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Severe traumatic brain injury

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https://www.readbyqxmd.com/read/28234783/is-there-still-a-role-for-hypothermia-in-neurocritical-care
#1
Florian Frank, Gregor Broessner
PURPOSE OF REVIEW: Therapeutic hypothermia (i.e. induced body core temperature ≈ 33-35°C) in neurological patients with cerebrovascular disease and traumatic brain injury is a controversially discussed issue in the literature. In this review, we have included the most recently published research covering the use of therapeutic hypothermia and targeted temperature management in neurologic diseases and translated the results into a clinical decision support for the professional healthcare community...
February 23, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28234185/an-analysis-of-beta-blocker-administration-pre-and-post-traumatic-brain-injury-with-subanalyses-for-head-injury-severity-and-myocardial-injury
#2
Mathew Edavettal, Brian W Gross, Katelyn Rittenhouse, James Alzate, Amelia Rogers, Lisa Estrella, Jo Ann Miller, Frederick B Rogers
A growing body of literature indicates that beta-blocker administration after traumatic brain injury (TBI) is cerebroprotective, limiting secondary injury; however, the effects of preinjury beta blocker status remain poorly understood. We sought to characterize the effects of pre- and postinjury beta-blocker administration on mortality with subanalyses accounting for head injury severity and myocardial injury. In a Level II trauma center, all admissions of patients ≥18 years with a head Abbreviated Injury Scale Score ≥2, Glasgow Coma Scale ≤13 from May 2011 to May 2013 were queried...
December 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28234124/the-effect-of-interhospital-transfers-on-the-outcome-of-rural-trauma
#3
Jeffrey Wild, Jabran M Younus, Mahdi Malekpour, Nina Neuhaus, Kenneth Widom, Megan Rapp, Diane Leonard, Susan Baro, James Dove, Marie Hunsinger, Joseph Blansfield, Mohsen Shabahang, Denise Torres
Urban areas house the majority of the population in the United States but trauma deaths occur more commonly in rural areas. In this study, we aimed to investigate if direct patient admission to a Level I trauma center improves outcomes in rural trauma. We retrospectively reviewed data in our trauma database from January 2008 to the end of December 2012 to compare the overall outcomes between direct admissions (DAs) and interhospital transfers (IHTs). Of the 6118 patients who met the inclusion criteria, 59.5 per cent were in the DA group and 40...
January 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28233136/anisotropic-finite-element-models-for-brain-injury-prediction-the-sensitivity-of-axonal-strain-to-white-matter-tract-inter-subject-variability
#4
Chiara Giordano, Stefano Zappalà, Svein Kleiven
Computational models incorporating anisotropic features of brain tissue have become a valuable tool for studying the occurrence of traumatic brain injury. The tissue deformation in the direction of white matter tracts (axonal strain) was repeatedly shown to be an appropriate mechanical parameter to predict injury. However, when assessing the reliability of axonal strain to predict injury in a population, it is important to consider the predictor sensitivity to the biological inter-subject variability of the human brain...
February 23, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#5
Tyler J Loftus, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Scott C Brakenridge, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr
PURPOSE: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. METHODS: Retrospective cohort analysis of 132 patients with quantitative BAL and ≥1 risk factor: head Abbreviated Injury Score ≥2, ≥3 rib fractures, or radiographic signs of aspiration or pulmonary contusion...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28230712/updating-evidence-for-using-hypothermia-in-pediatric-severe-traumatic-brain-injury-conventional-and-bayesian-meta-analytic-perspectives
#6
Robert C Tasker, Frederick W Vonberg, Elizabeth D Ulano, Alireza Akhondi-Asl
OBJECTIVE: To evaluate clinical trials of hypothermia management on outcome in pediatric patients with severe traumatic brain injury using conventional and Bayesian meta-analyses. DATA SOURCES: Screening of PubMed and other databases to identify randomized controlled trials of hypothermia for pediatric severe traumatic brain injury published before September 2016. STUDY SELECTION: Four investigators assessed and reviewed randomized controlled trial data...
February 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28229021/the-preventive-effect-of-dexmedetomidine-on-paroxysmal-sympathetic-hyperactivity-in-severe-traumatic-brain-injury-patients-who-have-undergone-surgery-a-retrospective-study
#7
Qilin Tang, Xiang Wu, Weiji Weng, Hongpeng Li, Junfeng Feng, Qing Mao, Guoyi Gao, Jiyao Jiang
BACKGROUND: Paroxysmal sympathetic hyperactivity (PSH) results and aggravates in secondary brain injury, which seriously affects the prognosis of severe traumatic brain injury patients. Although several studies have focused on the treatment of PSH, few have concentrated on its prevention. METHODS: Ninety post-operation (post-op) severe traumatic brain injury (sTBI) patients admitted from October 2014 to April 2016 were chosen to participate in this study. Fifty of the post-op sTBI patients were sedated with dexmedetomidine and were referred as the "dexmedetomidine group" (admitted from May 2015 to April 2016)...
2017: PeerJ
https://www.readbyqxmd.com/read/28228720/motor-learning-abilities-are-similar-in-hemiplegic-cerebral-palsy-compared-to-controls-as-assessed-by-adaptation-to-unilateral-leg-weighting-during-gait-part-i
#8
Diane L Damiano, Christopher J Stanley, Thomas C Bulea, Hyung Soon Park
Introduction: Individuals with cerebral palsy (CP) demonstrate high response variability to motor training insufficiently accounted for by age or severity. We propose here that differences in the inherent ability to learn new motor tasks may explain some of this variability. Damage to motor pathways involving the cerebellum, which may be a direct or indirect effect of the brain injury for many with CP, has been shown to adversely affect the ability to learn new motor tasks and may be a potential explanation...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28228155/catecholamines-as-outcome-markers-in-isolated-traumatic-brain-injury-the-coma-tbi-study
#9
Sandro B Rizoli, Blessing N R Jaja, Alex P Di Battista, Shawn G Rhind, Antonio Capone Neto, Leodante da Costa, Kenji Inaba, Luis Teodoro da Luz, Bartolomeu Nascimento, Adic Perez, Andrew J Baker, Airton Leonardo de Oliveira Manoel
BACKGROUND: Elevated catecholamine levels might be associated with unfavorable outcome after traumatic brain injury (TBI). We investigated the association between catecholamine levels in the first 24 h post-trauma and functional outcome in patients with isolated moderate-to-severe TBI. METHODS: A cohort of 174 patients who sustained isolated blunt TBI was prospectively enrolled from three Level-1 Trauma Centers. Epinephrine (Epi) and norepinephrine (NE) concentrations were measured at admission (baseline), 6, 12 and 24 h post-injury...
February 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28228060/resuscitation-with-lyophilized-plasma-is-safe-and-improves-neurologic-recovery-in-a-long-term-survival-model-of-swine-subjected-to-traumatic-brain-injury-hemorrhagic-shock-and-polytrauma
#10
Patrick E Georgoff, Vahagn C Nikolian, Ihab Halaweish, Kiril Chtraklin, Peter J Bruhn, Hassan Eidy, Monica Rasmussen, Yongqing Li, Ashok Srinivasan, Hasan B Alam
We have previously shown that fresh frozen plasma (FFP) and lyophilized plasma decrease brain lesion size and improve neurologic recovery in a swine model of traumatic brain injury (TBI) and hemorrhagic shock (HS). In this study, we examine whether these findings can be validated in a clinically relevant model of severe TBI, HS, and polytrauma. Female Yorkshire swine were subjected to TBI (controlled cortical impact), hemorrhage (40% volume), grade III liver and splenic injuries, rib fracture, and rectus abdominis crush...
February 22, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28227900/automated-assessment-of-postural-stability-system
#11
Alessandro Napoli, Christian R Ward, Stephen M Glassd, Carole Tucker, Iyad Obeid, Alessandro Napoli, Christian R Ward, Stephen M Glass, Carole Tucker, Iyad Obeid, Christian R Ward, Carole Tucker, Alessandro Napoli, Iyad Obeid, Stephen M Glass
The Balance Error Scoring System (BESS) is one of the most commonly used clinical tests to evaluate static postural stability deficits resulting from traumatic brain events and musculoskeletal injury. This test requires a trained operator to visually assess balance and give the subject a performance score based on the number of balance "errors" they committed. Despite being regularly used in several real-world situations, the BESS test is scored by clinician observation and is therefore (a) potentially susceptible to biased and inaccurate test scores and (b) cannot be administered in the absence of a trained provider...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227478/portable-video-oculography-device-for-implementation-in-sideline-concussion-assessments-a-prototype
#12
Joshua D Fischer, Dawie J van den Heever, Joshua D Fischer, Dawie J van den Heever, Dawie J Van den Heever, Joshua D Fischer
Concussion is currently a serious health problem and can lead to severe brain dysfunction. There is a definite need for sensitive and reliable tests to detect and evaluate the subtle changes in brain function caused by concussion. This study details the development of a low cost portable eye tracking device that can aid in the detection of concussions. The device evaluates ocular motor function and can be used on the sidelines of sporting events to give a quick indication of the severity of head trauma. It can further be used to evaluate and monitor mild Traumatic Brain Injuries and aid in the return to play decision making process...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227407/recursive-feature-elimination-for-biomarker-discovery-in-resting-state-functional-connectivity
#13
Hariharan Ravishankar, Radhika Madhavan, Rakesh Mullick, Teena Shetty, Luca Marinelli, Suresh E Joel, Hariharan Ravishankar, Radhika Madhavan, Rakesh Mullick, Teena Shetty, Luca Marinelli, Suresh E Joel, Suresh E Joel, Teena Shetty, Luca Marinelli, Rakesh Mullick, Hariharan Ravishankar, Radhika Madhavan
Biomarker discovery involves finding correlations between features and clinical symptoms to aid clinical decision. This task is especially difficult in resting state functional magnetic resonance imaging (rs-fMRI) data due to low SNR, high-dimensionality of images, inter-subject and intra-subject variability and small numbers of subjects compared to the number of derived features. Traditional univariate analysis suffers from the problem of multiple comparisons. Here, we adopt an alternative data-driven method for identifying population differences in functional connectivity...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226429/postural-responses-after-utilization-of-a-computerized-biofeedback-based-intervention-aimed-at-improving-static-and-dynamic-balance-in-traumatic-brain-injury-a-case-study
#14
Rakesh Pilkar, Nibal Arzouni, Arvind Ramanujam, Kathleen Chervin, Karen J Nolan, Rakesh Pilkar, Nibal Arzouni, Arvind Ramanujam, Kathleen Chervin, Karen J Nolan, Arvind Ramanujam, Kathleen Chervin, Nibal Arzouni, Karen J Nolan, Rakesh Pilkar
Balance dysfunction is one of the most disabling aspects of Traumatic Brain Injury (TBI). Without rapid transmission and accurate perception of somatosensory inputs, the automatic postural responses required during standing may be delayed or absent after TBI which can lead to instability. Further, the sensitivity level to which environmental perturbations can be detected is also vital, as the central nervous system will only employ balance control strategies when it perceives a change in equilibrium. Such undetectable perturbations, however small they may be, can result in fatal falls, especially after TBI...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225527/neuro-trauma-or-med-surg-intensive-care-unit-does-it-matter-where-multiple-injuries-patients-with-traumatic-brain-injury-are-admitted-secondary-analysis-of-the-american-association-for-the-surgery-of-trauma-multi-institutional-trials-committee-decompressive
#15
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Toby Enniss, Gregory J Jurkovich, Raminder Nirula
INTRODUCTION: Patients with nontraumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without traumatic brain injury (TBI) fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28224478/targeting-the-nf-e2-related-factor-2-pathway-a-novel-strategy-for-traumatic-brain-injury
#16
REVIEW
Li Zhang, Handong Wang
As an essential component of cellular defense against a variety of endogenous and exogenous stresses, nuclear factor erythroid 2-related factor 2 (Nrf2) has received increased attention in the past decades. Multiple studies indicate that Nrf2 acts not only as an important protective factor in injury models but also as a downstream target of therapeutic agents. Activation of Nrf2 has increasingly been linked to many human diseases, especially in central nervous system (CNS) injury such as traumatic brain injury (TBI)...
February 21, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28223249/predicted-unfavorable-neurological-outcome-is-overestimated-by-the-marshall-ct-score-crash-and-impact-models-in-severe-tbi-patients-management-with-early-decompressive-craniectomy
#17
Jose D Charry, Jorman H Tejada, Miguel A Pinzon, Wilson A Tejada, Juan D Ochoa, Manuel Falla, Jesus H Tovar, Ana M Cuellar-Bahamón, Juan P Solano
INTRODUCTION: Traumatic Brain Injury (TBI) is of public health interest and produces significant mortality and disability in Colombia. Calculators and prognostic models have been developed in order to establish neurologic outcome. We tested prognostic models (the Marshall CT score, IMPACT, and CRASH) for 14-day mortality, 6-month mortality, and 6-month outcome in TBI patients in a university Hospital in Colombia. METHODS: A 127 patients' cohort with TBI was treated in a regional trauma center in Colombia over 2 years and Bivariate and Multivariate analyses were used...
February 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28222568/severe-disorders-of-consciousness-after-acquired-brain-injury-a-single-centre-long-term-follow-up-study
#18
Alex Lopez-Rolon
OBJECTIVES: To assess long-term clinical outcome, functional independence and health-related quality of life (HRQOL) in acquired brain injury (ABI) patients with a disorder of consciousness at admission to inpatient rehabilitation. METHODS: We selected patients from a cohort of ABI patients from a single centre. In addition to mortality, we measured level of consciousness with the Coma Remission Scale, functional independence with the Barthel Index, as well as generic and condition-specific HRQOL with the EQ5D and the "Quality of Life after Brain Injury" (QOLIBRI) respectively...
February 10, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28222567/immune-biomarkers-for-the-diagnosis-of-mild-traumatic-brain-injury
#19
Ashley B Petrone, Valerie Gionis, Richard Giersch, Taura L Barr
BACKGROUND: In 2010, there were approximately 2.2 million emergency room visits associated with traumatic brain injury (TBI), with 80 percent diagnosed as mild TBI or concussion. In addition, there are a large number of TBIs, especially mild TBIs, which go either unreported by patients or initially undiagnosed by clinicians. Our team has previously identified a panel of immune-related genes that can diagnose ischemic stroke at triage, and due to shared pathophysiological mechanisms of TBI and stroke, we hypothesized that this panel of genes may also be utilized for the diagnosis of TBI...
February 10, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28222560/depression-following-traumatic-brain-injury-impact-on-post-hospital-residential-rehabilitation-outcomes
#20
Frank D Lewis, Gordon J Horn
BACKGROUND: A need exists to better understand the impact of depression on functional outcomes following TBI. OBJECTIVES: To evaluate the prevalence and severity of depression among a large group of chronic TBI adults; to determine the impact of depression on outcomes of post-hospital residential rehabilitation programs; and to assess effectiveness of post-hospital residential rehabilitation programs in treating depression. METHODS: 820 adults with moderate to severe traumatic brain injury (TBI) were assigned to one of four groups based on MPAI- 4 depression ratings: (1) Not Depressed, (2) Mildly Depressed, (3) Moderately Depressed, and (4) Severely Depressed...
February 8, 2017: NeuroRehabilitation
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