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brain trauma traumatic injury biomarker

Lewis S Gall, Paul Vulliamy, Scarlett Gillespie, Timothy F Jones, Rochelle S J Pierre, Sabine E Breukers, Christine Gaarder, Nicole P Juffermans, Marc Maegele, Jakob Stensballe, Pär I Johansson, Ross A Davenport, Karim Brohi
OBJECTIVE: To determine the characteristics of trauma patients with low levels of fibrinolysis as detected by viscoelastic hemostatic assay (VHA) and explore the underlying mechanisms of this subtype. BACKGROUND: Hyperfibrinolysis is a central component of acute traumatic coagulopathy but a group of patients present with low levels of VHA-detected fibrinolysis. There is concern that these patients may be at risk of thrombosis if empirically administered an antifibrinolytic agent...
March 19, 2018: Annals of Surgery
Simone Langness, Erin Ward, Jonathan Halbach, Radhames Lizardo, Katherine Davenport, Stephen Bickler, Karen Kling, Hari Thangarajah, Julia Grabowski, Timothy Fairbanks
PURPOSE: Serum D-dimer has been proposed as a biomarker to aid in the diagnosis of pediatric traumatic brain injury (TBI). We investigated the accuracy of D-dimer in predicting the absence of TBI and evaluated the degree by which D-dimer could limit unnecessary computed tomography scans of the head (CTH). METHODS: Retrospective review of patients with suspected TBI from 2011 to 2013 who underwent evaluation with CTH and quantitative D-dimer. D-dimer levels were compared among patients with clinically-important TBI (ciTBI), TBI, isolated skull fracture and no injury...
April 2018: Journal of Pediatric Surgery
Meng-Yu Wu, Pin-Li Chou, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Using extracorporeal membrane oxygenation (ECMO) to provide advanced life support in adult trauma patients remains a controversial issue now. The study was aimed at identifying the independent predictors of hospital mortality in adult trauma patients receiving ECMO for advanced cardiopulmonary dysfunctions. METHODS: This retrospective study enrolled 36 adult trauma patients receiving ECMO due to advanced shock or respiratory failure in a level I trauma center between August 2006 and October 2014...
February 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Ma-Jing Feng, Wei-Bin Ning, Wei Wang, Zhong-Hua Lv, Xin-Bing Liu, Yong Zhu, Wei Gao, Hong-Ze Jin, Shu-Shan Gao
BACKGROUND: S100A12 is related to acute brain injury and inflammation. We investigated the clinical prognostic value of serum S100A12 in patients with severe traumatic brain injury (sTBI). METHODS: Serum S100A12, S100B, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) concentrations were measured in 102 healthy controls and 102 sTBI patients. We recorded 30-day mortality and in-hospital major adverse events (IMAEs) including acute lung injury, acute traumatic coagulopathy, progressive hemorrhagic injury and posttraumatic cerebral infarction...
January 31, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Enrica Pinchi, Alessandro Frati, Luigi Cipolloni, Mariarosaria Aromatario, Vittorio Gatto, Raffaele La Russa, Alessandro Pesce, Alessandro Santurro, Flavia Fraschetti, Paola Frati, Vittorio Fineschi
Traumatic brain injury (TBI) is one of the most important death and disability cause, involving substantial costs, also in economic terms, when considering the young age of the involved subject. Aim of this paper is to report a series of patients treated at our institutions, to verify neurological results at six months or survival; in fatal cases we searched for βAPP, GFAP, IL-1β, NFL, Spectrin II, TUNEL and miR-21, miR-16, and miR-92 expressions in brain samples, to verify DAI diagnosis and grade as strong predictor of survival and inflammatory response...
February 5, 2018: Scientific Reports
Benjamin Ondruschka, Sandra Schuch, Dirk Pohlers, Heike Franke, Jan Dreßler
An inflammatory response occurring after fatal traumatic brain injury (TBI) initiates time-dependent cascades of acute phase response. This may offer the potential to monitor postmortem biomarker levels of several pro-inflammatory cytokines to gain information about the cause of death and the trauma survival time. Cerebrospinal fluid (CSF) and serum samples were collected from forensic autopsies of 95 adult cadavers after postmortem intervals up to 6 days. The cases were divided according to their cause of death into fatal TBI (n = 46) with different survival times and age- and gender-matching non-TBI fatalities as controls (n = 49)...
March 2018: International Journal of Legal Medicine
Mitchell T Caprelli, Andrea J Mothe, Charles H Tator
The ideal biomarker for central nervous system (CNS) trauma in patients would be a molecular marker specific for injured nervous tissue that would provide a consistent and reliable assessment of the presence and severity of injury and the prognosis for recovery. One candidate biomarker is the protein tau, a microtubule-associated protein abundant in the axonal compartment of CNS neurons. Following axonal injury, tau becomes modified primarily by hyperphosphorylation of its various amino acid residues and cleavage into smaller fragments...
November 1, 2017: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
Bridget Martinez, Philip V Peplow
Traumatic brain injury (TBI) is characterized by primary damage to the brain from the external mechanical force and by subsequent secondary injury due to various molecular and pathophysiological responses that eventually lead to neuronal cell death. Secondary brain injury events may occur minutes, hours, or even days after the trauma, and provide valuable therapeutic targets to prevent further neuronal degeneration. At the present time, there is no effective treatment for TBI due, in part, to the widespread impact of numerous complex secondary biochemical and pathophysiological events occurring at different time points following the initial injury...
November 2017: Neural Regeneration Research
Raimund Helbok, Ronny Beer
Traumatic brain injury is a major cause of morbidity and mortality worldwide. Pathophysiologic mechanisms of secondary brain injury are complex and still not fully understood. Cerebrospinal fluid deserves attention to detect infectious complications and to identify biomarkers of disease severity and impending secondary brain injury. As an adjunct, cerebral microdialysis (CMD) allows online measurements of biomarkers derived directly from brain extracellular fluid. We critically review relevant literature related to infectious complications detectable in the cerebrospinal fluid in trauma patients...
2017: Handbook of Clinical Neurology
Denes V Agoston, Andrew Shutes-David, Elaine R Peskind
PRIMARY OBJECTIVE: The purpose of this paper is to review the clinical and research utility and applications of blood, cerebrospinal fluid (CSF), and cerebral microdialysis biomarkers in traumatic brain injury (TBI). RESEARCH DESIGN: Not applicable. METHODS AND PROCEDURES: A selective review was performed on these biofluid biomarkers in TBI. MAIN OUTCOME AND RESULTS: Neurofilament heavy chain protein (NF-H), glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCHL1), neuron-specific enolase (NSE), myelin basic protein (MBP), tau, and s100β blood biomarkers are elevated during the acute phase of severe head trauma but have key limitations in their research and clinical applications to mild TBI (mTBI)...
2017: Brain Injury: [BI]
Breton M Asken, Molly J Sullan, Steven T DeKosky, Michael S Jaffee, Russell M Bauer
Importance: Scientific and lay interest in negative outcomes associated with exposure to repetitive brain trauma (RBT) continues to strengthen. Concerns about the association between RBT and dementia began more than a century ago, but have resurfaced in the last decade with the more recently described chronic traumatic encephalopathy (CTE). Chronic traumatic encephalopathy is a tauopathy associated with RBT that has become inextricably linked to conversations about sport-related concussion and mild traumatic brain injury...
October 1, 2017: JAMA Neurology
Istvan Frendl, Monika Katko, Erika Galgoczi, Judit Boda, Noemi Zsiros, Zoltan Nemeti, Zsuzsanna Bereczky, Renata Hudak, Janos Kappelmayer, Annamaria Erdei, Bela Turchanyi, Endre V Nagy
More than 80% of traumatic brain injury (TBI) patients suffer from mild TBI (mTBI). However, even mTBI carries the risk of late pituitary dysfunction. A predictive biomarker at the time of injury that could identify patients who subsequently may develop permanent pituitary dysfunction would help to direct patients toward endocrine care. We enrolled 508 TBI patients (406 with mTBI) into our study. Blood samples were collected for identification of predictive biomarkers of late pituitary dysfunction at the time of admission...
December 1, 2017: Journal of Neurotrauma
D H Lee, B K Lee, S M Noh, Y S Cho
PURPOSE: There is a lack of association between coagulation biomarkers and long-term mortality in severe trauma. We aimed to investigate the association between coagulation biomarkers on admission and outcome of late stage of trauma. METHODS: This retrospective observational study included patients admitted with severe trauma between 2012 and 2015. We used the area under the receiver operating characteristic curve (AUROC) of coagulation biomarkers to determine 28-day mortality...
September 18, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jussi P Posti, Alex M Dickens, Matej Orešič, Tuulia Hyötyläinen, Olli Tenovuo
Traumatic brain injury (TBI) is a complex disease with a multifaceted pathophysiology. Impairment of energy metabolism is a key component of secondary insults. This phenomenon is a consequence of multiple potential mechanisms including diffusion hypoxia, mitochondrial failure, and increased energy needs due to systemic trauma responses, seizures, or spreading depolarization. The degree of disturbance in brain metabolism is affected by treatment interventions and reflected in clinical patient outcome. Hence, monitoring of these secondary events in peripheral blood will provide a window into the pathophysiological course of severe TBI...
2017: Frontiers in Neurology
Julia Halford, Sean Shen, Kyohei Itamura, Jaclynn Levine, Albert C Chong, Gregg Czerwieniec, Thomas C Glenn, David A Hovda, Paul Vespa, Ross Bullock, W Dalton Dietrich, Stefania Mondello, Joseph A Loo, Ina-Beate Wanner
Traumatic brain injury (TBI) is an expanding public health epidemic with pathophysiology that is difficult to diagnose and thus treat. TBI biomarkers should assess patients across severities and reveal pathophysiology, but currently, their kinetics and specificity are unclear. No single ideal TBI biomarker exists. We identified new candidates from a TBI CSF proteome by selecting trauma-released, astrocyte-enriched proteins including aldolase C (ALDOC), its 38kD breakdown product (BDP), brain lipid binding protein (BLBP), astrocytic phosphoprotein (PEA15), glutamine synthetase (GS) and new 18-25kD-GFAP-BDPs...
October 2017: Journal of Cerebral Blood Flow and Metabolism
Karim Asehnoune, Zsolt Balogh, Giuseppe Citerio, Andre Cap, Timothy Billiar, Nino Stocchetti, Mitchell J Cohen, Paolo Pelosi, Nicola Curry, Christine Gaarder, Russell Gruen, John Holcomb, Beverley J Hunt, Nicole P Juffermans, Mark Maegele, Mark Midwinter, Frederick A Moore, Michael O'Dwyer, Jean-François Pittet, Herbert Schöchl, Martin Schreiber, Philip C Spinella, Simon Stanworth, Robert Winfield, Karim Brohi
In this research agenda on the acute and critical care management of trauma patients, we concentrate on the major factors leading to death, namely haemorrhage and traumatic brain injury (TBI). In haemostasis biology, the results of randomised controlled trials have led to the therapeutic focus moving away from the augmentation of coagulation factors (such as recombinant factor VIIa) and towards fibrinogen supplementation and administration of antifibrinolytics such as tranexamic acid. Novel diagnostic techniques need to be evaluated to determine whether an individualised precision approach is superior to current empirical practice...
September 2017: Intensive Care Medicine
Richard Rubenstein, Binggong Chang, John K Yue, Allen Chiu, Ethan A Winkler, Ava M Puccio, Ramon Diaz-Arrastia, Esther L Yuh, Pratik Mukherjee, Alex B Valadka, Wayne A Gordon, David O Okonkwo, Peter Davies, Sanjeev Agarwal, Fan Lin, George Sarkis, Hamad Yadikar, Zhihui Yang, Geoffrey T Manley, Kevin K W Wang, Shelly R Cooper, Kristen Dams-O'Connor, Allison J Borrasso, Tomoo Inoue, Andrew I R Maas, David K Menon, David M Schnyer, Mary J Vassar
Importance: Annually in the United States, at least 3.5 million people seek medical attention for traumatic brain injury (TBI). The development of therapies for TBI is limited by the absence of diagnostic and prognostic biomarkers. Microtubule-associated protein tau is an axonal phosphoprotein. To date, the presence of the hypophosphorylated tau protein (P-tau) in plasma from patients with acute TBI and chronic TBI has not been investigated. Objective: To examine the associations between plasma P-tau and total-tau (T-tau) levels and injury presence, severity, type of pathoanatomic lesion (neuroimaging), and patient outcomes in acute and chronic TBI...
September 1, 2017: JAMA Neurology
Yuan-Yuan Zhao, Lin Lou, Kai-Chuang Yang, Hai-Bo Wang, Yan Xu, Gang Lu, Hai-Yan He
BACKGROUND: Tenascin-C, a matricellular protein, is involved in brain injury. However, change of tenascin-C concentrations in peripheral blood remains unknown after traumatic brain injury (TBI). METHODS: Serum tenascin-C concentrations were measured in 100 healthy controls, 108 severe TBI patients, 79 moderate TBI patients and 32 mild TBI patients. RESULTS: Serum tenascin-C concentrations of patients were significantly higher than those of controls...
July 18, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
Ryan M Boudreau, Mark Johnson, Rosalie Veile, Lou Ann Friend, Holly Goetzman, Timothy A Pritts, Charles C Caldwell, Amy T Makley, Michael D Goodman
BACKGROUND: Posttraumatic coagulopathy and inflammation can exacerbate secondary cerebral damage after traumatic brain injury (TBI). Tranexamic acid (TXA) has been shown clinically to reduce mortality in hemorrhaging and head-injured trauma patients and has the potential to mitigate secondary brain injury with its reported antifibrinolytic and antiinflammatory properties. We hypothesized that TXA would improve posttraumatic coagulation and inflammation in a murine model of TBI alone and in a combined injury model of TBI and hemorrhage (TBI/H)...
July 2017: Journal of Surgical Research
Chao Chai, Rui Guo, Chao Zuo, Linlin Fan, Saifeng Liu, Tianyi Qian, E Mark Haacke, Shuang Xia, Wen Shen
Cerebral venous oxygen saturation (SvO2) is an important biomarker of brain function. In this study, we aimed to explore the relative changes of regional cerebral SvO2 among axonal injury (AI) patients, non-AI patients and healthy controls (HCs) using quantitative susceptibility mapping (QSM). 48 patients and 32 HCs were enrolled. The patients were divided into two groups depending on the imaging based evidence of AI. QSM was used to measure the susceptibility of major cerebral veins. Nonparametric testing was performed for susceptibility differences among the non-AI patient group, AI patient group and healthy control group...
2017: NeuroImage: Clinical
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