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https://www.readbyqxmd.com/read/29148640/short-term-outcome-of-operated-traumatic-brain-injury-patients-for-intracranial-hemorrhage-at-tikur-anbessa-specialized-teaching-hospital-tasth-addis-ababa-ethiopia
#1
Hagos Biluts, Azarias Kassahun, Mersha Abebe
Background: Traumatic brain injury is the leading cause of death and disability in people younger than 40 years of age worldwide. Objective: The study primarily aims at assessing the short-term outcome of patients operated for traumatic intracranial hemorrhage. Patients and Methods: This is a hospital based cross sectional study on patients with traumatic brain injury at Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia, between February 2013 and February 2014...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29145467/adenosine-lidocaine-and-mg2-alm-fluid-therapy-attenuates-systemic-inflammation-platelet-dysfunction-and-coagulopathy-after-non-compressible-truncal-hemorrhage
#2
Hayley Letson, Geoffrey Dobson
BACKGROUND: Systemic inflammation and coagulopathy are major drivers of injury progression following hemorrhagic trauma. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine and Mg2+ (ALM) bolus and 0.9% NaCl/ALM 'drip' on inflammation and coagulation in a rat model of hemorrhagic shock. METHODS: Sprague-Dawley rats (429±4 g) were randomly assigned to: 1) shams, 2) no-treatment, 3) saline-controls, 4) ALM-therapy, and 5) Hextend®. Hemorrhage was induced in anesthetized-ventilated animals by liver resection (60% left lateral lobe and 50% medial lobe)...
2017: PloS One
https://www.readbyqxmd.com/read/29142634/factors-associated-postoperative-hydrocephalus-in-patients-with-traumatic-acute-subdural-hemorrhage
#3
Han Kim, Heui Seung Lee, Sung Yeol Ahn, Sung Chun Park, Won Huh
Objective: Postoperative hydrocephalus is a common complication following craniectomy in patients with traumatic brain injury, and affects patients' long-term outcomes. This study aimed to verify the risk factors associated with the development of hydrocephalus after craniectomy in patients with acute traumatic subdural hemorrhage (tSDH). Methods: Patients with acute traumatic SDH who had received a craniectomy between December 2005 and January 2016 were retrospectively assessed by reviewing the coexistence of other types of hemorrahges, measurable variables on computed tomography (CT) scans, and the development of hydrocephalus during the follow-up period...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29142633/risk-factors-of-delayed-surgical-intervention-after-conservatively-treated-acute-traumatic-subdural-hematoma
#4
Hyungjoo Kwon, Kyu-Sun Choi, Hyeong-Joong Yi, Hyoung-Joon Chun, Young-Jun Lee, Dong-Won Kim
Objective: Acute subdural hematoma (ASDH) is generally considered a condition that should be managed surgically. However, some patients initially receive conservative treatment, a subset of whom require surgical intervention later. This study aimed to evaluate the predictors of delayed surgical intervention in ASDH patients who are initially managed conservatively. Methods: From January 2007 to December 2015, 842 patients diagnosed with ASDH were treated at our institution...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29142631/mortality-and-epidemiology-in-256-cases-of-pediatric-traumatic-brain-injury-korean-neuro-trauma-data-bank-system-kntdbs-2010-2014
#5
Hee-Won Jeong, Seung-Won Choi, Jin-Young Youm, Jeong-Wook Lim, Hyon-Jo Kwon, Shi-Hun Song
Objective: Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. Methods: We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery)...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29140952/-don-t-lose-hope-early-hemorrhagic-diffuse-axonal-injury-on-head-ct-is-not-associated-with-poor-outcome-in-moderate-severe-tbi-patients
#6
Nils Henninger, Rebecca A Compton, Muhammad W Khan, Raphael Carandang, Wiley Hall, Susanne Muehlschlegel
BACKGROUND: Diffuse axonal injury (DAI) on MRI has been associated with poor functional outcome after moderate-severe traumatic brain injury (msTBI). Yet, DAI assessment with highly-sensitive MRI-techniques is unfeasible in the acute trauma setting, and CT remains the key diagnostic modality despite its lower sensitivity. We sought to determine whether CT-defined-hemorrhagic-DAI (hDAI) is associated with discharge and favorable 3-and 12-month functional outcome (Glasgow Outcome Score ≥4) after msTBI...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140736/extremely-low-frequency-magnetic-field-protects-injured-spinal-cord-from-the-microglia-and-iron-induced-tissue-damage
#7
Soumil Dey, Samrat Bose, Suneel Kumar, Ravinder Rathore, Rashmi Mathur, Suman Jain
Spinal cord injury (SCI) is insult to the spinal cord, which results in loss of sensory and motor function below the level of injury. SCI results in both immediate mechanical damage and secondary tissue degeneration. Following traumatic insult, activated microglia release proinflammatory cytokines and excess iron due to hemorrhage, initiating oxidative stress that contributes to secondary degeneration. Literature suggests that benefits are visible with the reduction in concentration of iron and activated microglia in SCI...
November 15, 2017: Electromagnetic Biology and Medicine
https://www.readbyqxmd.com/read/29132577/reanimating-patients-after-traumatic-cardiac-arrest-a-practical-approach-informed-by-best-evidence
#8
REVIEW
Chris Evans, David O Quinlan, Paul T Engels, Jonathan Sherbino
Resuscitation of traumatic cardiac arrest is typically considered futile. Recent evidence suggests that traumatic cardiac arrest is survivable. In this article key principles in managing traumatic cardiac arrest are discussed, including the importance of rapidly seeking prognostic information, such as signs of life and point-of-care ultrasonography evidence of cardiac contractility, to inform the decision to proceed with resuscitative efforts. In addition, a rationale for deprioritizing chest compressions, steps to quickly reverse dysfunctional ventilation, techniques for temporary control of hemorrhage, and the importance of blood resuscitation are discussed...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132575/acute-management-of-the-traumatically-injured-pelvis
#9
REVIEW
Steven Skitch, Paul T Engels
Severe pelvic trauma is a challenging condition. The pelvis can create multifocal hemorrhage that is not easily compressible nor managed by traditional surgical methods such as tying off a blood vessel or removing an organ. Its treatment often requires reapproximation of bony structures, damage control resuscitation, assessment for associated injuries, and triage of investigations, as well as multimodality hemorrhage control (external fixation, preperitoneal packing, angioembolization, REBOA [resuscitative endovascular balloon occlusion of the aorta]) by multidisciplinary trauma specialists (general surgeons, orthopedic surgeons, endovascular surgeons/interventional radiologists)...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29129761/are-antiplatelet-and-anticoagulants-drugs-a-risk-factor-for-bleeding-in-mild-traumatic-brain-injury
#10
Laura Uccella, Cesare Zoia, Daniele Bongetta, Paolo Gaetani, Franz Martig, Christian Candrian, Raffaele Rosso
OBJECT: facing mild traumatic brain injury (mTBI) clinicians must decide whether to perform a CT scan to detect a potential intracranial hemorrhage.Many useful guidelines have been developed for general population, but there is no general consensus about the best practice to adopt when dealing with patients on antiplatelet or anticoagulation drugs. The relatively recent introduction of new anticoagulants and second generation antiplatelet drugs poses new challenges in this field. There is no data in the literature about the relative risk of intracranial bleeding in such categories...
November 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29127440/is-a-stepdown-unit-safe-for-patients-with-mild-traumatic-intracranial-hemorrhages
#11
L C Lamb, M M DiFiori, J Calafell, C H Comey, D S Shapiro, J M Feeney
PURPOSE: Traumatic brain injuries (TBIs) are a major source of disability in the United States. The ideal unit in the hospital for patients with mild traumatic intracranial hemorrhages (ICHs) has not been elucidated. We sought to investigate whether patients treated in the surgical stepdown area had worse outcomes than those treated in the surgical ICU. METHODS: We compared patients with ICHs and a Glasgow Coma Scale (GCS) upon admission of 14 or 15 who went to the ICU to those who went to the stepdown area from April 2014 to November 2016...
November 10, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29126430/lack-of-chronic-neuroinflammation-in-the-absence-of-focal-hemorrhage-in-a-rat-model-of-low-energy-blast-induced-tbi
#12
Miguel A Gama Sosa, Rita De Gasperi, Georgina S Perez Garcia, Heidi Sosa, Courtney Searcy, Danielle Vargas, Pierce L Janssen, Gissel M Perez, Anna E Tschiffely, William G Janssen, Richard M McCarron, Patrick R Hof, Fatemeh G Haghighi, Stephen T Ahlers, Gregory A Elder
Blast-related traumatic brain injury (TBI) has been a common cause of injury in the recent conflicts in Iraq and Afghanistan. Blast waves can damage blood vessels, neurons, and glial cells within the brain. Acutely, depending on the blast energy, blast wave duration, and number of exposures, blast waves disrupt the blood-brain barrier, triggering microglial activation and neuroinflammation. Recently, there has been much interest in the role that ongoing neuroinflammation may play in the chronic effects of TBI...
November 10, 2017: Acta Neuropathologica Communications
https://www.readbyqxmd.com/read/29125848/early-decreased-tlr2-expression-on-monocytes-is-associated-with-their-reduced-phagocytic-activity-and-impaired-maturation-in-a-porcine-polytrauma-model
#13
Lukas Schimunek, Rafael Serve, Michel P J Teuben, Philipp Störmann, Birgit Auner, Mathias Woschek, Roman Pfeifer, Klemens Horst, Tim-P Simon, Miriam Kalbitz, Ramona Sturm, Hans-C Pape, Frank Hildebrand, Ingo Marzi, Borna Relja
In their post-traumatic course, trauma patients suffering from multiple injuries have a high risk for immune dysregulation, which may contribute to post-injury complications and late mortality. Monocytes as specific effector cells of the innate immunity play a crucial role in inflammation. Using their Pattern Recognition Receptors (PRRs), notably Toll-Like Receptors (TLR), the monocytes recognize pathogens and/or pathogen-associated molecular patterns (PAMPs) and organize their clearance. TLR2 is the major receptor for particles of gram-positive bacteria, and initiates their phagocytosis...
2017: PloS One
https://www.readbyqxmd.com/read/29123874/early-administration-of-fibrinogen-concentrates-improves-the-short-term-outcomes-of-severe-pelvic-fracture-patients
#14
Koichi Inokuchi, Makoto Sawano, Koji Yamamoto, Atsushi Yamaguchi, Satoru Sugiyama
Aim: Hemorrhage from pelvic fracture is a major cause of mortality after blunt trauma. Several studies have suggested that early fibrinogen supplementation improves outcomes of traumatic hemorrhage. Thus, we revised our massive transfusion protocol (MTP) in April 2013 to include early off-label administration of fibrinogen concentrate. The objective of this study was to evaluate the impact of the revision on the short-term outcomes of pelvic fracture patients. Methods: This was a single-center, retrospective, cohort study...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123863/successful-non-operative-management-of-traumatic-extrahepatic-portal-venous-injury-without-intraperitoneal-hemorrhage-a-case-report
#15
Kunio Hamanaka, Yuusuke Hirokawa, Tsuyoshi Itoh, Mitsuhiro Fujino, Kenichi Kano, Satoru Beppu, Nozomu Sasahashi, Kei Nishiyama
Case: A 52-year-old woman was admitted to our hospital with hypotension after falling from the fifth floor of an apartment building. Contrast-enhanced computed tomography showed liver injury with extravasation of contrast material from the hepatic artery, and extrahepatic portal venous injury with extravasation and pseudoaneurysm. Intra-abdominal hemorrhage was not observed, and bleeding was confined to the retroperitoneal space. Hepatic arteriography showed extravasation, while portal venography showed pseudoaneurysm but no extravasation...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123853/high-grade-traumatic-torso-visceral-injury-with-hemodynamic-instability-effectiveness-of-transarterial-embolization-using-n-butyl-cyanoacrylate
#16
REVIEW
Junya Tsurukiri, Shoichi Ohta, Akira Hoshiai, Hidefumi Sano, Eitaro Okumura, Nobuhiko Tsubouchi, Hiroyuki Konishi, Tetsuo Yukioka
Trauma patients with uncontrolled hemorrhage encountering coagulopathy are often associated with poor outcome. Recently, the concept of damage control interventional radiology, which focuses on "speedy stoppage of bleeding" by interventional radiology among trauma patients with hemodynamic instability and acute traumatic coagulopathy, was proposed as an alternative to damage control surgery. N-butyl cyanoacrylate (NBCA) has been used as a liquid embolic agent in various non-traumatic situations, where it has been shown to have a high technical success rate and low recurrent bleeding rate, especially in patients with coagulopathy...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123850/delayed-massive-epistaxis-from-traumatic-intracranial-aneurysm-after-blunt-facial-injury
#17
Hajime Nakamura, Toshiyuki Fujinaka, Osamu Tasaki, Toshiki Yoshimine
Cases: Traumatic intracranial aneurysm following blunt head injury is uncommon but can be induced by extension of skull base fracture and causes unexpected hemorrhagic complications. We present two cases of traumatic intracranial aneurysm in the paraclinoid area that was revealed by delayed massive epistaxis. Lack of initial neurological deficits omitted screening for cerebrovascular injury. Outcome: Internal trapping was carried out using endovascular techniques in both cases, with extracranial-intracranial bypass in one case...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123840/a-system-of-delivering-medical-staff-members-by-helicopter-to-manage-severely-wounded-patients-in-an-area-where-medical-resources-are-limited
#18
Kohei Ishikawa, Kazuhiko Omori, Hiromichi Ohsaka, Kei Jitsuiki, Toshihiko Yoshizawa, Yasumasa Oode, Mutsumi Sakurada, Atsuhiko Mogami, Youichi Yanagawa
Aim: We review the case of a severely injured patient to evaluate the system of delivering medical staff by helicopter in areas with limited medical resources. Methods: The patient's chart was reviewed, summarized, and presented. Results: A 22-year-old woman attempted a suicidal fall after using a knife to stab herself. She was transported to a local hospital. A radiological study revealed fractures to the patient's face and the base of her skull, pneumocephalus, traumatic subarachnoid hemorrhage, stab wounds to the neck and chest, pneumothorax, unstable pelvic fracture, and right femoral shaft fracture...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122733/readmissions-in-anticoagulated-intracranial-hemorrhage-patients-a-retrospective-review
#19
Monica M DiFiori, Laura C Lamb, Lori L Calavan, Christopher H Comey, James M Feeney
OBJECTIVE: The objective of this study was to determine the effect of Direct Oral Anticoagulants (DOACs) when compared to warfarin, on the 30-day readmission rates in patients with traumatic intracranial hemorrhage (ICH). METHODS: We conducted a retrospective review of patients from our hospital's trauma database admitted from June 2011 to October 2015 to our Level II trauma center after sustaining a traumatic ICH while anticoagulated. Patients were stratified based on the anticoagulation drug (DOAC or warfarin) they were prescribed upon admission...
November 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29121826/treatment-of-traumatic-brain-injury-with-vepoloxamer-purified-poloxamer-188
#20
Yanlu Zhang, Michael Chopp, Martin Emanuele, Li Zhang, Zheng Gang Zhang, Mei Lu, Talan Zhang, Asim Mahmood, Ye Xiong
Vepoloxamer is an amphipathic polymer that has shown potent hemorrheologic, cytoprotective, and anti-inflammatory effects in both preclinical and clinical studies. This study was designed to investigate the therapeutic effects of vepoloxamer on sensorimotor and cognitive functional recovery in rats after traumatic brain injury (TBI) induced by controlled cortical impact. Young adult male Wistar rats were randomly divided into the following groups: 1) Sham; 2) Saline; or 3) Vepoloxamer. Vepoloxamer (300 mg/kg) or saline was intravenously administered over 60 min via intravenous infusion into tail veins starting at 2 h post injury...
November 9, 2017: Journal of Neurotrauma
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