Articles: traumatic-brain-injuries.
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Case Reports
Early and Severe Symptomatic Cerebral Vasospasm after Mild Traumatic Brain Injury: Case Report.
Symptomatic cerebral vasospasm has been reported in a low percentage of patients with moderate or severe traumatic brain injury (TBI) as defined by Glasgow Coma Scale (GCS) score. We present a case of mild TBI (GCS score 14) complicated by early and severe symptomatic cerebral vasospasm. ⋯ Early and severe symptomatic vasospasm may occur as a complication of mild TBI. GCS score alone may be an inadequate risk predictor of symptomatic cerebral vasospasm. Aggressive interventional management may be justified, such as with intra-arterial calcium channel blockers, to optimize the likelihood of a favorable outcome.
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J Trauma Acute Care Surg · May 2017
Repeat head imaging in blunt pediatric trauma patients: Is it necessary?
Children with confirmed brain injury usually undergo follow-up computed tomography (CT) scan of the head within 24 hours of admission. To date, no evidence exists to validate the diagnostic or therapeutic value of these repeat CTs. The purpose of this study was to (1) evaluate progression of traumatic brain injuries, (2) determine if routine repeat imaging changes management, and (3) compare the efficacy of recognizing worsening hemorrhage with serial neurological examination versus repeat imaging. ⋯ Therapeutic study, level III.
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To describe the diagnostic types and characteristics of headaches in soldiers with mild traumatic brain injury during the wars in Afghanistan and Iraq. ⋯ Persistent post-traumatic headache is most likely to present with continuous pain. Migraine is the most common primary diagnosis type. The presence of a continuous headache was strongly associated with negative occupational outcomes. Primary headache diagnosis type was not. Headache characteristics, therefore, may be more important than diagnosis type when determining active duty status. Further prospective research is indicated.
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The pathophysiology of traumatic brain injury (TBI) largely involves the brains vascular structural integrity. We analyzed the value of an intraoperative cortical indocyanine green (ICG) angiography in patients with severe TBI and acute subdural hematoma who underwent decompressive craniectomy. ⋯ Patients with an unfavorable clinical outcome showed an altered shape of the ICG-derived fluorescence curve, a shorter increase of the ICG-derived fluorescence intensity in the cortical arteries, and significantly greater residual fluorescence intensity. These observations are likely a correlate of an increased intracranial pressure, a capillary leak, and venous congestion. Intraoperative quantification of the ICG-derived fluorescence might help to appreciate the clinical outcome in patients with severe TBI.
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Randomized Controlled Trial
Effects of Oral Glibenclamide on Brain Contusion Volume and Functional Outcome of Patients with Moderate and Severe Traumatic Brain Injury; A Randomized Double-Blind Placebo-Controlled Clinical Trial.
This study investigated effects of oral glibenclamide on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injuries. ⋯ Oral glibenclamide is associated with decreased contusion expansion rate in patients with moderate and severe traumatic brain injuries sustaining cerebral contusions.