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https://www.readbyqxmd.com/read/28650361/pharmacological-thromboembolic-prophylaxis-in-traumatic-brain-injuries-low-molecular-weight-heparin-is-superior-to-unfractionated-heparin
#1
Elizabeth Benjamin, Gustavo Recinos, Alberto Aiolfi, Kenji Inaba, Demetrios Demetriades
OBJECTIVE: We hypothesized that low molecular weight heparin (LMWH) is superior to unfractionated heparin (UH) for venous thromboembolism (VTE) prophylaxis in patients with severe traumatic brain injuries (TBI). SUMMARY BACKGROUND DATA: Pharmacological VTE prophylaxis with LMWH or UH is the current standard of care in TBI. Clinical work suggests that LMWH may be more effective than UH for VTE prophylaxis in trauma patients. Experimental work shows that heparinoids may have neuroprotective properties...
June 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28640776/early-fever-after-trauma-does-it-matter
#2
Holly E Hinson, Susan Rowell, Cynthia Morris, Amber L Lin, Martin A Schreiber
BACKGROUND: Fever is strongly associated with poor outcome after traumatic brain injury (TBI). We hypothesized that early fever is a direct result of brain injury and thus would be more common in TBI than in patients without brain injury, and associated with inflammation. METHODS: We prospectively enrolled patients with major trauma with and without TBI from a busy level I trauma center ICU. Patients were assigned to one of four groups based on their presenting Head Abbreviated Injury Severity Scale scores (HAIS): Polytrauma: Head AIS score >2, one other region>2, Isolated Head: Head AIS score>2, all other regions <3, Isolated Body: One region >2, excluding Head/Face, Minor Injury: No region with AIS>2...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28628541/apathy-due-to-injury-of-the-prefrontocaudate-tract-following-mild-traumatic-brain-injury
#3
Sung Ho Jang, Hyeok Gyu Kwon
In this study, we report on a patient who developed apathy resulting from injury to the prefrontocaudate tract following mild traumatic brain injury (TBI), which was observed on diffusion tensor tractography (DTT). A 46-year-old female patient was involved in a bus accident. Her history included intracerebral hemorrhage (ICH) in the left putamen 4 years ago before the head trauma, and her family reported that she had fully recovered. She developed apathy after the TBI, worsening over time. Decreased neural connectivity of the left caudate nucleus (CN) to the left upper medial prefrontal cortex (PFC) resulting from the ICH was observed on the pre-TBI-DTT, whereas on the post-TBI-DTT (28 months after TBI), the neural connectivity of the left CN to the left upper medial PFC was increased, whereas that to the left lower medial PFC and orbitofrontal cortex was decreased...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28614144/early-fibrinolysis-associated-with-hemorrhagic-progression-following-traumatic-brain-injury
#4
Jay Karri, Jessica C Cardenas, Nena Matijevic, Yao-Wei Wang, Sangbum Choi, Liang Zhu, Bryan A Cotton, Ryan Kitagawa, John B Holcomb, Charles E Wade
BACKGROUND: Progressive hemorrhagic injury (PHI) is common in patients with severe traumatic brain injury (TBI) and is associated with worse outcomes. PHI pathophysiology remains poorly understood and difficult to predict. We performed an exploratory analysis aimed at identify markers in need of further investigation to establish their predictive value in PHI following TBI. METHODS: We performed a retrospective chart review of prospectively collected data from 424 highest-level activation trauma patients from January 2012 through December 2013...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28612105/-polytrauma-and-concomitant-traumatic-brain-injury-the-role-of-the-trauma-surgeon
#5
REVIEW
A Antoni, T Heinz, J Leitgeb
BACKGROUND: Concomitant traumatic brain injury (TBI) increases mortality and reduces quality of life of polytrauma patients. These facts demand effective treatment strategies while the growing specialization of medicine is questioning the role of the trauma surgeon in the management of these patients. OBJECTIVES: Which factors influence outcome of polytrauma with concomitant TBI? Who should be responsible for the management of these patients and what is the limit of management? MATERIALS AND METHODS: A literature search using Medline via PubMed was performed with Medical Subject Headings and text word search...
June 13, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28596923/unilateral-dilated-pupil-and-spontaneous-cardiac-arrest-with-successful-bystander-resuscitation
#6
James M Hancox, Julian Spiers, Nicholas Crombie, David N Naumann
A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient's wife by telephone, she said that he had fallen and hit his head earlier that day...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28590993/childhood-falls-with-occipital-impacts
#7
Norrell Atkinson, Rick R van Rijn, Suzanne P Starling
OBJECTIVES: Falls are commonly reported in children who present with both accidental and inflicted brain injuries. Short falls rarely result in serious or life-threatening injuries. Our purpose is to describe a series of cases of short falls with occipital impact leading to subdural hemorrhage (SDH). METHODS: We present a series of 8 witnessed accounts of young children diagnosed as having SDHs after striking the back of their heads during a short fall. Child-abuse physicians were surveyed to determine if they had evaluated a child younger than 24 months diagnosed as having SDH, with or without retinal hemorrhages, following a witnessed fall with occipital impact...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590358/erythropoietin-in-patients-with-traumatic-brain-injury-and-extracranial-injury-a-post-hoc-analysis-of-the-epo-tbi-trial
#8
Markus B Skrifvars, Michael Bailey, Craig French, Jeffrey Presneill, Alistair Nichol, Lorraine Little, Jacques Duranteau, Olivier Huet, Samir Haddad, Yaseen Arabi, Colin McArthur, D James Cooper, Rinaldo Bellomo
BACKGROUND: Erythropoietin (EPO) may reduce mortality after traumatic brain injury (TBI). Secondary brain injury is exacerbated by multiple trauma, and possibly modifiable by EPO. We hypothesized that EPO decreases mortality more in TBI patients with multiple trauma, than in patients with TBI alone. METHODS: A post hoc analysis of the EPO-TBI randomised controlled trial conducted in 2009 to 2014. To evaluate the impact of injuries outside the brain, we calculated an extracranial injury severity score (ISS) that included the same components of the ISS, excluding head and face components...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28589166/elevated-glutamate-and-lactate-predict-brain-death-after-severe-head-trauma
#9
Marco A Stefani, Rafael Modkovski, Gisele Hansel, Eduardo R Zimmer, Afonso Kopczynski, Alexandre P Muller, Nathan R Strogulski, Marcelo S Rodolphi, Randhall K Carteri, André P Schmidt, Jean P Oses, Douglas H Smith, Luis V Portela
OBJECTIVE: Clinical neurological assessment is challenging for severe traumatic brain injury (TBI) patients in the acute setting. Waves of neurochemical abnormalities that follow TBI may serve as fluid biomarkers of neurological status. We assessed the cerebrospinal fluid (CSF) levels of glutamate, lactate, BDNF, and GDNF, to identify potential prognostic biomarkers of neurological outcome. METHODS: This cross-sectional study was carried out in a total of 20 consecutive patients (mean [SD] age, 29 [13] years; M/F, 9:1) with severe TBI Glasgow Coma Scale ≤ 8 and abnormal computed tomography scan on admission...
June 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28578085/assault-in-children-admitted-to-trauma-centers-injury-patterns-and-outcomes-from-a-5-year-review-of-the-national-trauma-data-bank
#10
Galinos Barmparas, Navpreet K Dhillon, Eric J T Smith, James M Tatum, Rex Chung, Nicolas Melo, Eric J Ley, Daniel R Margulies
IMPORTANCE: While assault is commonly reported or suspected in children with traumatic wounds, a recent overview of these injuries, especially those requiring trauma surgery consultation is lacking in the literature. OBJECTIVES: Explore the incidence, demographics and injury patterns of children presenting to trauma centers following an assault. DESIGN: Retrospective review of the National Trauma Data Bank 2007 to 2011. SETTING AND PARTICIPANTS: Subjects up to 18 years old with "assault" reported as the intent of injury...
May 31, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28576125/dissection-of-the-internal-carotid-artery-and-stroke-after-mandibular-fractures-a-case-report-and-review-of-the-literature
#11
Ingrid Aune Tveita, Martin Ragnar Skjerve Madsen, Erik Waage Nielsen
BACKGROUND: We present a report of a patient with blunt trauma and mandibular fractures who developed a significant cerebral infarction due to an initially unrecognized injury of her left internal carotid artery. We believe that increased knowledge of this association will facilitate early recognition and hence prevention of a devastating outcome. CASE PRESENTATION: A 41-year-old ethnic Norwegian woman presented to our Emergency Room after a bicycle accident that had caused a direct blow to her chin...
June 2, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28566813/kickboxing-review-anthropometric-psychophysiological-and-activity-profiles-and-injury-epidemiology
#12
REVIEW
M Slimani, H Chaabene, B Miarka, E Franchini, K Chamari, F Cheour
Kickboxing is one of the modern combat sports. The psychophysiological demands of a kickboxing competition require athletes to achieve high thresholds of several aspects of physical fitness. The aim of the current review is to critically analyse and appraise the kickboxer's anthropometric, physiological, physical and psychological attributes with the activity profile and injury epidemiology in order to provide practical recommendations for training as well as new areas of scientific research. The available information shows that both amateur and elite-level male kickboxers are characterized by a higher proportion of mesomorphy with a well-developed muscle mass and low body fat percentage...
June 2017: Biology of Sport
https://www.readbyqxmd.com/read/28551409/the-crumple-zone-hypothesis-association-of-frontal-sinus-volume-and-cerebral-injury-after-craniofacial-trauma
#13
Stephen S Cai, Corey Mossop, Silviu C Diaconu, David S Hersh, Sara AlFadil, Yvonne M Rasko, Michael R Christy, Michael P Granta, Arthur J Nam
PURPOSE: The paranasal sinuses are complex anatomical structures of unknown significance. One hypothesis theorizes that the sinuses, in the event of a traumatic injury, function as a crumple zone to distribute and absorb energy to protect the brain and other critical structures. The current study investigates the association between frontal sinus (FS) volume and the severity of cerebral insults following craniofacial trauma. METHODS: All patients with FS fracture admitted to a level 1 trauma center from 2011 to 2014 were retrospectively reviewed...
July 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28548592/intracranial-pressure-monitoring-in-severe-blunt-head-trauma-does-the-type-of-monitoring-device-matter
#14
Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28544811/differential-protein-expression-in-exosomal-samples-taken-from-trauma-patients
#15
Ron B Moyron, Amber Gonda, Matthew J Selleck, Xian Luo-Owen, Richard D Catalano, Thomas O'Callahan, Carlos Garberoglio, David Turay, Nathan R Wall
Traumatic Brain Injuries (TBI) are among the most misdiagnosed and underreported types of head trauma. The potential long-term impact of undiagnosed or incorrectly identified concussions and other head injuries are potentially devastating, as evidenced by the increasing societal burden exhibited by soldiers returning from combat and athletes in contact sports. Concussions and TBI are notoriously difficult to correctly diagnose and prognosis for these injuries is poorly understood. In order to increase the likelihood of successful diagnosis, treatment, and prediction of outcomes, a definitive differential diagnosis will need to be established...
May 25, 2017: Proteomics. Clinical Applications
https://www.readbyqxmd.com/read/28538641/prehospital-plasma-resuscitation-associated-with-improved-neurologic-outcomes-after-traumatic-brain-injury
#16
Matthew C Hernandez, Cornelius A Thiels, Johnathon M Aho, Elizabeth B Habermann, Martin D Zielinski, James A Stubbs, Donald H Jenkins, Scott P Zietlow
INTRODUCTION: Trauma related hypotension and coagulopathy worsen secondary brain injury in patients with traumatic brain injuries (TBI). Early damage control resuscitation with blood products may mitigate hypotension and coagulopathy. Preliminary data suggest resuscitation with plasma in large animals improve neurologic function after TBI; however, data in humans are lacking. METHODS: We retrospectively identified all poly-trauma patients age >15 years with head injuries undergoing prehospital resuscitation with blood products at a single level I trauma center from 01/2002 to 12/2013...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538329/perioperative-care-for-pediatric-patients-with-penetrating-brain-injury-a-review
#17
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/28530785/anti-edematous-anti-inflammatory-and-neuroprotective-effect-of-etanercept-in-acute-stage-in-experimental-head-injury
#18
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/28528969/limitation-of-life-sustaining-treatment-in-severe-trauma-in-the-elderly-after-admission-to-an-intensive-care-unit
#19
Y Peñasco, A González-Castro, J C Rodríguez Borregán, M Ortiz-Lasa, R Jáuregui Solórzano, M J Sánchez Arguiano, P Escudero Acha
OBJECTIVE: To analyze the factors associated to limitation of life-sustaining treatment (LLST) measures in elderly patients admitted to an intensive care unit (ICU) due to trauma. DESIGN: A retrospective, descriptive, observational study was carried out. SETTING: ICU. PATIENTS: A total of 149 patients aged 65 years or older admitted to the ICU due to trauma. Hospital mortality, the decision to limit life-sustaining treatment and the factors associated to these measures were analyzed...
May 18, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28520670/neutrophil-to-lymphocyte-ratio-as-a-novel-predictor-of-outcome-in-patients-with-severe-traumatic-brain-injury
#20
Weiqiang Chen, Jinhua Yang, Bingbing Li, Guoyi Peng, Tianfei Li, Lianjie Li, Shousen Wang
OBJECTIVE: The neutrophil to lymphocyte ratio (NLR) has been reported to be a predictor of outcome in critical illness. Objective of this study was to investigate the changes of the NLR in patients with severe traumatic brain injury (TBI) and analyze the relationship between the NLR and TBI outcome. SETTING: China. PARTICIPANTS: A total of 855 patients with severe TBI from January 2007 to April 2012. DESIGN: Retrospective...
May 17, 2017: Journal of Head Trauma Rehabilitation
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