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Penetrating brain injury

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https://www.readbyqxmd.com/read/28726346/imaging-characteristics-and-treatment-of-a-penetrating-brain-injury-caused-by-an-oropharyngeal-foreign-body-in-a-dog
#1
Jennifer McKenzie, Megan Cooper Murphy, Cameron Broome, Hamaseh Tayari, Rodrigo Gutierrez-Quintana
A 4-year-old Border collie was presented with one episode of collapse, altered mentation, and a suspected pharyngeal stick injury. Magnetic resonance imaging (MRI) and computed tomography showed a linear foreign body penetrating the right oropharynx, through the foramen ovale and the brain parenchyma. The foreign body was surgically removed and medical treatment initiated. Complete resolution of clinical signs was noted at recheck 8 weeks later. Repeat MRI showed chronic secondary changes in the brain parenchyma...
July 20, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28706766/a-case-based-review-of-the-management-of-penetrating-brain-trauma
#2
Jason Milton, Alex Rugino, Kailash Narayan, Chris Karas, Victor Awuor
Principles of penetrating head trauma management were established by Harvey Cushing in relation to the management of penetrating brain injuries of World War One. Cushing radically debrided the scalp and skull and aggressively irrigated wound tracks to remove foreign bodies. He would then obtain water-tight closure. Cushing significantly decreased infection rates which reportedly limited the major cause of mortality due to penetrating head injuries. Many advances have been made by contributions from World War Two, Korean War, Vietnam War, and Iran/Iraq conflicts...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28698267/clinical-criteria-for-tracheostomy-decannulation-in-subjects-with-acquired-brain-injury
#3
Claudia Enrichi, Irene Battel, Cristiano Zanetti, Isabella Koch, Laura Ventura, Katie Palmer, Francesca Meneghello, Francesco Piccione, Simonetta Rossi, Marta Lazzeri, Maurizio Sommariva, Andrea Turolla
BACKGROUND: Patients with acquired brain injury (ABI) often require long periods of having a tracheostomy tube for airway protection and prolonged mechanical ventilation. It has been recognized that fast and safe decannulation improves outcomes and facilitates the recovery process. Nevertheless, few studies have provided evidence for decannulation criteria, despite the high prevalence of ABI subjects with tracheostomies. The aim of our study was to assess which clinical parameters are the best predictors for decannulation in subjects with ABI...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28674346/diagnosis-and-treatment-of-traumatic-cerebrovascular-injury-pitfalls-in-the-management-of-neurotrauma
#4
Hitoshi Kobata
Traumatic cerebrovascular injury (TCVI) is an uncommon clinical entity in traumatic brain injury (TBI), yet it may cause devastating brain injury with high morbidity and mortality. Early recognition and prioritized strategic treatment are of paramount importance. A total of 1966 TBI patients admitted between 1999 and 2015 in our tertiary critical care center were reviewed. Screening of TCVI was based on the Guidelines for the Management of Severe Head Injury in Japan. TCVI was confirmed in 33 (1.7%) patients; 29 blunt and 4 penetrating injuries...
June 30, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28661715/patient-characteristics-and-temporal-trends-in-police-transport-of-blunt-trauma-patients-a-multicenter-retrospective-cohort-study
#5
Elinore J Kaufman, Sara F Jacoby, Catherine E Sharoky, Brendan G Carr, M Kit Delgado, Patrick M Reilly, Daniel N Holena
BACKGROUND: Police transport (PT) of penetrating trauma patients has the potential to decrease prehospital times for patients with life-threatening hemorrhage and is part of official policy in Philadelphia, Pennsylvania. We hypothesized that rates of PT of bluntly injured patients have increased over the past decade. METHODS: We used Pennsylvania Trauma Outcomes Study registry data from 2006-15 to identify bluntly injured adult patients transported to all 8 trauma centers in Philadelphia...
June 29, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28641392/alcohol-is-not-protective-against-mortality-following-traumatic-brain-injury
#6
Jennifer S Albrecht, Majid Afshar, Deborah M Stein, Gordon S Smith
Alcohol exposure results in reduced mortality following traumatic brain injury (TBI) in animal models, yet clinical studies reported conflicting results and clinical trials based on proposed mechanisms have been disappointing. Methodological issues common to many of the clinical studies may have contributed to spurious results. Our objective was to evaluate the association between blood alcohol concentration (BAC) and in-hospital mortality following TBI, overcoming methodological problems of prior studies. We conducted a retrospective cohort study on individuals treated for isolated TBI at the R Adams Cowley Shock Trauma Center between 1997-2012 (n = 1,084)...
June 21, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28635146/the-effect-of-ct-scanners-in-the-trauma-room-an-observational-study
#7
S Wulffeld, L S Rasmussen, B Højlund Bech, J Steinmetz
BACKGROUND: A CT scanner incorporated in the trauma resuscitation bay may benefit trauma patients by fastening work-up times; however, evidence in the area is still sparse. We assessed if time from admission to first CT scan was lower after incorporation of a CT scanner in the resuscitation bay. METHODS: We included trauma patients admitted in two 1-year periods, before and after a major rebuilding of the trauma room. Beforehand, one CT scanner was located in an adjacent room...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28628600/alterations-in-brain-derived-neurotrophic-factor-and-insulin-like-growth-factor-1-protein-levels-after-penetrating-ballistic-like-brain-injury-in-rats
#8
Sindhu K Madathil, Ying Deng-Bryant, Bernard S Wilfred, Lai Yee Leung, Janice S Gilsdorf, Deborah A Shear
BACKGROUND: Brain-derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1) are essential for neuroplasticity and neuronal survival. Despite the importance of these endogenous factors in mediating posttraumatic recovery, little is known about their response after penetrating type traumatic brain injury. The objective of this study was to quantify the expression levels BDNF and IGF-1, two well-known neuroplasticity mediators, after penetrating ballistic-like brain injury (PBBI)...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28624361/low-intensity-rtms-has-sex-dependent-effects-on-the-local-response-of-glia-following-a-penetrating-cortical-stab-injury
#9
Darren Clarke, Marissa A Penrose, Alan R Harvey, Jennifer Rodger, Kristyn A Bates
Repetitive transcranial magnetic stimulation (rTMS), a non-invasive form of brain stimulation, has shown experimental and clinical efficacy in a range of neuromodulatory models, even when delivered at low intensity (i.e. subthreshold for action potential generation). After central nervous system (CNS) injury, studies suggest that reactive astrocytes and microglia can have detrimental but also beneficial effects; thus modulating glial activity, for example through application of rTMS, could potentially be a useful therapeutic tool following neurotrauma...
June 15, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28624032/epidural-analgesia-for-traumatic-rib-fractures-is-associated-with-worse-outcomes-a-matched-analysis
#10
Katherine M McKendy, Lawrence F Lee, Kerianne Boulva, Dan L Deckelbaum, David S Mulder, Tarek S Razek, Jeremy R Grushka
BACKGROUND: The optimal method of pain control for patients with traumatic rib fractures is unknown. The aim of this study was to determine the effect of epidural analgesia on respiratory complications and in-hospital mortality in patients with rib fractures. METHODS: Adult patients at a level I trauma center with ≥1 rib fracture from blunt trauma were included (2004-2013). Those with a blunt-penetrating mechanism, traumatic brain injury, or underwent a laparotomy or thoracotomy were excluded...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28602833/a-novel-il-1ra-pep-fusion-protein-with-enhanced-brain-penetration-ameliorates-cerebral-ischemia-reperfusion-injury-by-inhibition-of-oxidative-stress-and-neuroinflammation
#11
Dong-Dong Zhang, Min-Ji Zou, Ya-Tao Zhang, Wen-Liang Fu, Tao Xu, Jia-Xi Wang, Wen-Rong Xia, Zhi-Guang Huang, Xiang-Dong Gan, Xiao-Ming Zhu, Dong-Gang Xu
Neuroinflammation and oxidative stress are involved in cerebral ischemia-reperfusion, in which Interleukin 1 (IL-1), as an effective intervention target, is implicated. Interleukin-1 receptor antagonist (IL-1RA) is the natural inhibitor of IL-1, but blood-brain barrier (BBB) limits the brain penetration of intravenously administered IL-1RA, thereby restricting its therapeutic effect against neuroinflammation. In this study, we evaluated the potential effects of anti-inflammation and anti-oxidative stress of a novel protein IL-1RA-PEP, which fused IL-1RA with a cell penetrating peptide (CPP)...
June 8, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28539078/can-we-safely-monitor-posterior-fossa-intracranial-pressure-a-cadaveric-study
#12
Vicente Vanaclocha, Nieves Sáiz-Sapena, Marlon Rivera-Paz, Juan Manuel Herrera, José María Ortiz-Criado, Francisco Verdu-López, Leyre Vanaclocha
BACKGROUND: measuring intracranial pressure (ICP) is considered the gold standard of care for brain injury. While supratentorial ICP monitoring has been adopted everywhere, posterior fossa ICP monitoring is rarely performed. In this study, we aimed to evaluate the feasibility of inserting ICP sensors into the posterior fossa of cadavers, to measure ICP in the posterior fossa. METHODS: An ICP sensor was transcranially implanted into the posterior fossa of fifteen fresh adult cadavers...
May 25, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28538329/perioperative-care-for-pediatric-patients-with-penetrating-brain-injury-a-review
#13
Marco Mikhael, Elizabeth Frost, Maria Cristancho
Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury...
May 19, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28532914/penetrating-bihemispheric-traumatic-brain-injury-a-collective-review-of-gunshot-wounds-to-the-head
#14
REVIEW
Lauren Turco, David L Cornell, Bradley Phillips
BACKGROUND: Head injuries that cross midline structures of the brain are bihemispheric. Other terms have been used to describe such injuries, but bihemispheric is the most accurate and should be standard nomenclature. Bihemispheric head injuries are associated with greater mortality and morbidity than other penetrating traumatic brain injuries (TBIs). Currently, there is a tendency to manage severe gunshot wounds (GSWs) to the head nonoperatively, despite reports of improved outcome in military patients treated aggressively...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28530785/anti-edematous-anti-inflammatory-and-neuroprotective-effect-of-etanercept-in-acute-stage-in-experimental-head-injury
#15
Ömer Aykanat, Durmuş Oğuz Karakoyun, Mehmet Erhan Türkoğlu, Cem Dinç
BACKGROUND: To study the anti-edematous, anti-inflammatory, and neuroprotective effect of etanercept in the model of experimental head injury. METHODS: In this study, 40 male-adult Spraque-Dawley rats, with weight ranging from 250g to 300g, were used. The rats are divided into groups as control; non-penetrating trauma; trauma +NS; post-traumatic normal saline; trauma + D; post-traumatic dexamethasone and trauma + E. All medicines were given into peritoneum. After applying trauma and medicine, rats were decapitated in the 24th hour and the samples were studied histopathologically...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28515545/traumatic-brain-injury-and-neuropsychiatric-complications
#16
REVIEW
Saeed Ahmed, Hema Venigalla, Hema Madhuri Mekala, Sara Dar, Mudasar Hassan, Shahana Ayub
Traumatic brain injury (TBI) occurs when a blow or jolt to the head or a penetrating injury results in damage to the brain. It is the most frequent cause of hospitalization in young people with a higher prevalence in men. TBI is the leading cause of disability and mortality between the ages 1 and 45. TBI can be caused either by the direct result of trauma or due to a complication of the primary injury. The most common etiological factors for TBI are falls, road traffic accidents, violent physical assaults, and injuries associated with athletic activities...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28485037/serotonin-axons-in-the-neocortex-of-the-adult-female-mouse-regrow-after-traumatic-brain-injury
#17
Tymoteusz J Kajstura, Sarah E Dougherty, David J Linden
It is widely held that injured neurons in the central nervous system do not undergo axonal regrowth. However, there is mounting evidence that serotonin axons are a notable exception. Serotonin axons undergo long-distance regrowth in the neocortex after amphetamine lesion, and, following a penetrating stab injury, they can regrow from cut ends to traverse the stab rift. Traumatic brain injury (TBI) is clinically prevalent and can lead to pathologies, such as depression, that are related to serotonergic dysfunction...
May 9, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28484551/self-inflicted-stab-with-a-knife-an-unusual-mode-of-penetrating-brain-injury
#18
Zeeshan Qazi, Bal Krishna Ojha, Anil Chandra, Sunil Kumar Singh, Chhitij Srivastava, Nishant Verma, Tushar B Patil
Self-inflicted penetrating injuries have been very rarely described in the medical literature. We describe a middle-aged woman, who had driven a long knife inside her skull with the help of a brick. She had done this to get relief from chronic headache, which was troubling her for 10 years. Patient was hemodynamically stable and had Glassgow Coma scale score of 15. She was immediately operated to remove the knife and evacuate the acute subdural hematoma. Patient made a steady postoperative recovery. Psychiatric and neurological evaluation in the postoperative period revealed features of mixed anxiety and depressive disorder with migraine, for which she was started on treatment...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28482157/enhancing-continuous-online-microdialysis-using-dexamethasone-measurement-of-dynamic-neurometabolic-changes-during-spreading-depolarization
#19
Erika L Varner, Chi Leng Leong, Andrea Jaquins-Gerstl, Kathryn M Nesbitt, Martyn G Boutelle, Adrian Charles Michael
Microdialysis is well established in chemical neuroscience as a mainstay technology for real time intracranial chemical monitoring in both animal models and human patients. Evidence shows that microdialysis can be enhanced by mitigating the penetration injury caused during the insertion of microdialysis probes into brain tissue. Herein, we show that retrodialysis of dexamethasone in the rat cortex enhances the microdialysis detection of K+ and glucose transients induced by spreading depolarization. Without dexamethasone, quantification of glucose transients was unreliable by 5 days after probe insertion...
May 8, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28481163/body-temperature-after-ems-transport-association-with-traumatic-brain-injury-outcomes
#20
Joshua B Gaither, Vatsal Chikani, Uwe Stolz, Chad Viscusi, Kurt Denninghoff, Bruce Barnhart, Terry Mullins, Amber D Rice, Moses Mhayamaguru, Jennifer J Smith, Samuel M Keim, Bentley J Bobrow, Daniel W Spaite
INTRODUCTION: Low body temperatures following prehospital transport are associated with poor outcomes in patients with traumatic brain injury (TBI). However, a minimal amount is known about potential associations across a range of temperatures obtained immediately after prehospital transport. Furthermore, a minimal amount is known about the influence of body temperature on non-mortality outcomes. The purpose of this study was to assess the correlation between temperatures obtained immediately following prehospital transport and TBI outcomes across the entire range of temperatures...
May 8, 2017: Prehospital Emergency Care
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