Perfil epidemiológico, clínico e desfecho de pacientes com traumatismo cranioencefálico / Epidemiological, clinical profile and outcome of patients with traumatic brain injury

2021 ◽  
Vol 66 (1u) ◽  
pp. 1
Author(s):  
Jeniffer Araújo Valentim da Silva ◽  
Marcele Pescuma Capeletti Padula ◽  
Camila Waters
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Clinical Treatment ◽  
Clinical Profile ◽  
Average Hospital Stay ◽  
Mild Tbi ◽  
Average Hospital ◽  
Firearm Injury ◽  
Severe Tbi

Objetivo: Identificar o perfil epidemiológico, clínico e o desfecho dos pacientes com Traumatismo Cranioencefálico (TCE). Métodos: Pesquisa retrospectiva realizada com pacientes com idade maior ou igual a 18 anos, que estiveram internados na Instituição no ano de 2017, vítimas de TCE por qualquer etiologia. Resultados: Analisados 268 prontuários, sendo 78,7% do sexo masculino, com uma média de idade de 51 anos e maior incidência na faixa etária dos 31 a 50 anos (38,4%). A maioria (76,1%) chegou ao Pronto Socorro (PS) pelo Serviço de Atendimento Móvel de Urgência (SAMU), com uma média da Escala de Coma de Glasgow de 12 pontos, sendo que 78,0% apresentavam TCE leve (13 a 15 pontos), 14,2% apresentavam TCE grave (3 a 8 pontos) e 7,8% apresentavam TCE moderado (9 a 12 pontos). A maioria (57,5%) apresentou o TCE por queda, seguido de 16,0% por atropelamento, 12,0% por agressão, 5,9% por politrauma de mecanismos desconhecidos, 5,6% por acidente de moto, 1,9% por acidente automobilístico e 1,1% por ferimento por arma de fogo. A maioria (84,3%) ficou internada no hospital por até 10 dias, com uma média de internação hospitalar de seis dias, 92,9% receberam tratamento clínico (conservador) e 85,8% receberam alta hospitalar. Conclusões: Prevaleceram indivíduos do sexo masculino, com uma média de idade de 51 anos, encaminhados ao PS pelo SAMU, vítimas de TCE leve, ocasionado por queda, com uma média de internação hospitalar de seis dias, recebendo tratamento clínico e com desfecho de alta hospitalar.Palavras chave: Perfil de saúde, Lesões encefálicas traumáticas, Traumatismo cerebrovascularABSTRACTObjective: To identify the epidemiological, clinical profile and outcome of patients with Traumatic Brain Injury (TBI). Methods: Retrospective research conducted with patients aged 18 years or older, who were admitted to the Institution in 2017, victims of TBI due to any etiology. Results: 268 medical records were analyzed, of wich 78,7% were male, with an average age of 51 years and a higher incidence in the age group from 31 to 50 years (38,4%). The majority (76,1%) arrived at the Emergency Room (ER) through the Mobile Emergency Service (SAMU), with an average of the Glasgow Coma Scale of 12 points, with 78,0% having mild TBI (13 at 15 points), 14,2% had severe TBI (3 to 8 points) and 7,8% had moderate TBI (9 to 12 points). The majority (57,5%) presented TBI due a fall, followed by 16,0% due to being run over, 12,0% due to aggression, 5,9% due to polytrauma of unknown mechanisms, 5,6% due to motorcycle accident, 1,9% due to automobile accident and 1,1% due to firearm injury. The majority (84,3%) stayed in the hospital for up to 10 days, with an average hospital stay of six days, 92,9% received clinical treatment and 85,8% were discharged. Conclusions: Male individuals prevailed, with an average age of 51 years, referred to ER by SAMU, victims of mild TBI, caused by a fall, with an average hospital stay of six days, receiving clinical treatment and with outcome of discharge hospital.Keywords: Health profile, Traumatic brain injury, Cerebrovascular trauma

Behavioural Profiles and Injury Severity Following Childhood Traumatic Brain Injury

2007 ◽  
Vol 8 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Suzanne L. Barker-Collo
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Child Behavior Checklist ◽  
Injury Severity ◽  
Attention Problems ◽  
Normal Limits ◽  
Orthopaedic Injury ◽  
Severe Tbi ◽  
The Impact

AbstractTraumatic brain injury (TBI) is a leading cause of death and morbidity in children and can result in cognitive, behavioural, social and emotional difficulties that may impact quality of life. This study examined the impact of mild, moderate, and severe childhood TBI, when compared to severe orthopaedic injury, on behaviour as measured by the Child Behavior Checklist (CBCL) in a sample of 74 children with TBI and 13 with orthopaedic injury aged 4 to 13 years at the time of injury. Correlational analyses revealed that within the TBI sample increased anxiety/depression and somatisation were related to increased age at the time of injury and shorter inpatient hospital stay. Increased age was also related to increased parental reports of attention problems; while increased hospital stay was related to increased withdrawal and thought problems. Symptomatology was within normal limits for all groups, approaching the borderline clinical range in the moderate TBI group for somatic symptoms and in the severe TBI group for thought and attention problems. Those with severe TBI had more thought and attention problems, and to a lesser extent social problems, than those with mild or moderate TBI; while those with moderate TBI had the highest levels of somatic and anxious–depressed symptoms. The only scale where performance seemed to increase in relation to injury severity was the attention problems scale. It is suggested that the findings for those with moderate TBI reflect increased awareness of one's own vulnerability/mortality, with the implication that issues such as grief, loss, and mortality may need to be addressed therapeutically.

Parametric manipulation of working memory load in traumatic brain injury: Behavioral and neural correlates

2004 ◽  
Vol 10 (5) ◽  
pp. 724-741 ◽  
Author(s):  
WILLIAM M. PERLSTEIN ◽  
MICHAEL A. COLE ◽  
JASON A. DEMERY ◽  
PAUL J. SEIGNOUREL ◽  
NEHA K. DIXIT ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Working Memory ◽  
Brain Injury ◽  
Memory Load ◽  
Brain Regions ◽  
Small Subset ◽  
Chronic Patients ◽  
Mild Tbi ◽  
Severe Tbi ◽  
High Level

Traumatic brain injury (TBI) is often associated with enduring impairments in high-level cognitive functioning, including working memory (WM). We examined WM function in predominantly chronic patients with mild, moderate and severe TBI and healthy comparison subjects behaviorally and, in a small subset of moderate-to-severe TBI patients, with event-related functional magnetic resonance imaging (fMRI), using a visualn-back task that parametrically varied WM load. TBI patients showed severity-dependent and load-related WM deficits in performance accuracy, but not reaction time. Performance of mild TBI patients did not differ from controls; patients with moderate and severe TBI were impaired, relative to controls and mild TBI patients, but only at higher WM-load levels. fMRI results show that TBI patients exhibit altered patterns of activation in a number of WM-related brain regions, including the dorsolateral prefrontal cortex and Broca's area. Examination of the pattern of behavioral responding and the temporal course of activations suggests that WM deficits in moderate-to-severe TBI are due to associative or strategic aspects of WM, and not impairments in active maintenance of stimulus representations. Overall, results demonstrate that individuals with moderate-to-severe TBI exhibit WM deficits that are associated with dysfunction within a distributed network of brain regions that support verbally mediated WM. (JINS, 2004,10, 724–741.)

scholarly journals AN ANALYSIS OF TRAUMATIC BRAIN INJURY [TBI] IN TERMS OF 3-MONTH GLASGOW OUTCOME SCORE [GOS] AT A TERTIARY CARE CENTRE

2021 ◽  
pp. 13-15
Author(s):  
Shrikant Govindrao Palekar ◽  
Kailash K Mogal ◽  
Vedanti Rajesh Patil ◽  
I Vijay Sundar
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Clinical Features ◽  
Tertiary Care ◽  
Glasgow Outcome Score ◽  
Tertiary Care Centre ◽  
Mild Tbi ◽  
Outcome Score ◽  
Severe Tbi

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

scholarly journals Hubungan antara Skor GCS dengan Kadar C-Reactive Protein (CRP) Pasien Cedera Otak Traumatik di IGD RSUD Ulin Banjarmasin

2019 ◽  
Vol 8 (3) ◽  
pp. 153-59
Author(s):  
Gusti Muhammad Fuad Suharto ◽  
Kenanga M Sikumbang ◽  
Dewi I N Pratiwi
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
General Hospital ◽  
C Reactive Protein ◽  
Mild Tbi ◽  
Reactive Protein ◽  
Consecutive Sampling ◽  
Severe Tbi ◽  
Gcs Score ◽  
Post Hoc

AbstrakLatar Belakang dan Tujuan: Pada cedera otak traumatik (COT) terjadi perubahan tingkat kesadaran dan neurologis pasien, sehingga perlu dilakukan penilaian skor GCS untuk mengkategorikan tingkat keparahan COT. Saat terjadinya COT, akibat dari pengeluaran mediator inflamasi, hati akan mengeluarkan suatu penanda pertama inflamasi, yaitu c-reactive protein (CRP). Tujuan penelitian ini untuk mengetahui apakah terdapat hubungan antara skor GCS dengan kadar CRP pasien COT di IGD RSUD Ulin Banjarmasin. Subjek dan Metode: Penelitian ini menggunakan studi desain observasional analitik dengan rancangan potong lintang. Data diambil secara prospektif dengan metode consecutive sampling pada pasien COT yang masuk ke  IGD RSUD Ulin Banjarmasin periode Juli-September 2018 yang memenuhi kriteria inklusi dan eksklusiHasil:Didapatkan 53 subjek terdiri dari 42 pasien laki-laki dan 11 pasien perempuan dengan distribusi 22 (41,5%) pasien COT ringan, 20 (37,7%) pasien COT sedang, dan 11 (20,8%) pasien COT berat. Pengukuran kadar CRP didapatkan rata-rata 4,64 mg/l pada COT ringan, 18,00 mg/l pada COT sedang, dan 26,73 mg/dl pada COT berat. Analisis data menggunakan uji Kruskal-Wallis dengan tingkat kepercayaan 95% menunjukan peningkatan kadar CRP seiring dengan semakin beratnya COT (p=0,034), analisis Post Hoc menggunakan Mann-Whitney Test didapatkan perbedaan bermakna peningkatan kadar CRP antara pasien COT sedang berat dibandingkan COT ringan. Simpulan: Terdapat hubungan antara skor GCS dengan kadar CRP pada pasien cedera otak traumatik.Correlations between GCS Score and C-Reactive Protein (CRP) in Patients with Traumatic Brain Injury at Emergency Departement of Ulin General Hospital BanjarmasinAbstractBackgound and Objective: In traumatic brain injury (TBI), the level of severity could be assessed by GCS, so it is necessary to measure the GCS score to categorize the severity of TBI. TBI may followed by inflammatory mediators cell and one of inflammation marker released by liver, namely c-reactive protein (CRP).The purpose of this study is to analyze correlation between GCS scores and CRP levels in patients with traumatic brain injury at the emergency departement of Ulin General Hospital Banjarmasin. Subject and Method: This study is a analytic observational study with cross sectional design. Data acquired prospectively with consecutive sampling method in TBI patients who entered the emergency department of Ulin General Hospital in the period from July-September 2018 that fulfilled inclusion criteria and exclusion criteria.Result: We obtained 53 subjects consisted of 42 males and 11 females with a distribution of 22 (41.5%) mild TBI patients, 20 (37.7%) modarate TBI patients, and 11 (20,8%) severe TBI patients. Measurements of CRP levels were obtained at an averange of 4.64 mg/l in mild TBI, 18.00 mg/l in moderate TBI, and 26.73 mg/l in severe TBI. There was correlation between the increasing of CRP levels with severity of TBI using Kruskal-Wallis test with a confidence level of 95% (p=0.034), in Post Hoc analysis using Mann-Whitney test, there was significant differences in elevated CRP levels between moderate-severe TBI patients compared to mild TBI patients. Conclusion: It was concluded that there was a corellation between GCS scores and CRP levels in TBI patients.

scholarly journals Characterizing the type and location of intracranial abnormalities in mild traumatic brain injury

2018 ◽  
Vol 129 (6) ◽  
pp. 1588-1597 ◽  
Author(s):  
Harri Isokuortti ◽  
Grant L. Iverson ◽  
Noah D. Silverberg ◽  
Anneli Kataja ◽  
Antti Brander ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Brain Lesions ◽  
Ct Scans ◽  
Mild Tbi ◽  
Intracranial Lesion ◽  
Traumatic Lesion ◽  
Traumatic Lesions ◽  
Severe Tbi

OBJECTIVEThe incidence of intracranial abnormalities after mild traumatic brain injury (TBI) varies widely across studies. This study describes the characteristics of intracranial abnormalities (acute/preexisting) in a large representative sample of head-injured patients who underwent CT imaging in an emergency department.METHODSCT scans were systematically analyzed/coded in the TBI Common Data Elements framework. Logistic regression modeling was used to quantify risk factors for traumatic intracranial abnormalities in patients with mild TBIs. This cohort included all patients who were treated at the emergency department of the Tampere University Hospital (between 2010 and 2012) and who had undergone head CT imaging after suffering a suspected TBI (n = 3023), including 2766 with mild TBI and a reference group with moderate to severe TBI.RESULTSThe most common traumatic lesions seen on CT scans obtained in patients with mild TBIs and those with moderate to severe TBIs were subdural hematomas, subarachnoid hemorrhages, and contusions. Every sixth patient (16.1%) with mild TBI had an intracranial lesion compared with 5 of 6 patients (85.6%) in the group with moderate to severe TBI. The distribution of different types of acute traumatic lesions was similar among mild and moderate/severe TBI groups. Preexisting brain lesions were a more common CT finding among patients with mild TBIs than those with moderate to severe TBIs. Having a past traumatic lesion was associated with increased risk for an acute traumatic lesion but neurodegenerative and ischemic lesions were not. A lower Glasgow Coma Scale score, male sex, older age, falls, and chronic alcohol abuse were associated with higher risk of acute intracranial lesion in patients with mild TBI.CONCLUSIONSThese findings underscore the heterogeneity of neuropathology associated with the mild TBI classification. Preexisting brain lesions are common in patients with mild TBI, and the incidence of preexisting lesions increases with age. Acute traumatic lesions are fairly common in patients with mild TBI; every sixth patient had a positive CT scan. Older adults (especially men) who fall represent a susceptible group for acute CT-positive TBI.

scholarly journals Managing Visitors During the Hospital Stay: The Experience of Family Caregivers of Patients With Traumatic Brain Injury

2017 ◽  
Vol 23 (2) ◽  
pp. 273-298 ◽  
Author(s):  
Tolu O. Oyesanya ◽  
Barbara Bowers
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Family Caregivers ◽  
Severe Traumatic Brain Injury ◽  
Hospital Staff ◽  
Policy Implications ◽  
Family Nursing ◽  
Severe Tbi ◽  
Emotional Safety

Family caregivers of patients with moderate-to-severe traumatic brain injury (TBI) regularly visit the patient during the hospital stay and are involved in their care. As impairments caused by the TBI often preclude the patient from stating preferences for visitors, family caregivers often make decisions about visitors on the patient’s behalf during the hospital stay. However, limited literature investigates this process. The purpose of this study was to describe family caregivers’ experience of visitors while the patient with moderate-to-severe TBI is hospitalized. Authors used grounded theory to conduct 24 interviews with 16 family caregivers. Findings showed family caregivers manage welcome and unwelcome visitors throughout the hospital stay to protect the patient’s physical and emotional safety and to conserve their own energy. Staff had limited involvement in management of unwelcome visitors. These findings have practice implications for educating hospital staff about providing family nursing and assisting families to manage unwelcome visitors and about policy implications for improving hospital visiting policies.

scholarly journals Traumatic brain injury: Future application of nanomedicine

2021 ◽  
Vol 6 (2) ◽  
pp. 020-027
Author(s):  
Nasima Khanam ◽  
Debjani Nath
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neurological Dysfunction ◽  
Future Application ◽  
Mild Tbi ◽  
Severe Tbi ◽  
Sports Arena ◽  
The Military ◽  
The Brain ◽  
Brain Homeostasis

Traumatic brain injury (TBI) is currently a rising player in the cause of disability and neurological dysfunction worldwide. TBI is a common occurrence in the military and extreme activities, sports arena and accidents. Severe TBI can be fatal but mild TBI persists and progressively deteriorates brain homeostasis and physiology. Apart from the physical disabilities, psychological complexities arise in people with mild TBI. Despite the seriousness of this hazard, treatments for TBI are not adequate, mostly due to the brain being involved. Nanoparticle (NP) therapy seems to be an effective alternative to combat TBI. This review outlines the state of TBI and describes the probable medical support that nanomedicine can provide.

scholarly journals Influence of severity of traumatic brain injury at hospital admission on clinical outcomes

2018 ◽  
Vol 25 (1) ◽  
pp. 3-8
Author(s):  
Thiago Henrique da Silva ◽  
Thais Massetti ◽  
Talita Dias da Silva ◽  
Laercio da Silva Paiva ◽  
Denise Cardoso Ribeiro Papa ◽  
...  
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Medical Records ◽  
Length Of Hospital Stay ◽  
Public Health Problem ◽  
Prolonged Hospital Stay ◽  
Severe Tbi ◽  
Prolonged Hospital

ABSTRACT Traumatic brain injury (TBI) is a public health problem with high mortality and socioeconomic repercussions. We aimed to investigate the influence of TBI severity on the length of mechanical ventilation (MV) stay and length of hospital stay and on the prevalence of tracheostomy, pneumonia, neurosurgery and death. This retrospective, observational study evaluated medical records of 67 patients with TBI admitted to Irmandade da Santa Casa de Misericórdia de São Paulo. Severity was determined according to the Glasgow Coma Scale (GCS): mild (13-15 points; 36 patients; 53.7%), moderate (9-12 points; 14 patients; 20.9%) or severe (3-8 points; 17 patients; 25.4%). Severe TBI patients had higher prevalence of tracheostomy, pneumonia and neurosurgery. No significant differences were observed between TBI severity, mortality and length of MV stay. However, TBI severity influenced the length of hospital stay. TBI severity at admission, evaluated according to the GCS, influenced the prevalence of tracheostomy, pneumonia, neurosurgery and was associated to prolonged hospital stay.

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