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https://www.readbyqxmd.com/read/27923754/successful-coil-embolization-of-pediatric-carotid-cavernous-fistula-due-to-ruptured-post-traumatic-giant-internal-carotid-artery-aneurysm
#1
Daisuke Wajima, Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: The goal of the treatment of direct carotid cavernous fistula (CCF) is to occlude the arteriovenous shunt and to preserve the patency of the concerned internal carotid artery (ICA). However, for the ipsilateral post-traumatic fragile cerebrum, coil embolization plus parent artery occlusion for the high flow direct CCF would be better for the prevention of hyper-perfusion syndrome and the intracranial hemorrhage. We experienced such a case and managed it successfully. CASE DESCRIPTION: A 6-year-old boy was suffered from severe head trauma caused by being hit by a car...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27922966/local-coverage-for-acute-severely-herniated-brain-using-scalp-and-forehead-flaps-in-a-pediatric-patient-with-head-trauma
#2
Matthew Brown, Navid Pourtaheri, Kristopher Katira, Sunil Manjila, Ali S Totonchi
A 4-year-old-boy required emergent craniectomy and drainage of a large right-sided acute subdural hematoma after head trauma, during which massive sinus hemorrhage with brain swelling occurred. Acute intraoperative management entailed dural cover using synthetic dural membrane substitute and scalp coverage over the herniated brain using acellular dermal matrix. After intensive monitoring and control of raised intracranial pressure over the next few days, the exposed brain was then covered by scalp and forehead flaps with cadaveric skin grafting to the donor site...
December 5, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27920935/cerebral-foreign-body-granuloma-in-brain-triggering-generalized-seizures-without-obvious-craniocerebral-injury-a-case-report-and-review-of-the-literature
#3
Nina Brawanski, Peter Baumgarten, Jürgen Konczalla, Volker Seifert, Christian Senft
BACKGROUND: Intracerebral foreign body granuloma is rarely reported. We present the case of a male patient with a cerebral foreign body granuloma. CASE DESCRIPTION: Initial admission of a 67-year-old male patient was after an aphasia followed by secondary generalized seizures. Cranial computed tomography (CCT) showed a metal-dense, wedge-shaped foreign body in the range of the frontal sinus on the left side, breaking through the frontal sinus, and creating a connection to the frontal cerebral lobe...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#4
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27914583/injuries-from-all-terrain-vehicles-an-opportunity-for-injury-prevention
#5
Emily C Benham, Samuel W Ross, Mariana Mavilia, Peter E Fischer, A Britton Christmas, Ronald F Sing
BACKGROUND: Patient demographics, behavior, and injury patterns were assessed to inform preventative efforts for reduced incidence of all-terrain vehicle (ATV) trauma. METHODS: ATV-related injuries treated at a Level I trauma center from 2008 to 2012 were retrospectively reviewed. Patient outcomes and incidence of traumatic brain injury (TBI) were compared by helmet use and alcohol intoxication. RESULTS: Helmet data were available for 304 patients of 404 patients included; of these, 75 (24...
November 14, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#6
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27909098/reversible-disruption-of-neuronal-mitochondria-by-ischemic-and-traumatic-injury-revealed-by-quantitative-two-photon-imaging-in-the-neocortex-of-anesthetized-mice
#7
Mikhail Kislin, Jeremy Sword, Ioulia V Fomitcheva, Deborah Croom, Evgeny Pryazhnikov, Eero Lihavainen, Dmytro Toptunov, Heikki Rauvala, Andre S Ribeiro, Leonard Khiroug, Sergei A Kirov
: Mitochondria play a variety of functional roles in cortical neurons, from metabolic support and neuroprotection to the release of cytokines that trigger apoptosis. In dendrites, mitochondrial structure is closely linked to their function, and fragmentation (fission) of the normally elongated mitochondria indicates loss of their function under such pathological conditions as stroke and brain trauma. Using in vivo two-photon microscopy in mouse brain, we quantified mitochondrial fragmentation in a full spectrum of cortical injuries ranging from severe to mild...
December 1, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27906870/effectiveness-of-low-molecular-weight-heparin-versus-unfractionated-heparin-to-prevent-pulmonary-embolism-following-major-trauma-a-propensity-matched-analysis
#8
James P Byrne, William Geerts, Stephanie A Mason, David Gomez, Christopher Hoeft, Ryan Murphy, Melanie Neal, Avery B Nathens
BACKGROUND: Pulmonary embolism (PE) is a leading cause of delayed mortality in patients with severe injury. While low molecular weight heparin (LMWH) is often favored over unfractionated heparin (UH) for thromboprophylaxis, evidence is lacking to demonstrate an effect on the occurrence of PE. This study compared the effectiveness of LMWH versus UH to prevent PE in patients following major trauma. METHODS: Data for adults with severe injury who received thromboprophylaxis with LMWH or UH were derived from the American College of Surgeons Trauma Quality Improvement Program (2012-2015)...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27904755/paraplegia-caused-by-cerebral-contusions-in-the-bilateral-precentral-gyri
#9
Hideaki Matsumura, Hiroyuki Fujimori, Naoaki Sato, Akira Matsumura
BACKGROUND: Paraplegia is mainly caused by spinal cord disease and rarely occurs due to head trauma. In this report, we describe a case of paraplegia caused by cerebral contusions in the bilateral precentral gyri. CASE DESCRIPTION: A 72-year-old man was admitted to our hospital with mildly impaired consciousness and severe pure motor paralysis in both legs. He was healthy until the morning of the day, but his wife found him injured in front of his house upon returning home...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27901414/cognitive-deficits-and-inflammatory-response-resulting-from-mild-to-moderate-traumatic-brain-injury-in-rats-are-exacerbated-by-repeated-pre-exposure-to-an-innate-stress-stimulus
#10
Michaël Ogier, Amor Belmeguenai, Thomas Lieutaud, Béatrice Georges, Sandrine Bouvard, Emilie Carré, Frédéric Canini, Laurent Bezin
Traumatic brain injury (TBI) is common in both military and civilian populations, and often results in neurobehavioral sequelae that impair quality of life in both patients and their family. Although individuals who are chronically exposed to stress are more likely to experience TBI, it is still unknown whether pre-injury stress influences the outcome after TBI. The present study tested whether behavioral and cognitive long-term outcome after TBI in rats is affected by prior exposure to an innate stress stimulus...
November 30, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27899118/surgical-intervention-for-paediatric-liver-injuries-is-almost-history-a-12-year-cohort-from-a-major-scandinavian-trauma-centre
#11
Tomohide Koyama, Jorunn Skattum, Peder Engelsen, Torsten Eken, Christine Gaarder, Pål Aksel Naess
BACKGROUND: Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. METHODS: Patients <17 years old with liver injury admitted to Oslo University Hospital Ullevaal during the period 2002-2013 were retrospectively reviewed...
November 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27894286/the-family-experiences-of-in-hospital-care-questionnaire-in-severe-traumatic-brain-injury-fecq-tbi-a-validation-study
#12
Audny Anke, Unn Sollid Manskow, Oddgeir Friborg, Cecilie Røe, Cathrine Arntzen
BACKGROUND: Family members are important for support and care of their close relative after severe traumas, and their experiences are vital health care quality indicators. The objective was to describe the development of the Family Experiences of in-hospital Care Questionnaire for family members of patients with severe Traumatic Brain Injury (FECQ-TBI), and to evaluate its psychometric properties and validity. METHODS: The design of the study is a Norwegian multicentre study inviting 171 family members...
November 28, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27893148/osteopathic-manipulative-treatment-for-somatic-dysfunction-after-acute-severe-traumatic-brain-injury
#13
Adrienne McCallister, Christopher Brown, Michael Smith, Hugh Ettlinger, Gerard A Baltazar
Somatic dysfunction caused by traumatic brain injury (TBI) may be managed by osteopathic manipulative treatment (OMT). In this case report, the authors describe 2 patients with severe TBI who were each treated with OMT in a level-1 regional trauma center. Both patients received OMT beginning in the acute care phase of injury. Somatic dysfunction improved during the course of treatment, and no adverse effects of OMT were noted. More comprehensive research may clarify the efficacy and adverse effects of OMT as part of multimodal acute care of patients with severe TBI...
December 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27889010/neuropsychiatric-aspects-of-concussion
#14
REVIEW
Rajiv Radhakrishnan, Amir Garakani, Lawrence S Gross, Marcia K Goin, Janet Pine, Andrew E Slaby, Calvin R Sumner, David A Baron
Over the past decade, concussion has become the most widely discussed injury in contact sports. However, concussions also occur in several other settings, such as non-contact sports, elderly individuals, young children, military personnel, and victims of domestic violence. Concussion is frequently undiagnosed as a cause of psychiatric morbidity, especially when the patient has no history of loss of consciousness or direct head trauma. Almost all of the extant literature focuses on traumatic brain injury and assumes that concussion is merely a mild form of traumatic brain injury, which has resulted in a lack of understanding about what concussion is, and how to diagnose, monitor, and treat its varied neuropsychiatric symptoms...
December 2016: Lancet Psychiatry
https://www.readbyqxmd.com/read/27888550/mesenchymal-stem-stromal-cells-biology-and-preclinical-evidence-for-therapeutic-potential-for-organ-dysfunction-following-trauma-or-sepsis
#15
Michael A Matthay, Shibani Pati, Jae-Woo Lee
Several experimental studies have provided evidence that bone-marrow derived mesenchymal stem (stromal) cells (MSC) may be effective in treating critically ill surgical patients who develop traumatic brain injury, acute renal failure, or the acute respiratory distress syndrome. There is also preclinical evidence that MSC may be effective in treating sepsis-induced organ failure, including evidence that MSC have anti-microbial properties. This review considers preclinical studies with direct relevance to organ failure following trauma, sepsis or major infections that apply to critically ill patients...
November 26, 2016: Stem Cells
https://www.readbyqxmd.com/read/27886876/complications-in-the-management-of-patients-with-spine-trauma
#16
REVIEW
Geoffrey Stricsek, George Ghobrial, Jefferson Wilson, Thana Theofanis, James S Harrop
More than 50% of patients diagnosed with acute, traumatic spinal cord injury will experience at least 1 complication during their hospitalization. Age, severity of neurological injury, concurrent traumatic brain injury, comorbid illness, and mechanism of injury are all associated with increasing risk of complication. More than 75% of complications will occur within 2 weeks of injury. The complications associated with SCI carry a significant risk of morbidity and mortality; their early identification and management is critical in the care of the SCI patient...
January 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27884843/traumatic-brain-injury-in-england-and-wales-prospective-audit-of-epidemiology-complications-and-standardised-mortality
#17
T Lawrence, A Helmy, O Bouamra, M Woodford, F Lecky, P J Hutchinson
OBJECTIVES: To provide a comprehensive assessment of the management of traumatic brain injury (TBI) relating to epidemiology, complications and standardised mortality across specialist units. DESIGN: The Trauma Audit and Research Network collects data prospectively on patients suffering trauma across England and Wales. We analysed all data collected on patients with TBI between April 2014 and June 2015. SETTING: Data were collected on patients presenting to emergency departments across 187 hospitals including 26 with specialist neurosurgical services, incorporating factors previously identified in the Ps14 multivariate logistic regression (Ps14(n)) model multivariate TBI outcome prediction model...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27882255/tip-of-an-iceberg-skull-fracture-as-an-adult-presentation-of-encephalocraniocutaneous-lipomatosis
#18
Sinead Culleton, Christen D Barras, Hamed Asadi, Seamus Looby, Paul Brennan, Hong Kuan Kok
The severity of seizures presenting to the emergency department ranges from benign to life threatening. There are also a wide number of possible etiologies. Computed tomography (CT) emergency imaging may be required at presentation to elucidate a possible cause and assess signs of intracranial trauma. This case describes a serious seizure episode in a young man while on holiday. A CT brain showed a skull fracture as a consequence of seizure-related head trauma but unexpectedly there were image findings consistent with encephalocraniocutaneous lipomatosis...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27881344/-value-of-urinary-liver-fatty-acid-binding-protein-in-assessing-severity-of-brain-trauma-and-predicting-acute-kidney-injury
#19
Guang-Yong Wu, Kai Zhuang, Yu Liu, Zhi-Fei Wang
OBJECTIVE: To assess the value of urinary liver-type fatty acid-binding protein (L-FABP) in early assessment of the severity of traumatic brain injury and in predicting the occurrence of acute kidney injury (AKI) following the brain injury. METHODS: Sixty-five patients with traumatic brain injury patients were divided into 4 groups according to their Glasgow coma scale (GCS) scores. Blood and urine samples were collected at 2, 6, 12, 24, 48 and 72 h after the injury to detect serum creatinine (SCr) level using biochemical analyzer and urinary L-FABP using enzyme-linked immunosorbent assay (ELISA), with samples from 15 healthy adults as controls...
November 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27878771/growth-hormone-deficiency-and-hypopituitarism-in-adults-after-complicated-mild-traumatic-brain-injury
#20
Stefania Giuliano, Serafina Talarico, Lucia Bruno, Francesco Beniamino Nicoletti, Claudio Ceccotti, Antonino Belfiore
PURPOSE: Traumatic brain injury is considered the main cause of hypopituitarism in adults, and GH deficiency appears to be the most frequent pituitary deficit. Most of the available studies have included all degrees of severity of trauma. We aimed to assess pituitary function and GH deficiency in adult patients at different time lengths after complicated mild TBI according to Glasgow Coma Scale. We also aimed to evaluate whether mild TBI patients with GH deficiency had developed alterations in the glycolipid profile...
November 23, 2016: Endocrine
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