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https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28663765/minimally-invasive-thalamic-hematoma-drainage-can-improve-the-six-month-outcome-of-thalamic-hemorrhage
#9
Wen-Ming Liu, Xue-Guang Zhang, Ze-Li Zhang, Gang Li, Qi-Bing Huang
OBJECTIVE: To explore predictors of the 6-month clinical outcome of thalamic hemorrhage, and evaluate if minimally invasive thalamic hematoma drainage (THD) could improve its prognosis. METHODS: A total of 54 patients with spontaneous thalamic hemorrhage were evaluated retrospectively. Clinical data, including demographics, stroke risk factors, neuroimaging variables, Glasgow Coma Score (GCS) on admission, surgical strategy, and outcome, were collected. Clinical outcome was assessed using a modified Rankin Scale, six months after onset...
April 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28632657/role-of-computed-tomography-in-the-classification-of-pediatric-pelvic-fractures-revisited
#10
Melissa A Bent, William L Hennrikus, Johan E Latorre, Douglas G Armstrong, Brian Shaw, Kerwyn C Jones, Lee S Segal
OBJECTIVES: To determine the need for computerized tomography (CT) scans in the assessment of pediatric pelvic fractures. DESIGN: Retrospective Chart Review. SETTING: Level-1 Pediatric Trauma Center. PATIENTS/PARTICIPANTS: Thirty pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT scan. MAIN OUTCOME MEASUREMENTS: Fleiss Kappa coefficient to compare interreliability...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28622477/an-examination-of-factors-affecting-the-length-of-stay-in-a-palliative-care-center
#11
Metin Dincer, Kadriye Kahveci, Cihan Doger
BACKGROUND: With the increase in elderly population, life-threatening chronic diseases are increasing, simultaneously increasing the need for palliative care centers (PCCs). OBJECTIVES: To evaluate the factors affecting the length of stay (LOS) and discharge of patients from a PCC. METHODS: A retrospective scan was made of the records of patients followed up in the PCC between January 2013 and March 2016. A record was made of patient age, gender, diagnosis, conditions/comorbidities, Glasgow Coma Scale, Karnofsky Performance Scale, LOS, prognosis (exitus or surviving), percutaneous endoscopic gastrostomy (PEG), tracheostomy, mechanical ventilator, nutrition (total parenteral nutrition [TPN] or enteral nutrition), and the results of cultures taken during stay in PCCs (blood, tracheal aspirate, urine, rectal swab, wound)...
June 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28618921/surgical-evacuation-of-acute-subdural-hematoma-in-octogenarians-a-ten-year-experience-from-a-single-trauma-center
#12
Michael J McGinity, Joel E Michalek, Jesse S Rodriguez, John R Floyd
BACKGROUND: Elderly patients presenting with an acute subdural hematoma (aSDH) have historically had unfavorable outcomes. METHODS: We retrospectively reviewed patient records from 2005 through 2015 that were ≥80 years of age and underwent surgical evacuation of aSDH. RESULTS: Thirty-four patients met inclusion criteria, with a mean age of 84 years (range 80-91). Glascow Outcome Scale (GOS) of 4-5 was deemed a good outcome and a GOS 1-3 was deemed to be a poor outcome...
June 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28612131/three-factor-versus-four-factor-prothrombin-complex-concentrate-for-the-emergent-management-of-warfarin-associated-intracranial-hemorrhage
#13
Daniel Fischer, Jeffrey Sorensen, Gabriel V Fontaine
BACKGROUND: Four-factor prothrombin complex concentrates (PCC) produce a more rapid and complete INR correction compared with 3-factor PCC in patients receiving warfarin. It is unknown if this improves clinical outcomes in the setting of intracranial hemorrhage (ICH). METHODS: This multicenter, retrospective cohort study included patients presenting with warfarin-associated ICH reversed with either 4- or 3-factor PCC. The primary outcome was in-hospital mortality...
June 13, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28553427/functional-evaluation-of-awareness-in-vegetative-and-minimally-conscious-state
#14
Silvia Marino, Lilla Bonanno, Rosella Ciurleo, Annalisa Baglieri, Rosa Morabito, Silvia Guerrera, Carmela Rifici, Antonio Giorgio, Placido Bramanti, Nicola De Stefano
OBJECTIVE: The aim of this study was to assess differences in brain activation in a large sample of Vegetative State (VS) and Minimally Conscious State (MCS) patients, using functional magnetic resonance imaging (fMRI). METHODS: We studied 50 patients four to seven months after brain injury. By using international clinical criteria and validated behavioural scales such as the Glasgow Coma Scale and the Clinical Unawareness Assessment Scale, the patients were grouped into VS (n=23) and MCS (n=27)...
2017: Open Neuroimaging Journal
https://www.readbyqxmd.com/read/28534673/effects-of-preference-and-sensory-modality-on-behavioural-reaction-in-patients-with-disorders-of-consciousness
#15
L Heine, B Tillmann, M Hauet, A Juliat, A Dubois, S Laureys, M Kandel, J Plailly, J Luauté, F Perrin
BACKGROUND: Reliable evaluation of patients with unresponsive wakefulness syndrome (UWS) or in a minimally conscious state (MCS) remains a major challenge. It has been suggested that the expression of residual cerebral function could be improved by allowing patients to listen to their favourite music. However, the potential effect of music on behavioural responsiveness, as well as the effect of preferred stimuli in other sensory modalities (e.g. olfaction), remain poorly understood. OBJECTIVE: The aim of our study was to investigate the effect of sensory modality (auditory versus olfactory) and preference (preferred versus neutral) of the test stimuli on patients' subsequent performance on the Coma Recovery Scale-Revised (CRS-R)...
May 23, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28523336/multum-in-parvo
#16
Dan Cristian Voinescu, Aurel George Mohan, Andrei Alexandru Marinescu, Alexandru Vlad Ciurea
The authors begin from the Latin expression Multum in parvo, which is used to summarize the essential aspects of something. This phrase is used in this case to define the Glasgow Coma Scale (GCS) - the posttraumatic conscious state evaluation scale. The authors gather the entire information regarding the creation of a uniform evaluation scale for the patients that have the state of consciousness altered or are even in a posttraumatic coma. This subject has been thoroughly debated for over 40 years. Teasdale & Jennett represented a huge step in the evaluation of patient's state of consciousness...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28521527/employment-outcome-four-years-after-a-severe-traumatic-brain-injury-results-of-the-paris-severe-traumatic-brain-injury-study
#17
Alexis Ruet, Claire Jourdan, Eléonore Bayen, Emmanuelle Darnoux, Dalila Sahridj, Idir Ghout, Sylvie Azerad, Pascale Pradat Diehl, Philippe Aegerter, James Charanton, Claire Vallat Azouvi, Philippe Azouvi
OBJECTIVE: To describe employment outcome four years after a severe traumatic brain injury by the assessment of individual patients' preinjury sociodemographic data, injury-related and postinjury factors. DESIGN: A prospective, multicenter inception cohort of 133 adult patients in the Paris area (France) who had received a severe traumatic brain injury were followed up postinjury at one and four years. Sociodemographic data, factors related to injury severity and one-year functional and cognitive outcomes were prospectively collected...
May 18, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28511965/relationship-between-hospital-volume-and-outcomes-in-patients-with-traumatic-brain-injury-a-retrospective-observational-study-using-a-national-inpatient-database-in-japan
#18
Tomoki Wada, Hideo Yasunaga, Kent Doi, Hiroki Matsui, Kiyohide Fushimi, Yoichi Kitsuta, Susumu Nakajima
BACKGROUND: The relationship between hospital volume and outcome after traumatic brain injury (TBI) is not completely understood in a real clinical setting. We investigated whether patients admitted with TBI achieved better outcomes in high-volume hospitals than in low-volume hospitals using a national inpatient database in Japan. METHODS: This retrospective cohort study used the Diagnosis Combination Procedure database in Japan. We included patients with TBI admitted to hospitals with a Japan Coma Scale (JCS) score ≥2 between April 1, 2013 and March 31, 2014...
May 3, 2017: Injury
https://www.readbyqxmd.com/read/28496029/a-newly-established-severity-scoring-system-in-predicting-the-prognosis-of-patients-with-severe-fever-with-thrombocytopenia-syndrome
#19
Bo Yang, Xiaoli Wang, Yaping Li, Anzhao Wu, Qian Liu, Yuyin Lu, Chengmin Yuan, Mingming Wang
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by novel Bunyavirus. Due to the peculiarity of SFTS, accurate assessment is difficult to achieve with the current score systems. This study aimed to establish a new severity scoring system in predicting the prognosis of patients with SFTS. We included 123 patients with SFTS: 92 patients (45 males and 47 females), aged 59 ± 12 years, in survive group and 31 patients (17 males and 14 females), aged 61 ± 10 years, in death group...
May 2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28455815/perfusion-abnormalities-are-frequently-detected-by-early-ct-perfusion-and-predict-unfavourable-outcome-following-severe-traumatic-brain-injury
#20
Cino Bendinelli, Shannon Cooper, Tiffany Evans, Andrew Bivard, Dianne Pacey, Mark Parson, Zsolt J Balogh
BACKGROUND: In patients with severe traumatic brain injury (TBI), early CT perfusion (CTP) provides additional information beyond the non-contrast CT (NCCT) and may alter clinical management. We hypothesized that this information may prognosticate functional outcome. METHODS: Five-year prospective observational study was performed in a level-1 trauma centre on consecutive severe TBI patients. CTP (obtained in conjunction with first routine NCCT) was interpreted as: abnormal, area of altered perfusion more extensive than on NCCT, and the presence of ischaemia...
April 28, 2017: World Journal of Surgery
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