Articles: traumatic-brain-injuries.
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In a trauma situation, it is essential that emergency room physicians are able to think clearly, make decisions quickly and manage patients in a way consistent with their injuries. In order for emergency medicine residents to adequately develop the skills to deal with trauma situations, it is imperative that they have the opportunity to experience such scenarios in a controlled environment with aptly timed feedback. ⋯ The following describes a simulation session in which trainees were tasked with managing an infantile patient who had experienced a major trauma as a result of a single vehicle accident. The described simulation session utilized human patient simulators and was tailored to junior (year 1 and 2) emergency medicine residents.
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This study examined the clinical utility of the Wechsler Adult Intelligence Scales-Fourth Edition (WAIS-IV) in individuals with complicated mild, moderate or severe TBI. One hundred individuals with TBI (n = 35 complicated mild or moderate TBI; n = 65 severe TBI) and 100 control participants matched on key demographic variables from the WAIS-IV normative dataset completed the WAIS-IV. Univariate analyses indicated that participants with severe TBI had poorer performance than matched controls on all index scores and subtests (except Matrix Reasoning). ⋯ Effect sizes for index and subtest scores were generally small-to-moderate for the group with complicated mild/moderate and moderate-to-large for the group with severe TBI. PSI also showed good sensitivity and specificity for classifying individuals with severe TBI versus controls. Findings provide support for the clinical utility of the WAIS-IV in individuals with complicated mild, moderate, and severe TBI.
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Observational Study
Prevalence of severe hypokalaemia in patients with traumatic brain injury.
Patients with traumatic brain injury (TBI) are more vulnerable to develop hypokalaemia, we sought to investigate the prevalence, and the relationship between severe hypokalaemia and the mortality of traumatic brain injury patients. ⋯ The peak incidence of severe hypokalaemia occurred in the first 24-96h. TBI patients with severe hypokalaemia are more vulnerable to develop hypophosphataemia and hypernatraemia than patients with mild and moderate hypokalaemia. Severe hypokalaemia are the independent risk factors for mortality in TBI patients.
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Brain injury : [BI] · Jan 2015
Longitudinal changes in mathematical abilities and white matter following paediatric mild traumatic brain injury.
Paediatric traumatic brain injury (TBI) has been associated with acute and long-term mathematical difficulties. Little is known about the recovery of these impairments in children with mild TBI (mTBI) and their underlying pathophysiology, such as white matter abnormalities. ⋯ Children with mTBI recovered in terms of mathematical abilities and white matter. These children continued to show working memory deficits, which might interfere with learning at school.
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Computed Tomography Angiography (CTA) is being used to identify traumatic intracranial aneurysms (TICA) in patients with findings such as skull fracture and intracranial haemorrhage on initial Computed Tomography (CT) scans after blunt traumatic brain injury (TBI). However, the incidence of TICA in patients with blunt TBI is unknown. The aim of this study is to report the incidence of TICA in patients with blunt TBI and to assess the utility of CTA in detecting these lesions. ⋯ The incidence of traumatic intracranial aneurysm was exceedingly low (0.65%) over 10-years. This study adds to the growing literature questioning the empiric use of CTA for detecting vascular injuries in patients with blunt TBI.