Articles: traumatic-brain-injuries.
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The C-reactive protein/albumin ratio (CAR), Glasgow coma scale score, and blood glucose level serve as reference values to evaluate the prognosis of critically ill patients. However, the prognostic significance of the admission serum CAR for patients with moderate to severe traumatic brain injury (TBI) has remained unclear. We examined the effect of the admission CAR on the outcomes of patients with moderate to severe TBI. ⋯ The CAR can serve as an independent risk factor of mortality for patients with moderate to severe TBI. Incorporating CAR into a predictive model could contribute to efficiently predicting the prognosis of adults with moderate to severe TBI.
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Decompressive hemicraniectomy (DHC) is performed to relieve life-threatening intracranial pressure elevations. After swelling abates, a cranioplasty is performed for mechanical integrity and cosmesis. Cranioplasty is costly with high complication rates. Prior attempts to obviate second-stage cranioplasty have been unsuccessful. The Adjustable Cranial Plate (ACP) is designed for implantation during DHC to afford maximal volumetric expansion with later repositioning without requiring a second major operation. ⋯ ACP implantation during DHC is technically feasible. It achieves a volume of cranial expansion that will accommodate that observed following survivable hemicraniectomy operations. Moving the implant from the up to the down position can easily be performed as a simple outpatient or inpatient bedside procedure, thus potentially eliminating second-stage cranioplasty procedures.
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Amazonas is the largest state in Brazil, covering an area of 1,559,159.148 km2 and primarily occupied by the Amazon rainforest. Fluvial and aerial transport are the primary means of transportation. Studying the epidemiologic profile of patients transported by neurologic emergencies is essential because there is only 1 referral center hospital serving approximately 4 million inhabitants in Amazonas. ⋯ Air transportation for neurologic evaluation is essential in Amazonas. However, most patients did not require neurosurgical intervention, indicating that investments in medical infrastructures, such as computed tomography scanners and telemedicine, may optimize health costs.