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Adult traumatic brain injury

Jing Li Huang, Theo A Woehrle, Pat Conway, Catherine A McCarty, Madeline M Eyer, Steven D Eyer
PURPOSE: In 2007, Essentia Health St. Mary's Medical Center (SMMC), a Level II trauma center in northeastern Minnesota, implemented a protocol for patients who presented with blunt head trauma and were receiving warfarin for anticoagulation. The purpose of this study was to determine the incidence and risk factors of early delayed, warfarin-associated intracranial hemorrhage (ICH). METHODS: Adult patients with signs and symptoms of head injury on warfarin who were admitted by protocol to SMMC between March 2007 and June 2015 were included...
March 14, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jong Min Kim, Seung Beom Woo, Zeeihn Lee, Sung Jae Heo, Donghwi Park
RATIONALE: Verbal auditory agnosia is the selective inability to recognize verbal sounds. Patients with this disorder lose the ability to understand language, write from dictation, and repeat words with reserved ability to identify nonverbal sounds. However, to the best of our knowledge, there was no report about verbal auditory agnosia in adult patient with traumatic brain injury. PATIENT CONCERNS: He was able to clearly distinguish between language and nonverbal sounds, and he did not have any difficulty in identifying the environmental sounds...
March 2018: Medicine (Baltimore)
Samuel Enumah, Elizabeth J Lilley, Stephanie Nitzschke, Adil H Haider, Ali Salim, Zara Cooper
BACKGROUND: Hospice improves quality and value of end of life care (EOLC), and enrollment has increased for older patients dying from chronic medical conditions. It remains unknown if the same is true for older patients who die after moderate to severe traumatic brain injury (msTBI). METHODS: Subjects included Medicare beneficiaries (≥65 years) who were hospitalized for msTBI from 2005 to 2011. Outcomes included intensity and quality of EOLC for decedents within 30 days of admission, and 30-day mortality for the entire cohort...
March 1, 2018: American Journal of Surgery
Laura B Ngwenya, Sarmistha Mazumder, Zachary R Porter, Amy Minnema, Duane J Oswald, H Francis Farhadi
Cognitive deficits after traumatic brain injury (TBI) are debilitating and contribute to the morbidity and loss of productivity of over 10 million people worldwide. Cell transplantation has been linked to enhanced cognitive function after experimental traumatic brain injury, yet the mechanism of recovery is poorly understood. Since the hippocampus is a critical structure for learning and memory, supports adult neurogenesis, and is particularly vulnerable after TBI, we hypothesized that stem cell transplantation after TBI enhances cognitive recovery by modulation of endogenous hippocampal neurogenesis...
2018: Stem Cells International
Maria Punchak, Jihad Abdelgadir, Oscar Obiga, Martha Itait, Josephine N Najjuma, Michael M Haglund, David Kitya
BACKGROUND: RTIs, falls and violence contribute to more than two thirds of pediatric TBIs in SSA. In this study, we sought to assess mechanisms of pediatric TBI in an effort to propose interventions for more effective pediatric head injury prevention. METHODS: A cohort of 100 patients who were <18 years treated at MRRH between November 2016 and June 2017 were enrolled in the study. Information on etiology of injury was obtained via a questionnaire administered to patient caretakers at the time of admission...
March 9, 2018: World Neurosurgery
Saeed Kayhanian, Adam M H Young, Rory J Piper, Joseph Donnelly, Daniel Scoffings, Matthew R Garnett, Helen M Fernandes, Peter Smielewski, Marek Czosnyka, Peter J Hutchinson, Shruti Agrawal
Radiological assessment of the head is a routine part of the management of traumatic brain injury. This assessment can help to determine the requirement for invasive intracranial pressure (ICP) monitoring. The radiological correlates of elevated ICP have been widely studied in adults but far fewer specific pediatric studies have been conducted. There is, however, growing evidence that there are important differences in the radiological presentations of elevated ICP between children and adults; a reflection of the anatomical and physiological differences, as well as a difference in the pathophysiology of brain injury in children...
2018: Frontiers in Pediatrics
Lenore Hawley, Jessica M Ketchum, Clare Morey, Kathleen Collins Pharm D, Susan Charlifue
OBJECTIVE: To describe the prevalence of cannabis use in an adult sample with spinal cord injury (SCI) or traumatic brain injury (TBI) in Colorado, and to describe the self-reported reasons and side effects of cannabis use in this sample. DESIGN: Mixed methods observational study, using focus group data and telephone survey SETTING: Community PARTICIPANTS: Colorado adults who have sustained SCI or moderate to severe TBI and have received services through the rehabilitation hospital conducting the study...
March 7, 2018: Archives of Physical Medicine and Rehabilitation
Vijay Krishnamoorthy, Monica S Vavilala, Nophanan Chaikittisilpa, Frederick P Rivara, Nancy R Temkin, Abhijit V Lele, Edward F Gibbons, Ali Rowhani-Rahbar
OBJECTIVES: To examine the impact of early myocardial workload on in-hospital mortality following isolated severe traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: Data from the National Trauma Databank, a multicenter trauma registry operated by the American College of Surgeons, from 2007 to 2014. PATIENTS: Adult patients with isolated severe traumatic brain injury (defined as admission Glasgow Coma Scale < 8 and head Abbreviated Injury Score ≥ 4)...
March 3, 2018: Critical Care Medicine
Jonathan D Porath, Arjun P Meka, Chelsea Morrow, Rahul Iyengar, Eytan Shtull-Leber, Angela Fagerlin, William J Meurer
BACKGROUND: Diagnostic testing is common during emergency department visits. Little is understood about patient preferences for such testing. We hypothesized that a patient's willingness to undergo diagnostic testing is influenced by the potential benefit, risk, and personal cost. METHODS: We conducted a cross sectional survey among emergency department patients for diagnostic testing in 2 hypothetical scenarios: chest pain (CP) and mild traumatic brain injury (mTBI)...
March 5, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Hyung-Joo Lee, Youn-Jung Kim, Dong-Woo Seo, Chang Hwan Sohn, Seung Mok Ryoo, Shin Ahn, Yoon-Seon Lee, Won Young Kim, Kyoung Soo Lim
OBJECTIVE: The detection of intracranial injury in patients with facial injury rather than traumatic brain injury (TBI) remains a challenge for emergency physicians. This study aimed to evaluate the incidence and risk factors of intracranial injury in patients with orbital wall fracture (OWF), who were classified with a chief complaint of facial injury rather than TBI. METHODS: This retrospective case-control study enrolled adult OWF patients (age ≥18 years) who presented at the hospital between January 2004 and March 2016...
February 24, 2018: Injury
Rebecca A Johnson, David L Albright, James R Marzolf, Jessica L Bibbo, Hayley D Yaglom, Sandra M Crowder, Gretchen K Carlisle, Amy Willard, Cynthia L Russell, Karen Grindler, Steven Osterlind, Marita Wassman, Nathan Harms
BACKGROUND: Large numbers of post-deployment U.S. veterans are diagnosed with post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI), leading to an urgent need for effective interventions to reduce symptoms and increase veterans' coping. PTSD includes anxiety, flashbacks, and emotional numbing. The symptoms increase health care costs for stress-related illnesses and can make veterans' civilian life difficult. METHODS: We used a randomized wait-list controlled design with repeated measures of U...
January 19, 2018: Military Medical Research
William Levack, Kounosuke Tomori, Kayoko Takahashi, Aidan J Sherrington
OBJECTIVE: This study aimed to investigate the content of an English-language version of a Japanese iPad application designed to facilitate shared decision-making around goal setting in rehabilitation: Aid for Decision-making in Occupational Choice-English (ADOC-E). DESIGN: Phase 1: Delphi methods to reach consensus with an international group of expert occupational therapists on the text and images in ADOC-E. Phase 2: Testing correct recognition (unprompted and prompted) of images in ADOC-E by health service users in inpatient rehabilitation and residential care...
March 1, 2018: BMJ Open
Denglei Ma, Na Wang, Xiaotong Fan, Lan Zhang, Yi Luo, Rui Huang, Li Zhang, Yali Li, Guoguang Zhao, Lin Li
Cornel iridoid glycoside (CIG) is the active ingredient extracted from Cornus officinalis. Our previous studies showed that CIG had protective effects on several brain injury models. In the present study, we aimed to examine the effects and elucidate the mechanisms of CIG against traumatic brain injury (TBI). TBI was induced in the right cerebral cortex of male adult rats. The neurological and cognitive functions were evaluated by modified neurological severity score (mNSS) and object recognition test (ORT), respectively...
February 28, 2018: Neurochemical Research
Marine Flechet, Geert Meyfroidt, Ian Piper, Giuseppe Citerio, Iain Chambers, Patricia A Jones, Tsz-Yan Milly Lo, Per Enblad, Pelle Nilsson, Bart Feyen, Philippe Jorens, Andrew Maas, Martin U Schuhmann, Rob Donald, Laura Moss, Greet Van den Berghe, Bart Depreitere, Fabian Güiza
OBJECTIVE:   The aim of this study is to assess visually the impact of duration and intensity of cerebrovascular autoregulation insults on 6-month neurological outcome in severe traumatic brain injury. MATERIAL AND METHODS:   Retrospective analysis of prospectively collected minute-by-minute intracranial pressure (ICP) and mean arterial blood pressure data of 259 adult and 99 paediatric traumatic brain injury (TBI) patients from multiple European centres. The relationship of the 6-month Glasgow Outcome Scale with cerebrovascular autoregulation insults (defined as the low-frequency autoregulation index above a certain threshold during a certain time) was visualized in a colour-coded plot...
2018: Acta Neurochirurgica. Supplement
Martin Shaw, Laura Moss, Chris Hawthorne, John Kinsella, Ian Piper
OBJECTIVES: Raised intracranial pressure (ICP) is well known to be indicative of a poor outcome in traumatic brain injury (TBI). This phenomenon was quantified using a pressure time index (PTI) model of raised ICP burden in a paediatric population. Using the PTI methodology, this pilot study is aimed at investigating the relationship between raised ICP and length of stay (LOS) in adults admitted to a neurological intensive care unit (neuro-ICU). MATERIALS AND METHODS: In 10 patients admitted to the neuro-ICU following TBI, ICP was measured and data from the first 24 h were analysed...
2018: Acta Neurochirurgica. Supplement
Christopher Hawthorne, Martin Shaw, Ian Piper, Laura Moss, John Kinsella
OBJECTIVES: We have previously demonstrated a relationship between transcranial bioimpedance (TCB) measurements and intracranial pressure (ICP) in an animal model of raised ICP. The primary objective of this study was to explore the relationship between non-invasive bioelectrical impedance measurements of the brain and skull and ICP in traumatic brain injury (TBI) patients. MATERIALS AND METHODS: Included patients were adults admitted to the Neurological Intensive Care Unit with TBI and undergoing invasive ICP monitoring as part of their routine clinical care...
2018: Acta Neurochirurgica. Supplement
M Moreira, D Fernandes, E Pereira, E Monteiro, R Pascoa, C Dias
OBJECTIVE: Severe traumatic brain injury (TBI) management has been associated with adult respiratory distress syndrome (ARDS) in previous literature. We aimed to investigate the relationships between optimal CPP-guided management, ventilation parameters over time and outcome after severe TBI. MATERIALS AND METHODS: We performed retrospective analysis of recorded data from 38 patients admitted to the NCCU after severe TBI, managed with optimal cerebral perfusion pressure (CPPopt)-guided therapy, calculated using pressure reactivity index (PRx)...
2018: Acta Neurochirurgica. Supplement
T Lo, I Piper, B Depreitere, G Meyfroidt, M Poca, J Sahuquillo, T Durduran, P Enblad, P Nilsson, A Ragauskas, K Kiening, K Morris, R Agbeko, R Levin, J Weitz, C Park, P Davis
OBJECTIVES: Validated optimal cerebral perfusion pressure (CPP) treatment thresholds in children do not exist. To improve the intensive care unit (ICU) management of the paediatric traumatic brain injury (TBI) population, we are forming a new paediatric multi-centre collaboration to recruit standardised ICU data for running and reporting upon models for assessing autoregulation and optimal CCP (CPPopt). MATERIALS AND METHODS: We are adapting the adult BrainIT group's approach to develop a new Paediatric Brain Monitoring and Information Technology Group (KidsBrainIT), which will include a repository to store prospectively collected high-resolution physiological, clinical, and outcome data...
2018: Acta Neurochirurgica. Supplement
Laura Jolliffe, Natasha A Lannin, Dominique A Cadilhac, Tammy Hoffmann
OBJECTIVES: Rehabilitation clinical practice guidelines (CPGs) contain recommendation statements aimed at optimising care for adults with stroke and other brain injury. The aim of this study was to determine the quality, scope and consistency of CPG recommendations for rehabilitation covering the acquired brain injury populations. DESIGN: Systematic review. INTERVENTIONS: Included CPGs contained recommendations for inpatient rehabilitation or community rehabilitation for adults with an acquired brain injury diagnosis (stroke, traumatic or other non-progressive acquired brain impairments)...
February 28, 2018: BMJ Open
Richard A Armstrong
Traumatic brain injury (TBI) and its associated concussion are major causes of disability and death. All ages can be affected but children, young adults and the elderly are particularly susceptible. A decline in mortality has resulted in many more individuals living with a disability caused by TBI including those affecting vision. This review describes: (1) the major clinical and pathological features of TBI; (2) the visual signs and symptoms associated with the disorder; and (3) discusses the assessment of quality of life and visual rehabilitation of the patient...
February 28, 2018: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
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