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https://www.readbyqxmd.com/read/28822390/physiologic-features-of-brain-death
#1
Eno-Obong Essien, Kristina Fioretti, Thomas M Scalea, Deborah M Stein
Brain death is known to be associated with physiologic derangements but their incidence is poorly described. Knowledge of the changes that occur during brain death is important for management of the potential organ donor. Thus, we sought to characterize the pathophysiology that occurs during brain death in patients with traumatic injuries. All brain-dead patients over a 10-year period were identified from the trauma registry at a level 1 urban trauma center. Patient demographics, injury characteristics, and clinical data for defining organ dysfunction were reviewed for the 24 hours surrounding brain-death declaration...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28822387/indicators-of-survival-and-favorable-functional-outcomes-after-decompressive-craniectomy-a-multi-institutional-retrospective-study
#2
Abid D Khan, Anna J Elseth, Brian Head, Jack Rostas, Julie A Dunn, Thomas J Schroeppel, Richard P Gonzalez
The role of decompressive craniectomy (DC) for severe traumatic brain injury (STBI) remains controversial. The purpose of this study was to identify factors that are indicators of survival and improved functional outcome in patients who undergo DC for STBI. A retrospective review of STBI patients who underwent DC was performed at four trauma centers during a 45-month period. Data collected included age, gender, mechanism of injury, Injury Severity Score (ISS), admission Glasgow Coma Scale (GCS), time from admission to DC, mortality, and extended Glasgow Outcome Score before discharge...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28821516/a-retrospective-review-of-paediatric-head-injuries-in-asia-a-pan-asian-trauma-outcomes-study-patos-collaboration
#3
Shu-Ling Chong, Uzma Rahim Khan, Indumathy Santhanam, Jun Seok Seo, Quan Wang, Sabariah Faizah Jamaluddin, Quoc Ai Hoang Trong, Su Yah Chew, Marcus Eng Hock Ong
OBJECTIVE: We aim to examine the mechanisms of head-injured children presenting to participating centres in the Pan Asian Trauma Outcomes Study (PATOS) and to evaluate the association between mechanism of injury and severe outcomes. DESIGN AND SETTING: We performed a retrospective review of medical records among emergency departments (EDs) of eight PATOS centres, from September 2014 - August 2015. PARTICIPANTS: We included children <16 years old who presented within 24 hours of head injury and were admitted for observation or required a computed tomography (CT) of the brain from the ED...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28811212/incidence-and-risk-factors-of-delayed-intracranial-hemorrhage-in-emergency-department
#4
Byunghyun Kim, Hyeonjeong Jeong, Joonghee Kim, Tackeun Kim, Kyuseok Kim, Heeyoung Lee, Soyeon Ahn, Yoo Hwan Jo, Jae Hyuk Lee, Ji Eun Hwang
OBJECTIVES: This study was performed to identify the risk factors for delayed intracranial hemorrhage and develop a risk stratification system for disposition of head trauma patients with negative initial brain imaging. METHODS: The data source was National Health Insurance Service-National Sample Cohort of Korea. We analyzed adult patients presenting to the ER from January 2004 to September 2012, who underwent brain imaging and discharged with or without short-term observation no longer than two days...
August 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28807524/peak-linear-and-rotational-acceleration-magnitude-and-duration-effects-on-maximum-principal-strain-in-the-corpus-callosum-for-sport-impacts
#5
Andrew Post, T Blaine Hoshizaki, Michael D Gilchrist, Michael D Cusimano
Concussion has been linked to the presence of injurious strains in the brain tissues. Research investigating severe brain injury has reported that strains in the brain may be affected by two parameters: magnitude of the acceleration, and duration of that acceleration. However, little is known how this relationship changes in terms of creating risk for brain injury for magnitudes and durations of acceleration common in sporting environments. This has particular implications for the understanding and prevention of concussive risk of injury in sporting environments...
July 25, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28807428/decreased-mortality-in-patients-with-isolated-severe-blunt-traumatic-brain-injury-receiving-higher-plasma-to-packed-red-blood-cells-transfusion-ratios
#6
Tobias Haltmeier, Elizabeth Benjamin, John Peter Gruen, Ira A Shulman, Lydia Lam, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Higher transfusion ratios of plasma to packed red blood cells (PRBC) and platelets (PLT) to PRBC have been shown to be associated with decreased mortality in major trauma patients. However, little is known about the effect of transfusion ratios on mortality in patients with isolated severe traumatic brain injury (TBI). The aim of this study was to investigate the effect of transfusion ratios on mortality in patients with isolated severe blunt TBI. We hypothesized that higher transfusion ratios of plasma to PRBC and PLT to PRBC are associated with a lower mortality rate in these patients...
August 5, 2017: Injury
https://www.readbyqxmd.com/read/28807194/the-impact-of-glasgow-coma-scale-age-prognosis-score-on-geriatric-traumatic-brain-injury-outcomes
#7
Muhammad Khan, Terence O'Keeffe, Faisal Jehan, Narong Kulvatunyou, Abdullah Kattaa, Lynn Gries, Andrew Tang, Bellal Joseph
BACKGROUND: As the population ages, increasing number of geriatric patients sustain traumatic brain injury (TBI). Communication of accurate prognostic information is crucial for making informed decisions on behalf of such patients. Therefore, the aim of our study was to develop a simple and clinically applicable tool that accurately predicts the prognosis in geriatric TBI patients. METHODS: We performed a 1-y (2011) retrospective analysis of isolated geriatric TBI patients (age ≥65 y, head abbreviated injury score [AIS] ≥ 3, and other body AIS < 3) in the National Trauma Data Bank...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28804609/therapeutic-effects-of-ellagic-acid-on-memory-hippocampus-electrophysiology-deficits-and-elevated-tnf-%C3%AE-level-in-brain-due-to-experimental-traumatic-brain-injury
#8
Shahram Mashhadizadeh, Yaghoub Farbood, Mahin Dianat, Ali Khodadadi, Alireza Sarkaki
OBJECTIVES: Cognitive defects such as learning and memory impairment are amongst the most repetitious sequelae after sever and moderate traumatic brain injury (TBI). It was suggested that ellagic acid (EA), an innate phenol product, display neuroprotective properties against oxidative and inflammatory damages after brain injury. The object of the current study was therapeutic properties of EA on blood-brain barrier (BBB) interruption and elevated content of TNF-α in brain tissue followed by neurologic aftereffects, cognitive and brain electrophysiology deficits as outcomes of diffuse TBI in rat...
April 2017: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28801041/diagnosis-of-delayed-diffuse-axonal-%C3%A4-njury
#9
Çağri Kokkoz, Mehmet Irik, Halil I Dayangaç, Mustafa Hayran, Adnan Bilge, Musa Çavuş
Diffuse axonal injury is usually caused by head trauma, and patients have significant clinical symptoms during admission to the emergency department. In our case, we present a five-year-old patient who was involved in a car accident. During admission to the emergency department, the patient had no symptoms of trauma. However, 6 h after admission to emergency service, neurological symptoms occurred, and mental status changed. Diffuse axonal injury (DAI) is characterized by diffuse nerve axon injury in the brain and brainstem...
August 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28774762/epidemiology-of-mild-traumatic-brain-injury-with-intracranial-hemorrhage-focusing-predictive-models-for-neurosurgical-intervention
#10
Alessandro Orlando, A Stewart Levy, Matthew M Carrick, Allen Tanner, Charles W Mains, David Bar-Or
OBJECTIVE: To adumbrate differences in neurosurgical intervention (NI) rates between intracranial hemorrhage (ICH) types in mild traumatic brain injuries (mTBIs), and help identify which ICH types are most likely to benefit from the creation of predictive models for NI. METHODS: This was a multi-center retrospective study of adult patients over three years at four Trauma Centers in the USA. Patients were included if they presented with a mTBI (GCS 13-15) and a head CT positive for ICH...
July 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28774508/compliance-with-evidence-based-guidelines-for-computed-tomography-of-children-with-head-and-abdominal-trauma
#11
Ihab Halaweish, Jane Riebe-Rodgers, Amy Randall, Peter F Ehrlich
INTRODUCTION: Recently, two large prospective clinical trials developed and validated prediction rules for children at very low risk for clinically important traumatic brain injuries (ciTBI) or abdominal injury for whom CT is unnecessary. Specific criteria/guidelines were identified which if met would obviate the need for CT scanning. The purpose of this study was to assess compliance at a level one pediatric center with these guidelines as a tool for quality improvement. METHODS: Records of children admitted to our pediatric trauma center one year before and two years after publication of head (Kuppermann '09) and abdominal trauma (Holmes '13) CT imaging guidelines were reviewed...
July 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28768968/isolated-adrenocorticotropic-hormone-deficiency-following-chronic-subdural-hematoma-in-an-elderly-man-is-there-a-connection
#12
Satoshi Suzuki, Keiko Suzuki
The delayed diagnosis of adrenal insufficiency is relatively common because its symptoms are non-specific. One of the causes of adrenal insufficiency is isolated adrenocorticotropic hormone deficiency (IAD), which is sometimes caused by traumatic brain injury. Indeed, severe head trauma is considered to contribute to the incidence of this disease. However, the relationship between milder head trauma-such as chronic subdural hematoma - and the occurrence of hormonal deficiency is uncertain. We herein report the case of a 79-year-old man with IAD who presented with leg edema and pain in his extremities following a recent history of chronic subdural hematoma...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28765270/improving-hospital-death-certification-in-vietnam-results-of-a-pilot-study-of-injury-related-fatalities
#13
Merrilyn Walton, Reema Harrison, Anna Chevalier, Esmond Esguerra, Nguyen Duc Chinh, Haphan Haian, Dang Van Duong, Huong Giang
BACKGROUND: Vietnam has prioritised the establishment of a civil registration system for deaths but as yet is unable to report accurate national statistics for the population of 93.5 million people due to inadequate mortality data. Verbal autopsy data suggest that injury is a third leading cause of death (by International Statistical Classification of Diseases and Related Health Problems 10th Revision chapters) in Vietnam, with road traffic injuries in particular a significant and increasing challenge...
August 1, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28764996/coagulopathy-as-a-predictor-of-mortality-after-penetrating-traumatic-brain-injury
#14
Lindley E Folkerson, Duncan Sloan, Elizabeth Davis, Ryan S Kitagawa, Bryan A Cotton, John B Holcomb, Jeffrey S Tomasek, Charles E Wade
STUDY HYPOTHESIS: Traumatic brain injury (TBI) is a leading cause of mortality with penetrating TBI (p-TBI) patients having worse outcomes. These patients are more likely to be coagulopathic than blunt TBI (b-TBI) patients, thus we hypothesize that coagulopathy would be an early predictor of mortality. METHODS: We identified highest-level trauma activation patients who underwent an admission head CT and had ICU admission orders from August 2009-May 2013, excluding those with polytrauma and anticoagulant use...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28757696/can-pneumocephalus-present-as-flashes-of-light-a-rare-case-report
#15
Santanu Ghosh, Menon P Jayasree, Mathew Biju, Basu Snehanshu
Orbital emphysema and associated pneumocephalus usually result from trauma to orbital bones or due to sinus disease, allowing air to travel from paranasal sinus into orbit and brain. However, it is extremely rare to have orbital emphysema and pneumocephalus in the absence of orbital wall fracture. In our case, a young male was admitted with severe eye pain, diminution of vision due to sudden exposure of compressed air gun. Examination revealed proptosed, emphysematous right eye with conjunctival laceration...
May 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/28756201/multiple-mild-traumatic-brain-injury-in-the-rat-produces-persistent-pathological-alterations-in-the-brain
#16
Diane M Brooks, Sarjubhai A Patel, Eric D Wohlgehagen, Erin O Semmens, Alan Pearce, Edmond A Sorich, Thomas F Rau
Multiple mild traumatic brain injury (mmTBI), in certain cases, produces persistent symptoms. However, the molecular mechanisms underlying these symptoms remain unclear. Here, we demonstrate extended pathological changes in the rat brain following mmTBI. Using the lateral fluid percussion (LFP) technique we exposed adult male Wistar rats to a mild TBI (mTBI) once a week for four weeks and compared them to surgical shams. At 90days following the last TBI or sham procedure the animals were cognitively tested in the Morris Water Maze (MWM), euthanized, and the brains removed for immunohistochemistry...
July 27, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28752349/citicoline-in-severe-traumatic-brain-injury-indications-for-improved-outcome-a%C3%A2-retrospective-matched-pair-analysis-from-14%C3%A2-austrian-trauma-centers
#17
Helmut Trimmel, Marek Majdan, Andrea Wodak, Guenther Herzer, Daniel Csomor, Alexandra Brazinova
Goal-oriented management of traumatic brain injury (TBI) can save the lives and/or improve the long-term outcome of millions of affected patients worldwide. Additionally, enhancing quality of life will save enormous socio-economic costs; however, promising TBI treatment strategies with neuroprotective agents, such as citicoline (CDP-choline), lacked evidence or produced contradictory results in clinical trials. During a prehospital TBI project to optimize early TBI care within 14 Austrian trauma centers, data on 778 TBI patients were prospectively collected...
July 27, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28745851/maxillofacial-trauma-managing-potentially-dangerous-and-disfiguring-complex-injuries-digest
#18
Devjani Das, Lea Salazar, Milana Zaurova
Patients with maxillofacial trauma require a careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial injuries can range from soft-tissue lacerations and nondisplaced nasal fractures to severe, complex fractures, eye injuries, and possible brain injury. Though the Advanced Trauma Life Support (ATLS) guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries. This issue adds a more comprehensive and systematic approach to the secondary survey of the maxillofacial area and emergency department management of injuries to the face...
April 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28743043/neurotrophy-and-immunomodulation-of-induced-neural-stem-cell-grafts-in-a-mouse-model-of-closed-head-injury
#19
Mou Gao, Hui Yao, Qin Dong, Yan Zhang, Yang Yang, Yihua Zhang, Zhijun Yang, Minhui Xu, Ruxiang Xu
Closed head injury (CHI) usually results in severe and permanent neurological impairments, which are caused by several intertwined phenomena, such as cerebral edema, blood-brain barrier (BBB) disruption, neuronal loss, astroglial scarring and inflammation. We previously reported that induced neural stem cells (iNSCs), similar to neural stem cells (NSCs), can accelerate neurological recovery in vivo and produce neurotrophic factors in vitro. However, the effects of iNSC neurotrophy following CHI were not determined...
July 18, 2017: Stem Cell Research
https://www.readbyqxmd.com/read/28741437/traumatic-brain-injury-in-a-community-based-cohort-of-homeless-and-vulnerably-housed-individuals
#20
Toby Schmitt, Allen Thornton, Iris Rawtaer, Alasdair Barr, Kristina Gicas, Donna Lang, Talia Vertinsky, Alexander Rauscher, Ric Procyshyn, Tari Buchanan, Alex Cheng, Sarah Mackay, Olga Leonova, Verena Langheimer, Thalia Field, Manraj K S Heran, Fidel Vila-Rodriguez, Tiffany-Anne O'Connor, William MacEwan, William Honer, William Panenka
We characterized traumatic brain injury (TBI) and studied its associations with mental and physical health in a community cohort of homeless and vulnerably-housed individuals. METHODS: Detailed mental and physical health structured interviews, neuropsychological testing, and multimodal MRI were performed on 283 participants. Two traumatic brain injury (TBI) participant groups were defined for primary analyses: those with a self-reported history of TBI and those with MRI evidence of TBI...
July 25, 2017: Journal of Neurotrauma
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