Brain injury : [BI]
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Brain injury : [BI] · Jan 2013
Multiple traumatic brain injury and concussive symptoms among deployed military personnel.
To identify if concussive symptoms occur with greater frequency among military personnel with multiple lifetime TBIs and if a history of TBI increases risk for subsequent TBI. ⋯ Among deployed military personnel, the relationship of previous TBI with recent TBI and concussive symptoms may be largely explained by the presence of psychological symptoms.
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Brain injury : [BI] · Jan 2013
ReviewThe current role of decompressive craniectomy in the management of neurological emergencies.
Decompressive craniectomy has been used as a lifesaving procedure for many neurological emergencies, including traumatic brain injury, ischaemic stroke, subarachnoid haemorrhage, cerebrovenous thrombosis, severe intracranial infection, inflammatory demyelination and encephalopathy. The evidence to support using decompressive craniectomy in these situations is, however, limited. Decompressive craniectomy has only been evaluated by randomized controlled trials in traumatic brain injury and ischaemic stroke and, even so, its benefits and risks in these situations remain elusive. If one considers a modified Rankin Scale of 4 or 5 or dependency in daily activity as an unfavourable outcome, decompressive craniectomy is associated with an increased risk of survivors with unfavourable outcome (relative risk [RR] = 2.9, 95% confidence interval [CI] = 1.5-5.8, p = 0.002, I(2 )= 0%; number needed to operate to increase an unfavourable outcome = 3.5, 95% CI = 2.4-7.4), but not the number of survivors with a favourable outcome (RR = 1.5, 95% CI = 0.9-2.6, p = 0.13, I(2 )= 0%).
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Brain injury : [BI] · Jan 2013
Multicenter StudyParent perceptions of early prognostic encounters following children's severe traumatic brain injury: 'locked up in this cage of absolute horror'.
Little guidance exists for discussing prognosis in early acute care with parents following children's severe traumatic brain injury (TBI). Providers' beliefs about truth-telling can shape what is said, how it is said and how providers respond to parents. ⋯ Parents blatantly and tacitly revealed their beliefs that providers play an important role in shaping parent reception of and synthesis of prognostic information, which constructs the family's ability to cope and participate in shared decision-making. Negative medical certainty created a fearful or threatening environment that kept parents from being fully informed.
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Brain injury : [BI] · Jan 2013
Comparative Study Controlled Clinical TrialEffects of dexmedetomidine on cerebral blood flow in critically ill patients with or without traumatic brain injury: a prospective controlled trial.
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Brain injury : [BI] · Jan 2013
Serial monitoring of CO2 reactivity following sport concussion using hypocapnia and hypercapnia.
This study examined the effects of mild traumatic brain injury (mTBI) on cerebrovascular reactivity (CVR). ⋯ These data suggest that, following mTBI: (1) CVR is not impaired at rest; (2) CVR is impaired in response to respiratory stress; and (3) the impairment may be resolved as early as 4 days post-injury.