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Glasgow Coma Scale

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https://www.readbyqxmd.com/read/28323524/comparison-of-two-predictive-models-for-short-term-mortality-in-patients-after-severe-traumatic-brain-injury
#1
Klara Julia Kesmarky, Cécile Delhumeau, Marie Zenobi, Bernhard Walder
The Glasgow Coma Scale (GCS) and the abbreviated injury score of the head region (HAIS) are validated prognostic factors in traumatic brain injury (TBI). The aim of this study was to compare the prognostic performance of an alternative predictive model including motor GCS, pupillary reactivity, age, HAIS, and presence of multi-trauma for short term mortality with a reference predictive model including motor GCS, pupil reaction and age (IMPACT core model). A secondary analysis of a prospective epidemiological cohort study in Switzerland including patients after severe TBI (HAIS >3) with the outcome death at 14 days was performed...
March 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28323516/does-normobaric-hyperoxia-cause-oxidative-stress-in-the-injured-brain-a-microdialysis-study-using-8-iso-pgf2%C3%AE-as-a-biomarker
#2
Marian Vidal-Jorge, Angela Sánchez-Guerrero, Gemma Mur-Bonet, Lidia Castro, Andreea Rădoi, Marilyn Riveiro, Natividad Fernández-Prado, Jacinto Baena, Maria A Poca, Juan Sahuquillo
Significant controversy exists regarding the potential clinical benefit of normobaric hyperoxia therapy (NBO) in patients with traumatic brain injury (TBI). This study consisted of two aims: 1) to assess whether NBO improves brain oxygenation and metabolism and 2) to determine whether this therapy may increase the risk of oxidative stress (OxS), using 8-iso-PGF2α as a biomarker. Thirty-one patients with a median admission Glasgow Coma Scale score of 4 (min: 3, max: 12) were monitored with cerebral microdialysis and brain tissue oxygen sensors and treated with FiO2 of 1...
March 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28315797/craniotomy-versus-decompressive-craniectomy-for-acute-subdural-hematoma-systematic-review-and-meta-analysis
#3
Kevin Phan, Justin M Moore, Christoph Griessenauer, Adam A Dmytriw, Daniel B Scherman, Sharaf Sheik-Ali, Nimer Adeeb, Christopher S Ogilvy, Ajith Thomas, Jeffrey V Rosenfeld
INTRODUCTION: Acute subdural hematoma (SDH) is a major cause of morbidity following severe traumatic brain injury. Surgical evacuation of the hematoma, either via craniotomy or craniectomy, is the mainstay of treatment in patients with progressive neurological deficits or significant mass effect. However, the decision between either procedure remains controversial. METHODS: A literature search using major online databases and a manual search of reference on the topic of craniotomy and craniectomy for evacuation of subdural hematoma until September 2016 was performed...
March 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28299469/comparative-evaluation-of-h-h-and-wfns-grading-scales-with-modified-h-h-sans-systemic-disease-a-study-on-1000-patients-with-subarachnoid-hemorrhage
#4
Ashish Aggarwal, Sivashanmugam Dhandapani, Kokkula Praneeth, Harsimrat Bir Singh Sodhi, Sudhir Singh Pal, Sachin Gaudihalli, N Khandelwal, Kanchan K Mukherjee, M K Tewari, Sunil Kumar Gupta, S N Mathuriya
The comparative studies on grading in subarachnoid hemorrhage (SAH) had several limitations such as the unclear grading of Glasgow Coma Scale 15 with neurological deficits in World Federation of Neurosurgical Societies (WFNS), and the inclusion of systemic disease in Hunt and Hess (H&H) scales. Their differential incremental impacts and optimum cut-off values for unfavourable outcome are unsettled. This is a prospective comparison of prognostic impacts of grading schemes to address these issues. SAH patients were assessed using WFNS, H&H (including systemic disease), modified H&H (sans systemic disease) and followed up with Glasgow Outcome Score (GOS) at 3 months...
March 15, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28298042/the-effect-of-cranioplasty-following-decompressive-craniectomy-on-cerebral-blood-perfusion-neurological-and-cognitive-outcome
#5
Adnan Hussain Shahid, Manju Mohanty, Navneet Singla, Bhagwant Rai Mittal, Sunil Kumar Gupta
OBJECTIVE Decompressive craniectomy is an established therapy for refractory intracranial hypertension. Cranioplasty following decompressive craniectomy not only provides protection to the brain along with cosmetic benefits, but also enhances rehabilitation with meaningful functional recovery of potentially reversible cortical and subcortical damaged areas of the affected as well as the contralateral hemisphere. The aim of the study was to assess neurological and cognitive outcome as well as cerebral blood flow after cranioplasty...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28297825/-the-clinical-application-of-retractorless-surgery-in-patients-with-hypertensive-basal-ganglia-hemorrhage
#6
Z H Zhao, X M Zhong, Y Q Wang, J G Yang, Y Cai, Z H Fei, L Zhang
Objective: To discuss the clinical feasibility and practical application of retractorless surgical for patients with hypertensive basal ganglia hemorrhage. Methods: A total of 84 patients underwentretractorless surgery in The First People's Hospital of Huzhou from Jun 2014 to Jun 2016 were retrospectively reviewed.There were 53 male and 31 female of the 84 patients. Their mean age were 58.7 years with range: 29-74 years.Glasgow coma scale score(GCS) at admissionwereas follow: GCS 4-5 points 10 cases(including 3 cases companied dilated pupils), GCS 6-8 points 25 cases, GCS 9-12 points 32 cases, and GCS 13-14 points 17 cases...
March 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28296530/early-post-haemorrhagic-stroke-testosterone-and-oestradiol-levels-and-long-term-risk-of-death
#7
Jing Cai, Jingbo Li, Shuda Chen, Jing Meng, Reng Ren, Min Li
OBJECTIVE: The influence of oestrogen and testosterone replacement on stroke risk has been examined, as well as mechanisms by which oestrogen may protect from post-stroke damage. However, whether testosterone levels in the early time period after haemorrhagic stroke influence long-term mortality has not previously been investigated. We examined whether these concentrations were predictive of risk of death. SETTING: University hospital. DESIGN: Prospective study...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28296528/the-impact-of-early-hyperglycaemia-on-children-with-traumatic-brain-injury
#8
Yue-Qiang Fu, Shu-Ling Chong, Jan Hau Lee, Cheng-Jun Liu, Sheng Fu, Tsee Foong Loh, Kee Chong Ng, Feng Xu
OBJECTIVE: Hyperglycaemia is common amongst children with traumatic brain injury (TBI). We aim to investigate the association between early hyperglycaemia and poor clinical outcomes in children with moderate to severe TBI. METHODS: We performed a retrospective study in a tertiary paediatric hospital between May 2012 and October 2014 of all patients with TBI who were aged <16 years with a Glasgow Coma Scale (GCS) of ≤13. The primary outcome was death. Secondary outcomes were 14 ventilation-free, 14 paediatric intensive care unit (PICU)-free and 28 hospital-free days...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28293979/work-related-difficulties-in-patients-with-traumatic-brain-injury-a-systematic-review-on-predictors-and-associated-factors
#9
Chiara Scaratti, Matilde Leonardi, Davide Sattin, Silvia Schiavolin, Michelle Willems, Alberto Raggi
PURPOSE: To address the content of work-related difficulties and explore which variables are associated to or determinants of these difficulties in persons that suffered from Traumatic Brain Injury (TBI). METHOD: Papers published between 1993 and February 2015 were included. Quality was judged as poor, acceptable, good or excellent. Determinants were extracted from longitudinal data, associated variables from cross-sectional data; variables were grouped by similarity...
May 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28293977/a-prospective-pilot-study-on-serum-cleaved-tau-protein-as-a-neurological-marker-in-severe-traumatic-brain-injury
#10
Sharad Pandey, Kulwant Singh, Vivek Sharma, Deepa Pandey, Ravi Prakash Jha, Sunil Kumar Rai, Richa Singh Chauhan, Royana Singh
OBJECTIVE: Neurotrauma has been labelled as a "silent epidemic" affecting both the developed and the developing nations. To date, no single brain-specific biomarker has been unanimously accepted for routine clinical use in TBI. Our study aims to determine the correlation of "cleaved-tau protein" in severe traumatic brain injury (TBI) with Glasgow Coma Scale (GCS) at the time of admission, mode of injury, CT findings and outcome at discharge. METHODS: The study has been approved by the institutional ethical committee...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28293215/classification-of-different-degrees-of-disability-following-intracerebral-hemorrhage-a-decision-tree-analysis-from-vista-ich-collaboration
#11
Thanh G Phan, Jian Chen, Richard Beare, Henry Ma, Benjamin Clissold, John Van Ly, Velandai Srikanth
BACKGROUND AND PURPOSE: Prognostication following intracerebral hemorrhage (ICH) has focused on poor outcome at the expense of lumping together mild and moderate disability. We aimed to develop a novel approach at classifying a range of disability following ICH. METHODS: The Virtual International Stroke Trial Archive collaboration database was searched for patients with ICH and known volume of ICH on baseline CT scans. Disability was partitioned into mild [modified Rankin Scale (mRS) at 90 days of 0-2], moderate (mRS = 3-4), and severe disabilities (mRS = 5-6)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28291703/fdp-fibrinogen-ratio-reflects-the-requirement-of-packed-red-blood-cell-transfusion-in-patients-with-blunt-trauma
#12
Shuichi Hagiwara, Makoto Aoki, Masato Murata, Minoru Kaneko, Yumi Ichikawa, Jun Nakajima, Yuta Isshiki, Yusuke Sawada, Jun'ichi Tamura, Kiyohiro Oshima
PURPOSE: To find factors that predict the requirement of packed red blood cells (pRBC) transfusion in patients with blunt trauma on arrival at the hospital. METHODS: We conducted blood tests in trauma patients whose trauma severity was suspected as being 3 and over in the Abbreviated Injury Scale. Patients were divided into the blood transfusion (BT) and control groups according to the requirement of pRBC transfusion within 24h after arrival. RESULTS: We analyzed 347 patients (BT group, n=14; control group, n=333)...
March 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28288338/ghb-involved-crimes-among-intoxicated-patients
#13
Máté Kapitány-Fövény, Gábor Zacher, János Posta, Zsolt Demetrovics
INTRODUCTION: In recent years, the involvement of GHB in drug facilitated sexual assaults has been one of the most frequently studied aspects of GHB in both clinical and non-clinical settings. GHB-involved acquisitory crimes, however, can be mentioned as understudied research topics, as well as the poisoning severity properties of GHB. MEASURES: The medical reports of Péterfy Sándor Street Hospital Clinic and Casualty Centre's 408 GHB-intoxication cases (352 patients) were reviewed and registered...
March 10, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28286831/predictive-factors-of-survival-and-6-month-favorable-outcome-of-very-severe-head-trauma-patients-a-historical-cohort-study
#14
Karin Vathanalaoha, Thakul Oearsakul, Thara Tunthanathip
INTRODUCTION: Very severe head trauma cases, defined as Glasgow Coma Scale (GCS) scores of less than 6, have a higher mortality rate and poorer outcome. The purpose of this study was to recognize factors associated with survival and 6-month favorable outcome of very severe head trauma patients presenting to emergency department. METHODS: In this historical cohort study, the authors retrospectively reviewed medical records of head trauma patients who were admitted to the emergency department with post-resuscitation GCS scores of less than 6...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286822/ability-of-ultrasonography-in-detection-of-different-extremity-bone-fractures-a-case-series-study
#15
Farzad Bozorgi, Massoud Shayesteh Azar, Seyed Hossein Montazer, Aroona Chabra, Seyed Farshad Heidari, Alireza Khalilian
INTRODUCTION: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. METHODS: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286656/are-you-ernest-shackleton-the-polar-explorer-refining-the-criteria-for-delirium-and-brain-dysfunction-in-sepsis
#16
EDITORIAL
Frank Anthony Rasulo, Giuseppe Bellelli, Eugene Wesley Ely, Alessandro Morandi, Pratik Pandharipande, Nicola Latronico
The Third International Consensus Definitions for Sepsis and Septic Shock has recently defined sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunctions in this consensus definition were identified as an organ-specific Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score ≥ 2 points. The quick SOFA (qSOFA) considers altered mentation indicating brain dysfunction when the Glasgow Coma Scale (GCS) score is ≤13 or ≤14. However, concern has been expressed that the revised criteria may lead to a failure in recognizing the signs of potentially lethal organ dysfunction and thus sepsis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28285089/frequency-and-predicting-factors-on-chronic-expanding-intracerebral-hematoma-in-spontaneous-intracerebral-hemorrhage
#17
Kiyoharu Shimizu, Takashi Sadatomo, Takeshi Hara, Hideo Ohba, Kiyoshi Yuki, Kaoru Kurisu
BACKGROUND: Chronic expanding intracerebral hematoma is a well-known complication of spontaneous intracerebral hemorrhage. However, because chronic expanding intracerebral hematoma is relatively rare, it has not been studied systemically. The purpose of this study was to characterize a patient population with chronic expanding intracerebral hematoma, and to identify the predictive factors for it. METHODS: We retrospectively evaluated 112 patients with spontaneous putaminal hemorrhage who were treated at our institution between January 1, 2010 and December 31, 2015...
March 8, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28283821/significance-of-admission-hypoalbuminemia-in-acute-intracerebral-hemorrhage
#18
Andrea Morotti, Sandro Marini, Umme K Lena, Katherine Crawford, Kristin Schwab, Christina Kourkoulis, Alison M Ayres, M Edip Gurol, Anand Viswanathan, Steven M Greenberg, Christopher D Anderson, Jonathan Rosand, Joshua N Goldstein
Low levels of serum albumin may increase the risk of infections and mortality in critically ill patients. We tested the hypothesis that admission hypoalbuminemia predicted infectious complications and poor outcome in subjects with acute intracerebral hemorrhage (ICH). We analyzed a single center cohort of ICH patients collected between 1994 and 2015. Pneumonia, urinary tract infection and sepsis were retrospectively identified, according to validated criteria. Serum albumin was measured on admission and hypoalbuminemia was defined as total albumin ≤3...
March 10, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28283771/non-invasive-ventilation-for-acute-hypercapnic-respiratory-failure-in-older-patients
#19
Fatma Çiftci, Aydın Çiledağ, Serhat Erol, Akın Kaya
BACKGROUND: This trial was conducted to carry out an age and etiology-based analysis of the clinical efficacy of non-invasive ventilation (NIV) in acute hypercapnic respiratory failure (AHRF). METHODS: This single center, prospective, cohort study included patients aged ≥65 years with chronic obstructive pulmonary disease (COPD), acute cardiogenic pulmonary edema (ACPE), community-acquired pneumonia (CAP), bronchiectasis, and kyphoscoliosis, who were treated with NIV for AHRF in the intensive care unit within a 4-year period...
March 10, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28283187/successful-delayed-coiling-of-a-ruptured-growing-distal-posterior-cerebral-artery-mycotic-aneurysm
#20
C Champeaux, N Walker, J Derwin, A Grivas
Intracranial infectious aneurysm (IIA) is a rare form of cerebrovascular malformation for which obliteration may be undertaken after rupture or non-response to targeted antibiotic therapy. We discuss the case of a 19-year-old man who presented with acute neurologic decline (Glasgow Coma Scale of 8) and endocarditis. CT images demonstrated subarachnoid haemorrhage, hydrocephalus and a mycotic aneurysm on the left posterior cerebral artery. Conservative management was initially decided due to the high risk of stroke and hemianopia...
March 7, 2017: Neuro-Chirurgie
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