scholarly journals Serum Progesterone Levels as Predictor of Outcome in Severe Traumatic Brain Injury: Analysis of Cohort of 100 Patients

2021 ◽  
Author(s):  
Sarbjit Singh Chhiber ◽  
Adfer Gul ◽  
Sajad Arif ◽  
Abrar Ahad Wani ◽  
Altaf Umar Ramzan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Pharmacological Therapy ◽  
Gonadal Hormone ◽  
Serum Progesterone ◽  
Neurological Intensive Care ◽  
Severe Tbi ◽  
Brain Tissue Damage ◽  
Injured Patients

AbstractDespite advances in research and improved neurological intensive care in recent years, the clinical outcome of severely head injured patients is still poor. Primary insult is followed by a complex cascade of molecular and biochemical events that lead to neuroinflammation, brain edema, and delayed neuronal death. No specific pharmacological therapy is currently available which prevents the development of secondary brain injuries, and most therapeutic strategies have failed in translation from bench to bedside. There are limitations of clinical and radiological methods in delineating the exact severity and prognosis of traumatic brain injury (TBI). A myriad complex biochemical markers are under investigation to delineate the extent of brain tissue damage and to independently predict the outcome, but a search for simple biomarker still eludes the research. Progesterone, a gonadal hormone and a neurosteroid, although controversial as a neuroprotective agent, may hold promise as a simple biochemical marker of the outcome in severe TBI.

scholarly journals The Expanding Role of Quantitative Pupillometry in the Evaluation and Management of Traumatic Brain Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Jason H. Boulter ◽  
Margaret M. Shields ◽  
Melissa R. Meister ◽  
Gregory Murtha ◽  
Brian P. Curry ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Ease Of Use ◽  
Brain Injured ◽  
The World ◽  
Injured Patients ◽  
Austere Environments ◽  
Active Investigation

Traumatic brain injury is a rapidly increasing source of morbidity and mortality across the world. As such, the evaluation and management of traumatic brain injuries ranging from mild to severe are under active investigation. Over the last two decades, quantitative pupillometry has been increasingly found to be useful in both the immediate evaluation and ongoing management of traumatic brain injured patients. Given these findings and the portability and ease of use of modern pupillometers, further adoption and deployment of quantitative pupillometers into the preclinical and hospital settings of both resource rich and medically austere environments.

HOW DOES ANESTHESIA AFFECT VARIOUS LEVELS OF EXPERIMENTAL TRAUMATIC BRAIN INJURY?

2011 ◽  
Vol 04 (04) ◽  
pp. 409-420 ◽  
Author(s):  
BARBIRO-MICHAELY EFRAT ◽  
MANOR TAMAR ◽  
ROGATSKY GENNADY ◽  
MAYEVSKY AVRAHAM
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Injuries ◽  
Doppler Flowmetry ◽  
Fluid Percussion Injury ◽  
Physiological Properties ◽  
Mitochondrial Redox State ◽  
Severe Tbi ◽  
Four Levels ◽  
Injured Patients

The use of anesthetics is a well-known treatment for severely injured patients. In the present study we tested the pathophysiology of several levels of injury damage in a rat model and also tested the effect of Equithesin on brain vitality in these models. Traumatic Brain Injury (TBI) was induced using the fluid percussion injury model in four levels: mild, moderate and two levels of severe TBI. Brain real-time evaluation was performed by the multiparametric monitoring assembly (MPA) which enable cerebral blood flow (CBF) monitoring by laser Doppler flowmetry, mitochondrial NADH (Nicotinamide adenine dinucleotide) monitoring by the fluorometric technique, ionic homehostasis using special mini-electrodes, intracranial pressure (ICP) by the ICP camino device and needle electrodes for ECoG (Electrocorticogram) recording. Our results showed high correlation between the level of impact and the extent of changes in the physiological properties of the injury as indicated by the changes in all parameters monitored using the MPA device. Moreover, Equithesin improved CBF, ionic extracellular level and mitochondrial redox state following mild and moderate TBI while in severe TBI, Equithesin did not improve the metabolic state of the cerebral cortex, although it decreased the mortality rate from 66% to 20%, and following extra-severe TBI level, Equithesin did not improve survival rate. In conclusion it seems that Equithesin's protective effect exists under mild to moderate levels of injury and not in case of severe injuries.

scholarly journals Prevalence of traumatic brain injury among the guests at a low-barrier homeless shelter

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Nicholas Benjamin Ang ◽  
Jason Adam Wasserman
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
General Population ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Loss Of Consciousness ◽  
Homeless Shelter ◽  
Trauma History ◽  
First Onset ◽  
Severe Tbi

Abstract Objective This study aimed at determining the prevalence of traumatic brain injuries (TBI) among guests staying at a low-barrier homeless shelter who represent an especially vulnerable subset of individuals experiencing homelessness. Results A total of 21 out of 35 shelter guests participated in the survey. We found that 17 (81.0%) had experienced at least one traumatic brain injury in their lifetime and 15 (71.3%) had TBI associated with loss of consciousness. In addition, 7 (33.3%) of the participants had experienced TBIs rated as moderate to severe. Of the participants with head trauma history, 16 (94.1%) experienced their injury before their first onset of homelessness. Compared to both the general population and the broader population of individuals experiencing homelessness, those in this sample were significantly more likely to experience TBI (95% CI 0.0000:0.2857; p < 0.001 and 95% CI 0.3333:0.7619; p < 0.015, respectively) and significantly more likely to experience severe TBI (95% CI 0.0000:0.09524; p < 0.001).

History, Overview, and Human Anatomical Pathology of Traumatic Brain Injury

Neurotrauma ◽  
2018 ◽  
pp. 3-12
Author(s):  
Kentaro Shimoda ◽  
Shoji Yokobori ◽  
Ross Bullock
Keyword(s):  
Traumatic Brain Injury ◽  
Young Adults ◽  
Intensive Care ◽  
Brain Injury ◽  
Brain Injuries ◽  
Research Effort ◽  
Intensive Care Treatment ◽  
Mortality And Morbidity ◽  
Severe Tbi ◽  
Anatomical Pathology

Traumatic brain injury (TBI) is one of the oldest and commonest causes of medical distress in humans. However, despite much research effort, the prognosis for severe TBI patients remains poor. Worldwide, TBI is recognized as the leading cause of mortality and morbidity in young adults. TBI is a major worldwide health and socioeconomic problem. The most important factor in the prognosis of TBI patients is the severity of the "primary" brain injury. Additional delayed "secondary" brain damage continues from the time of traumatic impact in TBI patients, and the two combine to determine outcome. This chapter discusses the incidence of TBI, trends in morbidity and mortality, shifts in causes of TBI, its economic burden on society, and the pathophysiology of primary and secondary brain injuries. The authors discuss indications for surgical and intensive care treatment for intracranial hypertension and mass lesion management in TBI patients.

scholarly journals miR-142-3p Expression Is Predictive for Severe Traumatic Brain Injury (TBI) in Trauma Patients

2020 ◽  
Vol 21 (15) ◽  
pp. 5381
Author(s):  
Cora Rebecca Schindler ◽  
Mathias Woschek ◽  
Jan Tilmann Vollrath ◽  
Kerstin Kontradowitz ◽  
Thomas Lustenberger ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Predictive Biomarkers ◽  
Severe Trauma ◽  
Trauma Patients ◽  
Predictive Values ◽  
Risk Of Mortality ◽  
Affected Tissue ◽  
Severe Tbi ◽  
Injured Patients

Background: Predictive biomarkers in biofluids are the most commonly used diagnostic method, but established markers in trauma diagnostics lack accuracy. This study investigates promising microRNAs (miRNA) released from affected tissue after severe trauma that have predictive values for the effects of the injury. Methods: A retrospective analysis of prospectively collected data and blood samples of n = 33 trauma patients (ISS ≥ 16) is provided. Levels of miR-9-5p, -124-3p, -142-3p, -219a-5p, -338-3p and -423-3p in severely injured patients (PT) without traumatic brain injury (TBI) or with severe TBI (PT + TBI) and patients with isolated TBI (isTBI) were measured within 6 h after trauma. Results: The highest miR-423-3p expression was detected in patients with severe isTBI, followed by patients with PT + TBI, and lowest levels were found in PT patients without TBI (2−∆∆Ct, p = 0.009). A positive correlation between miR-423-3p level and increasing AIShead (p = 0.001) and risk of mortality (RISC II, p = 0.062) in trauma patients (n = 33) was found. ROC analysis of miR-423-3p levels revealed them as statistically significant to predict the severity of brain injury in trauma patients (p = 0.006). miR-124-3p was only found in patients with severe TBI, miR-338-3p was shown in all trauma groups. miR-9-5p, miR-142-3p and miR-219a-5p could not be detected in any of the four groups. Conclusion: miR-423-3p expression is significantly elevated after isolated traumatic brain injury and predictable for severe TBI in the first hours after trauma. miR-423-3p could represent a promising new biomarker to identify severe isolated TBI.

Relation between extracellular Chemistry and Patient Outcome for Severe Traumatic Brain Injury within the First 24 hours: A Microdialysis Study

2017 ◽  
Vol 14 (02/03) ◽  
pp. 122-128
Author(s):  
Yutaka Igarashi ◽  
Shoji Yokobori ◽  
Hidetaka Onda ◽  
Tomohiko Masuno ◽  
Hiroyuki Yokota
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Extracellular Fluid ◽  
Intracerebral Microdialysis ◽  
Focal Brain Injury ◽  
Severe Tbi ◽  
Microdialysis Study ◽  
The Relationship ◽  
Diffuse Brain

Abstract Object Many studies have reported that extracellular chemistry is related to the outcome of patients with traumatic brain injury (TBI). No study has reported that extracellular chemistry predicts outcome in less than 3 days. Moreover, in other studies, both focal brain and diffuse brain injuries have been often discussed. The authors focused on the relationship between extracellular chemistry in a shorter period and the outcome of patients with focal brain injury. Methods By using intracerebral microdialysis monitoring, extracellular fluid concentrations of glucose, lactate, glycerol, glutamate, lactate/pyruvate (L/P), and lactate/glucose (L/G) were determined in 30 patients with severe TBI for initial 24 hours. The results were analyzed between favorable and unfavorable, and between survival and mortality. Results The medians of glycerol and L/P in the favorable group were significantly lower than those in the unfavorable group (124 µmol/L vs. 808 µmol/L, p = 0.002; 31 vs. 48, p = 0.021, respectively). All parameters apart from glutamate differed significantly between the survival and mortality groups (glucose, 25 mmol/L vs. 77 mmol/L, p = 0.035; lactate, 38 mmol/L vs. 73 mmol/L, p = 0.018; glycerol, 168 µmol/L vs. 1462 µmol/L, p = 0.002; glutamate, 14 µmol/L vs. 95 µmol/L, p = 0.019; L/P, 32 vs. 124, p < 0.001; L/G, 1.46 vs. 4.52, p = 0.004). Conclusion Cerebral extracellular glycerol and L/P was the most reliable predictor of outcomes in patients with focal brain injury and can discriminate between favorable and unfavorable outcomes for the first 24 hours, using the threshold of 200 and 40, respectively.

scholarly journals Analysis of Traumatic brain injury related to Kite flying festival: An institutional study

2018 ◽  
Vol 32 (2) ◽  
pp. 355-358
Author(s):  
Manish Jaiswal ◽  
Somil Jaiswal ◽  
Bal Krishna Ojha ◽  
Sunil Kumar Singh ◽  
Anil Chandra ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Brain Injuries ◽  
Injury Severity ◽  
Emergency Admission ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Depressed Fracture ◽  
Injured Patients

Abstract Introduction: Makar Sankranti or Uttarayan is the kite flying festival in India. The festival marks the end of winter and the beginning of summer as the sun moves to the Tropic of Cancer bringing with it longer and warmer days. But it turns into a difficult day for those who are hospitalised after suffering from kite flying related injuries. Aims & Objectives: The objective of this cross sectional study was to review the demographics, causes injury, severity, treatment and outcome of traumatic brain injuries in victims of this kite flying festival who were admitted in department of Neurosurgery on the occasion this year in January. Patients & Methods: A total of 46 traumatic brain injured patients was admitted under Neurosurgery Services that day, out of which 18 cases were related to kite flying related injury. Data of these 18 patients were analysed and outcome were measured at discharge. Result: kite flying festival related neurotrauma increase 39% more emergency admission burden as compared to routine days in neuro-emergency ward. Most common cause of head injury among them was fall from roof. Majority of them had mild head injury. Associated injuries to other part of body were present in 46% patients. Conclusion: Children were most affected due to unsupervised kite flying on roof and road side catching of kites. Depressed fracture was commonest type of traumatic brain injury. Strict attention to safety measures and parental supervision while flying kites can avoid many preventable injuries to life.

scholarly journals MESENCHYMAL STEM CELLS IN THE COMPLEX TREATMENT OF TRAUMATIC BRAIN INJURY

2021 ◽  
Vol 17 (1) ◽  
pp. 11-23
Author(s):  
Y.G. Shanko ◽  
S.I. Krivenko ◽  
V.V. Goncharov ◽  
V.V. Novitskaya ◽  
A.S. Zamaro ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Adipose Tissue ◽  
Brain Injury ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Complex Treatment ◽  
Complex Therapy ◽  
Severe Tbi

Relevance. The problem of effective prevention and treatment of traumatic brain injuries (TBI) of various etiologies has not been resolved in all countries of the world. Primary brain damage from trauma initiates secondary damage to the nervous tissue. As a result, the interaction of brain neural networks is disrupted and the control of somatic and visceral functions of the body is weakened. The article is based on our own clinical observations and comparison of results with literature data and provides a discussion of the prospects for the use of cell technologies in the prevention of fatal disorders of vital functions control in traumatic brain injuries. Objective. To evaluate the effectiveness of intranasal perineural implantation of mesenchymal stem cells (MSCs) in the complex therapy of patients with TBI. Materials and methods. The technique intranasal perineural administration of MSCs was used in complex therapy of 15 patients with severe TBI. The patients were 19÷69 years old, 13 men and two women. A cell suspension was isolated from the adipose tissue of the patient's abdominal wall and centrifuged for 10 min at 1500 rpm. The cell pellet was washed in phosphate buffered saline and DMEM. Cells were cultured in plastic culture flasks in a humidified atmosphere with 5% CO2 content. The cell mass was trypsinized according to standard technique and resuspended in physiological saline on the day of implantation. Dynamics of culture growth, pluripotency, phenotyping of MSCs were monitored. MSCs were injected under general anesthesia into the submucosa of the nasal cavity 3-4 times with an interval of 3-7 days, depending on the growth rate of MSCs, in a single dose from 12.0×106 to 35.0×106 cells. Results. The use of allogeneic and predominantly autologous MSCs of adipose tissue in the complex treatment of patients with severe TBI by intranasal perineural delivery to the area of traumatic brain injury does not cause complications and is a safe technique. 8 patients with severe TBI showed from 4 to 7 points according to the Glasgow Outcome Scale Extended, with an average of 5.4±1.1 points after 6 months. The main result is that complex therapy, including intranasal implantation of MSCs in acute and subacute periods of severe TBI, contributes to the survival of patients and restoration of neurological – including cognitive – functions control. Conclusions. The effectiveness of intranasal perineural implantation of MSCs in the complex therapy of patients with TBI has been demonstrated. The mechanisms of the beneficial effects of perineural implantation of MSCs in patients with TBI require further research.

Characterizing Traumatic Brain Injury and Its Association with Losing Stable Housing in a Community-based Sample : Caractérisation d’une lésion cérébrale traumatique et de son association avec la perte d’un logement stable dans un échantillon communautaire

2021 ◽  
pp. 070674372110006
Author(s):  
Jacob L. Stubbs ◽  
Allen E. Thornton ◽  
Kristina M. Gicas ◽  
Tiffany A. O’Connor ◽  
Emily M. Livingston ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Common Mechanism ◽  
Stable Housing ◽  
History Of ◽  
Severe Tbi ◽  
The Impact ◽  
Precarious Housing

Objective: Traumatic brain injury (TBI) is increasingly recognized as a common and impactful health determinant in homeless and precariously housed populations. We sought to describe the history of TBI in a precariously housed sample and evaluate how TBI was associated with the initial loss and lifetime duration of homelessness and precarious housing. Method: We characterized the prevalence, mechanisms, and sex difference of lifetime TBI in a precariously housed sample. We also examined the impact of TBI severity and timing on becoming and staying homeless or precariously housed; 285 precariously housed participants completed the Brain Injury Screening Questionnaire in addition to other health assessments. Results: A history of TBI was reported in 82.1% of the sample, with 64.6% reporting > 1 TBI, and 21.4% reporting a moderate or severe TBI. Assault was the most common mechanism of injury overall, and females reported significantly more traumatic brain injuries due to physical abuse than males (adjusted OR = 1.26, 95% CI = 1.14 to 1.39, P < 0.0001). The first moderate or severe TBI was significantly closer to the first experience of homelessness ( b = 2.79, P = 0.003) and precarious housing ( b = 2.69, P < 0.0001) than was the first mild TBI. In participants who received their first TBI prior to becoming homeless or precariously housed, traumatic brain injuries more proximal to the initial loss of stable housing were associated with a longer lifetime duration of homelessness (RR = 1.04, 95% CI = 1.02 to 1.06, P < 0.0001) and precarious housing (RR = 1.03, 95% CI = 1.01 to 1.04, P < 0.0001). Conclusions: These findings demonstrate the high prevalence of TBI in this vulnerable population, and that aspects of TBI severity and timing are associated with the loss and lifetime duration of stable housing.

MANAGEMENT OF MULTIPLE TRAUMATIC INTRACRANIAL HEMATOMAS

2020 ◽  
Vol 3 (1) ◽  
pp. 70-74
Author(s):  
Rustam Hazratkulov ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Surgical Treatment ◽  
Brain Injury ◽  
Hospital Stay ◽  
Treatment Outcomes ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Diagnostic Approach ◽  
Early Activation ◽  
Intracranial Hematomas

Multiple traumatic hematomas (MG) account for 0.74% of all traumatic brain injuries. A comprehensive diagnostic approach to multiple traumatic intracranial hematomas allows to establish a diagnosis in the early stages of traumatic brain injury and to determine treatment tactics. A differentiated approach to the choice of surgical treatment of multiple hematomas allows to achieve satisfactory results and treatment outcomes, which accordingly contributes to the early activation of the patient, a reduction in hospital stay, a decrease in mortality and disabilityin patients with traumatic brain injury

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