Articles: traumatic-brain-injuries.
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Oxidative stress is thought to participate in the pathobiology of secondary brain injury after acute traumatic brain injury (TBI). This study posits that oxidative stress levels in acute TBI are predictive of outcome. ⋯ Quantifying biomarkers of oxidative stress and antioxidant status of serum correlate with trauma severity and may be used to predict outcomes after TBI. Higher serum GSH levels on admission are associated with better outcome.
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Observational Study
On-field management and return-to-play in sports-related concussion in children: Are children managed appropriately?
On-field management and return-to-play guidelines aim to ensure the identification and appropriate management of the concussed athlete. Compliance with current guidelines in many settings is unknown. We assessed whether key components of current concussion guidelines are being followed in child athletes. ⋯ Many children with sports related-concussion are not formally assessed on-field and continue to play. On-field concussion management and return to play practices are often suboptimal. Awareness and education of coaches, teachers, parents and children need to be improved.
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Sleep disturbances are frequently reported following traumatic brain injury (TBI); however, the exact disturbances remain unclear. This meta-analysis aimed to characterize sleep disturbance in community dwelling patients with TBI as compared to controls. ⋯ The evidence suggests that TBI is associated with widespread objective and subjective sleep deficits. The present results highlight the need for physicians to monitor and address sleep deficits following TBI.
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Traumatic brain injury (TBI) remains a major cause of morbidity and mortality worldwide. Largely, the prognosis is dependent on the nonmodifiable factors such as severity of the initial injury, Glasgow coma scale score, pupillary response, age, and presence of additional physiological derangements such as hypoxia or hypotension. However, secondary insults continue to take place after the initial injury and resuscitation. The study hypothesis in the present research article was that hypoglycemia is an independent outcome prognosticator in severe traumatic brain injury. The study aimed to assess the role of glucose monitoring in the brain parenchyma as an independent outcome prognosticator and also to study its association with plasma glucose levels. ⋯ After decompressive craniectomy in severe TBI, there was a poor correlation between the plasma and CMD glucose concentration. A higher degree of variation was seen in the correlations for individual patients. Neither the mean blood glucose values nor the mean cerebral glucose values predicted the outcome at 3 months. The good outcome group had fewer episodes of both hyperglycemia and hypoglycemia.
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Pediatr Crit Care Me · Mar 2016
Observational StudyEffectiveness of Pharmacological Therapies for Intracranial Hypertension in Children With Severe Traumatic Brain Injury-Results From an Automated Data Collection System Time-Synched to Drug Administration.
To describe acute cerebral hemodynamic effects of medications commonly used to treat intracranial hypertension in children with traumatic brain injury. Currently, data supporting the efficacy of these medications are insufficient. ⋯ Intracranial pressure decreased after multiple drug administrations, but hypertonic saline may warrant consideration as the first-line drug for treating intracranial hypertension, as it was associated with the most favorable cerebral hemodynamics and fastest resolution of intracranial hypertension.