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https://www.readbyqxmd.com/read/29143568/the-inter-rater-reliability-and-prognostic-value-of-coma-scales-in-nepali-children-with-acute-encephalitis-syndrome
#1
Stephen Ray, Ajit Rayamajhi, Laura J Bonnett, Tom Solomon, Rachel Kneen, Michael J Griffiths
Background Acute encephalitis syndrome (AES) is a common cause of coma in Nepali children. The Glasgow coma scale (GCS) is used to assess the level of coma in these patients and predict outcome. Alternative coma scales may have better inter-rater reliability and prognostic value in encephalitis in Nepali children, but this has not been studied. The Adelaide coma scale (ACS), Blantyre coma scale (BCS) and the Alert, Verbal, Pain, Unresponsive scale (AVPU) are alternatives to the GCS which can be used. Methods Children aged 1-14 years who presented to Kanti Children's Hospital, Kathmandu with AES between September 2010 and November 2011 were recruited...
November 16, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29122733/readmissions-in-anticoagulated-intracranial-hemorrhage-patients-a-retrospective-review
#2
Monica M DiFiori, Laura C Lamb, Lori L Calavan, Christopher H Comey, James M Feeney
OBJECTIVE: The objective of this study was to determine the effect of Direct Oral Anticoagulants (DOACs) when compared to warfarin, on the 30-day readmission rates in patients with traumatic intracranial hemorrhage (ICH). METHODS: We conducted a retrospective review of patients from our hospital's trauma database admitted from June 2011 to October 2015 to our Level II trauma center after sustaining a traumatic ICH while anticoagulated. Patients were stratified based on the anticoagulation drug (DOAC or warfarin) they were prescribed upon admission...
November 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29095390/prediction-of-poor-prognosis-after-severe-head-injury-in-children-using-logistic-regression
#3
Rie Ichikawa, Yukihiro Maeda, Akiko Shibuya, Yoshimasa Umesato, Yoshiaki Kondo, Takeshi Maeda, Atsuo Yoshino, Shori Takahashi
OBJECTIVES: Head trauma is one of the main causes of death in childhood and often leaves severe disability with serious neurological damage. Appropriate treatment must be provided immediately to improve outcomes. This study was performed to identify factors associated with a poor prognosis at an early stage of severe head injury in children. METHODS: The subjects were registered in the Japan Neurotrauma Data Bank. They were 119 children (mean age, 8 years; male, 67...
October 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29077228/air-ambulance-delivery-and-administration-of-4-factor-prothrombin-complex-concentrate-is-feasible-and-decreases-time-to-anticoagulation-reversal
#4
Claire Vines, Stephanie J Tesseneer, Robert D Cox, Damon A Darsey, Kristin Carbrey, Michael A Puskarich
OBJECTIVES: To evaluate the feasibility, safety, and preliminary efficacy of four-factor prothrombin complex concentrate (4-factor PCC) administration by an air ambulance service prior to or during transfer of patients with warfarin-associated major hemorrhage to a tertiary care center for definitive management (interventional arm) compared to patients receiving 4-factor PCC following transfer by air ambulance or ground without 4-factor PCC treatment (conventional arm). METHODS: Retrospective chart review of patients presenting to a large academic medical center...
October 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29050383/early-detection-of-consciousness-in-patients-with-acute-severe-traumatic-brain-injury
#5
Brian L Edlow, Camille Chatelle, Camille A Spencer, Catherine J Chu, Yelena G Bodien, Kathryn L O'Connor, Ronald E Hirschberg, Leigh R Hochberg, Joseph T Giacino, Eric S Rosenthal, Ona Wu
See Schiff (doi:10.1093/awx209) for a scientific commentary on this article. Patients with acute severe traumatic brain injury may recover consciousness before self-expression. Without behavioural evidence of consciousness at the bedside, clinicians may render an inaccurate prognosis, increasing the likelihood of withholding life-sustaining therapies or denying rehabilitative services. Task-based functional magnetic resonance imaging and electroencephalography techniques have revealed covert consciousness in the chronic setting, but these techniques have not been tested in the intensive care unit...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29026668/fourth-ventricle-neurocysticercosis-rigid-endoscopic-management-description-of-direct-transcerebellar-approach
#6
A Ceja-Espinosa, J A Franco-Jiménez, A Sosa-Nájera, G A Gutiérrez-Aceves, M I Ruiz-Flores
BACKGROUND: Endoscopy has gained a crucial role in high specialty neurosurgery during the last decades. At present, there are well-defined flexible neuroendoscopic procedures to treat ventricular and subarachnoid space pathologies. Neurocysticercosis is recognized as a common cause of neurologic disease in developing countries and the United States. Surgical intervention, especially cerebrospinal fluid diversion, is the key for management of hydrocephalus. In 2002, a consensus suggested that ventricular forms should be treated with endoscopy as the first option...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29025525/-translation-and-validation-of-the-four-scale-for-children-and-its-use-as-outcome-predictor-a-pilot-study
#7
Sofia Simões Ferreira, Daniel Meireles, Alexandra Pinto, Francisco Abecasis
INTRODUCTION: The Full Outline of UnResponsiveness - FOUR scale has been previously validated to assess impaired consciousness in the adult population. The aim of this study is the translation into Portuguese and validation of the FOUR scale in the pediatric population. The study also compares the FOUR scale and Glasgow coma scale score ratings and the clinical outcome of patients hospitalized in Pediatric Intensive Care Units. MATERIAL AND METHODS: This study prospectively rated patients admitted to the Pediatric Intensive Care Units with impaired consciousness during one year...
September 29, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28972278/a-retrospective-study-of-ketamine-administration-and-the-development-of-acute-or-post-traumatic-stress-disorder-in-274-war-wounded-soldiers
#8
G Mion, J Le Masson, C Granier, C Hoffmann
The objective of this study was to explore whether ketamine prevents or exacerbates acute or post-traumatic stress disorders in military trauma patients. We conducted a retrospective study of a database from the French Military Health Service, including all soldiers surviving a war injury in Afghanistan (2010-2012). The diagnosis of post-traumatic stress disorder was made by a psychiatrist and patients were analysed according to the presence or absence of this condition. Analysis included the following covariables: age; sex; acute stress disorder; blast injury; associated fatality; brain injury; traumatic amputation; Glasgow coma scale; injury severity score; administered drugs; number of surgical procedures; physical, neurosensory or aesthetic sequelae; and the development chronic pain...
December 2017: Anaesthesia
https://www.readbyqxmd.com/read/28966304/the-profile-of-mmp-9-mmp-9-mrna-expression-1562-c-t-polymorphism-and-outcome-in-high-risk-traumatic-brain-injury-the-effect-of-therapeutic-mild-hypothermia
#9
Eko Prasetyo, Andi Asadul Islam, Mochammad Hatta, Djoko Widodo, Ilhamjaya Pattelongi
The aim of this study was to investigate the effect of mild hypothermia therapy (34-36°C) and the alterations of matrix metalloproteinase-9 (MMP-9) in 20 patients with high-risk traumatic brain injury (TBI). The neurologic status and outcome were assessed using Full Outline of UnResponsiveness (FOUR) score and Glasgow Coma Scale (GCS). A prospective randomized control study involved patients with high-risk TBI (FOUR score ≤ 7). Patients were randomized into two groups, with and without mild hypothermia therapy which were investigated within 24 and 72 h...
October 2, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28956660/traumatic-axonal-injury-despite-clinical-phenotype-of-mild-traumatic-brain-injury-a-case-report
#10
Sung Ho Jang, Han Do Lee
OBJECTIVES: We report on a patient who suffered traumatic axonal injury (TAI) of various neural tracts despite airbag deployment following mild traumatic brain injury (TBI), which was demonstrated by diffusion tensor tractography (DTT). CASE DESCRIPTION: A 58-year-old female patient suffered from head trauma resulting from an in-car traffic accident. At the time of head trauma, her head and face hit the deployed airbag after flexion-hyperextension-rotation injury...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28954004/independent-early-predictors-of-mortality-in-polytrauma-patients-a-prospective-observational-longitudinal-study
#11
Luiz Guilherme V da Costa, Maria José C Carmona, Luiz M Malbouisson, Sandro Rizoli, Joel Avancini Rocha-Filho, Ricardo Galesso Cardoso, José Otávio C Auler-Junior
OBJECTIVES: Trauma is an important public health issue and associated with substantial socioeconomic impacts and major adverse clinical outcomes. No single study has previously investigated the predictors of mortality across all stages of care (pre-hospital, emergency room, surgical center and intensive care unit) in a general trauma population. This study was designed to identify early predictors of mortality in severely injured polytrauma patients across all stages of care to provide a better understanding of the physiologic changes and mechanisms by which to improve care in this population...
August 2017: Clinics
https://www.readbyqxmd.com/read/28946586/unexpected-recovery-from-a-vegetative-state-or-misdiagnosis-lesson-learned-from-a-case-report
#12
Antonino Naro, Rocco Salvatore Calabrò, Patrizia Pollicino, Carmen Lombardo, Placido Bramanti
BACKGROUND: Growing research is focusing on the identification of markers predicting recovery and demonstrating covert awareness in patients with chronic disorders of consciousness (DOC). Herein, we describe the case of a woman who emerged from unresponsive wakefulness syndrome (UWS) after four years, in whom an experimental protocol assessing brain connectivity predicted her awareness recovery, indicating a functional locked-in syndrome (FLIS) diagnosis. CASE DESCRIPTION: A 68-year-old woman was admitted to our institute in 2012 in a UWS secondary to a severe brain hemorrhage, with a Coma Recovery Scale-Revised score of five...
September 16, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#13
Joseph P Drain, Douglas S Weinberg, James S Ramey, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective. OBJECTIVE: The purpose of this project is to identify factors that predict vertebral artery injury (VAI) in an effort to assess risks and benefits of computed tomography angiography (CT-A) of the neck in the trauma setting. We seek to develop guidelines for practitioners to stratify patients at medium/high risk of VAI from those who are at low risk. SUMMARY OF BACKGROUND DATA: VAI and blunt carotid injury (BCI) together comprise blunt cerebrovascular injury (BCVI)...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28919828/jugular-bulb-oxygen-saturation-correlates-with-full-outline-of-responsiveness-score-in-severe-traumatic-brain-injury-patients
#14
Tjokorda Gde Agung Senapathi, Made Wiryana, Ketut Sinardja, Ketut Wibawa Nada, Ida Bagus Krisna Jaya Sutawan, Christopher Ryalino, Aloysius Alphonso
BACKGROUND: Maintaining brain oxygenation status is the main goal of treatment in severe traumatic brain injury (TBI). Jugular venous oxygen saturation (SjvO2) monitoring is a technique to estimate global balance between cerebral oxygen supply and its metabolic requirement. Full Outline of Responsiveness (FOUR) score, a new consciousness measurement scoring, is expected to become an alternative for Glasgow Coma Scale (GCS) in evaluating neurologic status of patients with severe traumatic head injury, especially for those under mechanical ventilation...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28881122/traumatic-brain-injury-in-children-under-age-24-months-analysis-of-demographic-data-risk-factors-and-outcomes-of-post-traumatic-seizure
#15
Sang-Youl Yoon, Yeon-Ju Choi, Seong-Hyun Park, Jeong-Hyun Hwang, Sung Kyoo Hwang
OBJECTIVE: Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. METHODS: We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28862044/acute-lamotrigine-overdose-a-systematic-review-of-published-adult-and-pediatric-cases
#16
Bader Alyahya, Marjorie Friesen, Bénédicte Nauche, Martin Laliberté
CONTEXT: Lamotrigine is a broad-spectrum anticonvulsant commonly used to treat seizure and bipolar mood disorders. Evidence from case series and retrospective studies indicate that lamotrigine overdose is usually benign. However, there are reported cases of cardiac arrest and mortality following lamotrigine overdose. We undertook a systematic review of the literature on lamotrigine overdoses to better understand the clinical severity, the relevance of serum concentrations, and therapeutic interventions for overdose...
September 1, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28855775/studying-morbidity-and-predicting-mortality-in-patients-with-blunt-chest-trauma-using-a-novel-clinical-score
#17
Priyadarshini Manay, Rajeev R Satoskar, V Karthik, Ram P Prajapati
BACKGROUND: A departmental audit in March 2015 revealed significant mortality rate of 40% in blunt chest trauma patients (much greater than the global 25%). A study was thus planned to study morbidity and predictors of mortality in blunt chest trauma patients admitted to our hospital. METHODS: This study was a prospective observational study of 139 patients with a history of blunt chest trauma between June 2015 and November 2015 after the Institutional Ethics Committee approval in April 2015...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28822387/indicators-of-survival-and-favorable-functional-outcomes-after-decompressive-craniectomy-a-multi-institutional-retrospective-study
#18
MULTICENTER STUDY
Abid D Khan, Anna J Elseth, Brian Head, Jack Rostas, Julie A Dunn, Thomas J Schroeppel, Richard P Gonzalez
The role of decompressive craniectomy (DC) for severe traumatic brain injury (STBI) remains controversial. The purpose of this study was to identify factors that are indicators of survival and improved functional outcome in patients who undergo DC for STBI. A retrospective review of STBI patients who underwent DC was performed at four trauma centers during a 45-month period. Data collected included age, gender, mechanism of injury, Injury Severity Score (ISS), admission Glasgow Coma Scale (GCS), time from admission to DC, mortality, and extended Glasgow Outcome Score before discharge...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28803574/retrospective-evaluation-of-the-big-score-to-predict-mortality-in-pediatric-blunt-trauma
#19
Charlotte Grandjean-Blanchet, Guillaume Emeriaud, Marianne Beaudin, Jocelyn Gravel
OBJECTIVES: This study's objective was to measure the criterion validity of the BIG score (a new pediatric trauma score composed of the initial base deficit [BD], international normalized ratio [INR], and Glasgow Coma Scale [GCS]) to predict in-hospital mortality among children admitted to the emergency department with blunt trauma requiring an admission to the intensive care unit, knowing that a score <16 identifies children with a high probability of survival. METHODS: This was a retrospective cohort study performed in a single tertiary care pediatric hospital between 2008 and 2016...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28681745/a-randomized-controlled-study-of-operative-versus-nonoperative-treatment-for-large-spontaneous-supratentorial-intracerebral-hemorrhage
#20
Mukesh K Bhaskar, Rakesh Kumar, Balakrishna Ojha, Sunil K Singh, Nishant Verma, Rajesh Verma, Anil Chandra, Chhitij Srivastava, Manish Jaiswal, Somil Jaiswal, Harsha Huliyappa
CONTEXT: Spontaneous intracerebral haemorrhage (ICH) accounts for 4-14% of all strokes and has a high mortality rate of 30-50% during the first month. Management of large hematomas is controversial, with some advocating medical management while others favoring surgical evacuation. AIM: This study was undertaken to compare the outcome of patients with a spontaneous supratentorial intracerebral hemorrhage (SSICH) managed with or without surgical evacuation. SETTINGS AND DESIGN: Four hundred and eighty-two SSICH patients admitted from September 2013 to August 2015 were evaluated based on the inclusion and exclusion criteria...
July 2017: Neurology India
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