Brain injury : [BI]
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Brain injury : [BI] · Jan 2012
ReviewTherapeutic hypothermia for the management of intracranial hypertension in severe traumatic brain injury: a systematic review.
Traumatic brain injury (TBI) is a major source of death and severe disability worldwide. Raised Intracranial pressure (ICP) is an important predictor of mortality in patients with severe TBI and aggressive treatment of elevated ICP has been shown to reduce mortality and improve outcome. The acute post-injury period in TBI is characterized by several pathophysiologic processes that start in the minutes to hours following injury. All of these processes are temperature-dependent; they are all aggravated by fever and inhibited by hypothermia. ⋯ Pending results from large multi-centre studies evaluating the effect of TH on ICH and outcome, TH should be included as a therapeutic option to control ICP in patients with severe TBI.
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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 Case ReportsIs high PEEP ventilation strategy safe for acute respiratory distress syndrome after severe traumatic brain injury?
To investigate the safety and efficacy of high positive end-expiratory pressure (PEEP) ventilation strategy for acute respiratory distress syndrome (ARDS) after traumatic brain injury. ⋯ With close monitoring of cerebral and systemic haemodynamics, PEEP can be safely applied and titrated to an optimal level in the management of ARDS following traumatic brain injury.
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Brain injury : [BI] · Jan 2012
Increased levels of serum MAP-2 at 6-months correlate with improved outcome in survivors of severe traumatic brain injury.
To evaluate microtubule-associated proteins (MAP-2), a dendritic marker of both acute damage and chronic neuronal regeneration after injury, in serum of survivors after severe TBI and examine the association with long-term outcome. ⋯ Severe TBI results in a chronic release of MAP-2 into the peripheral circulation in patients with higher levels of consciousness, suggesting that remodelling of synaptic junctions and neuroplasticity processes occur several months after injury. The data indicate MAP-2 as a potential marker for emergence to higher levels of cognitive function.
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Brain injury : [BI] · Jan 2012
Ability of S100B to predict severity and cranial CT results in children with TBI.
To evaluate the ability of S100B to predict severity of TBI and abnormal cranial CT results for children with TBI. ⋯ For children following TBI, S100B appears to predict severity of TBI; however, it may not be clinically useful as an independent screening test to select children with mild TBI who need a cranial CT.