Stereology of cerebral cortex after traumatic brain injury matched to the Glasgow Outcome Score

INTRODUCTION - Traumatic brain injury [TBI] most affects the working population and their earning capacity. The various sub categories of TBI in terms of clinical features,Glasgow coma scale [GCS] and radiology are well defined.We have attempted an analysis in terms of long term Glasgow outcome score [GOS] and tried to correlate with the various factors of TBI. MATERIALS AND METHODS – All patients of TBI over 12 years and below 60 years and those without other major trauma were included over a period of about two years. The clinical features, presentation GCS, treatment given, and outcomes were assessed.The three month GOS was scored for all patients and was used to analyse the the initial data in its light. RESULTS – A total of 200 patients were eligible for the study and were included. Of these 159 were males and 41 were females.The average age was 37.16 years.There was a relatively higher proportion of mild TBI and greater prevalence of fractures and EDH [extradural hematoma].On analyzing with three month GOS we found that 90.4 % of the patients with mild TBI had a three month GOS of 5 whereas only 31.9% of patients with moderate or severe TBI had a three month GOS of 5. CONCLUSION – The long term GOS is most representative of the extent to which the patient has been able to return to their pre TBI lives. In our study the three month GOS co related well with the initial GCS. Further prospective data can elaborate more on the effect of other clinical features and radiology on long term GOS

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Comparison of Mean Glasgow Outcome Score in Patients with Traumatic Brain Injury after Magnesium Sulphate Therapy and Placebo. A Prospective Study of Shaikh Zayed Hospital Lahore

Pakistan Journal Of Neurological Surgery ◽

10.36552/pjns.v24i2.451 ◽

2020 ◽

Vol 24 (2) ◽

Author(s):

KAZIM ALI ◽

MUHAMMAD IRFAN ◽

RABIA ABBAS ◽

MUHAMMAD AFAQ SARWAR ◽

KAMRAN HUSSAIN

Keyword(s):

Traumatic Brain Injury ◽

Placebo Group ◽

Brain Injury ◽

Magnesium Sulphate ◽

Standard Treatment ◽

Therapy Group ◽

Glasgow Outcome Score ◽

Sulphate Group ◽

Outcome Score ◽

A Prospective Study

Objective: We evaluated the effectiveness of magnesium sulphate treatment for the management and outcome of TBI. Material and Methods: The prospective cases (n = 112) of TBI were included from Department of Neurosurgery, Shaikh Zayed Hospital, Lahore. Patients were split into two groups. Magnesium sulphate treatment group (n = 56) and placebo group (n = 56). Detailed history of patients was taken along with comprehensive examinations with CT scans.56 TBI patients were given standard treatment plus magnesium sulphate and remaining 56 patients received just standard treatment. Results: Mean age of the magnesium supplement therapy group was 36.83 ± 13.45 years while in the placebo group was 33.64 ± 12.88 years). Majority 28 (67.9%) were male in the magnesium sulphate group while 37 (66.1%) were in the placebo group. Mean duration passed between hospital presentation and traumatic brain injury was 4.98 ± 2.32 hours in the magnesium sulphate group while it was 5.05 ± 2.48 in the placebo group. Mean Glasgow outcome score was 3.57 ± 1.33 in the magnesium sulphate group while 2.78 ± 1.23 in the placebo group and this difference was statistically significant. Conclusion: There is significant improvement in GOS after magnesium sulphate therapy in patients with traumatic brain injury versus placebo group as noted in the results.

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Biomechanics of Traumatic Brain Injury: Influences of the Morphologic Heterogeneities of the Cerebral Cortex

Annals of Biomedical Engineering ◽

10.1007/s10439-008-9510-3 ◽

2008 ◽

Vol 36 (7) ◽

pp. 1203-1215 ◽

Cited By ~ 85

Author(s):

R.J.H. Cloots ◽

H.M.T. Gervaise ◽

J.A.W. van Dommelen ◽

M.G.D. Geers

Keyword(s):

Traumatic Brain Injury ◽

Cerebral Cortex ◽

Brain Injury

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Development of a de novo arteriovenous malformation after severe traumatic brain injury

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.7.peds1431 ◽

2014 ◽

Vol 14 (4) ◽

pp. 418-420 ◽

Cited By ~ 12

Author(s):

Brandon A. Miller ◽

David I. Bass ◽

Joshua J. Chern

Keyword(s):

Traumatic Brain Injury ◽

Cerebral Cortex ◽

Brain Injury ◽

Arteriovenous Malformation ◽

Severe Traumatic Brain Injury ◽

Arteriovenous Malformations ◽

De Novo ◽

First Report ◽

Congenital Lesions

Arteriovenous malformations (AVMs) are typically considered congenital lesions, although there is growing evidence for de novo formation of these lesions as well. The authors present the case of an AVM in the same cerebral cortex that had been affected by a severe traumatic brain injury (TBI) more than 6 years earlier. To the best of the authors' knowledge, this is the first report attributing the formation of an AVM directly to TBI.

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Association between blood glucose levels and Glasgow Outcome Score in patients with traumatic brain injury: secondary analysis of a randomized trial

Trials ◽

10.1186/s13063-022-06005-5 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Tao Yuan ◽

Hongyu He ◽

Yuepeng Liu ◽

Jianwei Wang ◽

Xin Kang ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Blood Glucose ◽

Brain Injury ◽

Blood Glucose Level ◽

Glucose Level ◽

Threshold Effect ◽

Glasgow Outcome Score ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Average Blood Glucose

Abstract Background Blood glucose levels that are too high or too low after traumatic brain injury (TBI) negatively affect patient prognosis. This study aimed to demonstrate the relationship between blood glucose levels and the Glasgow Outcome Score (GOS) in TBI patients. Methods This study was based on a randomized, dual-center, open-label clinical trial. A total of 208 patients who participated in the randomized controlled trial were followed up for 5 years. Information on the disease, laboratory examination, insulin therapy, and surgery for patients with TBI was collected as candidate variables according to clinical importance. Additionally, data on 5-year and 6-month GOS were collected as primary and secondary outcomes, respectively. For multivariate analysis, a generalized additive model (GAM) was used to investigate relationships between blood glucose levels and GOS. The results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). We further applied a two- piecewise linear regression model to examine the threshold effect of blood glucose level and GOS. Results A total of 182 patients were included in the final analysis. Multivariate GAM analysis revealed that a bell-shaped relationship existed between average blood glucose level and 5-year GOS score or 6-month GOS score. The inflection points of the average blood glucose level were 8.81 (95% CI: 7.43–9.48) mmol/L considering 5-year GOS as the outcome and were 8.88 (95% CI 7.43−9.74) mmol/L considering 6-month GOS score as the outcome. The same analysis revealed that there was also a bell relationship between average blood glucose levels and the favorable outcome group (GOS score ≥ 4) at 5 years or 6 months. Conclusion In a population of patients with traumatic brain injury, blood glucose levels were associated with the GOS. There was also a threshold effect between blood glucose levels and the GOS. A blood glucose level that is either too high or too low conveys a poor prognosis. Trial registration ClinicalTrials.gov NCT02161055. Registered on 11 June 2014.

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Temporal Lobe Syndromes

Examining Biological Foundations of Human Behavior - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-7998-2860-0.ch008 ◽

2020 ◽

pp. 122-135

Author(s):

Arpit Parmar ◽

G. S. Kaloiya ◽

Harsimarpreet Kaur

Keyword(s):

Traumatic Brain Injury ◽

Cerebral Cortex ◽

Brain Injury ◽

Middle Cerebral Artery ◽

Temporal Lobe ◽

Cerebral Artery ◽

Left Temporal Lobe ◽

Temporal Lobes ◽

Functional Aspects ◽

The Common

Temporal lobes are one of the four major lobes of the cerebral cortex and perform a complex array of interrelated functions. They play an important role in various day-to-day functioning. The common pathologies leading to isolated temporal lobe dysfunction are infarction (of the middle cerebral artery), hemorrhage, seizures, tumors, encephalitis, and traumatic brain injury. Temporal lobe syndromes include a wide array of various neurological (Kluver-Bucy syndrome, Geschwind Gastaut syndrome, etc.), elementary (e.g., vertiginous syndromes, hallucinations, etc.), neuropsychiatric (e.g., anxiety, agitation, aggression, etc.), and cognitive (e.g., Korsakoff amnesia, cortical deafness, etc.) disorders. The presentation depends on a multitude of factors including involvement of dominant or non-dominant lobe. Left temporal lobe involvement usually leads to various forms of aphasia while right side involvement leads to more covert and varied syndromes. In this chapter, the authors discuss the anatomy of the temporal lobe, its functional aspects, and various syndromes of temporal lobe dysfunction.

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