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Severe traumatic brain injury

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https://www.readbyqxmd.com/read/29050383/early-detection-of-consciousness-in-patients-with-acute-severe-traumatic-brain-injury
#1
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/29049053/treatment-options-for-posttraumatic-epilepsy
#2
Lara L Zimmermann, Ryan M Martin, Fady Girgis
PURPOSE OF REVIEW: Posttraumatic seizures (PTS) and posttraumatic epilepsy (PTE) are common and debilitating consequences of traumatic brain injury (TBI). Early PTS result in secondary brain injury by raising intracranial pressure and worsening cerebral edema and metabolic crisis. PTE is a localization-related epilepsy strongly associated with TBI severity, but risk factors for PTE and epileptogenesis are incompletely understood and are active areas of research. Medical management of PTS in adults and children is reviewed...
October 18, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29043082/effect-of-sex-and-age-on-traumatic-brain-injury-a-geographical-comparative-study
#3
Raaj Kishore Biswas, Enamul Kabir, Rachel King
BACKGROUND: Traumatic brain injury (TBI) is a much researched topic in medical health, which requires additional studies to understand various effects of demographic and geographic factors that can assist in developing the most effective treatments. Thousands of people of different ages are suffering from lifelong disabilities, either mild or severe, from TBI and the number is increasing. This study aims to increase our understanding of the effect of sex and age by applying five different statistical methods to evaluate the effect of these covariates on two independent TBI data sets representing patients from different geographical cohorts...
2017: Archives of Public Health, Archives Belges de Santé Publique
https://www.readbyqxmd.com/read/29042562/cis-p-tau-is-induced-in-clinical-and-preclinical-brain-injury-and-contributes-to-post-injury-sequelae
#4
Onder Albayram, Asami Kondo, Rebekah Mannix, Colin Smith, Cheng-Yu Tsai, Chenyu Li, Megan K Herbert, Jianhua Qiu, Michael Monuteaux, Jane Driver, Sandra Yan, William Gormley, Ava M Puccio, David O Okonkwo, Brandon Lucke-Wold, Julian Bailes, William Meehan, Mark Zeidel, Kun Ping Lu, Xiao Zhen Zhou
Traumatic brain injury (TBI) is characterized by acute neurological dysfunction and associated with the development of chronic traumatic encephalopathy (CTE) and Alzheimer's disease. We previously showed that cis phosphorylated tau (cis P-tau), but not the trans form, contributes to tau pathology and functional impairment in an animal model of severe TBI. Here we found that in human samples obtained post TBI due to a variety of causes, cis P-tau is induced in cortical axons and cerebrospinal fluid and positively correlates with axonal injury and clinical outcome...
October 17, 2017: Nature Communications
https://www.readbyqxmd.com/read/29042001/recovery-from-vegetative-state-of-patients-with-a-severe-brain-injury-a-4-year-real-practice-prospective-cohort-study
#5
Alessio Baricich, A de Sire, E Antoniono, F Gozzerino, G Lamberti, C Cisari, M Invernizzi
Patients who have suffered severe traumatic or nontraumatic brain injuries can show a progressive recovery, transitioning through a range of clinical conditions. They may progress from coma to a vegetative state (VS) and/or a minimally conscious state (MCS). A longer duration of the VS is known to be related to a lower probability of emergence from it; furthermore, the literature seems to lack evidence of late improvements in these patients. This real-practice prospective cohort study was conducted in inpatients in a VS following a severe brain injury, consecutively admitted to a vegetative state unit (VSU)...
July 2017: Functional Neurology
https://www.readbyqxmd.com/read/29041954/combined-cognitive-and-vocational-interventions-after-mild-to-moderate-traumatic-brain-injury-study-protocol-for-a-randomized-controlled-trial
#6
Emilie I Howe, Knut-Petter S Langlo, Hans Christoffer Aargaard Terjesen, Cecilie Røe, Anne-Kristine Schanke, Helene L Søberg, Unni Sveen, Eline Aas, Heidi Enehaug, Daniele E Alves, Pål Klethagen, Kjersti Sagstad, Christine M Moen, Karin Torsteinsbrend, Anne-Margrethe Linnestad, Tonje Haug Nordenmark, Birte Sand Rismyhr, Grete Wangen, Juan Lu, Jennie Ponsford, Elizabeth W Twamley, Helene Ugelstad, Øystein Spjelkavik, Marianne Løvstad, Nada Andelic
BACKGROUND: A considerable proportion of patients with mild to moderate traumatic brain injury (TBI) experience long-lasting somatic, cognitive, and emotional symptoms that may hamper their capacity to return to work (RTW). Although several studies have described medical, psychological, and work-related factors that predict RTW after TBI, well-controlled intervention studies regarding RTW are scarce. Furthermore, there has traditionally been weak collaboration among health-related rehabilitation services, the labor and welfare sector, and workplaces...
October 17, 2017: Trials
https://www.readbyqxmd.com/read/29035978/use-of-blood-biomarkers-in-the-assessment-of-sports-related-concussion-a-systematic-review-in-the-context-of-their-biological-significance
#7
Brendan OʼConnell, Áine M Kelly, David Mockler, Matej Orešič, Karl Denvir, Garreth Farrell, Damir Janigro, Fiona Wilson
OBJECTIVES: To critically review current knowledge on the positive and negative predictive value of blood biomarkers for concussion; to illustrate the clinical and biological contexts that help evaluate the use of these markers in sport-related traumatic brain injuries (TBIs). METHODS: This systematic review was performed in accordance with PRISMA guidelines. We reviewed the measurement, clinical utility, endpoint, and biological significance of blood biomarkers in concussion...
October 12, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29035459/level-of-platelet-distribution-width-and-outcome-prediction-in-patients-with-traumatic-brain-injury
#8
Biao Zhang, Jianjun Gu, Yizhen Qiu, Jin Zhao, Yi Song, Huojun Jiang, Aliang Ding, Xiaoqi Chen, Rongming Yu, Guofang Liu, Aihao Hu
BACKGROUND: This study examines the clinical utility of the level of increased platelet distribution width (PDW) as a predictor of outcome in patients with traumatic brain injury. METHODS: In this retrospective study, 120 patients with traumatic brain injury (TBI) were recruited. Age, gender, PDW, and Glasgow Coma Scale (GCS) scores were measured. These patients were divided into two groups based on their 30-day outcomes. Receiver operating curves (ROCs) were generated to identify predictors of 30-day mortality...
October 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/29035067/executive-functioning-in-relation-to-coping-in-mild-versus-moderate-severe-traumatic-brain-injury
#9
Sandra E Rakers, Myrthe E Scheenen, Herma J Westerhof-Evers, Myrthe E de Koning, Harm J van der Horn, Joukje van der Naalt, Jacoba M Spikman
OBJECTIVE: To examine associations between executive functioning (EF) and coping styles, separately for mild and moderate-severe traumatic brain injury (TBI) in the chronic phase postinjury. METHOD: Patients with mild (n = 47) and moderate-severe TBI (n = 59) were included, in addition to healthy controls (HCs; n = 51). Assessment consisted of EF tests (Trail Making Test, Zoo Map Test, Controlled Oral Word Association Test) and questionnaires examining EF (Dysexecutive Questionnaire) and coping styles (Utrecht Coping List)...
October 16, 2017: Neuropsychology
https://www.readbyqxmd.com/read/29033859/multi-watt-near-infrared-phototherapy-for-the-treatment-of-comorbid-depression-an-open-label-single-arm-study
#10
Theodore A Henderson, Larry D Morries
BACKGROUND: The treatment of depression has been hampered by low efficacy of antidepressant medications and safety concerns with alternative modalities. Recent work demonstrated that multi-Watt transcranial near-infrared light therapy (NILT) can effectively treat traumatic brain injury (TBI). The current objective is to explore multi-Watt NILT efficacy in a proof-of-concept study as a treatment for depression. METHODS: Thirty-nine sequential patients treated for TBI between March 2013 and May 2017 provided depression self-assessment data and/or were administered the Hamilton depression rating scale...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29032776/neuropsychological-recovery-trajectories-in-moderate-to-severe-traumatic-brain-injury-influence-of-patient-characteristics-and-diffuse-axonal-injury
#11
Amanda R Rabinowitz, Tessa Hart, John Whyte, Junghoon Kim
OBJECTIVES: The goal of the present study was to elucidate the influence of demographic and neuropathological moderators on the longitudinal trajectory neuropsychological functions during the first year after moderate to severe traumatic brain injury (TBI). In addition to examining demographic moderators such as age and education, we included a measure of whole-brain diffuse axonal injury (DAI), and examined measures of processing speed (PS), executive function (EF), and verbal learning (VL) separately...
October 16, 2017: Journal of the International Neuropsychological Society: JINS
https://www.readbyqxmd.com/read/29032474/discrepancy-between-the-initial-assessment-of-injury-severity-and-post-hoc-determination-of-injury-severity-in-patients-with-apparently-mild-traumatic-brain-injury-a-retrospective-multicenter-cohort-analysis
#12
S M Bossers, K M Pol, E P A Oude Ophuis, B Jacobs, M C Visser, S A Loer, C Boer, J van der Naalt, P Schober
PURPOSE: Traumatic brain injury (TBI) is a major cause of trauma-related visits to emergency departments (ED). Determination of monitoring requirements of patients with apparently mild TBI is challenging. Patients may turn out to be more severely injured than initially assumed, and failure to identify these patients constitutes a serious threat to patient safety. We, therefore, aimed to identify clinical risk factors for more severe injuries in patients with apparently mild TBI. METHODS: In a retrospective cohort analysis performed at two level I trauma centers, 808 patients aged ≥ 16 presenting to the ED with head trauma and a Glasgow Coma Scale (GCS) score 13-15 who received a head CT scan were studied...
October 14, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29030415/comorbidity-and-outcomes-in-traumatic-brain-injury-protocol-for-a-systematic-review-on-functional-status-and-risk-of-death
#13
Tatyana Mollayeva, Chen Xiong, Sara Hanafy, Vincy Chan, Zheng Jing Hu, Mitchell Sutton, Michael Escobar, Angela Colantonio
INTRODUCTION: Reports on the association between comorbidity and functional status and risk of death in patients with traumatic brain injury (TBI) have been inconsistent; it is currently unknown which additional clinical entities (comorbidities) have an adverse influence on the evolution of outcomes across the lifespan of men and women with TBI. The current protocol outlines a strategy for a systematic review of the current evidence examining the impact of comorbidity on functional status and early-term and late-term mortality, taking into account known risk factors of these adverse outcomes (ie, demographic (age and sex) and injury-related characteristics)...
October 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/29029289/post-traumatic-hydrocephalus-in-children-a-retrospective-study-in-42-pediatric-hospitals-using-the-pediatric-health-information-system
#14
Robert H Bonow, Assaf P Oron, Brian W Hanak, Samuel R Browd, Randall M Chesnut, Richard G Ellenbogen, Monica S Vavilala, Frederick P Rivara
BACKGROUND: Post-traumatic hydrocephalus (PTH) is a potentially treatable cause of poor recovery from traumatic brain injury (TBI) that remains poorly understood, particularly among children. OBJECTIVE: To better understand the risk factors for pediatric PTH using a large, multi-institutional database. METHODS: We conducted a retrospective cohort study using administrative data from 42 pediatric hospitals participating in the Pediatric Health Information System...
October 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29028764/the-prognostic-value-of-mri-in-moderate-and-severe-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#15
Hourmazd Haghbayan, Amélie Boutin, Mathieu Laflamme, François Lauzier, Michèle Shemilt, Lynne Moore, Ryan Zarychanski, Vincent Douville, Dean Fergusson, Alexis F Turgeon
OBJECTIVES: Traumatic brain injury is a major cause of death and disability, yet many predictors of outcome are not precise enough to guide initial clinical decision-making. Although increasingly used in the early phase following traumatic brain injury, the prognostic utility of MRI remains uncertain. We thus undertook a systematic review and meta-analysis of studies evaluating the predictive value of acute MRI lesion patterns for discriminating clinical outcome in traumatic brain injury...
October 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29028747/nervous-system-delivery-of-antilysophosphatidic-acid-antibody-by-nasal-application-attenuates-mechanical-allodynia-after-traumatic-brain-injury-in-rats
#16
Andreas Eisenried, Anders C N Meidahl, Michael Klukinov, Alexander Z Tzabazis, Roger A Sabbadini, J David Clark, David C Yeomans
Lysophosphatidic acid (LPA) is a bioactive lipid that impacts neurological outcomes after neurotrauma by inhibiting neuroregeneration, promoting inflammation, and contributing to behavioral deficits. Blocking LPA signaling with a novel anti-LPA monoclonal antibody (mAb) is neuroprotective after traumatic brain injury (TBI) if given to injured animals whose blood-brain barrier (BBB) has been compromised. It is hypothesized that the anti-LPA mAb could improve chronic pain initiated by TBI. However, poor brain penetration after systemic application of the antibody makes access to the central nervous system (CNS) problematic in situations where the BBB is intact...
November 2017: Pain
https://www.readbyqxmd.com/read/29028696/brain-oxygen-optimization-in-severe-traumatic-brain-injury-phase-ii-a-phase-ii-randomized-trial
#17
David O Okonkwo, Lori A Shutter, Carol Moore, Nancy R Temkin, Ava M Puccio, Christopher J Madden, Norberto Andaluz, Randall M Chesnut, M Ross Bullock, Gerald A Grant, John McGregor, Michael Weaver, Jack Jallo, Peter D LeRoux, Dick Moberg, Jason Barber, Christos Lazaridis, Ramon R Diaz-Arrastia
OBJECTIVES: A relationship between reduced brain tissue oxygenation and poor outcome following severe traumatic brain injury has been reported in observational studies. We designed a Phase II trial to assess whether a neurocritical care management protocol could improve brain tissue oxygenation levels in patients with severe traumatic brain injury and the feasibility of a Phase III efficacy study. DESIGN: Randomized prospective clinical trial. SETTING: Ten ICUs in the United States...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29027859/quantitative-cerebral-blood-flow-using-xenon-enhanced-ct-after-decompressive-craniectomy-in-traumatic-brain-injury
#18
Aditya Vedantam, Claudia S Robertson, Shankar P Gopinath
OBJECTIVE Few studies have reported on changes in quantitative cerebral blood flow (CBF) after decompressive craniectomy and the impact of these measures on clinical outcome. The aim of the present study was to evaluate global and regional CBF patterns in relation to cerebral hemodynamic parameters in patients after decompressive craniectomy for traumatic brain injury (TBI). METHODS The authors studied clinical and imaging data of patients who underwent xenon-enhanced CT (XeCT) CBF studies after decompressive craniectomy for evacuation of a mass lesion and/or to relieve intractable intracranial hypertension...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29026665/lasting-bilateral-mydriasis-after-traumatic-brain-injury-may-not-always-be-a-lost-case
#19
Alkinoos Athanasiou, Ioannis Balogiannis, Ioannis Magras
BACKGROUND: Lasting bilateral mydriasis and absence of pupillary light reflex following severe traumatic brain injury (TBI) are considered signs of irreversible brainstem damage and have been strongly associated with poor outcome. CASE DESCRIPTION: A young female patient presented with severe TBI, contusions, and diffuse brain edema. She was initially treated medically, but developed delayed secondary refractory intracranial hypertension and bilaterally dilated, non-reactive pupils for 12 h...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29025454/an-audit-of-traumatic-brain-injury-tbi-in-a-busy-developing-world-trauma-service-exposes-a-significant-deficit-in-resources-available-to-manage-severe-tbi
#20
Ellen Jerome, Grant L Laing, John L Bruce, Ben Sartorius, Petra Brysiewicz, Damian L Clarke
BACKGROUND: Traumatic brain injury (TBI) affects large numbers of patients, both adults and children, and significant resources are needed to manage it. OBJECTIVE: To determine the burden of TBI and the adequacy of available resources to manage in the Pietermaritzburg Metropolitan Trauma Service (PMTS). METHODS: All patients with a TBI were identified from the hybrid electronic medical registry at Grey's and Edendale hospitals in Pietermaritzburg (PMB), KwaZulu-Natal, South Africa...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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