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Traumatic Brain Injury literature

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30 papers 100 to 500 followers
Martin Lauritzen, Anthony J Strong
A new research field in translational neuroscience has opened as a result of the recognition since 2002 that "spreading depression of Leão" can be detected in many patients with acute brain injury, whether vascular and spontaneous, or traumatic in origin, as well as in those many individuals experiencing the visual (or sensorimotor) aura of migraine. In this review, we trace from their first description in rabbits through to their detection and study in migraine and the injured human brain, and from our personal perspectives, the evolution of understanding of the importance of spread of mass depolarisations in cerebral grey matter...
June 28, 2016: Journal of Cerebral Blood Flow and Metabolism
Mark H Wilson
For 200 years, the 'closed box' analogy of intracranial pressure (ICP) has underpinned neurosurgery and neuro-critical care. Cushing conceptualised the Monro-Kellie doctrine stating that a change in blood, brain or CSF volume resulted in reciprocal changes in one or both of the other two. When not possible, attempts to increase a volume further increase ICP. On this doctrine's "truth or relative untruth" depends many of the critical procedures in the surgery of the central nervous system. However, each volume component may not deserve the equal weighting this static concept implies...
August 2016: Journal of Cerebral Blood Flow and Metabolism
Gordon W Fuller, Jeanine Ransom, Jay Mandrekar, Allen W Brown
BACKGROUND: Long-term mortality may be increased following traumatic brain injury (TBI); however, the degree to which survival could be reduced is unknown. We aimed at modelling life expectancy following post-acute TBI to provide predictions of longevity and quantify differences in survivorship with the general population. METHODS: A population-based retrospective cohort study using data from the Rochester Epidemiology Project (REP) was performed. A random sample of patients from Olmsted County, Minnesota with a confirmed TBI between 1987 and 2000 was identified and vital status determined in 2013...
2016: Neuroepidemiology
Qiang Yuan, Xing Wu, Hongwei Cheng, Chaohua Yang, Yuhai Wang, Ersong Wang, Binghui Qiu, Zhimin Fei, Qing Lan, Sirong Wu, Yunzhao Jiang, Hua Feng, Jingfang Liu, Ke Liu, Fayun Zhang, Rongcai Jiang, Jianmin Zhang, Yue Tu, Xuehai Wu, Liangfu Zhou, Jin Hu
BACKGROUND: Although intracranial pressure (ICP) monitoring of patients with severe traumatic brain injury (TBI) is recommended by the Brain Trauma Foundation, any benefits remain controversial. OBJECTIVE: To evaluate the effects of ICP monitoring on the mortality of and functional outcomes in patients with severe diffuse TBI. METHODS: Data were collected on patients with severe diffuse TBI (Glasgow Coma Scale [GCS] score on admission <9 and Marshall Class II-IV) treated from January 2012 to December 2013 in 24 hospitals (17 level I trauma centers and 7 level II trauma centers) in 9 Chinese provinces...
March 2016: Neurosurgery
Sarah Hellewell, Bridgette D Semple, Maria Cristina Morganti-Kossmann
Traumatic brain injury (TBI) elicits a complex secondary injury response, with neuroinflammation as a crucial central component. Long thought to be solely a deleterious factor, the neuroinflammatory response has recently been shown to be far more intricate, with both beneficial and detrimental consequences depending on the timing, magnitude and specific immune composition of the response post-injury. Despite extensive preclinical and clinical research into mechanisms of secondary injury after TBI, no effective neuroprotective therapy has been identified, with potential candidates repeatedly proving disappointing in the clinic...
June 1, 2016: Brain Research
Wai Cheong Soon, Hani Marcus, Mark Wilson
Extradural haematomas (EDH) occur in approximately 2% of all head injuries but account for a significant proportion of fatal head injuries with mortality rates ranging from 1.2 to 33%. The expeditious surgical evacuation of EDH is associated with an excellent prognosis and is considered the most cost-effective operation performed by neurosurgeons. The Brain Trauma Foundation (BTF) has produced informative guidance on the management of EDH. The criteria laid out for conservative management comprises non-comatose patients with EDH less than 30 cm in volume, less than 15 mm thick and causing less than 5 mm midline shift...
2016: British Journal of Neurosurgery
Ben Gaastra, Aisling Longworth, Basil Matta, Catherine Snelson, Tony Whitehouse, Nick Murphy, Tonny Veenith
INTRODUCTION: The UK population is ageing with increasing number of elderly patients suffering traumatic brain injury (TBI). The purpose of this study was to identify national TBI admission demographics, analyse the temporal evolution of TBI mortality in a single centre and conduct a systematic review of the literature to identify whether there is an age bias amongst researchers studying TBI. METHODS: National demographics for TBI were obtained from Health Episode Statistics...
2016: British Journal of Neurosurgery
W Dalton Dietrich, Helen M Bramlett
The use of therapeutic hypothermia (TH) and targeted temperature management (TTM) for severe traumatic brain injury (TBI) has been tested in a variety of preclinical and clinical situations. Early preclinical studies showed that mild reductions in brain temperature after moderate to severe TBI improved histopathological outcomes and reduced neurological deficits. Investigative studies have also reported that reductions in post-traumatic temperature attenuated multiple secondary injury mechanisms including excitotoxicity, free radical generation, apoptotic cell death, and inflammation...
June 1, 2016: Brain Research
Tuck-Voon How, Amy S Hwang, Robin E A Green, Alex Mihailidis
Purpose Cognitive telerehabilitation is the concept of delivering cognitive assessment, feedback, or therapeutic intervention at a distance through technology. With the increase of mobile devices, wearable sensors, and novel human-computer interfaces, new possibilities are emerging to expand the cognitive telerehabilitation paradigm. This research aims to: (1) explore design opportunities and considerations when applying emergent pervasive computing technologies to cognitive telerehabilitation and (2) develop a generative co-design process for use with rehabilitation clinicians...
January 8, 2016: Disability and Rehabilitation. Assistive Technology
Terence S Fu, Ruwei Jing, Wayne W Fu, Michael D Cusimano
OBJECTIVES: To examine epidemiological trends of Traumatic Brain Injury (TBI) treated in the Emergency Department (ED), identify demographic groups at risk of TBI, and determine the factors associated with hospitalization following an ED visit for TBI. METHODS: A province-wide database was used to identify all ED visits for TBI in Ontario, Canada between April 2002 and March 2010. Trends were analyzed using linear regression, and predictors of hospital admission were evaluated using logistic regression...
2016: PloS One
Hamid Reza Talari, Esmaeil Fakharian, Nooshin Mousavi, Masoumeh Abedzadeh-Kalahroudi, Hossein Akbari, Sommayeh Zoghi
OBJECTIVE: Predicting outcomes in patients with traumatic brain injury is critically important for making sound clinical decisions. This study aimed at determining the prognostic value of the Rotterdam scoring system to predict early death among these patients. MATERIALS AND METHODS: This study was performed prospectively on 150 patients with traumatic brain injury hospitalized in Shahid Beheshti Hospital, Kashan, Iran. Patients' demographic and clinical characteristics such as age, sex, mechanism of trauma, initial Glasgow Coma Scale score, and accompanying lesions were documented...
March 2016: World Neurosurgery
Patrick M Kochanek, Helen M Bramlett, Deborah A Shear, C Edward Dixon, Stefania Mondello, W Dalton Dietrich, Ronald L Hayes, Kevin K W Wang, Samuel M Poloyac, Philip E Empey, John T Povlishock, Andrea Mountney, Megan Browning, Ying Deng-Bryant, Hong Q Yan, Travis C Jackson, Michael Catania, Olena Glushakova, Steven P Richieri, Frank C Tortella
Operation Brain Trauma Therapy (OBTT) is a fully operational, rigorous, and productive multicenter, pre-clinical drug and circulating biomarker screening consortium for the field of traumatic brain injury (TBI). In this article, we synthesize the findings from the first five therapies tested by OBTT and discuss both the current work that is ongoing and potential future directions. Based on the results generated from the first five therapies tested within the exacting approach used by OBTT, four (nicotinamide, erythropoietin, cyclosporine A, and simvastatin) performed below or well below what was expected based on the published literature...
March 15, 2016: Journal of Neurotrauma
Megan Browning, Deborah A Shear, Helen M Bramlett, C Edward Dixon, Stefania Mondello, Kara E Schmid, Samuel M Poloyac, W Dalton Dietrich, Ronald L Hayes, Kevin K W Wang, John T Povlishock, Frank C Tortella, Patrick M Kochanek
Levetiracetam (LEV) is an antiepileptic agent targeting novel pathways. Coupled with a favorable safety profile and increasing empirical clinical use, it was the fifth drug tested by Operation Brain Trauma Therapy (OBTT). We assessed the efficacy of a single 15 min post-injury intravenous (IV) dose (54 or 170 mg/kg) on behavioral, histopathological, and biomarker outcomes after parasagittal fluid percussion brain injury (FPI), controlled cortical impact (CCI), and penetrating ballistic-like brain injury (PBBI) in rats...
March 15, 2016: Journal of Neurotrauma
Brent E Masel, Dennis J Zgaljardic, Jack Forman
Post-traumatic hypopituitarism (PTH) associated with chronic cognitive, psychiatric, and/or behavioural sequelae is common following moderate to severe traumatic brain injury (TBI). More specifically, due to a cascade of hormonal deficiencies secondary to PTH, individuals with TBI may experience debilitating fatigue that can negatively impact functional recovery, as it can limit participation in brain injury rehabilitation services and lead to an increase in maladaptive lifestyle practices. While the mechanisms underlying fatigue and TBI are not entirely understood, the current review will address the specific anatomy and physiology of the pituitary gland, as well as the association between pituitary dysfunction and fatigue in individuals with TBI...
December 18, 2015: Neuropsychological Rehabilitation
Ali R Rezai, Per B Sederberg, Jennifer Bogner, Dylan M Nielson, Jun Zhang, W Jerry Mysiw, Michael V Knopp, John D Corrigan
BACKGROUND: Severe traumatic brain injury (TBI) damages the frontal lobes and connecting networks, which impairs executive functions, including the ability to self-regulate. Despite significant disabling effects, there are few treatment options in the chronic phase after injury. OBJECTIVE: To investigate the safety and potential effectiveness of deep brain stimulation (DBS) for individuals with chronic, disabling TBI and problems of behavioral and emotional self-regulation...
August 2016: Neurosurgery
Michael S Kelleher, Guangzu Gao, Michael F Rolen, S A Jamal Bokhari
PURPOSE: To determine the frequency of acute traumatic findings in computed tomographic (CT) chest abdomen pelvis (CAP) examinations in patients with acute traumatic head and/or cervical spine injury and no evidence suggesting bodily injury. MATERIALS AND METHODS: After institutional review board approval with a waiver of informed consent was obtained, a HIPAA-compliant retrospective study was performed. A review of the electronic medical records and dictated reports identified patients who met the following criteria: CT-documented acute head and/or cervical spine trauma, CT CAP performed at least 20 minutes after initial brain and/or cervical spine CT, and no evidence of bodily injury at physical examination or on initial plain radiographs...
May 2016: Radiology
Jeff W Chen, Michelle R Paff, Daniella Abrams-Alexandru, Sean W Kaloostian
Traumatic brain injury (TBI) is a major public health problem worldwide that affects all age groups. In the United States alone, there are approximately 50,000 deaths from severe traumatic brain injuries each year. In most studies, about 40 % of severe TBI have associated traumatic intracerebral hemorrhages (tICHs). The surgical treatment of tICH is debated largely because of its invasive nature, particularly in reaching deep tICHs. tICHs have a clear contribution to mass effect and exacerbate cerebral edema and ICP because of the break-down products of hemorrhage...
2016: Acta Neurochirurgica. Supplement
Rosette C Biester, Dave Krych, M J Schmidt, Devan Parrott, Douglas I Katz, Melissa Abate, Chari I Hirshson
PURPOSE OF THE STUDY: An online survey was developed to assess how well individuals with brain injuries and family/friends of those with traumatic brain injury (TBI) (significant others) felt they were informed about the nature and consequences of brain injury. PARTICIPANTS: A total of 117 significant others completed the survey. They were primarily female (84.6%), white (94.9%), and well educated (81.2%). A total of 149 individuals with brain injuries completed the survey and again were primarily female (63...
January 2016: Professional Case Management
K M Ho
Haemodynamic monitoring is a vital part of daily practice in anaesthesia and intensive care. Although there is evidence to suggest that goal-directed therapy may improve outcomes in the perioperative period, which haemodynamic targets we should aim at to optimise patient outcomes remain elusive and controversial. This review highlights the pitfalls in commonly used haemodynamic targets, including arterial blood pressure, central venous pressure, cardiac output, central venous oxygen saturation and dynamic haemodynamic indices...
January 2016: Anaesthesia and Intensive Care
Aditi Ahlawat, Raphael Carandang, Stephen O Heard, Susanne Muehlschlegel
INTRODUCTION: Conventional apnea testing in patients with severe hypoxemia or hemodynamic instability with removal from the ventilator support is unsafe. We describe an alternative approach to apnea testing, which may be used in patients with hypoxia unable to undergo conventional apnea testing. METHODS: Case Report. A 42-year-old man had a severe traumatic brain injury resulting in diffuse cerebral edema and subarachnoid hemorrhage with herniation. His presentation was complicated by hypoxic respiratory failure from pulmonary contusions and hemorrhagic shock...
January 2016: Journal of Intensive Care Medicine
2016-01-05 22:37:56
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