scholarly journals Outcomes Following Exploratory Burr Holes for Traumatic Brain Injury in a Resource Poor Setting

2017 ◽  
Vol 105 ◽  
pp. 257-264 ◽  
Author(s):  
Jessica Eaton ◽  
Asma Bilal Hanif ◽  
Gift Mulima ◽  
Chifundo Kajombo ◽  
Anthony Charles
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Resource Poor Setting ◽  
Resource Poor ◽  
Burr Holes

scholarly journals Factors affecting mortality after traumatic brain injury in a resource‐poor setting

BJS Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 320-325
Author(s):  
R. Okidi ◽  
D. M. Ogwang ◽  
T. R. Okello ◽  
D. Ezati ◽  
W. Kyegombe ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Resource Poor Setting ◽  
Factors Affecting ◽  
Resource Poor

scholarly journals 198 Outcomes Following Exploratory Burr Holes for Traumatic Brain Injury in a Resource-Poor Setting

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 253-253
Author(s):  
Jessica C Eaton ◽  
Asma Bilal Hanif ◽  
Gift Mulima ◽  
Chifundo Kajombo ◽  
Anthony Charles
Keyword(s):  
Traumatic Brain Injury ◽  
Logistic Regression ◽  
Brain Injury ◽  
Care Center ◽  
Tertiary Care ◽  
Total Mortality ◽  
Resource Poor Setting ◽  
Trauma Patients ◽  
Therapeutic Procedure ◽  
Burr Holes

Abstract INTRODUCTION Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Low- and middle-income countries (LMICs) suffer from a high incidence of and mortality from TBI. Computed tomography (CT) scan is the diagnostic method of choice, but is often inaccessible in LMICs, where exploratory burr holes (EBH) remain a necessary diagnostic and therapeutic procedure. We sought to describe indications and outcomes of patients undergoing EBH at our sub-Saharan African tertiary care center. METHODS We performed a retrospective review of prospectively collected data at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. All trauma patients presenting between June 2012 and July 2015 with a deteriorating level of consciousness and localizing signs who underwent EBH were included. Additionally, we included all patients admitted with TBI, requiring higher-level care during 2011. Because there was no neurosurgeon on staff in 2011, no patients underwent EBH. We performed logistic regression to identify predictors of mortality in the total population of TBI patients. RESULTS >241 patients presented to KCH with TBI requiring higher-level care, with a total mortality of 16.4% (Table 1). 163 (68%) underwent EBH. Of patients that underwent EBH, 87.6% of patients had intraoperative findings, with subdural hematoma being the most common (51.2%). Mortality in patients who underwent EBH was 6.8%. In surviving patients who underwent exploratory burr hole, 71.1% had a favorable outcome, defined as good recovery or moderate disability on the Glasgow Outcome Scale. Mortality in patients that did not undergo EBH was 43.9%. Upon logistic regression adjusted for age, sex, and Glasgow Coma Score, not undergoing EBH significantly increased the odds of mortality (OR = 12.0, P = 0.000, 95% CI = 4.48-31.9). CONCLUSION EBH remain an important diagnostic and therapeutic procedure for TBI in LMICs. In low-resource settings, EBH technique should be incorporated into general surgery education to attenuate TBI-related mortality.

scholarly journals Survival and Functional Outcomes at Discharge After Traumatic Brain Injury in Children versus Adults in Resource-Poor Setting

2020 ◽  
Vol 137 ◽  
pp. e597-e602 ◽  
Author(s):  
Laura N. Purcell ◽  
Rachel Reiss ◽  
Jessica Eaton ◽  
Ken-Kellar Kumwenda ◽  
Carolyn Quinsey ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Functional Outcomes ◽  
Resource Poor Setting ◽  
Resource Poor

Waterjet Assisted Craniotome for Reduced Dural Tears

2018 ◽  
Author(s):  
Mathew Orner ◽  
Michael Greminger ◽  
Amit Goyal
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Tumors ◽  
Cutting Tool ◽  
The United States ◽  
Dural Tears ◽  
Burr Holes ◽  
The Brain ◽  
Gain Access

A craniotomy is a procedure where a piece of the skull is removed in order to gain access to the brain. This is commonly done to remove brain tumors, treat epilepsy, and to treat traumatic brain injury. Currently, the craniotomy procedure involves drilling one or more burr holes and then using a craniotome to complete the cut. The craniotome consists of a rotating cutting tool and a dura guard, which is intended to prevent the cutting tool from touching the dura. However, even with the dura guard, dural tears occur in approximately 20–30% of craniotomy procedures [1], [2]. There are approximately 160,000 craniotomies performed per year in the United States [3]. Dural tears add time to the craniotomy procedure due to the increased difficulty in suturing the dura and the potential need to use synthetic dura material in order to reclose the dura. Also, if the dura tears while using the craniotome, the brain is no longer protected as the craniotomy is completed. There is a strong desire among neurosurgeons to have an improved tool for craniotomies that reduces the incidence of dural tears.

The Hudson Brace technique for emergency burr holes, an aide-memoire for the front-line military surgeon

2020 ◽  
pp. bmjmilitary-2020-001546
Author(s):  
James M W Robins ◽  
S Thomson ◽  
AJ Sheikh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cause Of Death ◽  
Surgical Intervention ◽  
British Army ◽  
Cranial Cavity ◽  
Front Line ◽  
Military Surgeon ◽  
Burr Holes ◽  
Early Surgical Intervention

Traumatic brain injury is the leading cause of death in conflict and early surgical intervention achieves better outcomes. The British Army surgical kit includes a Hudson Brace and bit and Gigli saw for decompression of the cranial cavity. Here we demonstrate the Hudson Brace technique for non-neurosurgeons.

Antiplatelet Agent Reversal Is Unnecessary in Blunt Traumatic Brain Injury Patients Not Requiring Immediate Craniotomy

2020 ◽  
Vol 86 (7) ◽  
pp. 826-829
Author(s):  
Kojo Agyabeng-Dadzie ◽  
Jocelyn E. Hunter ◽  
Timothy R. Smith ◽  
Monica Jordan ◽  
Karen Safcsak ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Antiplatelet Therapy ◽  
Platelet Transfusion ◽  
Injury Severity ◽  
Antiplatelet Agent ◽  
Antiplatelet Agents ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Burr Holes

Background The need to reverse the coagulation impairment caused by chronic antiplatelet agents in traumatic brain injury (TBI) patients with acute traumatic intracerebral hemorrhage (TICH) remains controversial. We sought to determine whether emergent platelet transfusion reduces the incidence of hemorrhage expansion, mortality, or need for neurosurgical intervention such as intracranial pressure (ICP) monitoring, burr holes, or craniotomy. Methods All adult blunt TICH patients (age ≥16 years) over a 4-year period were retrospectively reviewed. Patients with penetrating TBI, blunt TBI without TICH on admission computed tomography (CT), receiving warfarin, not on antiplatelet agents, or requiring immediate operative intervention were excluded. Patients were divided into 2 groups depending on whether they received a platelet transfusion: reversal group (RV) versus no reversal group (NR). Patient outcomes were analyzed using Mann-Whitney U and Fisher’s exact tests. Results 169 blunt TBI patients on chronic antiplatelet therapy were studied (102 RV group, 67 NR group). The groups were well matched with regard to age, Injury Severity Score, Abbreviated Injury Scale-head, Glasgow Coma Score, mechanism of injury, need for intubation, time to initial CT scan, and hospital length of stay. Immediate platelet transfusion did not alter the occurrence of TICH extension on follow-up CT (26% vs 21%, P = .71), TBI-specific mortality (9% vs 13%, P = .45), need for ICP monitor (2% vs 3%, P = 1.0), burr hole (1% vs 3%, P = .56), or craniotomy (1% vs 3%, P = .56). Discussion Immediate platelet transfusion is unnecessary in blunt TBI patients on chronic antiplatelet therapy who do not require immediate craniotomy.

Cognitive control constrains memory attributions

2019 ◽  
Vol 42 ◽  
Author(s):  
Colleen M. Kelley ◽  
Larry L. Jacoby
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Control

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy
Keyword(s):  
College Students ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sense Of Self ◽  
Scientific Evidence ◽  
Sudden Onset ◽  
Lessons Learned ◽  
Speech Language Pathologists ◽  
The Brain ◽  
Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

2019 ◽  
Vol 28 (3) ◽  
pp. 1363-1370 ◽  
Author(s):  
Jessica Brown ◽  
Katy O'Brien ◽  
Kelly Knollman-Porter ◽  
Tracey Wallace
Keyword(s):  
High School ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Disease Control ◽  
Mild Traumatic Brain Injury ◽  
School Age Children ◽  
School Age ◽  
Speech Language Pathologists ◽  
Control And Prevention ◽  
Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

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