Articles: traumatic-brain-injuries.
-
To understand the prevalence of comorbidities associated with traumatic brain injury (TBI) patients among active and reserve service members in the U.S. Military. ⋯ A large proportion of our TBI patients are afflicted with comorbidities, particularly post-TBI, indicating many have a complex profile. The military health system should continue tracking comorbidities associated with TBI within the U.S. Military and devise clinical practices that acknowledge the complexity of the TBI patient.
-
Traumatic brain injury is a major public health concern. Among patients with severe traumatic brain injury, epidural hemorrhage is known to swiftly lead to brain herniation and death unless there is emergent neurosurgical intervention. However, immediate neurosurgeon availability is frequently a problem outside of level I trauma centers. In this context, the authors desired to test a novel device for the emergent management of life-threatening epidural hemorrhage. A review of existing animal models determined that all were inadequate for this purpose, as they were found to be either inappropriate or obsolete. Here, we describe the development of a new epidural hemorrhage model in swine (Sus scrofa, 18-26 kg) ideal for translational device testing. ⋯ This animal model is the first to mirror the expected clinical course of epidural hemorrhage in a physiologically relevant manner, while allowing translational testing of emergency devices. This model successfully allowed the initial testing of a novel interventional device for the emergent management of epidural hemorrhage that was designed for use in the absence of traditional neurosurgical capabilities.
-
To examine the impact of military service on health literacy. ⋯ Both history of and current military service predict higher health literacy rates for patients treated at military otolaryngology clinics. Widely accessible health care and mandatory health evaluations for service members to maintain deployment readiness may contribute to this finding but warrant additional study.
-
Journal of neurotrauma · Jan 2023
A Study of 309 Patients and at One Year Follow-up for Depression Following Traumatic Brain Injury.
Traumatic brain injury (TBI) is one the major causes of death and morbidity in developing countries, where depression is a common psychiatric condition among individuals with TBI. The objectives were to investigate the occurrence and severity of depression one-year post-TBI; the association between radiological findings and depression; and the risk factors. We report a cross-sectional study among adult patients who were hospitalized because of TBI in the past one year. ⋯ The risk factors for depression at one-year post-TBI are moderate-severe TBI (odds ratio [OR]: 3.75, 95% confidence interval [CI] 2.03-6.90, p < 0.00), being unmarried (OR: 2.67, 95% CI 1.51-4.72, p = 0.001), female gender (OR: 2.62, 95% CI 1.25-5.46, p = 0.011), alcohol consumption (OR: 2.38, 95% CI 1.12-5.06, p = 0.024) and frontal lobe injury (OR: 1.96, 95% CI 1.05-3.68, p = 0.035). Increasing severity of TBI is associated with worsening levels of depression. Patients with frontal lobe injury have the highest risk of depression, while diffuse injury is associated with occurrence of moderate and moderately severe depression.
-
J Neurosurg Anesthesiol · Jan 2023
Randomized Controlled TrialKetofol as an Anesthetic Agent in Patients With Isolated Moderate to Severe Traumatic Brain Injury: A Prospective, Randomized Double-blind Controlled Trial.
The effects of ketofol (propofol and ketamine admixture) on systemic hemodynamics and outcomes in patients undergoing emergency decompressive craniectomy for traumatic brain injury (TBI) are unknown and explored in this study. ⋯ Compared with propofol, ketofol for induction and maintenance of anesthesia during decompressive surgery in patients with moderate/severe TBI was associated with improved hemodynamic stability, lower vasopressor requirement, and similar brain relaxation.