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Severe TBI

A Craig, N A Elbers, J Jagnoor, B Gopinath, A Kifley, M Dinh, I Pozzato, R Q Ivers, M Nicholas, I D Cameron
OBJECTIVE: To investigate the psychological impact of traffic injuries in bicyclists (cyclists) with comparisons to car occupants who also have sustained traffic injuries. Factors predictive of elevated psychological distress were also investigated. METHODS: An inception cohort prospective design was used. Participants included cyclists who sustained a physical injury (n = 238) aged ≥17 years (mean age 41.7yrs), assessed within 28 days of the crash, following medical examination by a registered healthcare practitioner...
October 20, 2016: Traffic Injury Prevention
Chung-Ching Chio, Mao-Tsun Lin, Ching-Ping Chang, Hung-Jung Lin
BACKGROUND: Transforming growth factor-beta 1 (TGF-β1) regulates many processes after traumatic brain injury (TBI). Both Neuro AiD(™) (MLC601) and Astragaloside (AST) attenuate microglia activation in rats with TBI. The purpose of this study was to investigate whether MLC601 or AST improves output of TBI by affecting microglial expression of TGF-β1. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (120 in number) were used to investigate the contribution of TGF-β1-containing microglia in the MLC601-mediated or the AST-mediated neuroprotection in the brain trauma condition using lateral fluid-percussion injury...
October 19, 2016: European Journal of Clinical Investigation
Victoria A McCredie, Simone Piva, Marlene Santos, Wei Xiong, Airton Leonardo de Oliveira Manoel, Andrea Rigamonti, Gregory M T Hare, Martin G Chapman, Andrew J Baker
BACKGROUND: There are a range of opinions on the benefits and thresholds for the transfusion of red blood cells in critically ill patients with traumatic brain injury (TBI) and an urgent need to understand the neurophysiologic effects. The aim of this study was to examine the influence of red blood cell transfusions on cerebral tissue oxygenation (SctO2) in critically ill TBI patients. METHODS: This prospective observational study enrolled consecutive TBI patients with anemia requiring transfusion...
October 18, 2016: Neurocritical Care
Rebeccah J Katzenberger, Barry Ganetzky, David A Wassarman
Outcomes of traumatic brain injury (TBI) vary because of differences in primary and secondary injuries. Primary injuries occur at the time of a traumatic event, whereas secondary injuries occur later as a result of cellular and molecular events activated in the brain and other tissues by primary injuries. We used a Drosophila melanogaster TBI model to investigate secondary injuries that cause acute mortality. By analyzing percent mortality within 24 hours of primary injuries, we previously found that age at the time of primary injuries and diet afterward affect the severity of secondary injuries...
October 17, 2016: G3: Genes—Genomes—Genetics
Abigail Livny, Anat Biegon, Tammar Kushnir, Sagi Harnof, Chen Hoffmann, Eyal Fruchter, Mark Weiser
Traumatic brain injury (TBI) is known to have a substantial, though highly variable, impact on cognitive abilities. Due to the wide range of cognitive abilities among healthy individuals, an objective assessment of TBI-related cognitive loss requires an accurate measurement of premorbid cognitive performance. To address this problem, we recruited 50 adults who sustained a TBI and had performed a cognitive baseline assessment in adolescence as part of the aptitude tests mandated by the Israeli Defense Forces...
October 18, 2016: Journal of Neurotrauma
Shannon B Juengst, Galen Switzer, Byung Mo Oh, Patricia M Arenth, Amy K Wagner
INTRODUCTION: Behavioral changes often occur after moderate-to-severe traumatic brain injury (TBI) and can lead to poor health, psychosocial functioning, and quality of life. Challenges in evaluating these behaviors often result from the complexity and variability in the way they are conceptualized and defined. We propose and test a conceptual model that is specific to behavioral symptoms after TBI, to serve as a basis for better assessment and treatment. We hypothesized that clusters of individuals, with unique emotional, cognitive, and behavioral characteristics, would emerge that would illustrate this conceptual model...
October 17, 2016: Journal of Clinical and Experimental Neuropsychology
Nickalus R Khan, Matthew A VanLandingham, Tamara M Fierst, Caroline Hymel, Kathryn Hoes, Linton T Evans, Rory Mayer, Fred Barker, Paul Klimo
BACKGROUND: Posttraumatic seizure (PTS) is a significant complication of traumatic brain injury (TBI). OBJECTIVE: To perform a systematic review and meta-analysis to compare levetiracetam with phenytoin for seizure prophylaxis in patients diagnosed with severe TBI. METHODS: An inclusive search of several electronic databases and bibliographies was conducted to identify scientific studies that compared the effect of levetiracetam and phenytoin on PTS...
September 30, 2016: Neurosurgery
Megan J Leonhard, Dagan A Wright, Rongwei Fu, David P Lehrfeld, Kathleen F Carlson
BACKGROUND: Traumatic brain injury (TBI) greatly contributes to morbidity and mortality in the pediatric population. We examined potential urban/rural disparities in mortality amongst Oregon pediatric patients with TBI treated in trauma hospitals. METHODS: We conducted a retrospective study of children ages 0-19 using the Oregon Trauma Registry for years 2009-2012. Geographic location of injury was classified using the National Center for Health Statistics Urban/Rural Classification Scheme...
December 2015: Injury Epidemiology
Philippe Azouvi, Idir Ghout, Eleonore Bayen, Emmanuelle Darnoux, Sylvie Azerad, Alexis Ruet, Claire Vallat-Azouvi, Pascale Pradat-Diehl, Philippe Aegerter, James Charanton, Claire Jourdan
OBJECTIVES: To assess predictors and indicators of disability and quality-of-life 4 years after severe traumatic brain injury (TBI), using structural equation modelling (SEM). METHODS: The PariS-TBI study is a longitudinal multi-centre inception cohort study of 504 patients with severe TBI. Among 245 survivors, 147 patients were evaluated upon 4-year follow-up, and 85 completed the full assessment. Two outcome measures were analysed separately using SEM: the Glasgow Outcome Scale-extended (GOS-E), to measure disability, and the QOLIBRI, to assess quality-of-life...
October 14, 2016: Brain Injury: [BI]
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]
Anne C Ritter, Amy K Wagner, Anthony Fabio, Mary Jo Pugh, William C Walker, Jerzy P Szaflarski, Ross D Zafonte, Allen W Brown, Flora M Hammond, Tamara Bushnik, Douglas Johnson-Greene, Timothy Shea, Jason W Krellman, Joseph A Rosenthal, Laura E Dreer
OBJECTIVE: Determine incidence of posttraumatic seizure (PTS) following traumatic brain injury (TBI) among individuals with moderate-to-severe TBI requiring rehabilitation and surviving at least 5 years. METHODS: Using the prospective TBI Model Systems National Database, we calculated PTS incidence during acute hospitalization, and at years 1, 2, and 5 postinjury in a continuously followed cohort enrolled from 1989 to 2000 (n = 795). Incidence rates were stratified by risk factors, and adjusted relative risk (RR) was calculated...
October 14, 2016: Epilepsia
Stephanie A Kolakowsky-Hayner, Kimberly Bellon, Ketra Toda, Tamara Bushnik, Jerry Wright, Linda Isaac, Jeffrey Englander
Fatigue is one of the most commonly reported sequelae after traumatic brain injury (TBI). This study evaluated the impact of a graduated physical activity programme on fatigue after TBI. Using a prospective randomised single-blind crossover design, 123 individuals with TBI, over the age of 18, were enrolled. Interventions included a home-based walking programme utilising a pedometer to track daily number of steps at increasing increments accompanied by tapered coaching calls over a 12-week period. Nutritional counselling with the same schedule of coaching calls served as the control condition...
October 13, 2016: Neuropsychological Rehabilitation
Ana Luiza Zaninotto, Jessica Elias Vicentini, Davi Jorge Fontoura Solla, Tatiana Tateishi Silva, Vinicius Monteiro de Paula Guirado, Fabrício Feltrin, Mara Cristina Souza de Lucia, Manoel Jacobsen Teixeira, Wellingson Silva Paiva
OBJECTIVE: Diffuse axonal injury (DAI) is prevalent in traumatic brain injury (TBI), and is often associated with poor outcomes and cognitive impairment, including memory deficits. Few studies have explored visual memory after TBI and its relationship to executive functioning. Executive functioning is crucial for remembering an object's location, operating devices, driving, and route finding. We compared visual memory performance via the Rey-Osterrieth Complex Figure (ROCF) test 6 and 12 months after DAI...
October 11, 2016: Acta Neuropsychiatrica
Ranabir Pal, Ashok Munivenkatappa, Amit Agrawal, Geetha R Menon, Sagar Galwankar, P Rama Mohan, S Satish Kumar, B V Subrahmanyam
BACKGROUND: A reliable prediction of outcome for the victims of traumatic brain injury (TBI) on admission is possible from concurrent data analysis from any systematic real-time registry. OBJECTIVE: To determine the clinical relevance of the findings from our TBI registry to develop prognostic futuristic models with readily available traditional and novel predictors. MATERIALS AND METHODS: Prospectively collected data using predesigned pro forma were analyzed from the first phase of a trauma registry from a South Indian Trauma Centre, compatible with computerized management system at electronic data entry and web data entry interface on demographics, clinical, management, and discharge status...
July 2016: International Journal of Critical Illness and Injury Science
David Salisbury, Simon J Driver, Megan Reynolds, Monica Bennett, Laura B Petrey, Anne Marie Warren
OBJECTIVE: To investigate trends of hospital-based health care utilization after admission to a Level 1 trauma center following acute traumatic brain injury (TBI). DESIGN: Retrospective review. SETTING: Large urban trauma hospital and a hospital council data registry consisting of 88 member institutions (>150 hospitals) covering 15,000 square miles. PARTICIPANTS: All patients admitted to a Level I trauma center between January 2006 - June 2014 who experienced an acute TBI based on ICD-9 coding...
October 6, 2016: Archives of Physical Medicine and Rehabilitation
Marquitta Smith, Thuvan Piehler, Richard Benjamin, Karen L Farizatto, Morgan C Pait, Michael F Almeida, Vladimir V Ghukasyan, Ben A Bahr
Explosives create shockwaves that cause blast-induced neurotrauma, one of the most common types of traumatic brain injury (TBI) linked to military service. Blast-induced TBIs are often associated with reduced cognitive and behavioral functions due to a variety of factors. To study the direct effects of military explosive blasts on brain tissue, we removed systemic factors by utilizing rat hippocampal slice cultures. The long-term slice cultures were briefly sealed air-tight in serum-free medium, lowered into a 37°C water-filled tank, and small 1...
October 5, 2016: Experimental Neurology
Ding-Kuo Chien, Hei-Fen Hwang, Mau-Roung Lin
This study compared the ability of five injury severity measures, namely the Abbreviated Injury Scale to the Head (AIS-H), Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), Extended Glasgow Outcome Scale (GOSE), and Injury Severity Score (ISS), to predict return-to-work after a traumatic brain injury (TBI). Furthermore, factors potentially associated with return-to-work were investigated. In total, 207 individuals aged ≤65 years newly diagnosed with a TBI and employed at the time of injury were recruited and followed-up for 1year by telephone every 3 months...
October 4, 2016: Accident; Analysis and Prevention
Anne Moessner, James F Malec, Scott Beveridge, Cara Camiolo Reddy, Tracy Huffman, Julia Marton, Audrey J Schmerzler
PRIMARY OBJECTIVE: To develop and provide initial validation of a measure for accurately determining the need for Constant Visual Observation (CVO) in patients with traumatic brain injury (TBI) admitted to inpatient rehabilitation. RESEARCH DESIGN: Rating scale development and evaluation through Rasch analysis and assessment of concurrent validity. METHODS AND PROCEDURES: One hundred and thirty-four individuals with moderate-severe TBI were studied in seven inpatient brain rehabilitation units associated with the National Institute for Disability, Independent Living and Rehabilitation Research (NIDILRR) TBI Model System...
August 11, 2016: Brain Injury: [BI]
Jonathan Lifshitz, Rachel K Rowe, Daniel R Griffiths, Megan N Evilsizor, Theresa C Thomas, P David Adelson, Tracy K McIntosh
BACKGROUND: After 30 years of characterisation and implementation, fluid percussion injury (FPI) is firmly recognised as one of the best-characterised reproducible and clinically relevant models of TBI, encompassing concussion through diffuse axonal injury (DAI). Depending on the specific injury parameters (e.g. injury site, mechanical force), FPI can model diffuse TBI with or without a focal component and may be designated as mild-to-severe according to the chosen mechanical forces and resulting acute neurological responses...
August 11, 2016: Brain Injury: [BI]
Jacqueline A Rushby, Skye McDonald, Alana C Fisher, Emma J Kornfeld, Frances M De Blasio, Nicklas Parks, Olivier Piguet
Severe traumatic brain injury (TBI) often leads to deficits in physiological arousal and empathy, which are thought to be linked. This study examined whether injury-related brain volume loss in key limbic system structures is associated with these deficits. Twenty-four adults with TBI and 24 matched Controls underwent MRI scans to establish grey matter volumes in the amygdala, thalamus, and hippocampus. EEG and skin conductance levels were recorded to index basal physiological arousal. Self-report emotional empathy levels were also assessed...
2016: NeuroImage: Clinical
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