Articles: traumatic-brain-injuries.
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Journal of neurotrauma · Dec 2014
A combined therapeutic regimen of buspirone and environmental enrichment is more efficacious than either alone in enhancing spatial learning in brain-injured pediatric rats.
Buspirone, a 5-HT1A receptor agonist, and environmental enrichment (EE) enhance cognition and reduce histopathology after traumatic brain injury (TBI) in adult rats, but have not been fully evaluated after pediatric TBI, which is the leading cause of death in children. Hence, the aims of this study were to assess the efficacy of buspirone alone (Experiment 1) and in combination with EE (Experiment 2) in TBI postnatal day-17 male rats. The hypothesis was that both therapies would confer cognitive and histological benefits when provided singly, but their combination would be more efficacious. ⋯ Moreover, the combined treatment group (buspirone+EE) performed markedly better than the buspirone+STD and vehicle+EE groups, which suggests an additive effect and supports the hypothesis. The data replicate previous studies assessing these therapies in adult rats. These novel findings may have important rehabilitation-relevant implications for clinical pediatric TBI.
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Journal of neurotrauma · Dec 2014
Formation of microparticles in the injured brain of patients with severe isolated traumatic brain injury.
The potential pathophysiological role of circulating microparticles (MPs) has been recognized in various conditions, such as cardiovascular and thrombotic diseases. Traumatic brain injury (TBI) has a complex pathophysiology that involves coagulopathy and inflammation. We investigated endothelial-, platelet-, and leukocyte-derived microparticles (EMPs, PMPs, and LMPs, respectively) in 16 patients with severe isolated TBI. ⋯ PMPs exposing P-selection and EMPs exposing TF seem to be generated in the injured brain, whereas LMPs exposing TF are accumulated. The pathophysiological significance of these changes in MP pattern in TBI should be further investigated. Including MPs exposing brain-specific antigens in the assessment of brain injury would give further information of origin and likely give additional information of the size of the injury, given that the MP phenotypes investigated in the present study are not brain-specific markers.
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As the aged population is rapidly growing globally, geriatric traumatic brain injury (TBI) becomes an increasing problem. There are higher mortality and poorer functional outcome in the geriatric TBI population (≥65 years) compared with younger groups despite neurosurgical interventions. Therefore, current treatment priorities and cost-effectiveness should be critically examined. We evaluated the benefit of surgical management in the elderly (≥65 years) after TBI. ⋯ We confirmed that age is a major determinant of outcome after TBI. In addition, we found that neurosurgical management is associated with the improvement of the prognosis and a decrease in the rate of mortality in geriatric TBI. However, surgical management was not shown to be an effective treatment in elderly patients with GCS scores of 3-5.
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Eur J Trauma Emerg Surg · Dec 2014
Rethinking bicycle helmets as a preventive tool: a 4-year review of bicycle injuries.
Traumatic brain injury is a leading cause of disability in bicycle riders. Preventive measures including bicycle helmet laws have been highlighted; however, its protective role has always been debated. The aim of this study was to determine the utility of bicycle helmets in prevention of intra-cranial hemorrhage. We hypothesized that bicycle helmets are protective and prevent the development of intra-cranial hemorrhage. ⋯ Bicycle helmets may have a protective effect against external head injury but its protective role for intra-cranial hemorrhage is questionable. Further studies assessing the protective role of helmets for intra-cranial hemorrhage are warranted.
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Injury epidemiology · Dec 2014
Outcomes of pediatric severe traumatic brain injury patients treated in adult trauma centers with and without added qualifications in pediatrics - United States, 2009.
Pediatric traumatic brain injury (TBI) is an important public health problem and little is known about site of care and outcomes of children with severe TBI. Across the country, most injured children are treated in adult trauma centers (ATCs). Recent literature suggests that ATCs with added qualifications in pediatrics (ATC-AQs) can have improved outcomes for pediatric trauma patients overall. This study characterizes the population of pediatric severe TBI patients treated at ATCs and investigates the effect of treatment at ATC-AQs versus ATCs on mortality. ⋯ After defining comparable populations, this study demonstrated no significant difference in mortality for pediatric severe TBI patients treated at ATC-AQs versus ATCs. Being younger, uninsured, and having severe injuries was associated with increased mortality. This study is limited by the exclusion of transferred patients and potentially underestimates differences in outcomes. Further research is needed to clarify the role of ATC additional pediatric qualifications in the treatment of severe TBI.