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Brain trauma injury

Daniel M Fountain, Angelos G Kolias, Rodney J Laing, Peter J Hutchinson
OBJECTIVES: Severe traumatic brain injury (TBI) is a potentially devastating insult to the brain with high rates of fatality and neurological deficits. TBI can result in substantial costs to the centre providing care. We sought to present the experience of a Major Trauma Centre (MTC) and ascertain the financial implications of this healthcare provision, in particular detailed costs, reimbursement and the surplus or deficit accrued by the centre. DESIGN: All cranial non-elective neurosurgical admissions with a TBI over 4...
October 22, 2016: British Journal of Neurosurgery
Cees de Baat, Paul de Baat, Anneloes E Gerritsen, Karien A Flohil, Gert-Jan van der Putten, Claar D van der Maarel-Wierink
One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma...
October 22, 2016: Special Care in Dentistry
Eve Valera, Aaron Kucyi
Traumatic brain injury (TBI) in women experiencing intimate-partner violence (IPV) is common, and IPV afflicts 30 % of women worldwide. However, the neurobiology and related sequelae of these TBIs have never been systematically examined. Consequently, TBI treatments are typically absent and IPV interventions are inadequate. There has been a call for a comprehensive assessment of IPV-related TBIs and their relationship to aspects of women's cognitive and neural functioning. In response, we examined brain-network organization associated with TBI and its cognitive effects using clinical interviews and neuropsychological measures as well as structural and functional Magnetic Resonance Imaging (fMRI) in women experiencing IPV-related TBI...
October 20, 2016: Brain Imaging and Behavior
Cameron A Elliott, Vijay Ramaswamy, Francois D Jacob, Tejas Sankar, Vivek Mehta
BACKGROUND: Traumatic brain injury (TBI) is a major cause of infant morbidity and mortality. In these patients, magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) is the test of choice to describe the extent of microstructural injury. CASE PRESENTATION AND DISCUSSION: In this case series, we describe novel acute and chronic MRI findings in four infants (6-19 months) with small, unilateral subdural hematomas in whom the etiology of head injury was suspicious for non-accidental trauma (NAT)...
October 20, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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
Rachael E C Schutz, Heather L Coats, Ruth A Engelberg, J Randall Curtis, Claire J Creutzfeldt
BACKGROUND: Patients with severe acute brain injury (SABI) raise important palliative care considerations associated with sudden devastating injury and uncertain prognosis. OBJECTIVE: The goal of this study was to explore how family members, nurses, and physicians experience the palliative and supportive care needs of patients with SABI receiving care in the neuroscience intensive care unit (neuro-ICU). DESIGN: Semistructured interviews were audiotaped, transcribed, and analyzed using thematic analysis...
October 20, 2016: Journal of Palliative Medicine
Sandro M Krieg, Raimund Trabold, Nikolaus Plesnila
Arginine-vasopressin (AVP) V1 receptors are known to mediate brain edema formation after traumatic brain injury (TBI). So far, however, AVP V1 receptors were only inhibited by genetic deletion or prior to trauma. Therefore the current study aimed to determine the therapeutic window of AVP V1 receptors anatomization after TBI. Male C57BL/6 mice (n=7 per group) were subjected to controlled cortical impact (CCI) and 500 ng of a selective peptide V1 receptor antagonist (V1880) were applied by intracerebroventricular injection 5 min, 1, 3, and 6 hours thereafter...
October 20, 2016: Journal of Neurotrauma
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
Thomas Beez, Jennifer Brown
BACKGROUND: Atlanto-occipital dislocation (AOD) is a rare but severe sequela of high energy trauma. Children are at increased risk, due to their immature spine and biomechanical characteristics. LITERATURE REVIEW: The prevailing mechanism of injury is motor vehicle collision as passenger. AOD commonly presents with cardiorespiratory arrest, spinal cord injury or cranial nerve deficits. Concomitant injuries, such as traumatic brain injury, are frequently encountered...
October 18, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Tellen D Bennett, Rebecca R Dixon, Cory Kartchner, Peter E DeWitt, Yamila Sierra, Diane Ladell, Allison Kempe, Desmond K Runyan, J Michael Dean, Heather T Keenan
OBJECTIVES: In children with traumatic brain injury, 1) to describe the hospital discharge functional outcome and change from baseline function using the Functional Status Scale and 2) to determine any associations between discharge Functional Status Scale and age, injury mechanism, neurologic examination, imaging, and other predictors of outcome. DESIGN: Prospective observational cohort study, May 2013 to November 2015. SETTING: Two U.S. children's hospitals designated as American College of Surgeons level 1 pediatric trauma centers...
October 6, 2016: Pediatric Critical Care Medicine
M Asunción Barreda-Manso, Natalia Yanguas-Casás, Manuel Nieto-Sampedro, Lorenzo Romero-Ramírez
Following a central nervous system (CNS) injury, restoration of the blood-brain barrier (BBB) integrity is essential for recovering homeostasis. When this process is delayed or impeded, blood substances and cells enter the CNS parenchyma, initiating an additional inflammatory process that extends the initial injury and causes so-called secondary neuronal loss. Astrocytes and profibrotic mesenchymal cells react to the injury and migrate to the lesion site, creating a new glia limitans that restores the BBB. This process is beneficial for the resolution of the inflammation, neuronal survival and the initiation of the healing process...
October 18, 2016: Journal of Cellular Physiology
N R Zembower, A Zhu, M Malczynski, C Qi
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the prevalence of brain and spinal cord injury (BSCI) patients among all patients with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) and to evaluate clinical characteristics and duration of colonization. SETTING: Tertiary care academic medical center. METHODS: Electronic medical records of BSCI patients with KPC-KP from February 2009 to December 2014 were reviewed to determine clinical characteristics...
October 18, 2016: Spinal Cord
J Willis Kiessling, Dean A Hertzler, David E M Drucker, Heather S Spader
BACKGROUND: This case report illustrates the need to evaluate the possibility of multiple arterial sources when presented with a frontal epidural hematoma associated with facial trauma. CASE DESCRIPTION: Our patient presented after being struck in the face by a baseball. Computed tomography (CT) of the brain revealed a large frontal epidural hematoma. Intraoperatively, bleeding from a frontal branch of the middle meningeal artery was encountered and cauterized, and the hematoma was removed...
October 14, 2016: World Neurosurgery
Vigneswaran Veeramuthu, Vairavan Narayanan, Norlisah Ramli, Aditya Hernowo, Vicknes Waran, Mark W Bondi, Lisa Delano-Wood, Dharmendra Ganesan
OBJECTIVE: To evaluate the extent of persistent neuropsychological impairment in patients with complicated versus uncomplicated mild traumatic brain injury (mTBI). METHODS: 61 patients with mTBI (GCS 13 to 15) were prospectively recruited, categorized according to baseline CT findings, and underwent neuropsychological assessment at initial admission (n=61) as well as at 6 month follow-up (n=30). A paired t-test, Cohen's d effect size calculation, and repeated measure ANOVA were used to establish the differences between the groups in terms of their neuropsychological performance...
October 14, 2016: World Neurosurgery
William Peacock
Dear Editor I read with great interest the manuscript titled "A New Panel of Blood Biomarkers for the Diagnosis of Mild Traumatic Brain Injury/Concussion in Adults" by Shan R, et al, published in the January issue of the Journal. (1) I do have some questions. The key to marker discovery studies is a precise and accurate description of how the population was identified, including controls. I have significant concerns about the control population in the manuscript. In the presentation the characteristics of the control group are unclear, described only as "not patients in the ED" and with the same exclusion criteria of the other cohorts...
October 18, 2016: Journal of Neurotrauma
Anthony R Mawson, Nola T Radford, Binu Jacob
Stuttering affects about 1% of the general population and from 8 to 11% of children. The onset of persistent developmental stuttering (PDS) typically occurs between 2 and 4 years of age. The etiology of stuttering is unknown and a unifying hypothesis is lacking. Clues to the pathogenesis of stuttering include the following observations: PDS is associated with adverse perinatal outcomes and birth-associated trauma; stuttering can recur or develop in adulthood following traumatic events such as brain injury and stroke; PDS is associated with structural and functional abnormalities in the brain associated with speech and language; and stuttering resolves spontaneously in a high percentage of affected children...
October 18, 2016: European Neurology
Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Sarit Shimony-Kanat, Julie Benbenishty
OBJECTIVE: To characterize trauma-related falls in infants and toddlers aged 0 to 3 years over a 4-year period and develop a risk stratification model of causes of fall injuries. METHODS: Data on falls of 0 to 3 year olds from 2009 to 2012 were identified from a Jerusalem tertiary hospital trauma registry (N = 422) and the National Trauma Registry of Israel (N = 4,131). RESULTS: Almost half of falls occurred during the first year of life, and 57% of the children were Jewish...
October 4, 2016: Pediatric Emergency Care
Philbert Y Van, Martin A Schreiber
PURPOSE OF REVIEW: The traumatically injured patient is at high risk for developing venous thromboembolism. Clinical practice guidelines developed by the American College of Chest Physicians and the Eastern Association for the Surgery of Trauma recognize the importance of initiating thromboprophylaxis, but the guidelines lack specific recommendations regarding the timing and dose of pharmacologic thromboprophylaxis. We review the literature regarding initiation of thromboprophylaxis in different injuries, the use of inferior vena cava filters, laboratory monitoring, dosing regimens, and the use of antiplatelet therapy...
October 5, 2016: Current Opinion in Critical Care
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
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