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Glasgow Coma Scale

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https://www.readbyqxmd.com/read/28925746/impact-of-extended-monitoring-guided-intensive-care-on-outcome-after-severe-traumatic-brain-injury-a-prospective-multicentre-cohort-study-paris-tbi-study
#1
Joaquim Mateo, Didier Payen, Idir Ghout, Fabrice Vallée, Thomas Lescot, Stephane Welschbillig, Karim Tazarourte, Philippe Azouvi, Jean-Jacques Weiss, Philippe Aegerter, Bernard Vigué
OBJECTIVE: We evaluated whether an integrated monitoring with systemic and specific monitoring affect mortality and disability in adults with severe traumatic brain injury (sTBI). METHODS: Adults with severeTBI (Glasgow Coma Scale [GCS] ≤ 8) admitted alive in intensive care units (ICUs) were prospectively included. Primary endpoints were in-hospital 30-day mortality and extended Glasgow outcome score (GOSE) at 3 years. Association with the intensity of monitoring and outcome was studied by comparing a high level of monitoring (HLM) (systemic and ≥3 specific monitoring) and low level of monitoring (LLM) (systemic and 0-2 specific monitoring) and using inverse probability weighting procedure...
September 19, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28925731/detection-of-metabolic-pattern-following-decompressive-craniectomy-in-severe-traumatic-brain-injury-a-microdialysis-study
#2
Deepak Gupta, Raghav Singla, Anna T Mazzeo, Eric B Schnieder, Vivek Tandon, S S Kale, A K Mahapatra
OBJECTIVE: The aim of the study was to detect mitochondrial dysfunction and ischaemia in severe traumatic brain injury and their relationship with outcome. METHODS: Forty-one patients with severe traumatic brain injury (TBI) who underwent decompressive craniectomy were prospectively monitored with intracerebral microdialysis catheters (MD). Variables related to energy metabolism were studied using microdialysis. RESULTS: Twentysix patients (63...
September 19, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#3
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
#4
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/28918089/urinary-incontinence-and-indwelling-urinary-catheters-as-predictors-of-death-after-new-onset-stroke-a-report-of-the-south-london-stroke-register
#5
Gregor John, Steve Primmaz, Siobhan Crichton, Charles Wolfe
OBJECTIVE: To explore the relationship between indwelling urinary catheters (IUCs), urinary incontinence (UI), and death in the poststroke period and to determine when, after the neurological event, UI has the best ability to predict 1-year mortality. METHODS: In a prospective observational study, 4477 patients were followed up for 1 year after a first-ever stroke. The impact of UI or urinary catheters on time to death was adjusted in a Cox model for age, sex, Glasgow Coma Scale, prestroke and poststroke Barthel Index, swallow test, motor deficit, diabetes, and year of inclusion...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#6
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28912713/meta-analysis-for-clinical-evaluation-of-xingnaojing-injection-for-the-treatment-of-cerebral-infarction
#7
REVIEW
Xiao Ma, Yu X Yang, Nian Chen, Qian Xie, Tao Wang, Xuan He, Jian Wang
Objective: Xingnaojing injection (XNJ) is derived from An-Gong-Niu-Huang pill, a well-known traditional Chinese patent medicine, which is widely used for stroke. To evaluate the therapeutic effect of XNJ on cerebral infarction, an extensive meta-analysis was used. Methods: Six major electronic databases including the Chinese Biomedical Database (CBM), Wanfang, the VIP medicine information system (VMIS) and the China National Knowledge Infrastructure (CNKI), PubMed, Embase, and the Cochrane Library were examined to retrieve randomized controlled trials designed to evaluate the clinical efficacy of XNJ in treating CI before November 26, 2016...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28912029/inclusion-of-highest-glasgow-coma-scale-motor-score-in-mortality-risk-adjustment-for-benchmarking-of-trauma-center-performance
#8
David Gomez, James P Byrne, Aziz S Alali, Wei Xiong, Chris Hoeft, Melanie Neal, Harris Subacius, Avery B Nathens
BACKGROUND: The Glasgow Coma Scale (GCS) score is the most widely utilized measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor score (mGCS) is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including highest mGCS on the performance of risk-adjustment models and subsequent external benchmarking results...
September 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28910815/the-outcome-and-patterns-of-traumatic-brain-injury-in-the-paediatric-population-of-a-developing-country-secondary-to-tv-trolley-tip-over
#9
Muhammad Waqas, Gohar Javed, Karim Rizwan Nathani, Badar Ujjan, Syed A Quadri, Muhammad Zubair Tahir
BACKGROUND: Television (TV) trolley tip-over incidences are common and can cause significant morbidity and mortality in children. This study was aimed at analyzing the pattern and outcomes of head injuries resulting from TV trolley tip-over. METHOD: We conducted a medical chart review of children with TV trolley tip-over head injuries from January 2009 to April 2016. We collected data on demographics, the mechanism of injury, clinical and radiological features of the injury, and outcomes...
September 15, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28906367/predicting-the-mortality-in-geriatric-patients-with-dengue-fever
#10
Hung-Sheng Huang, Chien-Chin Hsu, Je-Chiuan Ye, Shih-Bin Su, Chien-Cheng Huang, Hung-Jung Lin
Geriatric patients have high mortality for dengue fever (DF); however, there is no adequate method to predict mortality in geriatric patients. Therefore, we conducted this study to develop a tool in an attempt to address this issue.We conducted a retrospective case-control study in a tertiary medical center during the DF outbreak in Taiwan in 2015. All the geriatric patients (aged ≥65 years) who visited the study hospital between September 1, 2015, and December 31, 2015, were recruited into this study. Variables included demographic data, vital signs, symptoms and signs, comorbidities, living status, laboratory data, and 30-day mortality...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906307/lc-i-pelvic-ring-injury-not-benign-to-the-developing-fetus
#11
John C Weinlein, Rakesh P Mashru, Edward A Perez, Sara E Johnson
OBJECTIVE: To determine if certain patterns of pelvic ring injury are associated with more frequent intra-uterine fetal demise (IUFD). DESIGN: Retrospective review SETTING:: Level 1 trauma center. PATIENTS/PARTICIPANTS: Of 44 pregnant patients with pelvic and/or acetabular fractures, 40 had complete records that allowed determination of fetal viability. Chi-square tests were used for categorical variables (Fisher's exact tests when expected cell counts were fewer than five) and t-tests were used for continuous variables...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28904458/can-transcranial-color-doppler-spectral-signatures-be-a-novel-biomarker-for-monitoring-cerebrovascular-autoregulation-and-intracranial-pressure-a-speculative-synthesis
#12
Sandhya Mangalore, Kotresh, Rakshith Srinivasa, Alangar Sathyaranjandas Hegde, Rangashetty Srinivasa
BACKGROUND: Trans Cranial Colour Doppler (TCCD) has been extensively used in various neurological and neurosurgical conditions causing severe raise in the intracranial pressure (ICP). MATERIAL AND METHOD: Our study explores the sequential evolution of TCCD flow pattern by correlating with pupillary reactivity, Glasgow coma scale (GCS), and imaging. Our cohort consisted of thirty patients with ten patients in each subgroup admitted to the neuro-Intensive Care Unit (NICU) for various neurological and neurosurgical causes...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28900623/impact-of-thyroid-hormone-levels-on-functional-outcome-in-neurological-and-neurosurgical-early-rehabilitation-patients
#13
Melanie Boltzmann, Simone B Schmidt, Jens D Rollnik
BACKGROUND: Neurological and neurosurgical early rehabilitation (NNER) is a specialized treatment option for patients with severe neurological disorders. The present study investigated whether thyroid hormone levels on admission have an impact on the outcome of NNER patients. METHOD: The study included 500 NNER patients who were admitted to the BDH-Clinic Hessisch Oldendorf between 2009 and 2010. Data such as age, sex, diagnoses, comorbidities, Glasgow Coma Scale score, length of stay, and thyroid hormone levels (obtained as part of clinical routine care) were analyzed retrospectively...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28899886/brainstem-encephalitis-and-acute-polyneuropathy-associated-with-hepatitis-e-infection
#14
Omar Jabbar Salim, Amy Davidson, Kathy Li, John Paul Leach, Craig Heath
A 59-year-old man presented with feverish illness. His Glasgow Coma Scale was 15, had reduced visual acuity in the left eye with partial left ptosis and mild left hemiparesis with an extensor left plantar. Over 48 hours, he accrued multiple cranial nerves palsies and progressed to a flaccid paralysis necessitating admission to an intensive care unit.Cerebrospinal fluid (CSF) study showed 20 lymphocytes and raised protein. Viral and bacterial PCRs were negative. Samples for Lyme, blood-borne viruses, syphilis and autoantibodies were also negative...
September 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28895444/d-dimer-elevation-as-a-blood-biomarker-for-detection-of-structural-disorder-in-mild-traumatic-brain-injury
#15
Kazutaka Sugimoto, Eiichi Suehiro, Mizuya Shinoyama, Hirokazu Sadahiro, Kouhei Haji, Yuichi Fujiyama, Reo Kawano, Mitsuaki Nishioka, Michiyasu Suzuki
Computed tomography (CT) scans are useful in patients with traumatic brain injury (TBI), but the potential risks associated with ionizing radiation are unknown. Furthermore, CT scans are not commonly available in developing countries. In this study, coagulopathy and abnormal fibrinolysis were investigated as blood biomarkers for detection of structural disorder in mild TBI. A total of 88 patients with mild and isolated TBI (Glasgow Coma Scale (GCS) score 14-15) were admitted to Kenwakai Ootemachi Hospital between October 2014 and March 2016...
September 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28895254/cancer-is-an-independent-predictor-of-poor-outcomes-in-patients-following-intracerebral-hemorrhage
#16
Yasufumi Gon, Kenichi Todo, Hideki Mochizuki, Manabu Sakaguchi
BACKGROUND: Patients with cancer have been reported to have poorer outcomes following intracerebral hemorrhage (ICH) than those without cancer, but the findings were not consistent between studies. We aimed to test the hypothesis that cancer is associated with poor outcomes following ICH. METHODS: We reviewed 3137 consecutive patients admitted to the stroke unit of Osaka University Hospital. Patients diagnosed with ICH were extracted and divided into two groups according to the presence of cancer...
September 12, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28894943/swirl-sign-in-traumatic-acute-epidural-hematoma-prognostic-value-and-surgical-management
#17
Cheng Guo, Lin Liu, Bing Wang, Zhigang Wang
The swirl sign is identified as a small area of low attenuation within an intracranial hyperattenuating clot on non-enhanced computed tomography (CT) scans of the brain, which represents active bleeding. The purpose of this study was to evaluate the incidence of the swirl sign among patients with acute epidural hematoma (AEDH) and to identify its prognostic value and impact on surgical treatment. A retrospective review was performed of patients with a diagnosis of traumatic EDH by CT scan who were surgically treated at the Department of Neurosurgery of the First People's Hospital of Jingmen between January 2010 and January 2014...
September 11, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28894586/a-pilot-study-on-the-impact-of-dopamine-serotonin-and-brain-derived-neurotrophic-factor-genotype-on-long-term-functional-outcomes-after-subarachnoid-hemorrhage
#18
Ansley Stanfill, Claire Simpson, Paula Sherwood, Samuel Poloyac, Elizabeth Crago, Hyungsuk Kim, Yvette Conley
OBJECTIVES: Many that survive an aneurysmal subarachnoid hemorrhage experience lasting physical disability, which might be improved by medications with effects on the dopaminergic, serotonergic, and brain-derived neurotrophic factor neurotransmitter systems. But it is not clear which patients are most likely to benefit from these therapies. The purpose of this pilot study was to explore the relationship of genetic polymorphisms in these pathways with 12-month functional outcomes after aneurysmal subarachnoid hemorrhage...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28891977/polytrauma-defined-by-the-new-berlin-definition-a-validation-test-based-on-propensity-score-matching-approach
#19
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. This study was designed to investigate the outcome of patients with polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS) ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension [systolic blood pressure ≤ 90 mmHg], unconsciousness [Glasgow Coma Scale score ≤ 8], acidosis [base excess ≤ -6...
September 11, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28890064/evaluating-the-utilization-of-prophylactic-inferior-vena-cava-filters-in-trauma-patients
#20
Lloyd M Jones, Quyen D Chu, Navdeep Samra, Bo Hu, Wayne W Zhang, Tze-Woei Tan
BACKGROUND: The lack of evidence-based guidelines on the use of prophylactic inferior vena cava filters (IVCF) in patients after trauma has led to variation of its application. We seek to understand the national trend of the use of prophylactic IVCF in a trauma population. 

 METHODS: A retrospective review of the National Trauma Databank (2002-2014) was performed to identify patients who received an IVCF after trauma. Those without a pre-existing venous thromboembolism (VTE) or discharge diagnosis of VTE were classified as receiving prophylactic IVCF...
September 7, 2017: Annals of Vascular Surgery
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