Journal of neurotrauma
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Journal of neurotrauma · Jan 2008
Review Meta AnalysisHypothermia treatment for traumatic brain injury: a systematic review and meta-analysis.
In this study, we conducted an updated meta-analysis of the effects of hypothermia therapy on mortality, favorable neurologic outcome, and associated adverse effects in adults with traumatic brain injury (TBI) for use by Brain Trauma Foundation (BTF)/American Association of Neurological Surgeons (AANS) task force to develop evidence-based treatment guidelines. Our data sources relied on handsearches of four previous good-quality systematic reviews, which all conducted electronic searches of primarily MEDLINE (OVID), EMBASE, and Cochrane Library. An independent, supplemental electronic search of MEDLINE was undertaken as well (last searched June 2007). ⋯ However, this evidence comes with the suggestion that the potential benefits of hypothermia may likely be offset by a significant increase in risk of pneumonia (RR 2.37; 95% CI 1.37, 4.10). In sum, the present study's updated meta-analysis supports previous findings that hypothermic therapy constitutes a beneficial treatment of TBI in specific circumstances. Accordingly, the BTF/AANS guidelines task force has issued a Level III recommendation for optional and cautious use of hypothermia for adults with TBI.
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Journal of neurotrauma · Jan 2008
Comparative StudyLongitudinal comparison of two severities of unilateral cervical spinal cord injury using magnetic resonance imaging in rats.
Magnetic resonance imaging (MRI) should be a powerful tool for characterization of spinal cord pathology in animal models. We evaluated the utility of medium-field MRI for the longitudinal assessment of progression of spinal cord injury (SCI) in a rat model. Thirteen adult rats were subjected to a 6.25 or 25 g-cm unilateral cervical SCI, and underwent MRI and behavioral tests during a 3-week study period. ⋯ Significant correlation was also found between parameters determined by MRI: swelling, hypointense signal, hyperintense signal, and lesion length. MRI is a valuable imaging modality to assess the temporal evolution of SCI and to distinguish different severities of cervical SCI in rats. In future, MRI could be applied as a screening tool to either administer goal-directed therapies, or enable even group distribution, prior to therapeutic intervention for example through quantification and matching of swelling and edema.