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18 papers 25 to 100 followers Neurosurgery neurocirugia concusion
Paul Vespa, Meral Tubi, Jan Claassen, Manuel Buitrago-Blanco, David McArthur, Angela G Velazquez, Bin Tu, Mayumi Prins, Marc Nuwer
OBJECTIVE: Traumatic brain injury (TBI) results in persistent disruption of brain metabolism that has yet to be mechanistically defined. Early post-traumatic seizures are one potential mechanism for metabolic crisis and hence could be a therapeutic target. We hypothesized that seizures and pseudoperiodic discharges (PDs) may be mechanistically linked to metabolic crisis as measured by cerebral microdialysis. METHODS: A prospective multicenter study of surface and intracortical depth electroencephalography (EEG) was performed in conjunction with cerebral microdialysis in a cohort of severe TBI patients with time-locked analysis of the neurochemical response to seizures and pseudoperiodic discharges...
April 2016: Annals of Neurology
Alistair Nichol, Craig French, Lorraine Little, Samir Haddad, Jeffrey Presneill, Yaseen Arabi, Michael Bailey, D James Cooper, Jacques Duranteau, Olivier Huet, Anne Mak, Colin McArthur, Ville Pettilä, Markus Skrifvars, Shirley Vallance, Dinesh Varma, Judy Wills, Rinaldo Bellomo
BACKGROUND: Erythropoietin might have neurocytoprotective effects. In this trial, we studied its effect on neurological recovery, mortality, and venous thrombotic events in patients with traumatic brain injury. METHODS: Erythropoietin in Traumatic Brain Injury (EPO-TBI) was a double-blind, placebo-controlled trial undertaken in 29 centres (all university-affiliated teaching hospitals) in seven countries (Australia, New Zealand, France, Germany, Finland, Ireland, and Saudi Arabia)...
December 19, 2015: Lancet
Brian P Walcott, Navid Redjal, Jean-Valery C E Coumans
Neurosurgical patients are at a high risk for infectious sequelae following operations. For neurosurgery in particular, the risk of surgical site infection has a unique implication given the proximity of the CSF and the CNS. Patient factors contribute to some degree; for example, cancer and trauma are often associated with impaired nutritional status, known risk factors for infection. Additionally, care-based factors for infection must also be considered, such as the length of surgery, the administration of steroids, and tissue devascularization (such as a craniotomy bone flap)...
November 2012: Neurosurgical Focus
Abdul Rashid Bhat, Altaf Rehman Kirmani, Mohammed Afzal Wani
CONTEXT: The decompressive craniotomy alone or with dural flap opening to evacuate acute subdural hematoma with underlying brain edema in severe traumatic brain injury has proved either insufficient in the first place or has fatal complications secondly. AIMS: To reduce the fatality of conventional procedures and to evacuate acute subdural hematoma with severe brain edema by a combination of decompressive craniotomy and multi-dural stabs (SKIMS-Technique) without brain pouting and lacerations in low Glasgow coma scale (GCS) score patients...
January 2013: Asian Journal of Neurosurgery
Michael Buchfelder
Evidence exists that trephination was performed in Germany as early as the Stone Age. Late medieval barber surgeons further developed instruments and techniques for this procedure. Various surgeons performed individual cranial operations before the 1870s, and neurosurgery evolved as a distinct discipline in Germany around 1934. Before the 20th century, most cranial operations in Germany, as in other European countries, were performed for trauma. Since approximately 1870, a few individuals with a devoted interest in surgery of the nervous system have developed operative techniques for the brain and spinal cord...
March 2005: Neurosurgery
Catherine Buettner, Rony-Reuven Nir, Suzanne M Bertisch, Carolyn Bernstein, Aaron Schain, Murray A Mittleman, Rami Burstein
OBJECTIVE: The aim of this work was to assess efficacy and tolerability of simvastatin plus vitamin D for migraine prevention in adults with episodic migraine. METHODS: We performed a randomized, double-blind, placebo-controlled trial with a 12-week baseline period and 24-week intervention period in 57 adults with episodic migraine. Participants were randomly assigned to simvastatin 20 mg tablets twice-daily plus vitamin D3 1,000 international units capsules twice-daily or matching placebo tablets and capsules...
December 2015: Annals of Neurology
Guang-Yu Ying, Chao-Hui Jing, Jian-Ru Li, Cheng Wu, Feng Yan, Jing-Yin Chen, Lin Wang, Brandon J Dixon, Gao Chen
BACKGROUND: Blood-brain barrier (BBB) disruption and neural apoptosis are thought to promote early brain injury (EBI) after subarachnoid hemorrhage (SAH). Previous studies have demonstrated that valproic acid (VPA) decreased brain injury in a prechiasmatic injection model of SAH in mice. It should be noted that the beneficial effects of VPA and the underlying mechanisms have not been fully elucidated. OBJECTIVE: To characterize the effects of VPA on BBB disruption and neural apoptosis and to determine mechanisms involved in EBI after SAH...
August 2016: Neurosurgery
Zaheer Nabi, D Nageshwar Reddy
Gastroesophageal reflux disease (GERD) is defined by the presence of troublesome symptoms resulting from the reflux of gastric contents. The prevalence of GERD is increasing globally. An incompetent lower esophageal sphincter underlies the pathogenesis of GERD. Proton pump inhibitors (PPIs) form the core of GERD management. However, a substantial number of patients do not respond well to PPIs. The next option is anti-reflux surgery, which is efficacious, but it has its own limitations, such as gas bloating, inability to belch or vomit, and dysphagia...
September 2016: Clinical Endoscopy
Lara L Zimmermann, Ramon Diaz-Arrastia, Paul M Vespa
Posttraumatic seizures are a common complication of traumatic brain injury. Posttraumatic epilepsy accounts for 20% of symptomatic epilepsy in the general population and 5% of all epilepsy. Early posttraumatic seizures occur in more than 20% of patients in the intensive care unit and are associated with secondary brain injury and worse patient outcomes. Most posttraumatic seizures are nonconvulsive and therefore continuous electroencephalography monitoring should be the standard of care for patients with moderate or severe brain injury...
October 2016: Neurosurgery Clinics of North America
Kristin W Samuelson
Declarative memory dysfunction is associated with post-traumatic stress disorder (PTSD). This paper reviews this literature and presents two frameworks to explain the nature of this dysfunction: that memory deficits are a product of neurobiological abnormalities caused by PTSD and/or that pre-existing memory deficits serve as a risk factor for the development of PTSD following trauma exposure. Brain regions implicated in declarative memory deficits include the hippocampus and prefrontal cortex, and imaging and biochemistry studies as they relate to memory dysfunction are described...
2011: Dialogues in Clinical Neuroscience
Iman El Sayed, Adel Zaki, Akram M Fayed, Gihan M Shehata, Sherif Abdelmonem
Traumatic brain injury is a major problem worldwide. Our objective is to synthesize available evidence in the literature concerning the effectiveness of neuroprotective drugs (cerebrolysin, citicoline, and piracetam) on Glasgow outcome score (GOS), cognitive performance, and survival in traumatic brain injury patients. Comprehensive search of electronic databases, search engines, and conferences proceedings; hand search journals; searching reference lists of relevant articles, theses, and local publications; and contact of authors for incomplete data were performed...
April 2018: Neurosurgical Review
Joshua S Easter, Jason S Haukoos, William P Meehan, Victor Novack, Jonathan A Edlow
IMPORTANCE: Adults with apparently minor head trauma (Glasgow Coma Scale [GCS] scores ≥13 who appear well on examination) may have severe intracranial injuries requiring prompt intervention. Findings from clinical examination can aid in determining which adults with minor trauma have severe intracranial injuries visible on computed tomography (CT). OBJECTIVE: To assess systematically the accuracy of symptoms and signs in adults with minor head trauma in order to identify those with severe intracranial injuries...
December 22, 2015: JAMA: the Journal of the American Medical Association
Elida Vázquez, Ignacio Delgado, Angel Sánchez-Montañez, Anna Fábrega, Paola Cano, Nieves Martín
Abusive head trauma is the leading cause of death in child abuse cases. The majority of victims are infants younger than 1 year old, with the average age between 3 and 8 months, although these injuries can be seen in children up to 5 years old. Many victims have a history of previous abuse and the diagnosis is frequently delayed. Neuroimaging is often crucial for establishing the diagnosis of abusive head trauma as it detects occult injury in 37% of cases. Several imaging patterns are considered to be particularly associated with abusive head trauma...
December 2014: Pediatric Radiology
Calogero Iacono, Marianna Zicari, Simone Conci, Alessandro Valdegamberi, Michela De Angelis, Corrado Pedrazzani, Andrea Ruzzenente, Alfredo Guglielmi
BACKGROUND: Pancreatic trauma occurs in 0.2% of patients with blunt trauma and 1-12% of patients with penetrating trauma. Traumatic pancreatic injuries are characterised by high morbidity and mortality, which further increase with delayed diagnoses. The diagnosis of pancreatic trauma is challenging. Signs and symptoms can be non-specific or even absent. METHODS: A critical review of studies reporting the management and outcomes of pancreatic trauma was performed...
May 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Pedro A Gómez, Javier de-la-Cruz, David Lora, Luis Jiménez-Roldán, Gregorio Rodríguez-Boto, Rosario Sarabia, Juan Sahuquillo, Roberto Lastra, Jesus Morera, Eglis Lazo, Jaime Dominguez, Javier Ibañez, Marta Brell, Adolfo de-la-Lama, Ramiro D Lobato, Alfonso Lagares
OBJECT: Traumatic brain injury (TBI) represents a large health and economic burden. Because of the inability of previous randomized controlled trials (RCTs) on TBI to demonstrate the expected benefit of reducing unfavorable outcomes, the IMPACT (International Mission on Prognosis and Analysis of Clinical Trials in TBI) and CRASH (Corticosteroid Randomisation After Significant Head Injury) studies provided new methods for performing prognostic studies of TBI. This study aimed to develop and externally validate a prognostic model for early death (within 48 hours)...
December 2014: Journal of Neurosurgery
Esther L Yuh, Gregory W J Hawryluk, Geoffrey T Manley
Concussion is a significant public health problem that is receiving increased attention from physicians, the media, and the public. Recent studies suggest that persistent symptoms after concussion/mild traumatic brain injury (mTBI) may arise from structural or metabolic alterations in the brain, despite normal conventional neuroimaging studies. New, advanced neuroimaging techniques show promise in refining diagnosis and outcome prediction in concussion/mTBI. Here, we review some of these techniques, including diffusion tensor imaging, task-based and resting-state functional magnetic resonance imaging, as well as positron emission tomography, H magnetic resonance spectroscopy, and perfusion imaging...
October 2014: Neurosurgery
DaiWai M Olson, Meg Zomorodi, Gavin W Britz, Ali R Zomorodi, Anthony Amato, Carmelo Graffagnino
OBJECT: Cerebral artery vasospasm is a major cause of death and disability in patients recovering from subarachnoid hemorrhage (SAH). Although the exact cause of vasospasm is unknown, one body of research suggests that clearing blood products by CSF drainage is associated with a lower frequency and severity of vasospasm. There are multiple approaches to facilitating CSF drainage, but there is inadequate evidence to determine the best practice. The purpose of this study was to explore whether continuous or intermittent CSF drainage was superior for reducing vasospasm...
October 2013: Journal of Neurosurgery
A G Thomas, S V Hegde, R A Dineen, T Jaspan
OBJECTIVE: To describe the range of intracranial injuries encountered in 0-2-year-olds in cases of accidental head injury where the mechanism of trauma was well characterised and to assess the clinical consequences. DESIGN: A retrospective review of imaging and clinical data. SETTING: Two tertiary paediatric referral centres. PATIENTS: All children aged 0-2 undergoing cranial CT as indicated by National Institute for Health and Clinical Excellence guidance for head injury from 2006 to 2011...
October 2013: Archives of Disease in Childhood
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