Journal of neurotrauma
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Journal of neurotrauma · Sep 2018
Cerebral Blood Flow Velocities and Functional Outcomes in Pediatric Mild Traumatic Brain Injury.
Outcomes can be challenging to predict in children with mild traumatic brain injury (TBI). Transcranial Doppler (TCD) ultrasound has become an increasingly useful modality in adult and pediatric TBI by measuring blood flow velocities within the circle of Willis. In children with moderate-to-severe TBI, multiple studies have correlated abnormal TCD measurements and poor outcomes. ⋯ Although our data did not show correlation, it showed that the investigation could feasibly be done in pediatric patients with mild TBI. The study was limited by small sample size and infrequent outcome of interest. Future studies may help define the role of TCD in the large population of mild pediatric TBI patients.
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Journal of neurotrauma · Sep 2018
Selective Vulnerability of the Foramen Magnum in a Rat Blast Traumatic Brain Injury Model.
Primary blast traumatic brain injury (bTBI) accounts for a significant proportion of wartime trauma. Previous studies have demonstrated direct brain injury by blast waves, but the effect of the location of the blast epicenter on the skull with regard to brain injury remains poorly characterized. ⋯ At all blast overpressures studied (668-1880 kPa), rats subjected to FM-bTBI demonstrated strikingly higher mortality, increased durations of both apnea and hypoxia, and increased severity of convexity subdural hematomas, than rats subjected to B-bTBI. Together, these data suggest a unique role for the foramen magnum region in mortality and brain injury following blast exposure, and emphasize the importance of the choice of blast focus location in experimental models of bTBI.
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Journal of neurotrauma · Sep 2018
Measurement of Cerebral Biomarkers Proving Traumatic Brain Injuries in Post-Mortem Body Fluids.
Until now, it is impossible to identify a fatal traumatic brain injury (TBI) before post-mortem radiological investigations or an autopsy take place. It would be preferable to have an additional diagnostic tool such as post-mortem biochemistry to get greater insight into the pathological pathways and survival times after sustaining TBI. Cerebrospinal fluid (CSF) and serum samples of 84 autopsy cases were collected from forensic autopsies with post-mortem intervals (PMI) of up to 148 h. ⋯ This study is the first approach to measure the three proteins together in CSF and serum in autopsy cases. Determined threshold values may differentiate between fatal TBI and control cases. The presented results emphasize the possible use of post-mortem biochemistry as a supplemental tool in everyday forensic routine.
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Journal of neurotrauma · Sep 2018
Randomized Controlled Trials in Adult Traumatic Brain Injury: A Systematic Review on the Use and Reporting of Clinical Outcome Assessments.
As part of efforts to improve study design, the use of outcome measures in randomized controlled trials (RCTs) in traumatic brain injury (TBI) is receiving increasing attention. This review aimed to assess how clinical outcome assessments (COAs) have been used and reported in RCTs in adult TBI. Systematic literature searches were conducted to identify medium to large (n ≥ 100) acute and post-acute TBI trials published since 2000. ⋯ The use of PROs was limited, especially in acute study settings. Quality of reporting was variable, and key information concerning COAs was often omitted, making it difficult to know how precisely outcomes were assessed. Consistency across studies would be increased and future meta-analyses facilitated by (a) using common data elements (CDEs) recommendations for TBI outcomes and (b) following CONSORT guidelines when publishing RCTs.
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Journal of neurotrauma · Sep 2018
A Systematic Review of Positron Emission Tomography of Tau, Amyloid Beta, and Neuroinflammation in Chronic Traumatic Encephalopathy: The Evidence To Date.
Chronic traumatic encephalopathy (CTE) is associated with pathological changes, yet detecting these changes during life has proven elusive. Positron emission tomography (PET) offers the potential for identifying such pathology. Few studies have been completed to date and their approaches and results have been diverse. ⋯ Evidence for increased uptake in cortical regions was less consistent. The evidence suggests that the field of PET imaging in those at risk for CTE remains nascent. As the field evolves to include more stringent studies, ligands for PET may prove an important tool in identifying CTE in vivo.