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"glasgow coma scale"[TI]

Kirstin D Weerdenburg, Paul W Wales, Derek Stephens, Suzanne Beno, Jessica Gantz, Jessie Alsop, Suzanne Schuh
OBJECTIVES: Previous pediatric trauma studies focused on predictors of abnormal chest radiographs or included patients with low injury severity. This study identified predictors of thoracic injury (TI) diagnoses in a high-risk population and determined TI rate without predictors. METHODS: This study was a retrospective trauma registry analysis of previously healthy children aged 0 to 17 years with multisystem blunt trauma requiring trauma team activation and chest radiography who were divided into those with and without TI...
May 8, 2017: Pediatric Emergency Care
Justin T Hsieh, Beng Ti Ang, Yew Poh Ng, John C Allen, Nicolas K K King
BACKGROUND: Intracerebral hemorrhage (ICH) accounts for 10-15% of all first time strokes and with incidence twice as high in the Asian compared to Western population. This study aims to investigate gender differences in ICH patient outcomes in a multi-ethnic Asian population. METHOD: Data for 1,192 patients admitted for ICH were collected over a four-year period. Multivariate logistic regression was used to identify independent predictors and odds ratios were computed for 30-day mortality and Glasgow Outcome Scale (GOS) comparing males and females...
2016: PloS One
Seung Hwan Kim, Jung Soo Kim, Hae Yu Kim, Sun-Il Lee
OBJECTIVE: Treatment of spontaneous intracerebral hemorrhage (ICH) remains controversial. However, an extensive hemorrhage with a poor mental status is suitable for surgical evacuation. Our experience with the transsylvian-transinsular (TS-TI) microsurgical approach for deep-seated basal ganglia (BG) ICH was investigated. MATERIAL AND METHODS: A retrospective review was conducted on 86 patients with BG ICH who underwent an operation at the Department of Neurosurgery of our Hospital from September 2011 to October 2014...
June 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
Guilan Kong, Xiaofeng Yin, Tianbing Wang, Richard Body, Yu-Wang Chen, Jing Wang, Liying Cao, Shouling Wu, Jingli Gao, Guosheng Wang, Yonghua Hu, Baoguo Jiang
BACKGROUND: In China, a nationwide emergency system takes charge of pre-hospital emergency services, and it adopts a proximity principle to send trauma patients to the nearest hospitals. However, many severely injured patients have been sent to low level hospitals with no capability to treat severe trauma. Thus those patients with high probability of in-hospital death or intensive care unit (ICU) admission need to be identified in the emergency department (ED) for optimal utilisation of hospital resources and better patient outcomes...
September 2015: Injury
Chyi Yeu David Low, Yin Yee Sharon Low, Kah Keow Lee, Siew Pang Chan, Beng Ti Ang
Ventricular enlargement is a common finding after severe head injury and has a poor prognosis if associated with post-traumatic hydrocephalus (PTH). We retrospectively reviewed our head injury database and identified patients who suffered from severe head injury and subsequently had shunt insertion after a diagnosis of PTH. A total of 871 patients with severe head injury were admitted from April 1999 to December 2006. Twenty-three patients (2.6%) were diagnosed with post-traumatic hydrocephalus and had a shunt inserted...
June 2013: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Sonia Bansal, Venkatapura J Ramesh, Ganne S Umamaheswara Rao
BACKGROUND: The requirement of anesthetic drugs in a patient with an intracranial space-occupying lesion is of relevance to the neuroanesthetist. The requirement is often presumed to have reduced or at least altered. However, not much research has focused on this issue. Hence, we conducted this study to examine whether intracranial tumors reduce the induction dose of propofol in patients undergoing craniotomy based on plasma and effect site concentrations (Ce) of propofol and the effect of additional fentanyl...
October 2012: Journal of Neurosurgical Anesthesiology
Han-Chung Lee, Hao-Che Chuang, Der-Yang Cho, Kuang-Fu Cheng, Pao-Hsuan Lin, Chun-Chung Chen
BACKGROUND: Severe traumatic brain injury (TBI) was to be one of the major health problems encountered in modern medicine and had an incalculable socioeconomic impact. The initial cerebral damage after acute brain injury is often exacerbated by postischemic hyperthermia and worsens the outcome. Hypothermia is one of the current therapies designed to combat this deleterious effect. The brain tissue oxygen (P(ti)o(2))-guided cerebral perfusion pressure (CPP) management was successfully reduced because of cerebral hypoxic episodes following TBI...
December 2010: World Neurosurgery
Sze Yan Tay, Beng Ti Ang, Xin Yin Lau, Amutha Meyyappan, Simon Lowes Collinson
Prospective memory (PM), the ability to recall future intentions, is crucial for independent living. Impairment of PM is a common complaint following head injury and is a significant impediment to good recovery, yet no studies have explored PM in mild traumatic brain injury (mTBI). In this study, prospective memory was examined in 31 mTBI patients and matched controls within a month of injury and 3 months after. mTBI patients performed more poorly than controls on the MIST task (Raskin, 2004) within the first month following injury, indicating that PM impairment is part of the acute cognitive sequelae of mTBI...
January 2010: Journal of Neurotrauma
Beng Ti Ang, Siew Pang Chan, Kah Keow Lee, Ivan Ng
BACKGROUND: Primary intracerebral hemorrhage accounts for the relative minority of all strokes and yet is more fatal and disabling. Various prognostic models for mortality and functional outcome following primary intracerebral hemorrhage have been proposed, however there is little data which focuses on a multi-racial population profile characteristic of communities in South-East Asia. A reliable grading scale for this condition will allow for accurate risk stratification, treatment selection, resource allocation and possibly also aid in the definition of common enrollment criteria for clinical trials...
2008: Acta Neurochirurgica. Supplement
Bastiaan M Gerritse, Jos M Th Draaisma, Annelies Schalkwijk, Pierre M van Grunsven, Gert Jan Scheffer
OBJECTIVE: To determine the incidence and success rate of out-of-hospital tracheal intubation (TI) and ventilation of children, taking account of the type of healthcare provider involved. METHODS: A prospective observational study to analyse a consecutive group of children for which a helicopter-transported medical team (HMT) was called. In all cases, the emergency medical service (EMS)-paramedics arrived at the scene first. Data regarding type of incident, physiological parameters, treatment, and survival until hospital discharge were collected and subsequently analysed...
November 2008: Resuscitation
Kah Keow Lee, Ivan Ng, Beng Ti Ang
INTRODUCTION: Some studies have demonstrated an increased risk of death for patients admitted at nights or during weekends. This study was undertaken to investigate the demographic profile, medical interventions and outcome of severe head injury patients stratified according to day and time of admission to a specialised neurosciences intensive care unit (NICU). MATERIALS AND METHODS: A retrospective study using a prospectively maintained severe head injury database in a tertiary hospital...
May 2008: Annals of the Academy of Medicine, Singapore
Chi Long Ho, Chee Meng Wang, Kah Keow Lee, Ivan Ng, Beng Ti Ang
OBJECT: This study addresses the changes in brain oxygenation, cerebrovascular reactivity, and cerebral neurochemistry in patients following decompressive craniectomy for the control of elevated intracranial pressure (ICP) after severe traumatic brain injury (TBI). METHODS: Sixteen consecutive patients with isolated TBI and elevated ICP, who were refractory to maximal medical therapy, underwent decompressive craniectomy over a 1-year period. Thirteen patients were male and 3 were female...
May 2008: Journal of Neurosurgery
H Boret, J Fesselet, E Meaudre, P-E Gaillard, E Cantais
We report the case of a young patient with post-traumatic, intractable, intracranial hypertension leading to craniectomy. This intracranial hypertension was preceded by focal signs of ischemia diagnosed through P(ti)O2 monitoring and cerebral microdialysis, and occurred a few hours prior to a decrease in cerebral perfusion pressure below 60 mmHg. The neurological outcome was satisfactory with a Glasgow Outcome Scale of 4 at 3 months. We discuss the potential interest of such neuro-monitoring to determine the optimal time for performing a craniectomy...
February 2006: Acta Anaesthesiologica Scandinavica
Beng Ti Ang, Elgin Yap, Joyce Lim, Wan Loo Tan, Puay Yong Ng, Ivan Ng, Tseng Tsai Yeo
OBJECT: This study was designed to elucidate the pattern of expression of poly(adenosine diphosphate-ribose) polymerase (PARP) in human pericontusional brain tissue and to correlate these findings with commonly used clinical parameters. METHODS: The expression of PARP was ascertained using immunohistochemical studies in eight specimens of human pericontusional brain tissue obtained when the patients underwent craniotomy for mass effect. The following demographic and clinical parameters were also analyzed for each patient: age, sex, postresuscitation Glasgow Coma Scale score (GCS), computerized tomography findings, intracranial pressure (ICP) recordings during the first 24 hours postsurgery, and the time interval from injury to surgery...
July 2003: Journal of Neurosurgery
J Meixensberger, M Jaeger, A Väth, J Dings, E Kunze, K Roosen
OBJECTIVE: To evaluate the effects of a brain tissue oxygen (P(ti)O(2)) guided treatment in patients with traumatic brain injury. METHODS: P(ti)O(2) was monitored in 93 patients with severe traumatic brain injury. Forty patients admitted from 1993 to 1996 were treated with intracranial pressure/cerebral perfusion pressure (ICP/CPP) management alone (ICP < 20 mm Hg, CPP > 70 mm Hg). Fifty three patients admitted from 1997 to 2000 were treated using ICP/CPP management, but in this second group CPP was also increased as individually required to raise the P(ti)O(2) above 1...
June 2003: Journal of Neurology, Neurosurgery, and Psychiatry
M Menzel, J Soukup, D Henze, T Clausen, T Marx, A Hillman, I Miko, S Grond, A Rieger
Brain tissue oxygen monitoring (P(ti)O2 (Neurotrend, Codman, Germany) was employed in addition to standard intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring in seven patients with severe neuronal damage of heterogeneous etiology. The correlation between P(ti)O2 changes and CPP fluctuations during periods of 30 minutes were analyzed, when CPP was above 70 mmHg and lower than 100 mmHg. A new ratio, the CPP-oxygen-reactivity (COR) index was calculated as COR=delta p(ti)O2 %/delta CPP%...
January 2003: Journal of Neurosurgical Anesthesiology
J A Cozens, S Miller, I R Chambers, A D Mendelow
OBJECTIVES: (1) To establish the feasibility of myotatic reflex measurement in patients with head injury. (2) To test the hypothesis that cerebral dysfunction after head injury causes myotatic reflex abnormalities through disordered descending control. These objectives arise from a proposal to use reflex measurements in monitoring patients with head injury. METHODS: The phasic stretch reflex of biceps brachii was elicited by a servo-positioned tendon hammer. Antagonist inhibition was evoked by vibration to the triceps...
May 2000: Journal of Neurology, Neurosurgery, and Psychiatry
J Dings, J Meixensberger, A Jäger, K Roosen
OBJECTIVE: We assessed the technical and diagnostic reliability of partial pressure of oxygen (PO2) of brain tissue (P(ti)O2) monitoring. The monitoring system and the catheter probes were tested in vitro, and clinical experiences obtained with 118 brain P(ti)O2 catheter probes, used in 101 patients, are reported. METHODS: The polarographic (LICOX; Medical Systems Corp., Greenvale, NY) P(ti)O2 catheter probe lies 22 to 27 mm below the dura level; its PO2-sensitive surface is 7...
November 1998: Neurosurgery
J Meixensberger, A Jäger, J Dings, S Baunach, K Roosen
Fifty-five head injured patients (GCS < 8) were studied at an average of 7.5 +/- 3.4 days on the ICU to check quality of hemodynamic monitoring and the consequences for therapy. Multimodal neuromonitoring included intracranial pressure (ICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), endtidal CO2 (EtCO2) as well as brain tissue--pO2 (p(ti)O2), regional oxygen (rSO2) and jugular venous oxygen saturation (SjO2). Regional p(ti)O2 as well as global SjO2 were sensitive technologies to detect hemodynamic changes...
1998: Acta Neurochirurgica. Supplement
J Dings, J Meixensberger, J Amschler, K Roosen
Secondary ischemic events worsen the outcome of patients with severe head injury. Such a secondary ischemic event may be caused by a forced hyperventilation. A consequence of the induced vasoconstriction is the risk of ischemia with an adverse effect on outcome. As a reliable and on-line technique, brain tissue pO2 (p(ti)O2) is used for monitoring regional microcirculation, to detect critical hypoperfusion. On 22 patients with a severe head injury 70 hyperventilation tests were performed from day 0-9 after trauma, calculating TCD-CO2-reactivity (% change of mean flow velocity per mm Hg paCO2 change)...
1996: Zentralblatt Für Neurochirurgie
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