Articles: traumatic-brain-injuries.
-
Journal of neurotrauma · Aug 2023
Clinical Utility of Near-infrared Device in Detecting Traumatic Intracranial Hemorrhage: A Pilot Study Toward Application as an Emergent Diagnostic Modality in a Low Resource Setting.
Limited computed tomography (CT) availability in low- and middle-income countries frequently impedes life-saving neurosurgical decompression for traumatic brain injury. A reliable, accessible, cost-effective solution is necessary to detect and localize bleeds. We report the largest study to date using a near-infrared device (NIRD) to detect traumatic intracranial bleeds. ⋯ For all patients who required craniectomy or craniotomy, the device demonstrated 100% sensitivity. NIRD is highly sensitive, specific, and reproducible over time in diagnosing intracranial bleeds. NIRD may inform neurosurgical decision making in settings where CT scanning is unavailable or impractical.
-
Journal of neurotrauma · Aug 2023
Characterizing factors influencing baseline plasma biomarkers for sport-related concussion in youth.
Abstract Developing objective measures to diagnose sport-related concussion (SRC) is a top priority, particularly in the pediatric context, given the vulnerability of the developing brain. While advances in SRC blood biomarkers are being made in adult populations, less data are available for adolescents. Clinical validation of blood biomarkers post-SRC will first require investigation in a healthy uninjured state. ⋯ As such, age- and sex-specific reference intervals may be warranted for pediatric athlete populations prior to clinical validation of blood biomarkers for SRC. Additionally, hormonal associations highlight the need to consider puberty and development in adolescent studies. Overall, findings suggest these biomarkers are resilient to a history of previous concussion and menstrual cycle phase, supporting continued investigation in adolescent SRC.
-
Journal of neurotrauma · Aug 2023
An at-home, virtually administered graded exertion protocol for use in concussion management: Preliminary evaluation of safety and feasibility in healthy youth and children with subacute concussion.
Graded exertion testing (GXT) is an important tool for concussion management, as it is used to personalize post-concussion exercise prescription and return athletes to sport. However, most GXT requires expensive equipment and in-person supervision. Our objective was to assess the safety and feasibility of the Montreal Virtual Exertion (MOVE) protocol, a no-equipment, virtually compatible GXT, in healthy children and children with subacute concussion. ⋯ Among concussed youth, increases in heart rate (MOVE: 82.4 ± 17.9 bpm, BCTT: 72.1 ± 23.0 bpm; t(28) = 1.36, p = 0.18), RPE (MOVE: 5.87 ± 1.92, BCTT: 5.07 ± 2.34, t(28) = 1.02, p = 0.32), and overall symptom presentation were similar between the MOVE and BCTT protocols. The MOVE protocol is a safe and feasible GXT in healthy youth and youth with subacute concussion. Future studies should assess the fully virtual administration of the MOVE in children with concussion, MOVE protocol tolerability in children with acute concussion, and whether the MOVE protocol can be used to guide individualized exercise prescription.
-
J Clin Monit Comput · Aug 2023
Towards autoregulation-oriented management after traumatic brain injury: increasing the reliability and stability of the CPPopt algorithm.
CPPopt denotes a Cerebral Perfusion Pressure (CPP) value at which the Pressure-Reactivity index, reflecting the global state of Cerebral Autoregulation, is best preserved. CPPopt has been investigated as a potential dynamically individualised CPP target in traumatic brain injury patients admitted in intensive care unit. The prospective bedside use of the concept requires ensured safety and reliability of the CPP recommended targets based on the automatically-generated CPPopt. We aimed to: Increase stability and reliability of the CPPopt automated algorithm by fine-tuning; perform outcome validation of the adjusted algorithm in a multi-centre TBI cohort. ⋯ The CPPopt calculation algorithm was fine-tuned and adapted for prospective use with acceptable lower yield, improved stability and maintained prognostic power.
-
Journal of neurotrauma · Aug 2023
Investigating the Effect of Brain Size on Deformation Magnitude using Subject-Specific Finite Element Models.
Abstract In the last decade, computational models of the brain have become the gold standard tool for investigating traumatic brain injury (TBI) mechanisms and developing novel protective equipment and other safety countermeasures. However, most studies utilizing finite element (FE) models of the brain have been conducted using models developed to represent the average neuroanatomy of a target demographic, such as the 50th percentile male. Although this is an efficient strategy, it neglects normal anatomical variations present within the population and their contributions on the brain's deformation response. ⋯ Both techniques indicated a strong linear relationship between ICV and MPS-95, with MPS-95 varying by approximately 5% between the smallest and largest brains. This difference represented up to 40% of the mean strain across all subjects. This study represents a comprehensive assessment of the relationships between brain anatomy and deformation, which is crucial for the development of personalized protective equipment, identifying individuals at higher risk of injury, and using computational models to aid clinical diagnostics of TBI.