Articles: traumatic-brain-injuries.
-
J Head Trauma Rehabil · Nov 2016
Emergency Department Evaluation of Traumatic Brain Injury in the United States, 2009-2010.
To determine the dimensions of traumatic brain injury (TBI) evaluation in US emergency department (EDs) to inform potential application of novel diagnostic tests. ⋯ The ED is the main gateway to medical care for millions of patients evaluated for TBI each year. Novel diagnostic tests are needed to improve ED diagnosis and management of TBI.
-
Intracranial neurosurgical disorders are important causes of mortality and disability worldwide. Low tri-iodothyronine (T3) syndrome is a common complication in critically ill patients and is associated with a poor prognosis. ⋯ Low T3 syndrome is a common complication in patients suffering from intracranial neurosurgical disorders and is associated with greater disease severity, complicated clinical course, and greater mortality and handicap rates. However, it remains unclear if low T3 syndrome can impact the findings of currently available clinical prognostic models and if management of low T3 syndrome can improve outcomes in neurosurgical patients.
-
Impact to the head or rapid head acceleration-deceleration can cause traumatic brain injury (TBI) with a characteristic pathology of traumatic axonal injury (TAI) and secondary damage in white matter tracts. Myelin and oligodendrocyte lineage cells have significant roles in the progression of white matter pathology after TBI and in the potential for plasticity and subsequent recovery. The myelination pattern of specific brain regions, such as frontal cortex, may also increase susceptibility to neurodegeneration and psychiatric symptoms after TBI. ⋯ Thus, effective remyelination and myelin remodeling may be neurobiological substrates of plasticity in neuronal circuits that require long-distance communication. This perspective integrates findings from multiple contexts to propose a model of myelin and oligodendrocyte lineage cell relevance in white matter injury after TBI. This article is part of the Special Issue entitled 'Oligodendrocytes in Health and Disease'.
-
J Neurosurg Pediatr · Nov 2016
The application of adult traumatic brain injury models in a pediatric cohort.
OBJECTIVE There is increasing interest in the use of predictive models of outcome in adult head injury. Two international models have been identified to be reliable modalities for predicting outcome: the Corticosteroid Randomisation After Significant Head Injury (CRASH) model, and the International Mission on Prognosis and Analysis of randomized Controlled Trials in TBI (IMPACT) model. However, these models are designed only to identify outcomes in adult populations. ⋯ For the IMPACT-Core model, the SMtR was 1.03 and the model was also well calibrated (χ2 = 8.99, p = 0.34) and had good discrimination (AUROC = 0.85). Poor outcome was observed in 17% of the cohort and identified with the CRASH-Basic and IMPACT-Core models to varying degrees: standardized morbidity ratio = 0.89 vs 0.67, respectively; calibration = 6.5 (χ2) and 0.59 (p value) versus 8.52 (χ2) and 0.38 (p value), respectively; and discrimination (AUROC) = 0.92 versus 0.83, respectively. CONCLUSIONS Adult head injury models may be applied with sufficient accuracy to identify predictors of morbidity and mortality in pediatric TBI.
-
No guidelines exist for the evaluation of patients after near hanging. Most patients receive a comprehensive workup, regardless of examination. We hypothesize that patients with a normal neurologic examination, without major signs or symptoms suggestive of injury, require no additional workup. ⋯ Therapeutic/care management study, level V.