Articles: traumatic-brain-injuries.
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Arch Orthop Trauma Surg · May 2023
Clinical Trial25-Year experience with adult polytraumatized patients in a European level 1 trauma center: polytrauma between 1995 and 2019. What has changed? A retrospective cohort study.
To analyze the changes of the clinical characteristics, injury patterns, and mortality rates of polytraumatized patients within the past 25 years in a European Level I trauma center. ⋯ The number of polytraumatized patients remained constant over the 25-year study period. Also, the mortality rates remained stable over time, although a significant increase of the average age of polytraumatized patients could be seen with stable injury severity scores. Severe TBI and age beyond 65 years remained independent prognostic factors on the late-phase survival of polytraumatized patients.
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The French poet Apollinaire enrolled in the French army during World War I. In 1916, he sustained a penetrating brain injury when a fragment of shrapnel pierced his helmet in the right temporal region. Neurosurgical techniques were at that time standardized to manage the significant number of war-related neurosurgical casualties. ⋯ In the case of Apollinaire, if the ballistic trauma were also responsible for diffuse axonal injury, it could have also led to semantic and social cognition impairment, in addition to the neuropsychological disorders that had already been widely documented by his friends and family. The world will always remember Apollinaire's writing genius as deeply associated with the birth of surrealism. But what if the poet's new writing style was caused, at least in part, by the unexpected help of a lost shrapnel fragment?
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Ferroptosis, a newly characterized form of programmed cell death that results from lipid peroxidation and mitochondrial dysfunction, has been demonstrated to be involved in the pathogenesis of traumatic brain injury (TBI). Scientific evidence has shown that intermittent fasting (IF) reduces both the lipid peroxidation and the mitochondrial dysfunction, raising the question of whether IF affects the ferroptosis induced by TBI. Here, based on an established TBI animal model, we examine the effects of IF on the activation of ferroptosis pathway as well as related outcomes. ⋯ Furthermore, the characteristic cellular damage induced by ferroptosis was alleviated by IF, as revealed by Perls' Prussian blue staining, Nissl staining, and transmission electron microscope examination. Consistently, we examined the outcomes of mice subjected to TBI and found an improved cognitive function of the IF mice. In sum, our study demonstrated, to our knowledge for the first time, that a 1-mo IF regimen partly ameliorates ferroptosis in the cortex of mice subjected to TBI, which potentially contributes to a lessening of cognitive impairment.
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Traumatic brain injury (TBI) is a major public health problem worldwide. Although computed tomography (CT) scans are often used for TBI workup, clinicians in low-income countries are limited by fewer radiographic resources. The Canadian CT Head Rule (CCHR) and the New Orleans Criteria (NOC) are widely used screening tools to rule out clinically important brain injury without CT imaging. Although these tools are well validated in studies from upper- and middle-income countries, it is important to study these tools in low-income countries. This study sought to validate the CCHR and NOC in a tertiary teaching hospital population in Addis Ababa, Ethiopia. ⋯ The NOC and the CCHR are highly sensitive screening tools that can help rule out clinically important brain injury in mild TBI patients without a head CT in an urban Ethiopian population. Their implementation in this low-resource setting may help spare a significant number of CT scans.