziz S Alali, Nancy Temkin, Jason Barber, Jim Pridgeon, Kelley Chaddock, Sureyya Dikmen, Peter Hendrickson, Walter Videtta, Silvia Lujan, Gustavo Petroni, Nahuel Guadagnoli, Zulma Urbina, Randall M Chesnut
OBJECTIVE: While existing guidelines support the treatment of intracranial hypertension in severe traumatic brain injury (TBI), it is unclear when to suspect and initiate treatment for high intracranial pressure (ICP). The objective of this study was to derive a clinical decision rule that accurately predicts intracranial hypertension. METHODS: Using Delphi methods, the authors identified a set of potential predictors of intracranial hypertension and a clinical decision rule a priori by consensus among a group of 43 neurosurgeons and intensivists who have extensive experience managing severe TBI without ICP monitoring...
September 28, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/30261393/intraoperative-measuring-of-the-vascular-pressure-on-the-facial-nerve-at-rez-in-hfs-patients-during-mvd-a-prospective-study
#5
Pei Zhang, M Helmy Selim, Haiyan Wang, Wei Kuang, Miaojing Wu, Chenxing Ji, Guowen Hu, Lei Wu, Xingen Zhu, Hua Guo
OBJECT: The compression of the offending vessel upon the facial nerve at root exit zone (REZ) is considered as the leading cause of hemifacial spasm (HFS). However, the correlation between the severity of spasm and the pressure of neurovascular compression (NVC) has not yet been investigated. The aim of this study was to investigate the clinical correlation between the severity of HFS and the pressure of NVC. METHODS: A prospective study was performed, which included 52/151 patients who underwent microvascular decompression (MVD)...
September 24, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30251919/ventricular-drainage-catheters-versus-intracranial-parenchymal-catheters-for-intracranial-pressure-monitoring-based-management-of-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#6
Victor Volovici, Jilske A Huijben, Ari Ercole, Nino Stocchetti, Clemens M F Dirven, Mathieu van der Jagt, Ewout W Steyerberg, Hester Lingsma, David Menon, Andrew Maas, Iain Haitsma
Intracranial pressure (ICP) monitoring is one of the mainstays in the treatment of severe traumatic brain injury (TBI), but different approaches to monitoring exist. The aim of this systematic review and meta-analysis is to compare the effectiveness and complication rate of ventricular drainage (VD) versus intracranial parenchymal (IP) catheters to monitor and treat raised ICP in patients with TBI. Pubmed, EMBASE, Web of Science, Google Scholar and the Cochrane Database were searched for articles comparing ICP monitoring-based management with VDs and monitoring with IP monitors until March 2018...
September 25, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/30251073/differentiate-the-source-and-site-of-intracranial-pressure-measurements-using-more-precise-nomenclature
#7
EDITORIAL
DaiWai M Olson, Stefany Ortega Peréz, Jonathan Ramsay, Chethan P Venkatasubba Rao, Jose I Suarez, Molly McNett, Venkatesh Aiyagari
BACKGROUND: Intracranial pressure (ICP) monitoring is fundamental for neurocritical care patient management. For many years, ventricular and parenchymal devices have been available for this aim. The purpose of this paper is to review the published literature comparing ICP recordings via an intraventricular catheter or an intraparenchymal (brain tissue) catheter. METHODS: Literature search of Medline, CINAHL, Embase, and Scopus was performed in which manuscripts discussed both ICP monitoring via an intraventricular catheter and ICP monitoring through intraparenchymal (brain tissue) catheter...
September 24, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/30215559/intracranial-pressure-elevations-in-diffuse-axonal-injury-association-with-nonhemorrhagic-mr-lesions-in-central-mesencephalic-structures
#8
Sami Abu Hamdeh, Niklas Marklund, Anders Lewén, Tim Howells, Raili Raininko, Johan Wikström, Per Enblad
OBJECTIVE Increased intracranial pressure (ICP) in patients with severe traumatic brain injury (TBI) with diffuse axonal injury (DAI) is not well defined. This study investigated the occurrence of increased ICP and whether clinical factors and lesion localization on MRI were associated with increased ICP in patients with DAI. METHODS Fifty-two patients with severe TBI (median age 24 years, range 9-61 years), who had undergone ICP monitoring and had DAI on MRI, as determined using T2*-weighted gradient echo, susceptibility-weighted imaging, and diffusion-weighted imaging (DWI) sequences, were enrolled...
September 14, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/30181428/identifying-causal-relationships-between-eeg-activity-and-intracranial-pressure-changes-in-neurocritical-care-patients
#9
Ancor Sanz-Garcia, Miriam Perez-Romero, Jesus Pastor, Rafael G Sola, Lorena Vega-Zelaya, Fernando Monasterio, Carmen Torrecilla, Gema Vega, Paloma Pulido, Guillermo J Ortega
To exploring and assessing the relationship between the electroencephalography (EEG) activity with the intracranial pressure (ICP) in patients suffering from Traumatic Brain Injury (TBI) and Subarachnoid Hemorrhage (SAH) during their stay at the Intensive Care Unit (ICU)
 Methods: We performed an observational prospective cohort study of adult patients suffered from TBI or SAH. Continuous EEG-ECG was performed during ICP monitoring. In every patient, derived variables from the EEG were calculated and the Granger Causality (GC) methodology was employed to assess whether, and in which direction, any relationship between EEG and ICP exists...
September 5, 2018: Journal of Neural Engineering
https://www.readbyqxmd.com/read/30168413/therapeutic-hypothermia-to-reduce-intracranial-pressure-after-traumatic-brain-injury-the-eurotherm3235-rct
#10
Peter Jd Andrews, H Louise Sinclair, Aryelly Rodríguez, Bridget Harris, Jonathan Rhodes, Hannah Watson, Gordon Murray
BACKGROUND: Traumatic brain injury (TBI) is a major cause of disability and death in young adults worldwide. It results in around 1 million hospital admissions annually in the European Union (EU), causes a majority of the 50,000 deaths from road traffic accidents and leaves a further ≈10,000 people severely disabled. OBJECTIVE: The Eurotherm3235 Trial was a pragmatic trial examining the effectiveness of hypothermia (32-35 °C) to reduce raised intracranial pressure (ICP) following severe TBI and reduce morbidity and mortality 6 months after TBI...
August 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/30123585/improved-outcomes-following-the-establishment-of-a-neurocritical-care-unit-in-saudi-arabia
#11
Ibrahim Soliman, Waleed Tharwat Aletreby, Fahad Faqihi, Nasir Nasim Mahmood, Omar E Ramadan, Ahmad Fouad Mady, Babar Kahlon, Abdulrahman Alharthy, Peter Brindley, Dimitrios Karakitsos
Background: Dedicated neurocritical care units have dramatically improved the management and outcome following brain injury worldwide. Aim: This is the first study in the Middle East to evaluate the clinical impact of a neurocritical care unit (NCCU) launched within the diverse clinical setting of a polyvalent intensive care unit (ICU). Design and Methods: A retrospective before and after cohort study comparing the outcomes of neurologically injured patients...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/30074450/intraoperative-intracranial-pressure-monitoring-in-the-pediatric-craniosynostosis-population
#12
Brendan F Judy, Jordan W Swanson, Wuyang Yang, Phillip B Storm, Scott P Bartlett, Jesse A Taylor, Gregory G Heuer, Shih-Shan Lang
OBJECTIVE Evaluation of increased intracranial pressure (ICP) in the pediatric craniosynostosis population based solely on ophthalmological, clinical, and radiographic data is subjective, insensitive, and inconsistent. The aim of this study was to examine the intraoperative ICP before and after craniectomy in this patient population. METHODS The authors measured the ICP before and after craniectomy using a subdural ICP monitor in 45 children. They regulated end-tidal carbon dioxide and the monitoring site under general anesthesia to record consistent ICP readings...
August 3, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/30055363/intracranial-hypotension-with-coma-microsurgical-repair-of-a-spinal-ventral-dural-tear-and-drainage-of-subdural-hematoma-with-intracranial-pressure-monitoring
#13
Keisuke Takai, Makoto Taniguchi
BACKGROUND: Difficulties are associated with the diagnosis and management of patients with coma because of intracranial hypotension. CASE DESCRIPTION: A 70-year-old man with coma (Glasgow Coma Scale score of 6) with fixed dilated pupils because of severe intracranial hypotension is described. After unsuccessful epidural blood patch (EBP), the patient underwent microsurgical dural repair and drainage of hematoma with intracranial pressure (ICP) monitoring. Intraoperatively, a dural tear associated with a cerebrospinal fluid (CSF) leak was identified at the thoracolumbar junction ventral to the spinal cord...
October 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30053135/patients-who-benefit-from-intracranial-pressure-monitoring-without-cerebrospinal-fluid-drainage-after-severe-traumatic-brain-injury
#14
(no author information available yet)
BACKGROUND: India has a high traumatic brain injury (TBI) burden and intracranial pressure monitoring (ICP) remains controversial but some patients may benefit. OBJECTIVE: To examine the association between ICP monitor placement and outcomes, and identify Indian patients with severe TBI who benefit from ICP monitoring. METHODS: We conducted a secondary analysis of a prospective cohort study at a level 1 Indian trauma center. Patients over 18 yr with severe TBI (admission Glasgow coma scale score < 8) who received tracheal intubation for at-least 48 h were examined...
July 25, 2018: Neurosurgery
https://www.readbyqxmd.com/read/30050328/adjusting-for-confounding-by-indication-in-observational-studies-a-case-study-in-traumatic-brain-injury
#15
Maryse C Cnossen, Thomas A van Essen, Iris E Ceyisakar, Suzanne Polinder, Teuntje M Andriessen, Joukje van der Naalt, Iain Haitsma, Janneke Horn, Gaby Franschman, Pieter E Vos, Wilco C Peul, David K Menon, Andrew Ir Maas, Ewout W Steyerberg, Hester F Lingsma
Introduction: Observational studies of interventions are at risk for confounding by indication. The objective of the current study was to define the circumstances for the validity of methods to adjust for confounding by indication in observational studies. Patients and methods: We performed post hoc analyses of data prospectively collected from three European and North American traumatic brain injury studies including 1,725 patients. The effects of three interventions (intracranial pressure [ICP] monitoring, intracranial operation and primary referral) were estimated in a proportional odds regression model with the Glasgow Outcome Scale as ordinal outcome variable...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/30031178/effect-of-hypernatremia-on-outcomes-after-severe-traumatic-brain-injury-a-nationwide-inpatient-sample-analysis
#16
Haydn Hoffman, Muhammad S Jalal, Lawrence S Chin
OBJECTIVE: Induced hypernatremia is frequently used to reduce intracranial pressure in patients with severe traumatic brain injury (TBI). This technique is controversial, and some studies have independently associated hypernatremia with worse outcomes after TBI. We sought to investigate this potential association in a large healthcare database. METHODS: The Nationwide Inpatient Sample was used to obtain data on all adults who had been discharged from 2002 to 2011 with a primary diagnosis of TBI who required mechanical ventilation, intracranial pressure monitoring, or craniotomy/craniectomy...
October 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30014363/pulsatile-versus-non-pulsatile-tinnitus-in-idiopathic-intracranial-hypertension
#17
Jonathan P Funnell, Claudia L Craven, Simon D Thompson, Linda D'Antona, Aswin Chari, Lewis Thorne, Laurence D Watkins, Ahmed K Toma
INTRODUCTION: Tinnitus is a symptom commonly associated with idiopathic intracranial hypertension (IIH) that can have a profound effect on quality of life. We aim to determine tinnitus symptom response after dural venous sinus stenting (DVSS) or CSF diversion with a shunt, in patients with both pulsatile (PT) and non-pulsatile tinnitus (NPT). METHODS: Single-centre cohort of IIH patients (2006-2016) who underwent 24-h ICP monitoring (ICPM). An un-paired t test compared ICP and pulse amplitude (PA) values in IIH patients with PT vs...
October 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/30010593/implantable-wireless-intracranial-pressure-monitoring-based-on-air-pressure-sensing
#18
Hanjun Jiang, Yanshu Guo, Zeliang Wu, Chun Zhang, Wen Jia, Zhihua Wang
A wireless intracranial pressure (ICP) monitoring system based on the air pressure sensing is proposed in this work. The proposed system is composed of an implantable ICP sensing device and a portable wireless data recorder. The ICP sensing device consists of an air pressure sensor, an ultra-thin air pouch for pressure sensing, and a low-power dedicated system-on-a-chip (SoC) for the data acquisition control and wireless transmission. The SoC consists of a power management unit, a wake-up controller, the sensor interface, a wireless transmitter, and the workflow control logic...
July 16, 2018: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/30004311/intensive-care-resources-required-to-care-for-critically-ill-children-with-focal-intracranial-infections
#19
Marlina E Lovett, Zubin S Shah, Melissa Moore-Clingenpeel, Eric Sribnick, Adam Ostendorf, Melissa G Chung, Jeffrey Leonard, Nicole F O'Brien
OBJECTIVE Focal intracranial infections such as intraparenchymal abscesses or localized infections in the epidural or subdural spaces are relatively rare infections associated with both morbidity and mortality in children. Although children with these infections frequently require surgical intervention, there is a paucity of literature describing the critical care resources required to manage these cases. This retrospective chart review was performed to evaluate the resources necessary to care for critically ill children with focal intracranial infections at the authors' institution...
July 13, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29948998/noninvasive-intracranial-pressure-assessment-in-acute-liver-failure
#20
Venkatakrishna Rajajee, Craig A Williamson, Robert J Fontana, Anthony J Courey, Parag G Patil
BACKGROUND: Elevated intracranial pressure (ICP) is an important cause of death following acute liver failure (ALF). While invasive ICP monitoring (IICPM) is most accurate, the presence of coagulopathy increases bleeding risk in ALF. Our objective was to evaluate the accuracy of three noninvasive ultrasound-based measures for the detection of concurrent ICP elevation in ALF-optic nerve sheath diameter (ONSD) using optic nerve ultrasound (ONUS); middle cerebral artery pulsatility index (PI) on transcranial Doppler (TCD); and ICP calculated from TCD flow velocities (ICPtcd) using the estimated cerebral perfusion pressure (CPPe) technique...
June 8, 2018: Neurocritical Care
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