scholarly journals Predictive Factors for Fatality After Traumatic Brain Injury Among Road Traffic Crash Victims in Addis Ababa City, Ethiopia

2021 ◽  
Author(s):  
Zuriyash Mengistu ◽  
Ahmed Ali ◽  
Teferi Abegaz
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Predictive Factors ◽  
Road Traffic ◽  
Addis Ababa ◽  
Road Traffic Crash ◽  
Cluster Sampling ◽  
Traffic Crash ◽  
Brain Injured ◽  
Injured Patients

Abstract Background Traumatic brain injury (TBI) is one of the common preventable causes of mortality and disability among road traffic victims worldwide, most especially in low- and middle-income countries, including Ethiopia. Objective to determine risk factors of mortality after traumatic brain injury due to road traffic crash. Methods This study aimed to examine the predictive factors of short-term mortality after severe brain injury due to a road traffic crash. The study was done on a prospective cohort of 242 severely brain-injured patients selected using cluster sampling in Addis Ababa City hospitals. The study was conducted from February 2018 to November 2019. Data were collected from brain-injured patients using a questionnaire and recorded findings within the first 24 hours of admission, Survival Analysis was used for statistical analysis. Ethical clearance was obtained from the Addis Ababa University, College of Health Sciences Institutional Review Board (IRB). Confidentiality of information about injured patients was maintained. Results In this study, the death rate was 73(30.2%). The majority of TBI patients accounting for, 186(81%) were men. The median age of TBI patients was 29 years. The hazard for those patients with subnormal body temperature was 1.64 times that of normal temperature (AHR: 1.64; CI: 2.14-10.29). The estimated fatality hazard ratio for patients who experienced Glasgow Coma Scale (GCS)below six was 5.61 times higher compared to GCS six to eight (CI:3.1-10.24). Conclusion In conclusion, there was high early mortality of patients (30.2%) in Ethiopia. Being men, young and lower GCS were associated with higher mortality hazards. Hence, optimum advanced neuro-surgical pre-hospital care programs are urgently needed.

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.

Multimodality Monitoring

2018 ◽  
pp. 155-164
Author(s):  
Maranatha Ayodele ◽  
Kristine O’Phelan
Keyword(s):  
Traumatic Brain Injury ◽  
Critical Care ◽  
Brain Injury ◽  
Early Recognition ◽  
Secondary Injury ◽  
Multimodality Monitoring ◽  
Injured Brain ◽  
Brain Injured ◽  
Physiologic Parameters ◽  
Injured Patients

Advancements in the critical care of patients with various forms of acute brain injury (traumatic brain injury, subarachnoid hemorrhage, stroke, etc.) in its current evolution recognizes that in addition to the initial insult, there is a secondary cascade of physiological events in the injured brain that contribute significantly to morbidity and mortality. Multimodality monitoring (MMM) in neurocritical care aims to recognize this secondary cascade in a timely manner. With early recognition, critical care of brain-injured patients may then be tailored to preventing and alleviating this secondary injury. MMM includes a variety of invasive and noninvasive techniques aimed at monitoring brain physiologic parameters such as intracranial pressure, perfusion, oxygenation, blood flow, metabolism, and electrical activity. This chapter provides an overview of these techniques and offers a practical guide to their integration and use in the intensive care setting.

Clinical Concerns in Dealing with Brain-Injured Patients

Biofeedback ◽  
2015 ◽  
Vol 43 (1) ◽  
pp. 38-41 ◽  
Author(s):  
J. Lawrence Thomas
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Deficits ◽  
Treatment Strategies ◽  
Cognitive Remediation ◽  
Activation Patterns ◽  
Remediation Strategies ◽  
Brain Injured ◽  
Injured Patients ◽  
Broad Understanding

The author describes the clinical challenges in treating individuals with traumatic brain injury, typical patterns in patient behavior and symptoms, and pragmatic treatment strategies. Neurofeedback retraining of brain activation patterns can mitigate many of the cognitive deficits in traumatic brain injury. A broad understanding of brain function and knowledge of specific behavior therapy and cognitive remediation strategies is recommended for practitioners providing treatment to individuals with brain injury.

Amyloid β accumulation in axons after traumatic brain injury in humans

2003 ◽  
Vol 98 (5) ◽  
pp. 1072-1077 ◽  
Author(s):  
Douglas H. Smith ◽  
Xiao-han Chen ◽  
Akira Iwata ◽  
David I. Graham
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Amyloid Β ◽  
Immunohistochemical Analysis ◽  
Plaque Formation ◽  
Large Reservoir ◽  
Content Type ◽  
Brain Injured ◽  
Injured Patients ◽  
Fine Print

Object. Although plaques composed of amyloid β (Aβ) have been found shortly after traumatic brain injury (TBI) in humans, the source for this Aβ has not been identified. In the present study, the authors explored the potential relationship between Aβ accumulation in damaged axons and associated Aβ plaque formation. Methods. The authors performed an immunohistochemical analysis of paraffin-embedded sections of brain from 12 patients who died after TBI and from two control patients by using antibodies selective for Aβ peptides, amyloid precursor protein (APP), and neurofilament (NF) proteins. In nine brain-injured patients, extensive colocalizations of Aβ, APP, and NF protein were found in swollen axons. Many of these immunoreactive axonal profiles were present close to Aβ plaques or were surrounded by Aβ staining, which spread out into the tissue. Immunoreactive profiles were not found in the brains of the control patients. Conclusions. The results of this study indicate that damaged axons can serve as a large reservoir of Aβ, which may contribute to Aβ plaque formation after TBI in humans.

scholarly journals Three Bullets in Three Hemispheres—Shared Decision-Making During the Covid-19 Pandemic

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011811
Author(s):  
Tej D. Azad
Keyword(s):  
Traumatic Brain Injury ◽  
Decision Making ◽  
Brain Injury ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Careful Evaluation ◽  
Brain Injured ◽  
Injured Patients

Traumatic brain injury patients may be dependent on the decision-making of their families. Restrictive visitation policies implemented during the COVID-19 pandemic disproportionately affect these patients and their families. This narrative aims to illustrate this phenomenon and catalyze discussions regarding the need for careful evaluation of restrictive family visitation policies and exceptions that may be required for brain injured patients.

Mild Traumatic Brain Injury — the Fife Perspective

1997 ◽  
Vol 42 (2) ◽  
pp. 40-43 ◽  
Author(s):  
C.E. Skelton ◽  
R.M. Walley ◽  
J.B. Chisholm ◽  
R.L. Sloan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Neuropsychological Testing ◽  
Age Group ◽  
Post Injury ◽  
Accident And Emergency ◽  
Brain Injured ◽  
Accident And Emergency Department ◽  
Injured Patients

Results are reported from a study to identify patients residing in Fife with mild traumatic brain injury in the 16–65 year old age group, who attended an accident and emergency department following their brain injury. Over a two month period 161 such patients attended with minor head trauma, of which 33 entered our study. The major cause of mild traumatic brain injury was assault. We found that over two-thirds of patients in the study had persisting post-concussive symptoms six months post injury. Neuropsychological testing showed problems of concentration and memory, but not at a level that was significantly different from that expected in an average population. Other studies have shown that symptom rates are higher when patients get no explanation of their symptoms and we feel that better co-ordination of services for brain injured patients in Fife is required, to provide the necessary information, education and support.

scholarly journals The pattern of orthopedic fractures and visceral injury in road traffic crash victims, Addis Ababa, Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0253690
Author(s):  
Zuriyash Mengistu ◽  
Ahmed Ali ◽  
Teferi Abegaz
Keyword(s):  
Low Income ◽  
Road Traffic ◽  
Addis Ababa ◽  
Homeless Persons ◽  
Road Traffic Crash ◽  
Fracture Type ◽  
Compound Fracture ◽  
Visceral Injury ◽  
Traffic Crash ◽  
Orthopedic Injury

Background Road Traffic crash injury is one of the main public health problems resulting in premature death and disability particularly in low-income countries. However, there is limited evidence on the crash fractures in Ethiopia. Objective The study was conducted to assess the magnitude of road traffic crash fractures and visceral injuries. Methods A hospital-based cross-sectional study was conducted on 420 fracture patients. Participants were randomly selected from Addis Ababa City hospitals. The study was carried out between November 2019 and February 2020. Data were collected using a questionnaire and record of medical findings. Multilevel logistic regression analysis was carried out. Ethical clearance was obtained from the Addis Ababa University, College of Health Sciences Institutional Review Board. Confidentiality of participants’ information was maintained. Results The study found out that the majority 265 (63. 1%) of fracture cases were younger in the age group of 18 to 34 years. Males were more affected—311(74.0%). The mortality rate was 59(14.1%), of those 50(85.0%) participants were males. The major road traffic victims were pedestrians—220(52.4%), mainly affected by simple fracture type -105(53.3%) and compound fracture type—92(46. 7%). Drivers mainly suffered from compound fracture type -23 (59.0%). One hundred eighty-two (43.3%) of fracture patients had a visceral injury. Homeless persons who sit or sleep on the roadside had a higher risk of thoracic visceral injury compared to traveler pedestrians (AOR = 4.600(95%CI: 1.215–17.417)); P = 0.025. Conclusion Visceral injury, simple and compound fractures were the common orthopedic injury types reported among crash victims. Males, pedestrians, and young age groups were largely affected by orthopedic fracture cases. Homeless persons who sited or slept on the roadside were significant factors for visceral injury. Therefore, preventing a harmful crash and growing fracture care should be considered to reduce the burden of crash fracture.

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