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"glasgow coma scale"

Kyoungwon Jung, Shokei Matsumoto, Alan Smith, Kyungjin Hwang, John Cook-Jong Lee, Raul Coimbra
Background: This study aimed to compare treatment outcomes between patients with severe pelvic fractures treated at a representative trauma center that was established in Korea since 2015 and matched cases treated in the USA. Methods: Two cohorts were selected from a single institution trauma database in South Korea (Ajou Trauma Data Bank (ATDB)) and the National Trauma Data Bank (NTDB) in the USA. Adult blunt trauma patients with a pelvic Abbreviated Injury Scale >3 were included...
2018: Trauma surgery & acute care open
Imad Khan, Mehboob Rehan, Gunjan Parikh, Christopher Zammit, Neeraj Badjatia, Daniel Herr, Zachary Kon, Charles Hogue, Michael Mazzeffi
Background: Regional cerebral oxygen saturation (rScO2) measured by near-infrared spectroscopy (NIRS) can be used to monitor brain oxygenation in extracorporeal membrane oxygenation (ECMO). ECMO patients that develop acute brain injuries (ABIs) are observed to have worse outcomes. We evaluated the association between rScO2 and ABI in venoarterial (VA) ECMO patients. Methods: We retrospectively reviewed prospectively-collected NIRS data from patients undergoing VA ECMO from April 2016 to October 2016. Baseline demographics, ECMO and clinical characteristics, cerebral oximetry data, neuroradiographic images, and functional outcomes were reviewed for each patient...
2018: Frontiers in Neurology
Hiroshi Yamaguchi, Hiroaki Nagase, Masahiro Nishiyama, Shoichi Tokumoto, Yusuke Ishida, Kazumi Tomioka, Tsukasa Tanaka, Kyoko Fujita, Daisaku Toyoshima, Noriyuki Nishimura, Hiroshi Kurosawa, Kandai Nozu, Azusa Maruyama, Ryojiro Tanaka, Kazumoto Iijima
OBJECTIVES: To evaluate the proportion of children presenting to the emergency department (ED) with altered mental status who demonstrate nonconvulsive seizures on reduced-lead electroencephalography (EEG), and to further investigate the characteristics, treatment, and outcomes in these patients compared with patients without nonconvulsive seizures. STUDY DESIGN: In this retrospective cohort study, we reviewed the database and medical records of pediatric patients (aged <18 years) in a single ED between May 1, 2016, and April 30, 2018...
December 7, 2018: Journal of Pediatrics
Anthony Divito, Keith Kerr, Christopher Wilkerson, Scott Shepard, Alex Choi, Ryan Kitagawa
OBJECTIVES: Anticoagulant therapy (ACT) after traumatic intracranial hemorrhage may lead to progression of hemorrhage, but in the presence of thromboembolic events the clinician must decide if the benefits outweigh the risks. Currently, no data exist to guide therapy in the acute setting. PATIENTS AND METHODS: We retrospectively identified all patients admitted to our institution with traumatic intracranial hemorrhage that received intravenous heparin, full dose enoxaparin, or warfarin during their initial hospitalization over a three-year period...
December 5, 2018: World Neurosurgery
Cecily DuPree, Aaron Pinnola, Stefanie Gibson, Keely Muertos, John M Davis, Jason D Sciarretta
BACKGROUND: Mass casualty events are infrequent and create an abrupt surge of patients requiring emergency medical services within a brief period. We hypothesize that implementation of a controlled "traffic loop" pattern during a planned high-volume motorcycle rally could improve overall mortality and impact patient outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of all motorcycle-related injuries during the city's annual motorcycle rally over a 4-y period...
February 2019: Journal of Surgical Research
Mohammad Hamidi, Muhammad Zeeshan, Narong Kulvatunyou, Eseoghene Adun, Terence O'Keeffe, El Rasheid Zakaria, Lynn Gries, Bellal Joseph
BACKGROUND: Exsanguinating trauma patients often require massive blood transfusion (defined as transfusion of 10 or more pRBC units within first 24 h). The aim of our study is to assess the outcomes of trauma patients receiving massive transfusion at different levels of trauma centers. METHODS: Two-y (2013-2014) retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program. We included all adult trauma patients who received massive transfusion (MT) of blood...
February 2019: Journal of Surgical Research
Cheng-Hsin Cheng, Hung-Lin Lin, Hao-Yu Chuang
Tonsillar herniation is a rare and seldom reported complication after lumboperitoneal (LP) shunting. There have been only few reports that have presented possible options for treatment with varying degrees of success. In this report, we describe a rare case of tonsillar herniation after LP shunting and review related literature. A 17-year-old girl with hydrocephalus related to a traumatic brain injury underwent implantation of an adjustable pressure shunt (valve setting2.5) and a small lumen peritoneal catheter via the L4-L5 interspinal space...
December 6, 2018: British Journal of Neurosurgery
Galina V Portnova, Michael S Atanov
PRIMARY OBJECTIVE: We aimed to investigate the origin of EEG response of patients in coma and after moderate TBI to emotional stimulation, whether they distinguish emotional content or only react to the physical features of an audio signal. RESEARCH DESIGN: We registered EEG during continuous pleasant and unpleasant non-verbal stimulation and in rest. A total of 69 subjects participated in our study: healthy adults, conscious patients after moderate TBI and patients in coma after severe TBI...
December 6, 2018: Brain Injury: [BI]
Won Young Yong Jin, Jin Hee Jeong, Dong Hoon Kim, Tae Yun Kim, Changwoo Kang, Soo Hoon Lee, Sang Bong Lee, Seong Chun Kim, Yong Joo Park, Daesung Lim
BACKGROUND: The aim of this study was to identify factors predicting early mortality in trauma patients. METHODS: This was a study of 6288 trauma patients admitted to the hospital between July 2011 and June 2016. Among the variables recorded for a prospective trauma registry, the following were selected for analysis: sex; age; a combination of the Glasgow Coma Scale score, age, and systolic blood pressure (SBP) (GAP); a combination of the mechanism of injury, the Glasgow Coma Scale score, age, and SBP (MGAP); SBP; respiratory rate; peripheral oxygen saturation (SpO2 value); the Glasgow Coma Scale score; laboratory variables; and presentation time...
November 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Guangfu Di, Yuhai Zhang, Hua Liu, Xiaochun Jiang, Yong Liu, Kun Yang, Jiu Chen, Hongyi Liu
OBJECTIVE: Postoperative complications are common in patients who underwent decompressive craniectomy (DC) after traumatic brain injury (TBI). However, little is known about the degree of association between the postoperative complications and the long-term outcome of adult TBI patients after DC. The aim of this study was to evaluate the risk of postoperative complications that influenced the long-term outcome of DC in TBI patients. METHOD: A total of 121 patients were studied up to 6 months after DC in TBI...
December 4, 2018: Brain and Behavior
Mingzhe Zhang, Raynald Liu, Hongli Xing, Huixuan Luo, Leiting Cui, Zhaosheng Sun
We present a patient with pontine hemorrhage. On admission, the patient was in a comatose state (Glasgow coma scale, 3). Due to rapid deterioration of his breathing, we immediately performed a direct puncture to the hematoma site. We present a simple and rapid puncture method for drainage of hematomas. The method is described and discussed in detail in this article. The described technique may be beneficial in emergency situations where the condition of the patient, particularly their respiration is declining rapidly...
2018: Frontiers in Neurology
Jagoba Zarandona, Itziar Hoyos Cillero, Marta Arrue
BACKGROUND: Considering the prevalence and complexity of a stroke, it is necessary to think about how undergraduate nursing students are developing knowledge for stroke care. AIM: To obtain a vision of nursing students' learning, exploring difficulties concerning understanding stroke care delivery. DESIGN: A phenomenographic research approach. LOCATIONS AND PARTICIPANTS: This research is based on written exam papers (n = 126) from third-year nursing students enrolled in the 2015-16 academic year in two Nursing Schools in Spain...
November 24, 2018: Nurse Education Today
Shailendra Ratre, Nishtha Yadav, Vijay Singh Parihar, Amitesh Dubey, Yad Ram Yadav
Introduction: Although there are controversies about the optimal management of spontaneous intracerebral hemorrhage (ICH), benefits of endoscopic procedures in ICH have been reported. This study is aimed to evaluate the result of 270 patients undergoing endoscopic treatment of ICH. Methods: This was a retrospective study from July 2008 to June 2017. All procedures were done with the endoscopic technique using a tubular retractor. Patients with the hematoma volume between 30 to 80 ml, with the Glasgow Coma Scale (GCS) between 5 to 14, and evidence of severe mass effect, were included in the study...
November 2018: Neurology India
Tie-Jiang Chen, Ming-Xia Ji, Zhi-Qiang Tao, Qing-Yang Fu, Kai Xiong, Bin Cheng
BACKGROUND: Fibrinogen-like protein 2 (FGL2) is an inflammatory procoagulant protein. We discerned the impact of serum FGL2 on trauma severity and 30-day mortality in patients with traumatic brain injury (TBI). METHODS: A total of 114 severe TBI patients were subjected to assessment of trauma severity using the Glasgow coma scale (GCS). Measurement of the serum concentrations of FGL2 was done. 114 matched control subjects for their age and sex were included for comparison of serum concentration of FGL2...
November 29, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Christopher A Butts, Roberto Gonzalez, Linh Nguyen, John P Gaughan, Steven Ross, John Porter, Joshua P Hazelton
OBJECTIVE: Traditionally, all-terrain vehicles (ATVs) and dirt bikes (DBs) have been used in rural locations for recreation and work. Recently, there has been an increase in the use of these vehicles in an urban environment. The aim of this study is to compare the injury patterns of patients involved in crashes while riding off-road vehicles in both urban (UORV) and rural (RORV) environment. METHODS: A retrospective review (2005-2016) of patients who presented to an urban level 1 trauma center as a result of any ATV or DB crash was performed...
January 2019: Journal of Surgical Research
Amy Gl Nuttall, Katie M Paton, Alison M Kemp
OBJECTIVE: To evaluate utility and equivalence of Glasgow Coma Scale (GCS) and the Alert, Voice, Pain, Unresponsive (AVPU) scale in children with head injury. DESIGN: Cross sectional study. SETTING: UK hospital admissions: September 2009-February 2010. PATIENTS: <15 years with head injury. INTERVENTIONS: GCS and/or AVPU at injury scene and in emergency departments (ED). MAIN OUTCOME: Measures used, the equivalence of AVPU to GCS, GCS at the scene predicting GCS in ED, CT results by age, hospital type...
November 28, 2018: BMJ Open
(no author information available yet)
OBJECTIVETraumatic brain injury (TBI) is a significant cause of morbidity and mortality worldwide. Clinical outcomes in TBI are determined by the severity of injury, which is dependent on the primary and secondary brain injury processes. Whereas primary brain injury lesions are related to the site of impact, secondary brain injury results from physiological changes caused by oxidative stress and inflammatory responses that occur after the primary insult. The aim of this study was to identify important clinical and biomarker profiles that were predictive of recovery after moderate to severe TBI...
November 1, 2018: Journal of Neurosurgery
Zengpanpan Ye, Xiaolin Ai, Jun Zheng, Lu Ma, Sen Lin, Chao You, Hao Li
BACKGROUND Many factors are associated with the cerebral hypoperfusion after spontaneous intracerebral hemorrhage (sICH), however, the effect of cerebrovascular stenosis on peri-hematoma cerebral blood flow (CBF) and 90-day poor outcomes in patients with spontaneous intracerebral hemorrhage is still unclear. MATERIAL AND METHODS From September 2016 to March 2017, we prospectively collected data on adults with supratentorial spontaneous intracerebral hemorrhages. Using the Propensity Score model, we compared the peri-hematoma CBF and 90-day poor outcomes (mRS ≥3) in the stenosis group and the control group...
November 29, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Iftakher Hossain, Mehrbod Mohammadian, Riikka Sk Takala, Olli Tenovuo, Linnéa Lagerstedt, Henna Maria Ala-Seppälä, Janek Frantzén, Mark Van Gils, Peter John Hutchinson, Ari J Katila, Henna-Riikka Maanpää, David Menon, Virginia Newcombe, Jussi Tallus, Kevin Hrusovsky, David Wilson, Kaj Blennow, Jean-Charles Sanchez, Henrik Zetterberg, Jussi P Posti
To correlate the early levels of glial fibrillary acidic protein (GFAP) and neurofilament light protein (NF-L) with outcome in patients with mild traumatic brain injury (mTBI). 107 patients with mTBI [Glasgow Coma Scale (GCS) ≥13] having the blood samples for GFAP and NF-L available within 24 hrs from arrival were included. Patients with mTBI were divided into computed tomography (CT)-positive and CT-negative groups. Glasgow Outcome Scale extended (GOSE) was used to assess the outcome. Outcomes were defined as complete (GOSE 8) vs...
November 29, 2018: Journal of Neurotrauma
(no author information available yet)
OBJECTIVEThere remains uncertainty regarding the appropriate level of care and need for repeating neuroimaging among children with mild traumatic brain injury (mTBI) complicated by intracranial injury (ICI). This study's objective was to investigate physician practice patterns and decision-making processes for these patients in order to identify knowledge gaps and highlight avenues for future investigation.METHODSThe authors surveyed residents, fellows, and attending physicians from the following pediatric specialties: emergency medicine; general surgery; neurosurgery; and critical care...
October 1, 2018: Journal of Neurosurgery. Pediatrics
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