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Brain trauma injury

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https://www.readbyqxmd.com/read/28644101/safety-and-cost-efficiency-of-a-restrictive-transfusion-protocol-in-patients-with-traumatic-brain-injury
#1
Laura B Ngwenya, Catherine G Suen, Phiroz E Tarapore, Geoffrey T Manley, Michael C Huang
OBJECTIVE Blood loss and moderate anemia are common in patients with traumatic brain injury (TBI). However, despite evidence of the ill effects and expense of the transfusion of packed red blood cells, restrictive transfusion practices have not been universally adopted for patients with TBI. At a Level I trauma center, the authors compared patients with TBI who were managed with a restrictive (target hemoglobin level > 7 g/dl) versus a liberal (target hemoglobin level > 10 g/dl) transfusion protocol. This study evaluated the safety and cost-efficiency of a hospital-wide change to a restrictive transfusion protocol...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28643996/age-related-outcome-of-patients-after-traumatic-brain-injury-a-single-centre-observation
#2
Rolf Erlebach, Alberto Pagnamenta, Stephanie Klinzing, Federica Stretti, Silvia Cottini, Reto Schüpbach, Peter Steiger, Giovanna Brandi
BACKGROUND: Study-purpose is to analyze clinical features of patients with traumatic brain injury (TBI), their age-related outcomes and determinants of long- term outcome. METHODS: This retrospective cohort study was conducted in a level I University Swiss trauma center. Consecutive patients with moderate to severe TBI admitted for more than 48 hours to the Intensive Care Unit were included. Patients' and trauma characteristics, management during ICU-stay, prognostic scores and long- term outcomes were analyzed...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643032/fall-from-heights-does-height-really-matter
#3
G Alizo, J D Sciarretta, S Gibson, K Muertos, A Romano, J Davis, A Pepe
INTRODUCTION: Fall from heights is high energy injuries and constitutes a fraction of all fall-related trauma evaluations while bearing an increase in morbidity and mortality. We hypothesize that despite advancements in trauma care, the overall survivability has not improved in this subset of trauma patients. METHODS: All adult trauma patients treated after sustaining a fall from heights during a 40-month period were retrospectively reviewed. Admission demographics, clinical data, fall height (ft), injury patterns, ISS, GCS, length of stay, and mortality were reviewed...
June 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28641392/alcohol-is-not-protective-against-mortality-following-traumatic-brain-injury
#4
Jennifer S Albrecht, Majid Afshar, Deborah M Stein, Gordon S Smith
Alcohol exposure results in reduced mortality following traumatic brain injury (TBI) in animal models, yet clinical studies reported conflicting results and clinical trials based on proposed mechanisms have been disappointing. Methodological issues common to many of the clinical studies may have contributed to spurious results. Our objective was to evaluate the association between blood alcohol concentration (BAC) and in-hospital mortality following TBI, overcoming methodological problems of prior studies. We conducted a retrospective cohort study on individuals treated for isolated TBI at the R Adams Cowley Shock Trauma Center between 1997-2012 (n = 1,084)...
June 21, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28640776/early-fever-after-trauma-does-it-matter
#5
Holly E Hinson, Susan Rowell, Cynthia Morris, Amber L Lin, Martin A Schreiber
BACKGROUND: Fever is strongly associated with poor outcome after traumatic brain injury (TBI). We hypothesized that early fever is a direct result of brain injury and thus would be more common in TBI than in patients without brain injury, and associated with inflammation. METHODS: We prospectively enrolled patients with major trauma with and without TBI from a busy level I trauma center ICU. Patients were assigned to one of four groups based on their presenting Head Abbreviated Injury Severity Scale scores (HAIS): Polytrauma: Head AIS score >2, one other region>2, Isolated Head: Head AIS score>2, all other regions <3, Isolated Body: One region >2, excluding Head/Face, Minor Injury: No region with AIS>2...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28637553/more-helmets-fewer-deaths-motorcycle-helmet-legislation-impacts-traumatic-brain-injury-related-mortality-in-young-adults
#6
Ahmed Hassan, Tahereh Orouji Jokar, Peter Rhee, Kareem Ibraheem, Narong Kulvatunyou, Kathryn Tinsley Anderson, Lynn Gries, Zachary Thomas Roward, Bellal Joseph
The aim of our study was to assess the impact of helmet legislations on the incidence and the mortality rate of motorcycle collision (MCC)-related traumatic brain injury (TBI) in young adult trauma patients. A 1-year (2011) retrospective analysis was performed of all patients under 21 years old with trauma-related hospitalization using the Nationwide Inpatient Sample database (representing 20% of all in-patient admissions). Patients with MCC were identified using E-codes. States were classified into three groups based on helmet legislations: universal age helmet legislation, <18 years helmet legislation, and <21 years helmet legislation...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637551/outcomes-of-geriatric-trauma-patients-on-preinjury-anticoagulation-a-multicenter-study
#7
Darwin Ang, Stan Kurek, Mark McKenney, Scott Norwood, Brian Kimbrell, Erik Barquist, Huazhi Liu, Annette O'Dell, Michele Ziglar, James Hurst
Outpatient anticoagulation in the geriatric trauma patient is a challenging clinical problem. The aim of this study is to determine clinical outcomes associated with class of preinjury anticoagulants (PA) used by this population. This is a multicenter retrospective cohort study among four Level II trauma centers. A total of 1642 patients were evaluated; 684 patients were on anticoagulation and 958 patients were not. Patients on PA were compared with those who were not. Drug classes were divided into thromboxane A2 inhibitors, vitamin K factor-dependent inhibitors, antithrombin III activation, platelet P2Y12 inhibitors, and thrombin inhibitors...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28636962/reactive-astrocytes-production-function-and-therapeutic-potential
#8
REVIEW
Shane A Liddelow, Ben A Barres
Astrocytes constitute approximately 30% of the cells in the mammalian central nervous system (CNS). They are integral to brain and spinal-cord physiology and perform many functions important for normal neuronal development, synapse formation, and proper propagation of action potentials. We still know very little, however, about how these functions change in response to immune attack, chronic neurodegenerative disease, or acute trauma. In this review, we summarize recent studies that demonstrate that different initiating CNS injuries can elicit at least two types of "reactive" astrocytes with strikingly different properties, one type being helpful and the other harmful...
June 20, 2017: Immunity
https://www.readbyqxmd.com/read/28635146/the-effect-of-ct-scanners-in-the-trauma-room-an-observational-study
#9
S Wulffeld, L S Rasmussen, B Højlund Bech, J Steinmetz
BACKGROUND: A CT scanner incorporated in the trauma resuscitation bay may benefit trauma patients by fastening work-up times; however, evidence in the area is still sparse. We assessed if time from admission to first CT scan was lower after incorporation of a CT scanner in the resuscitation bay. METHODS: We included trauma patients admitted in two 1-year periods, before and after a major rebuilding of the trauma room. Beforehand, one CT scanner was located in an adjacent room...
June 20, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28631870/thalamic-deep-brain-stimulation-for-neuropathic-pain-efficacy-at-three-years-follow-up
#10
Vasco Abreu, Rui Vaz, Virgínia Rebelo, Maria José Rosas, Clara Chamadoira, Martin J Gillies, Tipu Z Aziz, Erlick A C Pereira
OBJECT: Chronic neuropathic pain is estimated to affect 3-4.5% of the worldwide population, posing a serious burden to society. Deep Brain Stimulation (DBS) is already established for movement disorders and also used to treat some "off-label" conditions. However, DBS for the treatment of chronic, drug refractory, neuropathic pain, has shown variable outcomes with few studies performed in the last decade. Thus, this procedure has consensus approval in parts of Europe but not the USA. This study prospectively evaluated the efficacy at three years of DBS for neuropathic pain...
June 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28628541/apathy-due-to-injury-of-the-prefrontocaudate-tract-following-mild-traumatic-brain-injury
#11
Sung Ho Jang, Hyeok Gyu Kwon
In this study, we report on a patient who developed apathy resulting from injury to the prefrontocaudate tract following mild traumatic brain injury (TBI), which was observed on diffusion tensor tractography (DTT). A 46-year-old female patient was involved in a bus accident. Her history included intracerebral hemorrhage (ICH) in the left putamen 4 years ago before the head trauma, and her family reported that she had fully recovered. She developed apathy after the TBI, worsening over time. Decreased neural connectivity of the left caudate nucleus (CN) to the left upper medial prefrontal cortex (PFC) resulting from the ICH was observed on the pre-TBI-DTT, whereas on the post-TBI-DTT (28 months after TBI), the neural connectivity of the left CN to the left upper medial PFC was increased, whereas that to the left lower medial PFC and orbitofrontal cortex was decreased...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28627447/pain-with-traumatic-brain-injury-and-psychological-disorders
#12
REVIEW
Samar Khoury, Rodrigo Benavides
Traumatic brain injury (TBI) is the cause for long-term disability in more than 3 million patients in the US alone, with chronic pain being the most frequently reported complain. To date, predisposing mechanisms for chronic pain in TBI patients are largely unknown. Psychological disorders, including post-traumatic stress disorder, depression and anxiety following TBI are commonly reported comorbidities to post-traumatic pain. Long term consequences can be debilitating and affect quality of life even when the injury is mild...
June 13, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28627348/-effect-of-hydrogen-rich-water-on-the-cd34-expression-in-lesion-boundary-brain-tissue-of-rats-with-traumatic-brain-injury
#13
Ying Liu, Qing Lan, Difen Wang, Xianjun Chen, Jia Yuan, Hailing Zhang
OBJECTIVE: To observe the effect of hydrogen-rich water on the CD34 expression and angiogenesis in lesion boundary brain tissue of rats with traumatic brain injury (TBI). METHODS: A total of 54 adult male Sprague-Dawley (SD) rats were divided into three groups by random number table: namely sham-operated group (sham group), trauma group (TBI group), and trauma + hydrogen-rich water group (TBI+HW group), the rats in each group were subdivided into 1, 3 and 7 days subgroups according to the time points after trauma, with 6 rats in each subgroup...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625441/the-protective-effects-of-dexmedetomidine-on-ischemic-brain-injury-a-meta-analysis
#14
REVIEW
Lianxiang Jiang, Meizhu Hu, Yan Lu, Ya Cao, Yan Chang, Zeping Dai
BACKGROUND: Intracranial lesions, trauma or surgery-related damage activate immune inflammation and neuroendocrine responses, causing ischemic brain injury. Studies have shown that inflammatory cascade mediated by neuroendocrine hormones and proinflammatory mediators is implicated in the pathophysiology of ischemic brain injury. Alpha2-adrenoceptor agonists, dexmedetomidine, is widely used as neuroprotectants in anesthesia practice. However, it is still lack of a comprehensive meta-analysis to evaluate the neuroprotection of dexmedetomidine against ischemic brain injury via suppressing these two physiological responses...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28624032/epidural-analgesia-for-traumatic-rib-fractures-is-associated-with-worse-outcomes-a-matched-analysis
#15
Katherine M McKendy, Lawrence F Lee, Kerianne Boulva, Dan L Deckelbaum, David S Mulder, Tarek S Razek, Jeremy R Grushka
BACKGROUND: The optimal method of pain control for patients with traumatic rib fractures is unknown. The aim of this study was to determine the effect of epidural analgesia on respiratory complications and in-hospital mortality in patients with rib fractures. METHODS: Adult patients at a level I trauma center with ≥1 rib fracture from blunt trauma were included (2004-2013). Those with a blunt-penetrating mechanism, traumatic brain injury, or underwent a laparotomy or thoracotomy were excluded...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623468/-intracranial-pressure-monitoring-in-polytrauma-patients-with-traumatic-brain-injury
#16
REVIEW
T Neubauer, W Buchinger, E Höflinger, J Brand
BACKGROUND: The monitoring of intracranial pressure (ICP) represents a cornerstone in the intensive care of patients with traumatic brain injury (TBI) and the industry provides various technical solutions to this end. Decompressive craniectomy can be an option if conservative measures fail to reduce excessive ICP. OBJECTIVE: To examine the pathophysiology of ICP in trauma, the management of polytrauma involving TBI, and the indications for decompressive craniectomy; and to compare the different monitoring systems and their complications...
June 16, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28623411/-i-am-not-afraid-of-death-a-survey-on-preferences-concerning-neurosurgical-interventions-among-patients-over-75-years
#17
Claudia Unterhofer, Wing Mann Ho, Katrin Wittlinger, Claudius Thomé, Martin Ortler
INTRODUCTION: Treatment decisions in elderly patients with traumatic brain injury (TBI) are mainly determined by trauma severity and patient age. The aim of this study was to explore personal preferences of potential patients regarding life-prolonging neurosurgical interventions by interviewing ambulatory, autonomous elderly people. METHODS: One hundred consecutive patients older than 75 years frequenting the outpatient clinic of the Department of Neurosurgery were interviewed about their attitudes regarding the hypothetical case of an 81-year-old patient with TBI and a space-occupying acute subdural hematoma (aSDH) using a 21-point questionnaire...
June 16, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28622071/survival-in-out-of-hospital-rapid-sequence-intubation-of-non-traumatic-brain-pathologies
#18
Pieter Francsois Fouche, Paul Andrew Jennings, Karen Smith, Malcolm Boyle, Gabriel Blecher, Jonathan Knott, Mani Raji, Pamela Rosengarten, Michael Roberto Augello, Stephen Bernard
INTRODUCTION: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28616019/hypoxia-inducible-factor-1-alpha-stabilization-for-regenerative-therapy-in-traumatic-brain-injury
#19
REVIEW
Mushfiquddin Khan, Hamza Khan, Inderjit Singh, Avtar K Singh
Mild traumatic brain injury (TBI), also called concussion, initiates sequelae leading to motor deficits, cognitive impairments and subtly compromised neurobehaviors. While the acute phase of TBI is associated with neuroinflammation and nitroxidative burst, the chronic phase shows a lack of stimulation of the neurorepair process and regeneration. The deficiency of nitric oxide (NO), the consequent disturbed NO metabolome, and imbalanced mechanisms of S-nitrosylation are implicated in blocking the mechanisms of neurorepair processes and functional recovery in the both phases...
May 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28614144/early-fibrinolysis-associated-with-hemorrhagic-progression-following-traumatic-brain-injury
#20
Jay Karri, Jessica C Cardenas, Nena Matijevic, Yao-Wei Wang, Sangbum Choi, Liang Zhu, Bryan A Cotton, Ryan Kitagawa, John B Holcomb, Charles E Wade
BACKGROUND: Progressive hemorrhagic injury (PHI) is common in patients with severe traumatic brain injury (TBI) and is associated with worse outcomes. PHI pathophysiology remains poorly understood and difficult to predict. We performed an exploratory analysis aimed at identify markers in need of further investigation to establish their predictive value in PHI following TBI. METHODS: We performed a retrospective chart review of prospectively collected data from 424 highest-level activation trauma patients from January 2012 through December 2013...
June 13, 2017: Shock
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