Brain injury : [BI]
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Brain injury : [BI] · Jan 2012
Review Case ReportsSyndrome of the trephined following bifrontal decompressive craniectomy: implications for rehabilitation.
The syndrome of the trephined is a rare complication observed following a unilateral decompressive craniectomy for traumatic brain injury. What has not been previously reported is the occurrence of this complication following a bifrontal procedure. The objective of this study was to present two clinical cases that serve to highlight this condition. ⋯ If the use of bifrontal decompressive craniectomies continues to increase it is important that those involved in the rehabilitation process are familiar with this rare condition. Early recognition is important so that patients can receive timely intervention and it also avoids valuable health resources being allocated to patients who cannot receive maximal benefit.
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Brain injury : [BI] · Jan 2012
Review Comparative StudyA clinical comparison of penetrating and blunt traumatic brain injuries.
Traumatic brain injury (TBI) is a leading cause of injury death and long-term disability in the USA. It commonly results from blunt (closed) or penetrating trauma. The majority of civilian TBI is caused by falls or motor vehicle collisions, whereas military TBI mainly results from explosions. Although penetrating injuries are less common than closed injuries in the civilian population, they are far more lethal. Unfortunately, the pathophysiologic differences between penetrating and closed TBI remain poorly understood due to the lack of studies on the subject. Many studies on the prognostic factors of mortality and functional outcome after TBI exclude penetrating brain injuries from their series because they are believed to have a different pathophysiology. ⋯ In view of the incomplete understanding of the impact of mechanism of injury on TBI outcomes, as demonstrated in the current review, new research studies are required to improve evidence-based TBI guidelines tailored especially for penetrating injuries.
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Brain injury : [BI] · Jan 2012
Randomized Controlled TrialProstacyclin treatment and clinical outcome in severe traumatic brain injury patients managed with an ICP-targeted therapy: a prospective study.
To prospectively assess clinical outcome in patients with severe traumatic brain injury (sTBI) managed according to an ICP-targeted programme as well as additional treatment with prostacyclin. ⋯ With this treatment protocol, a low number of deaths and a high number of favourable outcomes in sTBI were observed. Prostacyclin in this low dose does not seem to improve the outcome. ICP(max) is a positive predictor of worse outcome. Higher GCS at admission and lower age are correlated to better outcome.
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Brain injury : [BI] · Jan 2012
Accuracy of the S100β protein as a marker of brain damage in traumatic brain injury.
This study tested the hypothesis that S100β is a useful screening tool for detecting intracranial lesion (IL) in patients with a normal level of consciousness after traumatic brain injury (TBI). ⋯ Within the first 6 hours post-TBI, serum S100β seems to be an effective biochemical indicator of IL in patients without a decrease in consciousness. These results indicate that higher S100β cut-off values substantially improve the clinical relevance of this protein.
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Brain injury : [BI] · Jan 2012
Multiple indicators model of long-term mortality in traumatic brain injury.
To examine the prognostic ability of protein S100B, neuron-specific enolase (NSE) and glial fibrillary acid protein (GFAP) for prediction of 1-year mortality in patients with traumatic brain injury (TBI) in relation to clinical and radiological characteristics of TBI. ⋯ Mortality at 1-year post-TBI is accurately predicted by the combination of GFAP and S100B concentration and clinical and radiological characteristics at admission or in the acute post-injury period.