Articles: traumatic-brain-injuries.
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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.
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Comparative Study
In vivo leukocyte-mediated brain microcirculatory inflammation: a comparison of osmotherapies and progesterone in severe traumatic brain injury.
Mannitol, hypertonic saline, and progesterone may blunt leukocyte recruitment after traumatic brain injury (TBI). We hypothesized that progesterone reduces pericontusional recruitment of leukocytes to a greater extent than either osmotherapy a day after TBI. ⋯ Leukocyte recruitment to injured brain is lowest with mannitol administration. How different agents alter progression of secondary brain injury will require further evaluation in humans.
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Journal of neurotrauma · Dec 2014
Ouabain improves functional recovery following traumatic brain injury.
The cardiac steroid ouabain binds to Na(+), K(+)-ATPase and inhibits its activity. Administration of the compound to animals and humans causes an increase in the force of contraction of heart muscle and stabilizes heart rate. In addition, this steroid promotes the growth of cardiac, vascular, and neuronal cells both in vitro and in vivo. ⋯ Determination of the identity of the proliferating cells in the area surrounding the trauma showed that whereas there was no change in the proliferation of endothelial cells or astrocytes, neuronal cell proliferation almost doubled in the ouabain-treated mice in comparison with that of the vehicle animals. These results point to a neuroprotective effects of low doses of ouabain and imply its involvement in brain recovery and neuronal regeneration. This suggests that ouabain and maybe other cardiac steroids may be used for the treatment of traumatic brain injury.
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Learning and memory deficits are a source of considerable morbidity after traumatic brain injury (TBI). We investigated the effect of different patterns of hippocampal stimulation via a fornix electrode on cognitively demanding tasks after TBI. ⋯ Deficits in learning and memory after TBI are improved with TBS of the hippocampus. HFS and LFS do not appear to produce as great an effect as TBS.
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Journal of neurotrauma · Nov 2014
Imaging "brain strain" in youth athletes with mild traumatic brain injury during dual-task performance.
Mild traumatic brain injury (mTBI) is a common cause of injury in youth athletes. Much of what is known about the sequelae of mTBI is yielded from the adult literature, and it appears that it is mainly those with persistent post-injury symptoms who have ongoing cognitive and neural abnormalities. However, most studies have employed single-task paradigms, which may not be challenging enough to uncover subtle deficits. ⋯ The injured youths also exhibited abnormal recruitment of brain structures involved in both working memory and dual-tasking. These data show that the dual-task paradigm can uncover functional impairments in youth with mTBI who are not highly symptomatic and who do not exhibit neuropsychological dysfunction. Moreover, neural recruitment abnormalities were noted in both task conditions, which we argue suggests mTBI-related disruptions in achieving efficient cognitive control and allocation of processing resources.