Final Report from the 2000-2003 Traumatic Brain Injury State Planning Grant for the State of Idaho

This study aimed to understand the level of participation among transition-aged youth with traumatic brain injury (TBI) in the State/Federal Vocational Rehabilitation (VR) System in the context of the Workforce Innovation and Opportunity Act (WIOA). Case closures, case duration, and case expenditures in Federal fiscal years (FYs) 2014, 2015, and 2016 were examined among transition-aged youth (i.e., State VR clients under the age of 22 years at application) with TBI, autism spectrum order (ASD), and intellectual disability (ID), using a nonexperimental and descriptive design. A disproportionate number of transition-aged youth with ASD and ID had closed State VR cases compared with transition-aged youth with TBI. Alternatively, there were greater State VR case duration levels and case service expenditures for persons with TBI compared with those with ASD or ID. The disproportionate participation with State VR was consistent among these three groups via eligibility for services under the Individuals with Disabilities Education Act. This article highlights areas of attention concerning transition-aged youth with TBI and will hopefully stimulate future dialogue, research, and policy development concerning participation with State VR for this population.

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Extracellular Brain Ph with or without Hypoxia is a Marker of Profound Metabolic Derangement and Increased Mortality after Traumatic Brain Injury

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2012.186 ◽

2012 ◽

Vol 33 (3) ◽

pp. 422-427 ◽

Cited By ~ 21

Author(s):

Ivan Timofeev ◽

Jurgens Nortje ◽

Pippa G Al-Rawi ◽

Peter JA Hutchinson ◽

Arun K Gupta

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cerebral Metabolism ◽

Significant Negative Correlation ◽

Low Ph ◽

The State ◽

Metabolic Derangement ◽

Impaired Metabolism ◽

Brain Ph ◽

Proportional Contribution

Cerebral hypoxia and acidosis can follow traumatic brain injury (TBI) and are associated with increased mortality. This study aimed to evaluate a relationship between reduced pHbt and disturbances of cerebral metabolism. Prospective data from 56 patients with TBI, receiving microdialysis and Neurotrend monitoring, were analyzed. Four tissue states were defined based on pHbt and PbtO2: 1—low PbtO2/pHbt, 2—low pHbt/normal PbtO2, 3—normal pHbt/low PbtO2, and 4—normal pHbt/PbtO2). Microdialysis values were compared between the groups. The relationship between PbtO2 and lactate/pyruvate (LP) ratio was evaluated at different pHbt levels. Proportional contribution of each state was evaluated against mortality. As compared with the state 4, the state 3 was not different, the state 2 exhibited higher levels of lactate, LP, and glucose and the state 1—higher LP and reduced glucose ( P < 0.001). A significant negative correlation between LP and PbtO2 (rho = −0.159, P < 0.001) was stronger at low pHbt (rho = −0.201, P < 0.001) and nonsignificant at normal pHbt ( P = 0.993). The state 2 was a significant discriminator of mortality categories ( P = 0.031). Decreased pHbt is associated with impaired metabolism. Measuring pHbt with PbtO2 is a more robust way of detecting metabolic derangements.

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Traumatic brain injury state planning grant: Preparing for change in a rural state

Brain Injury ◽

10.1080/02699050701426857 ◽

2007 ◽

Vol 21 (8) ◽

pp. 837-849 ◽

Cited By ~ 4

Author(s):

Russell C. Spearman ◽

B. Hudnall Stamm ◽

Laura J. Tivis

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

State Planning ◽

Rural State

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Profile conservative treatment of cranioencephalic traumatism medium degree in the state of São Paulo

10.5327/1516-3180.116 ◽

2021 ◽

Author(s):

Paulo Roberto Hernandes Júnior ◽

Juliana de Souza Rosa ◽

Patrick de Abreu Cunha Lopes ◽

Bárbara Tisse da Silva ◽

Heloá Santos Faria da Silva ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Public Sector ◽

Mortality Rate ◽

Conservative Treatment ◽

Private Sector ◽

Sao Paulo ◽

The State ◽

The Public ◽

Treatment Procedures

Background: The traumatic brain injury has a great impact on neurological emergencies. Objectives: To analyze the current panorama of conservative treatment procedures for mid-level traumatic brain injury performed in the State of São Paulo and to correlate with the current epidemiology. Methods: Literature review and observational, descriptive and transversal data collect on conservative treatment data for medium grade traumatic brain injury, available at DATASUS from January 2008 to December 2020 and articles available at Scielo, Lilacs and PubMed. Results: There were 63,218 hospitalizations for conservative treatment procedures in this period, accounting for R$ 68,668,413.92, with 2011 being the year with the highest number of hospitalizations (5,262), although 2020 with the greatest expenditure (R$ 5,984,875.09). 1,149 of them were elective, while 47,478 were urgent, with the occurrence of 24,527 in the public sector and 13,705 in the private sector. All 63,218 considered to be of medium complexity. The total mortality rate was 9.69, corresponding to 6,125 deaths, with 2009 being the year with the highest mortality rate, 10.34, while 2011 had the lowest rate, 9.14. The mortality rate for elective procedures was 6.44 compared to 9.89 for urgent procedures, whereas in the public sector it was 10.80 compared to 7.63 for the private sector. The average total hospital stay was 7.7 days, with an average cost of R$ 1,086.22. Conclusion: Medium grade traumatic brain injury has a short period of inhospital stay and a higher number of admissions and mortality rates in emergency care and in the public sector.

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Profile conservative treatment of cranioencephalic traumatism medium degree in the state of São Paulo

10.5327/1516-3180.729 ◽

2021 ◽

Author(s):

Paulo Roberto Hernandes Júnior ◽

Juliana de Souza Rosa ◽

Patrick de Abreu Cunha Lopes ◽

Bárbara Tisse da Silva ◽

Heloá Santos Faria da Silva ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Public Sector ◽

Mortality Rate ◽

Conservative Treatment ◽

Private Sector ◽

Sao Paulo ◽

The State ◽

The Public ◽

Treatment Procedures

Background: The traumatic brain injury has a great impact on neurological emergencies. Objectives: To analyze the current panorama of conservative treatment procedures for mid-level traumatic brain injury performed in the State of São Paulo and to correlate with the current epidemiology. Methods: Literature review and observational, descriptive and transversal data collect on conservative treatment data for medium grade traumatic brain injury, available at DATASUS from January 2008 to December 2020 and articles available at Scielo, Lilacs and PubMed. Results: There were 63,218 hospitalizations for conservative treatment procedures in this period, accounting for R$ 68,668,413.92, with 2011 being the year with the highest number of hospitalizations (5,262), although 2020 with the greatest expenditure (R$ 5,984,875.09). 1,149 of them were elective, while 47,478 were urgent, with the occurrence of 24,527 in the public sector and 13,705 in the private sector. All 63,218 considered to be of medium complexity. The total mortality rate was 9.69, corresponding to 6,125 deaths, with 2009 being the year with the highest mortality rate, 10.34, while 2011 had the lowest rate, 9.14. The mortality rate for elective procedures was 6.44 compared to 9.89 for urgent procedures, whereas in the public sector it was 10.80 compared to 7.63 for the private sector. The average total hospital stay was 7.7 days, with an average cost of R$ 1,086.22. Conclusion: Medium grade traumatic brain injury has a short period of inhospital stay and a higher number of admissions and mortality rates in emergency care and in the public sector.

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The Known Unknowns: An Overview of the State of Blood-based Protein Biomarkers of Mild Traumatic Brain Injury

Journal of Neurotrauma ◽

10.1089/neu.2021.0011 ◽

2021 ◽

Author(s):

Stuart John McDonald ◽

Sandy R Shultz ◽

Denes V. Agoston

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

The State ◽

Protein Biomarkers ◽

Known Unknowns

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Model-derived assessment of cerebrovascular resistance and cerebral blood flow following traumatic brain injury

Experimental Biology and Medicine ◽

10.1258/ebm.2010.009253 ◽

2010 ◽

Vol 235 (4) ◽

pp. 539-545 ◽

Cited By ~ 3

Author(s):

Michael L Daley ◽

Nithya Narayanan ◽

Charles W Leffler

Keyword(s):

Traumatic Brain Injury ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Brain Injury ◽

Cerebral Perfusion ◽

The State ◽

Cerebrovascular Resistance ◽

Fluid Percussion ◽

Arterial Blood ◽

Cerebrovascular Regulation

The published guidelines point out the need for the development of methods that individualize patient cerebral perfusion management and minimize secondary ischemic complications associated with traumatic brain injury. A laboratory method has been developed to determine model-derived assessments of cerebrovascular resistance (mCVR) and cerebral blood flow (mCBF) from cerebrovascular pressure transmission, and the dynamic relationship between arterial blood pressure (ABP) and intracranial pressure (ICP). The aim of this two-fold study is to (1) evaluate relative changes in the model-derived parameters of mCVR and mCBF with the corresponding changes in the pial arteriolar vascular parameters of pial arteriolar resistance (PAR) and relative pial arteriolar blood flow (rPABF); and (2) examine the efficacy of the proposed modeling methodology for continuous assessment of the state of cerebrovascular regulation by evaluating relative changes in the model-derived parameters of CBF and cerebrovascular resistance in relation to changes of cerebral perfusion pressure prior to and following fluid percussion brain injury. Changes of ABP, ICP, PAR, relative arteriolar blood flow (rPABF) and the corresponding model-derived parameters of mCBF and mCVR induced by acute hypertensive challenge were evaluated before and following fluid percussion injury in piglets equipped with cranial windows. Before fluid percussion, hypertensive challenge resulted in a significant increase of PAR and mCVR, whereas both rPABF and mCBF remained constant. Following fluid percussion, hypertensive challenge resulted in a significant decrease of PAR and mCVR and consistent with impaired cerebrovascular regulation. Hypertensive challenge significantly increased both rPABF and mCBF, which approximately doubled with increased CPP with correlation values of r = 0.96 ( P < 0.01) and r = 0.97 ( P ≤ 0.01), respectively. The assessment of model-derived cerebrovascular resistance and CBF with changes of CPP provides a means to monitor continuously the state of cerebrovascular regulation.

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