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Severe traumatic brain injury

Thomas Lillicrap, Carlos Garcia-Esperon, Frederick Rohan Walker, Lin Kooi Ong, Michael Nilsson, Neil Spratt, Christopher R Levi, Mark Parsons, Jörgen Isgaard, Andrew Bivard
Introduction: The incidence of pituitary dysfunction after severe ischemic stroke is unknown, however given the increasing attention to pituitary dysfunction after neurological injuries such as traumatic brain injury, this may represent a novel area of research in stroke. Methods: We perform an arginine and human growth hormone releasing hormone challenge on ischemic stroke patients within a week of symptom onset. Results: Over the study period, 13 patients were successfully tested within a week of stroke (baseline NIHSS 10, range 7-16)...
2018: Frontiers in Neurology
Meghan O Blaya, Joseph M Wasserman, Andrew A Pieper, Thomas J Sick, Helen M Bramlett, W Dalton Dietrich
Traumatic brain injury (TBI) is a significant public health problem around the world. A promising area of research is the characterization of small, drug-like molecules that have potent clinical properties. One pharmacotherapeutic agent in particular, an aminopropyl carbazole called P7C3, was discovered using an in vivo screen to identify new agents that augmented the net magnitude of adult hippocampal neurogenesis. P7C3 greatly enhanced neurogenesis by virtue of increasing survival rates of immature neurons...
September 17, 2018: Neuropharmacology
Fengchen Zhang, PhD Hui Wu, Yichao Jin, Xiaohua Zhang
OBJECTIVE: Ketogenic diet (KD) improves cellular metabolism and functional recovery after moderate-severe traumatic brain injury (TBI). Here we evaluate changes of neurochemical metabolites after KD therapy for repetitive mild traumatic brain injury (rmTBI) and its possible role in neurodegeneration. METHODS: Postnatal day 35 rats were randomly divided into three groups: Sham, Control and KD groups. They were given 3 rmTBI by a fluid percussion TBI device 24 h apart...
September 17, 2018: World Neurosurgery
R Raj, S Bendel, M Reinikainen, S Hoppu, R Laitio, T Ala-Kokko, S Curtze, M B Skrifvars
BACKGROUND: Neurocritical illness is a growing healthcare problem with profound socioeconomic effects. We assessed differences in healthcare costs and long-term outcome for different forms of neurocritical illnesses treated in the intensive care unit (ICU). METHODS: We used the prospective Finnish Intensive Care Consortium database to identify all adult patients treated for traumatic brain injury (TBI), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) and acute ischemic stroke (AIS) at university hospital ICUs in Finland during 2003-2013...
September 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
Megan E Narad, Amery Treble-Barna, Huaiyu Zang, Nanhua Zhang, Julia Smith, Keith O Yeates, H Gerry Taylor, Terry Stancin, Shari L Wade
PURPOSE: Examine the impact of traumatic brain injury (TBI) on parenting behavior over time. METHOD: Included 206 children (3-7 years old) with moderate to severe TBI or orthopedic injury, using a prospective longitudinal cohort study design. Assessments completed at baseline, 6-months, 12-months, 18-months, 3.5 years, and 6.8 years after injury. Dependent variables included authoritative, permissive, and authoritarian parenting. RESULTS: Injury characteristics had limited impact on parenting behaviors over time...
September 20, 2018: Developmental Neurorehabilitation
Katharine A Stromberg, Amma A Agyemang, Kristin M Graham, William C Walker, Adam P Sima, Jennifer H Marwitz, Cynthia Harrison-Felix, Jeanne M Hoffman, Allen W Brown, Jeffrey S Kreutzer, Randall Merchant
OBJECTIVE: To build decision tree prediction models for long-term employment outcomes of individuals after moderate to severe closed traumatic brain injury (TBI) and assess model accuracy in an independent sample. SETTING: TBI Model Systems Centers. PARTICIPANTS: TBI Model Systems National Database participants injured between January 1997 and January 2017 with moderate to severe closed TBI. Sample sizes were 7867 (year 1 postinjury), 6783 (year 2 postinjury), and 4927 (year 5 postinjury)...
September 18, 2018: Journal of Head Trauma Rehabilitation
Audrey Renson, Finn D Schubert, Marc A Bjurlin
BACKGROUND: Uninsured traumatic brain injury (TBI) patients have higher mortality than their insured counterparts. One possible reason is disparities in receipt of appropriate diagnostic imaging. OBJECTIVE: Examine the association between lack of insurance and use of diagnostic imaging. RESEARCH DESIGN: This is a retrospective cohort study. SUBJECTS: All adult patients admitted with severe (AIS>4 and GCS<15) TBI, in the National Trauma Data Bank 2010-2015...
September 18, 2018: Medical Care
Lifeng Qi, Xinhong Xue, Jijun Sun, Qingjian Wu, Hongru Wang, Yan Guo, Baoliang Sun
Many studies have reported the recovery ability of umbilical cord-derived mesenchymal stem cells (UC-MSCs) for neural diseases. In this study, the authors explored the roles of UC-MSCs to treat the traumatic brain injury. Umbilical cord-derived mesenchymal stem cells were isolated from healthy neonatal rat umbilical cord immediately after delivery. The traumatic brain injury (TBI) model was formed by the classical gravity method. The authors detected the behavior changes and measured the levels of inflammatory factors, such as interleukin-lβ and tumor necrosis factor-α by enzyme linked immunosorbent assay (ELISA) at 1, 2, 3, 4 weeks after transplantation between TBI treated and untreated with UC-MSCs...
September 17, 2018: Journal of Craniofacial Surgery
James Gardner, Kevin W Sexton, John Taylor, William Beck, Mary Katherine Kimbrough, Ben Davis, Avi Bhavaraju, Saleema Karim, Austin Porter
Background: Readmissions after a traumatic brain injury (TBI) have significant impact on long-term patient outcomes through interruption of rehabilitation. This study examined readmissions in a rural population, hypothesizing that readmitted patients after TBI will be older and have more comorbidities than those not readmitted. Methods: Discharge data on all patients 15 years and older who were admitted to an Arkansas-based hospital for TBI were obtained from the Arkansas Hospital Discharge Data System from 2010 to 2014...
2018: Trauma surgery & acute care open
Junaid A Bhatti, Deva Thiruchelvam, Donald A Redelmeier
PURPOSE: To assess whether traumatic brain injury (TBI) increases the risks of subsequent problem gambling. METHODS: We conducted a matched case-control analysis of adults in Ontario, Canada. The study included those who self-reported their gambling activities in the Canadian Community Health Survey 2007-2008. Using Problem Gambling Severity Index, we defined cases as those who were problem gamblers and controls who were recreational gamblers. Cases were matched to controls 1:2 using propensity scores based on demographics, prior mental health, and self-reported behaviours...
September 19, 2018: Social Psychiatry and Psychiatric Epidemiology
Margaret A Flynn, Bilge Mutlu, Melissa C Duff, Lyn S Turkstra
Adults with traumatic brain injury (TBI) often report reduced social participation and loss of friends, but little is known about quality of friendship after TBI. Our objective was to characterize social participation, friendship quantity, and friendship quality of adults with TBI and a comparison group of uninjured adults. Participants included 18 adults with moderate to severe TBI and 16 of their informant friends; and 18 uninjured adults and 11 of their informant friends. The main measures used were the Participation Assessment with Recombined Tools-Objective, the Social Network Questionnaire, and the McGill Friendship Questionnaire...
September 19, 2018: Seminars in Speech and Language
Matthew E Peters, Michael Hsu, Vani Rao, Durga Roy, Bharat R Narapareddy, Kathleen T Bechtold, Haris I Sair, Timothy E Van Meter, Hayley Falk, Anna J Hall, Constantine G Lyketsos, Frederick K Korley
OBJECTIVES: The purpose of this study was to assess whether study population definition influences the effect of age on outcomes after blunt head trauma. We hypothesized that examining 'all comers' receiving head computerized tomography after blunt head trauma, fewer older individuals would meet Veterans Administration and Department of Defense (VA/DoD) criteria for traumatic brain injury (TBI), and would, therefore, display better outcomes than younger cohorts. However, restricting to participants meeting VA/DoD criteria for TBI, we hypothesized that older individuals would have worse outcomes...
September 19, 2018: Brain Injury: [BI]
Xiaojing Qin, Lingzhi Li, Qi Lv, Qingming Shu, Yongliang Zhang, Yaping Wang
Traumatic brain injury (TBI) is associated with trauma-related death. In this study, we evaluated differences in the expression of plasma microRNAs (miRNAs) in patients with different degrees of TBI, and explored the potential of miRNAs for use as diagnostic TBI biomarkers. The miRNA microarray results showed upregulation of 65, 33, and 16 miRNAs and downregulation of 29, 27, and 6 miRNAs in patients with mild, moderate, and severe TBI, respectively, compared with healthy controls. Thirteen miRNAs (seven upregulated and six downregulated) were found to be present in all TBI groups...
2018: PloS One
Scott J Farber, Rami S Kantar, Eduardo D Rodriguez
As the United States continues to increase its use of Special Operations Forces worldwide, treatment of craniomaxillofacial (CMF) trauma must be adapted to meet the needs of the warfighter. The remoteness of Special Operations can result in potentially longer times until definitive treatment may be reached. A significant portion of Servicemembers incur injury to the CMF region (42%). Severe CMF trauma can result in substantial hemorrhage and airway compromise. These can be immediately life threatening and must be addressed expeditiously...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Lukas Kurt Postl, Viktoria Bogner, Martijn van Griensven, Marc Beirer, Karl Georg Kanz, Christoph Egginger, Peter Biberthaler, Chlodwig Kirchhoff
BACKGROUND: Data on PNM elastase levels in cerebrospinal fluid following traumatic brain injury (TBI) in humans are not available in the literature. Therefore, the aim of this prospective study was to evaluate the dynamics of PMN elastase in the cerebrospinal fluid (CSF) of patients after TBI. METHODS: Patients suffering from isolated, closed TBI, presenting with an initial Glasgow coma score ≤ 8 and with intracerebral hemorrhage on the initial cranial computed tomography scan (performed within 90 min after TBI) were enrolled...
September 15, 2018: European Journal of Medical Research
Nasser M Aldossary, Mamdouh Ali Kotb, Ahmed M Kamal
BACKGROUND: Traumatic brain injury (TBI) is the major public health problem worldwide, particularly in the Middle East. Diffuse axonal injury (DAI) is commonly found in TBI. Although DAI can lead to physical and psychosocial disabilities, its prognostic value is still a matter of debate. Magnetic Resonance (MR) is more sensitive for detecting DAI lesions. OBJECTIVE: To identify the radiological and clinical factors associated with the functional capacity one year after the traumatic brain injury...
September 5, 2018: Journal of Affective Disorders
Kimberly M Avallone, Erin R Smith, Sean Ma, Sean Gargan, Katherine E Porter, Caitlin C Authier, Brian Martis, Israel Liberzon, Sheila A M Rauch
Introduction: Traumatic brain injury (TBI), pain, and post-traumatic stress disorder (PTSD) commonly co-occur in Veteran populations, particularly among Veterans returning from the recent conflicts in Iraq and Afghanistan. Extant research indicates that both TBI and PTSD can negatively impact pain broadly; however, less is known about how these variables impact one another. The current study examines the impact of self-reported post-concussive symptoms on both pain severity and pain interference among Veterans with PTSD who screened positive for a possible TBI, and subsequently, evaluates the potential mediating role of PTSD in these relationships...
September 12, 2018: Military Medicine
Jenny E Ozga, Jessica M Povroznik, Elizabeth B Engler-Chiurazzi, Cole Vonder Haar
Executive function is an umbrella term that includes cognitive processes such as decision-making, impulse control, attention, behavioral flexibility, and working memory. Each of these processes depends largely upon monoaminergic (dopaminergic, serotonergic, and noradrenergic) neurotransmission in the frontal cortex, striatum, and hippocampus, among other brain areas. Traumatic brain injury (TBI) induces disruptions in monoaminergic signaling along several steps in the neurotransmission process - synthesis, distribution, and breakdown - and in turn, produces long-lasting deficits in several executive function domains...
October 2018: Behavioural Pharmacology
Sami Abu Hamdeh, Niklas Marklund, Anders Lewén, Tim Howells, Raili Raininko, Johan Wikström, Per Enblad
OBJECTIVE Increased intracranial pressure (ICP) in patients with severe traumatic brain injury (TBI) with diffuse axonal injury (DAI) is not well defined. This study investigated the occurrence of increased ICP and whether clinical factors and lesion localization on MRI were associated with increased ICP in patients with DAI. METHODS Fifty-two patients with severe TBI (median age 24 years, range 9-61 years), who had undergone ICP monitoring and had DAI on MRI, as determined using T2*-weighted gradient echo, susceptibility-weighted imaging, and diffusion-weighted imaging (DWI) sequences, were enrolled...
September 14, 2018: Journal of Neurosurgery
Wei-Ji Weng, Chun Yang, Xian-Jian Huang, Yong-Ming Zhang, Jin-Fang Liu, Jie-Min Yao, Zi-Heng Zhang, Xue-Song Wu, Tao Mei, Chuan-Dong Zhang, Jun Jia, Xiao-Feng Shi, Qing Mao, Jun-Feng Feng, Guo-Yi Gao, Jiyao Jiang
A prospective observational study collected temperature data from 51 patients in 11 neurosurgical centers and follow-up outcome information at 6-months in 49 patients. Brain temperature (T<sub>br</sub>) was measured directly by an intraventricular temperature sensor. Axillary temperature (T<sub>ax</sub>) and rectal temperature (T<sub>re</sub>) were measured by electric thermometers. T<sub>br</sub> was 0.4 ~ 1.5℃ higher than body temperature. T<sub>re</sub> correlated well with the T<sub>br</sub> (coefficient: 0...
September 14, 2018: Journal of Neurotrauma
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