Articles: traumatic-brain-injuries.
-
Venous thromboembolisms (VTEs) occur more frequently in patients with traumatic brain injuries (TBIs) and spinal cord injuries, yet the use of chemoprophylaxis is controversial. The purpose of this study was to investigate the relationship between the timing of chemical VTE prophylaxis initiation and the development of VTE events in these patients. ⋯ Patients with VTEs had a significant delay in time to initiation of chemoprophylaxis compared with patients without VTEs. Patients sustaining a TBI had a 2-fold delay in initiation of chemoprophylaxis and an associated 2-fold increase in VTE events compared with patients who sustained spinal injuries. Of those patients who developed a TBI, patients who sustained a combination subarachnoid hemorrhage and/or subdural hemorrhage had a significant delay in initiation of chemoprophylaxis with a higher rate of VTE events.
-
The blood-brain barrier (BBB) can be impaired following traumatic brain injury (TBI), however the spatiotemporal dynamics of BBB leakage remain incompletely understood. In this study, we evaluated the spatiotemporal evolution of BBB permeability using dynamic contrast-enhanced MRI and measured the volume transfer coefficient (K(trans)), a quantitative measure of contrast agent leakage across the blood and extravascular compartment. Measurements were made in a controlled cortical impact (CCI) model of mild TBI in rats from 1h to 7 days following TBI. ⋯ Temporally, K(trans) changes peaked at day 3, similar to CBF and ADC changes, but differed from T2 and FA, whose changes peaked on day 2. The pattern of superficial cortical layer localization of K(trans) was consistent with patterns revealed by Evans Blue extravasation. Collectively, these results suggest that BBB disruption, edema formation, blood flow disturbance and diffusion changes are related to different components of the mechanical impact, and may play different roles in determining injury progression and tissue fate processes following TBI.
-
Acta Neurol. Scand. · Sep 2016
Plasma thrombospondin-1 and clinical outcomes in traumatic brain injury.
Thrombospondin-1 (TSP-1) acts as an anti-angiogenic factor, and its expression in rat brain is upregulated after intracerebral hemorrhage. The current study was designed to investigate the change of plasma TSP-1 levels and assess the prognostic predictive effect of plasma TSP-1 level and it is associated with head trauma severity in the patients with severe traumatic brain injury (STBI). ⋯ Plasma TSP-1 levels are elevated and are highly associated with head trauma severity and short-term and long-term outcomes of STBI. TSP-1 may be a good prognostic biomarker of STBI.
-
Epilepsy & behavior : E&B · Sep 2016
Continuous electroencephalography in pediatric traumatic brain injury: Seizure characteristics and outcomes.
Traumatic brain injury (TBI) is a major cause of pediatric morbidity and mortality. Secondary injury that occurs as a result of a direct impact plays a crucial role in patient prognosis. The guidelines for the management of severe TBI target treatment of secondary injury. Posttraumatic seizure, one of the secondary injury sequelae, contributes to further damage to the injured brain. Continuous electroencephalography (cEEG) helps detect both clinical and subclinical seizure, which aids early detection and prompt treatment. ⋯ Continuous electroencephalography demonstrated a pattern that associated seizures and poor outcomes in patients with moderate to severe traumatic brain injury, particularly in a subgroup of patients with nonaccidental trauma. Best practice should include institution-based TBI cEEG protocols, which may detect seizure activity early and promote outcomes. Future studies should include examination of individual cEEG characteristics to help improve outcomes in pediatric TBI.
-
J Trauma Acute Care Surg · Sep 2016
Sex differences in mortality following isolated traumatic brain injury among older adults.
Older adults have the highest rates of hospitalization and mortality from traumatic brain injury (TBI), yet outcomes in this population are not well studied. In particular, contradictory reports on the protective effect of female sex on mortality following TBI may have been related to age differences in TBI and other injury severity and mechanism. The objective of this study was to determine if there are sex differences in mortality following isolated TBI among older adults and compare with findings using all TBI. A secondary objective was to characterize TBI severity and mechanism by sex in this population. ⋯ Prognostic/epidemiologic study, level IV.