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Brain injury medical management

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https://www.readbyqxmd.com/read/29049053/treatment-options-for-posttraumatic-epilepsy
#1
Lara L Zimmermann, Ryan M Martin, Fady Girgis
PURPOSE OF REVIEW: Posttraumatic seizures (PTS) and posttraumatic epilepsy (PTE) are common and debilitating consequences of traumatic brain injury (TBI). Early PTS result in secondary brain injury by raising intracranial pressure and worsening cerebral edema and metabolic crisis. PTE is a localization-related epilepsy strongly associated with TBI severity, but risk factors for PTE and epileptogenesis are incompletely understood and are active areas of research. Medical management of PTS in adults and children is reviewed...
October 18, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29042299/non-pharmacological-interventions-for-spasticity-in-adults-an-overview-of-systematic-reviews
#2
REVIEW
Fary Khan, Bhasker Amatya, Djamel Bensmail, Alain Yelnik
OBJECTIVES: Spasticity causes significant long-term disability-burden, requiring comprehensive management. This review evaluates evidence from published systematic reviews of clinical trials for effectiveness of non-pharmacological interventions for improved spasticity outcomes. METHODS: Data sources: A literature search was conducted using medical and health science electronic (MEDLINE, EMBASE, CINAHL, PubMed, and the Cochrane Library) databases for published systematic reviews up to 15(th) June 2017...
October 14, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29030415/comorbidity-and-outcomes-in-traumatic-brain-injury-protocol-for-a-systematic-review-on-functional-status-and-risk-of-death
#3
Tatyana Mollayeva, Chen Xiong, Sara Hanafy, Vincy Chan, Zheng Jing Hu, Mitchell Sutton, Michael Escobar, Angela Colantonio
INTRODUCTION: Reports on the association between comorbidity and functional status and risk of death in patients with traumatic brain injury (TBI) have been inconsistent; it is currently unknown which additional clinical entities (comorbidities) have an adverse influence on the evolution of outcomes across the lifespan of men and women with TBI. The current protocol outlines a strategy for a systematic review of the current evidence examining the impact of comorbidity on functional status and early-term and late-term mortality, taking into account known risk factors of these adverse outcomes (ie, demographic (age and sex) and injury-related characteristics)...
October 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/29025454/an-audit-of-traumatic-brain-injury-tbi-in-a-busy-developing-world-trauma-service-exposes-a-significant-deficit-in-resources-available-to-manage-severe-tbi
#4
Ellen Jerome, Grant L Laing, John L Bruce, Ben Sartorius, Petra Brysiewicz, Damian L Clarke
BACKGROUND: Traumatic brain injury (TBI) affects large numbers of patients, both adults and children, and significant resources are needed to manage it. OBJECTIVE: To determine the burden of TBI and the adequacy of available resources to manage in the Pietermaritzburg Metropolitan Trauma Service (PMTS). METHODS: All patients with a TBI were identified from the hybrid electronic medical registry at Grey's and Edendale hospitals in Pietermaritzburg (PMB), KwaZulu-Natal, South Africa...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28988190/the-outcome-of-patients-in-traumatic-cardiac-arrest-presenting-to-deployed-military-medical-treatment-facilities-data-from-the-uk-joint-theatre-trauma-registry
#5
Ed B G Barnard, P A F Hunt, P E H Lewis, J E Smith
BACKGROUND: The UK military was continuously engaged in armed conflict in Iraq and Afghanistan between 2003 and 2014, resulting in 629 UK fatalities. Traumatic cardiac arrest (TCA) is a precursor to traumatic death, but data on military outcomes are limited. In order to better inform military treatment protocols, the aim of this study was to define the epidemiology of TCA in the military population with a particular focus on survival rates and injury patterns. METHODS: A retrospective database analysis of the UK Joint Theatre Trauma Registry was undertaken...
October 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28952326/education-on-the-brain-a-partnership-between-a-pediatric-primary-care-center-and-neurology-residency
#6
Eric Zwemer, Miya Bernson-Leung, Corinna Rea, Archana A Patel, Rejean Guerriero, David K Urion, Sara L Toomey
The national shortage of pediatric neurologists is worsening, yet referral rates by pediatricians are high. Suboptimal training of pediatric residents in care of patients with neurologic disease may be a contributing factor. We formed a partnership between the Boston Children's Primary Care at Longwood clinic and Child Neurology Residency Training Program. The educational intervention included lectures, observed neurologic examinations, in-person and virtual triage, and an electronic medical record-based consult system...
February 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28948121/novel-use-of-an-image-guided-stereotactic-approach-in-trauma-for-localization-of-transcranial-bullet
#7
Dat T Vo, George F Cravens, Robert E Germann
Penetrating brain injuries from gunshot wounds can carry a poor prognosis and require an aggressive, multifaceted approach to obtain a good prognosis and outcome. An initial evaluation requires appropriate imaging studies followed by management and prophylaxis against increased intracranial pressure, infection, and seizures. Surgical management is then followed to ensure the watertight closure of any wounds, removal of any areas of hematoma, and removal of any potential areas of infection. In this paper, we report the case of a patient who presented with a self-inflicted gunshot wound to the head and then received aggressive medical and surgical management...
July 21, 2017: Curēus
https://www.readbyqxmd.com/read/28933211/traumatic-brain-injury-current-treatment-strategies-and-future-endeavors
#8
Michael Galgano, Gentian Toshkezi, Xuecheng Qiu, Thomas Russell, Lawrence Chin, Li-Ru Zhao
Traumatic brain injury (TBI) presents in various forms ranging from mild alterations of consciousness to an unrelenting comatose state and death. In the most severe form of TBI, the entirety of the brain is affected by a diffuse type of injury and swelling. Treatment modalities vary extensively based on the severity of the injury and range from daily cognitive therapy sessions to radical surgery such as bilateral decompressive craniectomies. Guidelines have been set forth regarding the optimal management of TBI, but they must be taken in context of the situation and cannot be used in every individual circumstance...
July 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28929311/tbi-rehabilomics-research-an-exemplar-of-a-biomarker-based-approach-to-precision-care-for-populations-with-disability
#9
REVIEW
Amy K Wagner
PURPOSE OF REVIEW: The purpose of this review is to summarize how "-omics" technologies can inform rehabilitation-relevant outcomes for a range of populations with neurologically related disability by including outcome metrics linked to the World Health Organization's International Classification of Functioning, Disability, and Health (WHO-ICF) domains of impairments in body function, activity limitations, and participation restrictions. RECENT FINDINGS: To date, nearly every area of medicine uses biomarkers in some capacity to aid in understanding how personal biology informs clinical care...
September 19, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28926566/guidelines-for-the-management-of-a-brain-death-donor-in-the-rhesus-macaque-a-translational-transplant-model
#10
Tiffany J Zens, Juan S Danobeitia, Peter J Chlebeck, Laura J Zitur, Scott Odorico, Kevin Brunner, Jennifer Coonen, Saverio Capuano, Anthony M D'Alessandro, Kristina Matkowskyj, Weixiong Zhong, Jose Torrealba, Luis Fernandez
INTRODUCTION: The development of a translatable brain death animal model has significant potential to advance not only transplant research, but also the understanding of the pathophysiologic changes that occur in brain death and severe traumatic brain injury. The aim of this paper is to describe a rhesus macaque model of brain death designed to simulate the average time and medical management described in the human literature. METHODS: Following approval by the Institutional Animal Care and Use Committee, a brain death model was developed...
2017: PloS One
https://www.readbyqxmd.com/read/28926486/comorbid-posttraumatic-stress-disorder-and-traumatic-brain-injury-generalization-of-prolonged-exposure-ptsd-treatment-outcomes-to-postconcussive-symptoms-cognition-and-self-efficacy-in-veterans-and-active-duty-service-members
#11
Gregory K Wolf, Gregory J Mauntel, Tracy Kretzmer, Eric Crawford, Christina Thors, Thad Q Strom, Rodney D Vanderploeg
OBJECTIVES: To examine (a) generalization of the effectiveness of prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) in improving postconcussive symptoms (PCSs) and other outcomes in military service members and Veterans (VA) with histories of mild to severe traumatic brain injury (TBI), and (b) factors associated with PCS reduction. SETTING: VA polytrauma medical center. PARTICIPANTS: Consecutive referrals for PTSD treatment of Active Duty (n = 17) or Veterans (n = 27) diagnosed with PTSD and TBI (N = 44)...
September 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#12
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28912978/anoxic-brain-injury-presenting-as-pseudosubarachnoid-hemorrhage-in-the-medical-intensive-care-unit
#13
O'Dene Lewis, Samina Afreen, Supo Folaranmi, Marie Fidelia-Lambert, Vishal Poddar, Alicia Thomas
Anoxic encephalopathy is frequently encountered in the medical intensive care unit (ICU). Cerebral edema as a result of anoxic brain injury can result in increased attenuation in the basal cisterns and subarachnoid spaces on computerized tomography (CT) scans of the head. These findings can mimic those seen in acute subarachnoid hemorrhage (SAH) and are referred to as pseudosubarachnoid hemorrhage (pseudo-SAH). Pseudo-SAH is a diagnosis critical care physicians should be aware of as they treat and evaluate their patients with presumed SAH, which is a medical emergency...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28890524/diagnosis-and-management-of-patients-with-paroxysmal-sympathetic-hyperactivity-following-acute-brain-injuries-using-a-consensus-based-diagnostic-tool-a-single-institutional-case-series
#14
Shigeo Godo, Shigemi Irino, Atsuhiro Nakagawa, Yu Kawazoe, Motoo Fujita, Daisuke Kudo, Ryosuke Nomura, Hiroaki Shimokawa, Shigeki Kushimoto
Paroxysmal sympathetic hyperactivity (PSH) is a distinct syndrome of episodic sympathetic hyperactivities following severe acquired brain injury, characterized by paroxysmal transient fever, tachycardia, hypertension, tachypnea, excessive diaphoresis and specific posturing. PSH remains to be an under-recognized condition with a diagnostic pitfall especially in the intensive care unit (ICU) settings due to the high prevalence of concomitant diseases that mimic PSH. A consensus set of diagnostic criteria named PSH-Assessment Measure (PSH-AM) has been developed recently, which is consisted of two components: a diagnosis likelihood tool derived from clinical characteristics of PSH, and a clinical feature scale assigned to the severity of each sympathetic hyperactivity...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28886114/delivery-of-mental-health-treatment-to-combat-veterans-with-psychiatric-diagnoses-and-tbi-histories
#15
Shannon R Miles, Juliette M Harik, Natalie E Hundt, Joseph Mignogna, Nicholas J Pastorek, Karin E Thompson, Jessica S Freshour, Hong J Yu, Jeffrey A Cully
Traumatic brain injury (TBI) and mental health (MH) disorders are prevalent in combat veterans returning from Afghanistan and/or Iraq (hereafter referred to as returning veterans). Accurate estimates of service utilization for veterans with and without TBI exposure (referred to as TBI history) are imperative in order to provide high quality healthcare to returning veterans. We examined associations between TBI history and MH service utilization in a subsample of returning veterans who were newly diagnosed with posttraumatic stress disorder (PTSD), depression, and/or anxiety in the 2010 fiscal year (N = 55,458)...
2017: PloS One
https://www.readbyqxmd.com/read/28841573/pediatric-providers-attitudes-and-practices-regarding-concussion-diagnosis-and-management
#16
Khalida Itriyeva, Ronald Feinstein, Linda Carmine
Background Concussions, a form of mild traumatic brain injury, are a current "hot topic" in sports and medicine, with current research focusing on diagnosis, treatment, and the long-term effects of repeated concussions on development of chronic traumatic encephalopathy. Concussions represent 8.9% of all high school athletic injuries, and pediatricians see many of these patients in their practices, however evolving guidelines and recommendations have resulted in varying practices among providers. Objective To assess how local pediatricians in New York Chapter 2 of the American Academy of Pediatrics (AAP) diagnose and treat concussion patients, and to evaluate the need for continuing education in this area...
August 25, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28840552/the-emerging-role-of-proteomics-in-precision-medicine-applications-in-neurodegenerative-diseases-and-neurotrauma
#17
Rana Alaaeddine, Mira Fayad, Eliana Nehme, Hisham F Bahmad, Firas Kobeissy
Inter-individual variability in response to pharmacotherapy has provoked a higher demand to personalize medical decisions. As the field of pharmacogenomics has served to translate personalized medicine from concept to practice, the contribution of the "omics" disciplines to the era of precision medicine seems to be vital in improving therapeutic outcomes. Although we have observed significant advances in the field of genomics towards personalized medicine , the field of proteomics-with all its capabilities- is still in its infancy towards the area of personalized precision medicine...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28826717/head-computed-tomography-scan-in-isolated-traumatic-brain-injury-in-a-low-income-country
#18
Armel Flavien Kabore, Aziz Ouedraogo, Kélan Bertille Ki, Salah Seif Idriss Traore, Ibrahim Alain Traore, Cheik Tidiane Hafiz Bougouma, Darko Arnaudovski, Ousseini Diallo, Sylvain Zabsonre, Nazinigouba Ouedraogo, Pascal Augustin
BACKGROUND: Head Computed Tomography Scan (HCTS) is the cornerstone of the management of traumatic brain injury (TBI). The impact of performing HCTS in TBI has been scarcely investigated in low income countries (LICs). Furthermore, the cost of a HCTS is a burden for family finances. METHODS: A prospective observational study was conducted in Burkina Faso. All consecutive patients with isolated TBI needing a HCTS were included. Result and impact of HCTS were evaluated...
August 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28821777/decompressive-craniectomy-in-the-management-of-intracranial-hypertension-after-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#19
Danfeng Zhang, Qiang Xue, Jigang Chen, Yan Dong, Lijun Hou, Ying Jiang, Junyu Wang
We aim to perform a systematic review and meta-analysis to examine the prognostic value of decompressive craniectomy (DC) in patients with traumatic intracranial hypertension. PubMed, EMBASE, Cochrane Controlled Trials Register, Web of Science, http://clinicaltrials.gov/ were searched for eligible studies. Ten studies were included in the systematic review, with four randomized controlled trials involved in the meta-analysis, where compared with medical therapies, DC could significantly reduce mortality rate [risk ratio (RR), 0...
August 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28818818/validation-of-a-smartphone-based-approach-to-in-situ-cognitive-fatigue-assessment
#20
Edward Price, George Moore, Leo Galway, Mark Linden
BACKGROUND: Acquired Brain Injuries (ABIs) can result in multiple detrimental cognitive effects, such as reduced memory capability, concentration, and planning. These effects can lead to cognitive fatigue, which can exacerbate the symptoms of ABIs and hinder management and recovery. Assessing cognitive fatigue is difficult due to the largely subjective nature of the condition and existing assessment approaches. Traditional methods of assessment use self-assessment questionnaires delivered in a medical setting, but recent work has attempted to employ more objective cognitive tests as a way of evaluating cognitive fatigue...
August 17, 2017: JMIR MHealth and UHealth
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