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Acute trauma,head injury,

Jennifer M Leonard, Stephanie F Polites, Niels D Martin, Amy E Glasgow, Elizabeth B Habermann, Lewis J Kaplan
INTRODUCTION: Many injured patients or their families make the difficult decision to withdraw life-sustaining therapies (WLST) following severe injury. While this population has been studied in the setting of severe traumatic brain injury (TBI), little is known about patients who undergo WLST without TBI. We sought to describe patients who may benefit from early involvement of end-of-life resources. METHODS: Trauma Quality Improvement Program (2013-2014) patients who underwent WLST were identified...
January 14, 2019: Injury
Megan Cox, Timothy Becker, Mpapho Motsumi
This study aims to present and discuss acute Head Injury (HI) presentations including etiology, referral patterns and disposition in patients presenting to a major referral hospital in Gaborone, Botswana. Cross-sectional, retrospective data collection from July 2015 through September 2015 extracted descriptions of patient demographics, mechanism of injury, comorbidities, diagnosis and disposition from Emergency Centre (EC) records. 360 HI patients presented in three months, averaging four per day and increasing on weekends and end of the month...
October 1, 2018: Journal of Public Health in Africa
Claudia Yaneth Rodríguez-Triviño, Isidro Torrez, Zulma Dueñas
OBJECTIVE: To determine association between electrolyte disturbances and mortality in patients with severe traumatic brain injury (TBI). DESIGN: Retrospective cohort study. METHODOLOGY: Medical records of patients with diagnosis of severe traumatic brain injury and electrolytic alterations were reviewed. The electrolytic levels were analyzed in order to establish an association between patients who died and those who survived through statistical analysis...
January 22, 2019: World Neurosurgery
Nadine A Kerr, Juan Pablo de Rivero Vaccari, Oliver Umland, M Ross Bullock, Gregory E Conner, W Dalton Dietrich, Robert W Keane
Approximately 30% of traumatic brain injured patients suffer from acute lung injury or acute respiratory distress syndrome. Our previous work revealed that extracellular vesicle (EV)-mediated inflammasome signaling plays a crucial role in the pathophysiology of traumatic brain injury (TBI)-induced lung injury. Here, serum-derived EVs from severe TBI patients were analyzed for particle size, concentration, origin, and levels of the inflammasome component, an apoptosis-associated speck-like protein containing a caspase-recruiting domain (ASC)...
January 18, 2019: Cells
En-Pei Lee, Jainn-Jim Lin, Shao-Hsuan Hsia, Oi-Wa Chan, Han-Ping Wu
BACKGROUND: Pneumatosis intestinalis and portomesenteric venous gas are usually caused by necrotizing enterocolitis; however they can occur secondary to abusive abdominal trauma with bone fractures and bruising. It is difficult to recognize initially if there is no bruising on the skin or bone fractures. CASE PRESENTATION: We report a 1-year-old child with no obvious history of trauma who presented with conscious disturbance. Abdominal computed tomography showed acute ischemic bowel complicated with pneumatosis intestinalis and portomesenteric venous gas...
January 15, 2019: BMC Pediatrics
Aysa Hacioglu, Fahrettin Kelestimur, Fatih Tanriverdi
PURPOSE: After traumatic brain injury was accepted as an important etiologic factor of pituitary dysfunction (PD), awareness of risk of developing PD following sports-related traumatic brain injury (SR-TBI) has also increased. However there are not many studies investigating PD following SR-TBIs yet. We aimed to summarize the data reported so far and to discuss screening algorithms and treatment strategies. METHODS: Recent data on pituitary dysfunction after SR-TBIs is reviewed on basis of diagnosis, clinical perspectives, therapy, screening and possible prevention strategies...
January 14, 2019: Pituitary
Stefania Goncalves, Bradley J Goldstein
The olfactory epithelium (OE) is the peripheral organ for the sense of smell, housing primary sensory neurons that project axons from the nose to the brain. Due to the presence of a basal stem cell niche, the adult mammalian OE is a dynamic tissue capable of replacing neurons following their loss. Nonetheless, certain conditions, such as blunt head trauma, can result in persistent olfactory loss, thought to be due to shearing of olfactory nerve filaments at the skull base, degeneration, and failures in proper regeneration/reinnervation...
January 11, 2019: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
Lana Hirai Gimber, Mihra S Taljanovic, Zachary A Rockov, Elizabeth A Krupinski, Tyson S Chadaz, Lee F Rogers
OBJECTIVE: To describe a new radiographic sign, "veil of obscuration", associated with posterior glenohumeral joint (shoulder) dislocations and determine its incidence and validity compared to other known classic radiographic signs. METHODS: Four-year retrospective study identified 30 acute posterior shoulder dislocation patients. Radiographs reviewed in consensus by 2 musculoskeletal radiologists for the "veil of obscuration", seen on AP shoulder radiographs and representing a comminuted fracture of the lesser tuberosity projecting over the humeral head or glenohumeral joint...
November 2018: Acta Medica Academica
Shadi Lalezari, Christine Lee, Keyianoosh Z Paydar, Ashkaun Shaterian
BACKGROUND: Poly-trauma patients often sustain complex head/neck injuries requiring prolonged hospitalizations and multiple operations. Few studies have evaluated the associated injury patterns and risk factors for poor clinical outcomes. METHODS: Consecutive poly-trauma patients with operative maxillofacial fractures treated at a level 1 trauma medical center between 1995 and 2013 were evaluated. Concomitant head/neck injuries to identify potential injury patterns were numerated...
September 2018: World Journal of Plastic Surgery
Kent P Hymel, Ming Wang, Vernon M Chinchilli, Wouter A Karst, Douglas F Willson, Mark S Dias, Bruce E Herman, Christopher L Carroll, Suzanne B Haney, Reena Isaac
BACKGROUND: Evidence-based, patient-specific estimates of abusive head trauma probability can inform physicians' decisions to evaluate, confirm, exclude, and/or report suspected child abuse. OBJECTIVE: To derive a clinical prediction rule for pediatric abusive head trauma that incorporates the (positive or negative) predictive contributions of patients' completed skeletal surveys and retinal exams. PARTICIPANTS AND SETTING: 500 acutely head-injured children under three years of age hospitalized for intensive care at one of 18 sites between 2010 and 2013...
December 11, 2018: Child Abuse & Neglect
Clara Karton, T Blaine Hoshizaki
Head impacts that transfer mechanical energy to the skull and create brain injuries have unique dynamic responses and brain tissue trauma characteristics. The magnitude of the impact energy and how it is transmitted creates three-dimensional linear and rotational accelerations of the head, resulting in unique strains on brain tissue. Biomechanical investigations of head injuries in contact sports have historically focused on attenuating energy transfer to the skull and brain. Typically, severe life-threatening events are caused by high-energy impact events that result in anatomic damage...
2018: Handbook of Clinical Neurology
Alexander Lin, Molly Charney, Martha E Shenton, Inga Katharina Koerte
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder associated with repetitive head impact exposure, such as that resulting from sports-related concussive and subconcussive brain trauma. Currently, the only way to diagnose CTE is by using neuropathologic markers obtained postmortem. To diagnose CTE earlier, so that possible treatment interventions may be employed, there is a need to develop noninvasive in vivo biomarkers of CTE. Neuroimaging provides promising biomarkers for the diagnosis of CTE and may also help elucidate pathophysiologic changes that occur with chronic sports-related brain injury...
2018: Handbook of Clinical Neurology
Asif K Suri, Michael L Lipton
Computed tomography (CT) and magnetic resonance imaging (MRI) have revolutionized the assessment of traumatic brain injury (TBI) by permitting rapid detection and localization of acute intracranial injuries. In concussion, the most common presentation of sports-related head trauma, CT and MRI are unrevealing. This normal appearance of the brain on standard neuroimaging, however, belies the structural and functional pathology that underpins concussion-related symptoms and dysfunction. Advances in neuroimaging have expanded our ability to gain insight into this microstructural and functional brain pathology...
2018: Handbook of Clinical Neurology
Henrik Zetterberg, Bengt Winblad, Charles Bernick, Kristine Yaffe, Marek Majdan, Gunilla Johansson, Virginia Newcombe, Lars Nyberg, David Sharp, Olli Tenovuo, Kaj Blennow
Traumatic brain injury (TBI) is clinically divided into a spectrum of severities, with mild TBI being the least severe form and a frequent occurrence in contact sports, such as ice hockey, American football, rugby, horse riding and boxing. Mild TBI is caused by blunt non-penetrating head trauma that causes movement of the brain and stretching and tearing of axons, with diffuse axonal injury being a central pathogenic mechanism. Mild TBI is in principle synonymous with concussion; both have similar criteria in which the most important elements are acute alteration or loss of consciousness and/or post-traumatic amnesia following head trauma and no apparent brain changes on standard neuroimaging...
November 27, 2018: Journal of Internal Medicine
Vivek Kumar Kankane, Tarun Kumar Gupta
Aim: Delayed intracerebral tension pneumatocele (DITP) is an uncommon cause of raised intracranial pressure following trauma. However, it can cause herniation syndrome due to a sudden increase in intracranial pressure which requires emergent intervention. Pneumocephalus is a complication of head injury in 3.9%-9.7% of the cases. The accumulation of intracranial air can be acute (<72 h) or delayed (≥72 h). Method: When intracranial air causes intracranial hypertension and has a mass effect with neurological deterioration, it is called tension pneumocephalus...
October 2018: Asian Journal of Neurosurgery
Askin Esen Hasturk, Emre Cemal Gokce, Erdal Resit Yilmaz, Bahriye Horasanli, Oya Evirgen, Nazli Hayirli, Hilal Gokturk, Imge Erguder, Belgin Can
Purpose: The aim of the present study was to investigate the effect of etanercept (ETA) on histopathological and biochemical changes after traumatic brain injury (TBI) in rats. Materials and Methods: Thirty-six male Wistar albino rats were distributed into three groups ( n = 12 each). Control group rats were not subjected to trauma. Trauma group rats were subjected to TBI only. ETA group rats were subjected to TBI plus ETA (5 mg/kg intraperitoneal [i.p.]). The groups were further subdivided into those sacrificed in the hyperacute stage (1 h after TBI) (control-1, trauma-1, and ETA-1 groups) and the acute stage (6 h after TBI) (control-6, trauma-6, and ETA-6 groups)...
October 2018: Asian Journal of Neurosurgery
Fernando Mayor Basto, Patrick Lyden
Therapeutic hypothermia (TH) is a potent neuroprotective therapy in experimental cerebral ischemia, with multiple effects at several stages of the ischemic cascade. In animals, TH is so powerful that all preclinical stroke studies require strict temperature control. In humans, multiple clinical studies documented powerful protection with TH after accidental neonatal hypoxic-ischemic injury and global cerebral ischemia with return of spontaneous circulation after cardiac arrest. National and international guidelines recommend TH for selected survivors of global ischemia, with profound benefits seen...
2018: Handbook of Clinical Neurology
Aditya Safaya, Ashraf Elzaine, Min Li Xu, Jorge Con, Kartik Prabhakaran, Gary Lombardo
No abstract text is available yet for this article.
April 1, 2018: American Surgeon
Silvia Farkašová Iannaccone, Alžbeta Ginelliová, Ivana Šantová, Marián Šanta, Daniel Farkaš, Radoslav Morochovič, Lucia Fröhlichová, Vladimír Balik
Spinal subdural hematoma is a rare and potentionally life-threatening condition associated with trauma and other pathological conditions. In this paper we report the autopsy findings of a 64 year old male who was repeatedly hospitalized with traumatic head injuries in the past. In this case spinal subdural hematoma was diagnosed post-mortem and later comfirmed by ante-mortem CT scan revaluation. Keywords: intracranial subdural hematoma - recurrent spinal subdural hematoma - diffuse axonal injury - autopsy findings...
2018: Soudní Lékarství
Rachel M Nygaard, Ashley P Marek
BACKGROUND: Our aim was to examine the US trauma population before and after the Affordable Care Act (ACA), specifically examining racial disparities in insurance status as well as access to post-hospitalization care in the trauma population. MATERIALS AND METHODS: The National Trauma Data Bank was queried for all non-burn patients age 18 to 64. The patient data was grouped into pre-ACA (2012-2013) and post-ACA (2014-2015). Regression analysis was controlled for age, sex, race (when applicable), type of injury (blunt vs penetrating), ISS, shock, head injury, and mechanical ventilation and clustered by hospital...
November 14, 2018: Journal of Racial and Ethnic Health Disparities
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