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

scholarly journals Reply to Comment on Tsai, Y.-C., et al. Association of Stress-Induced Hyperglycemia and Diabetic Hyperglycemia with Mortality in Patients with Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population. Int. J. Environ. Res. Public Health 2020, 17, 4266

2021 ◽  
Vol 18 (5) ◽  
pp. 2531
Author(s):  
Yu-Chin Tsai ◽  
Shao-Chun Wu ◽  
Ting-Min Hsieh ◽  
Hang-Tsung Liu ◽  
Chun-Ying Huang ◽  
...  
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Propensity Score ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Injury Analysis

Thank you for Eduardo Mekitarian Filho’s appreciation of our work on the study of stress-induced hyperglycemia (SIH) and diabetic hyperglycemia (DH) in patients with traumatic brain injuries [...]

scholarly journals Study of Traumatic Brain Injury Due To Recent Earthquake in Manipal Teaching Hospital

2016 ◽  
Vol 12 (2) ◽  
pp. 63-66
Author(s):  
Bal G Karmacharya ◽  
Brijesh Sathian
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Teaching Hospital ◽  
Brain Injuries ◽  
Injury Severity ◽  
Traumatic Brain Injuries ◽  
The Body ◽  
Mild Head Injury ◽  
Associated Injuries

The objective of this study was to review the demographics, causes injury, severity, treatment and outcome of traumatic brain injuries in victims of the April 2015 earthquake who were admitted in Manipal Teaching Hospital, Pokhara. A total of 37 patients was admitted under Neurosurgery Services. Collapse of buildings was the commonest cause of head injury. The majority of them had mild head injury. Associated injuries to other parts of the body were present in 40.54% patients.Nepal Journal of Neuroscience 12:63-66, 2015

scholarly journals Effect Sizes for Symptomatic and Cognitive Improvements in Traumatic Brain Injury Following Hyperbaric Oxygen Therapy

2021 ◽  
Author(s):  
Adam Thomas Biggs ◽  
Hugh M. Dainer ◽  
Lanny F Littlejohn
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Brain Injuries ◽  
Statistical Significance ◽  
Traumatic Brain Injuries ◽  
Therapeutic Benefit ◽  
Effect Sizes

Hyperbaric oxygen therapy has been proposed as a method to treat traumatic brain injuries. The combination of pressure and increased oxygen concentration produces a higher content of dissolved oxygen in the bloodstream, which could generate a therapeutic benefit for brain injuries. This dissolved oxygen penetrates deeper into damaged brain tissue than otherwise possible and promotes healing. The result includes improved cognitive functioning and an alleviation of symptoms. However, randomized controlled trials have failed to produce consistent conclusions across multiple studies. There are numerous explanations that might account for the mixed evidence, although one possibility is that prior evidence focuses primarily on statistical significance. The current analyses explored existing evidence by calculating an effect size from each active treatment group and each control group among previous studies. An effect size measure offers several advantages when comparing across studies as it can be used to directly contrast evidence from different scales, and it provides a proximal measure of clinical significance. When exploring the therapeutic benefit through effect sizes, there was a robust and consistent benefit to individuals who underwent hyperbaric oxygen therapy. Placebo effects from the control condition could account for approximately one-third of the observed benefits, but there appeared to be a clinically significant benefit to using hyperbaric oxygen therapy as a treatment intervention for traumatic brain injuries. This evidence highlights the need for design improvements when exploring interventions for traumatic brain injury as well as the importance of focusing on clinical significance in addition to statistical significance.

scholarly journals Traumatic Brain Injuries: Unreported and Untreated in an Army Population

2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 154-160 ◽  
Author(s):  
Sandra M Escolas ◽  
Margie Luton ◽  
Hamid Ferdosi ◽  
Bianca D Chavez ◽  
Scot D Engel
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Medical Care ◽  
Brain Injuries ◽  
Negative Impact ◽  
Traumatic Brain Injuries ◽  
Future Research ◽  
Treatment History ◽  
Anonymous Questionnaire ◽  
The Military

ABSTRACT Introduction In 2008, it was reported that 19.5% of service members previously deployed experienced a mild traumatic brain injury (mTBI). Fifty-seven percent of those did not seek medical care. It was suggested that concerns with seeking care involved confidentiality and career issues. Objective: This study addressed mTBI history, medical treatment history, and stigmas associated with mTBI/concussion. Materials and Methods An anonymous questionnaire was developed. Data collection occurred throughout March 2018 in conjunction with Brain Injury Awareness Month activities. Results All 5,174 volunteers were Army; 86% male; 87% were between 18 and 34 years old; 89% had <14 years in the military; 35% had a combat deployment; and 10% reported having one or more mTBIs in their military careers. Of the Soldiers who reported a concussion, 52% sought medical care. Of those not seeking care, 64% reported they did not think the injury required care, followed by 18% fearing negative impact on their career. Twenty-eight percent who experienced an mTBI versus 11% who have not reported that there is a stigma associated with an mTBI. Conclusions Soldiers sometimes failed to report their suspected concussions and did not seek medical care. Educational efforts may increase reporting of and medical screening for potentially concussive events. Future research to determine the ramifications of unreported and untreated mTBIs/concussions is recommended.

scholarly journals Validation of the scandinavian guidelines for initial management of minor and moderate head trauma in children

2020 ◽  
Author(s):  
Caroline Sönnerqvist ◽  
Ole Brus ◽  
Magnus Olivecrona
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Negative Predictive Value ◽  
Head Trauma ◽  
Predictive Value ◽  
Brain Injuries ◽  
Head Injuries ◽  
Traumatic Brain Injuries ◽  
Predictive Values ◽  
Initial Management

Abstract Background Head trauma in children is common, with a low rate of clinically important traumatic brain injury. CT scan is the reference standard for diagnosis of traumatic brain injury, of which the increasing use is alarming because of the risk of induction of lethal malignancies. Recently, the Scandinavian Neurotrauma Committee derived new guidelines for the initial management of minor and moderate head trauma. Our aim was to validate these guidelines. Methods We applied the guidelines to a population consisting of children with mild and moderate head trauma, enrolled in the study: “Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study” by Kuppermann et al. (Lancet 374(9696):1160–1170, https://doi.org/10.1016/S0140-6736(09)61558-0, 2009). We calculated the negative predictive values of the guidelines to assess their ability to distinguish children without clinically-important traumatic brain injuries and traumatic brain injuries on CT scans, for whom CT could be omitted. Results We analysed a population of 43,025 children. For clinically-important brain injuries among children with minimal head injuries, the negative predictive value was 99.8% and the rate was 0.15%. For traumatic findings on CT, the negative predictive value was 96.9%. Traumatic finding on CT was detected in 3.1% of children with minimal head injuries who underwent a CT examination, which accounts for 0.45% of all children in this group. Conclusion Children with minimal head injuries can be safely discharged with oral and written instructions. Use of the SNC-G will potentially reduce the use of CT.

scholarly journals Ligoninėje gydytos galvos smegenų traumos epidemiologija Vilniuje ir Vilniaus krašte

2007 ◽  
Vol 5 (1) ◽  
pp. 0-0
Author(s):  
Aidanas Preikšaitis ◽  
Saulius Ročka
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Traffic Accidents ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Subdural Hemorrhage ◽  
Mild Traumatic Brain Injuries ◽  
Vilnius University ◽  
Gcs Score

Aidanas Preikšaitis, Saulius RočkaVilniaus universiteto Medicinos fakultetas, M. K. Čiurlionio g. 21, LT-03101 VilniusVilniaus universiteto Neurologijos ir neurochirurgijos klinikos Neurochirurgijos skyrius,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected]; [email protected] Įvadas / tikslas Pasaulyje galvos trauma patiriama kas penkiolika sekundžių, kas dvylika minučių nuo jos miršta žmogus. Daugiausia asmenų iki 40 metų miršta dėl išorinių priežasčių, tarp jų ir įvairių traumų. Mirtys dėl galvos smegenų traumų sudaro apie 30% visų trauminių mirčių. Ši studija buvo suplanuota dėl to, kad epidemiologinė galvos smegenų traumos situacija mūsų krašte yra neaiški. Ligoniai ir metodai Retrospektyvusis tyrimas atliktas Vilniaus greitosios pagalbos universitetinėje ligoninėje. Buvo ištirta 622 dėl galvos smegenų traumos hospitalizuotų pacientų. Duomenys buvo renkami į asmeninį kompiuterį ir apdoroti naudojant "MS office Excel 2003" ir "SPSS 10" programas. Rezultatai Vyrai galvos smegenų traumą patiria vidutiniškai tris kartus dažniau negu moterys. 20–59 metų žmonės sudarė 72,5%. Dažniausios galvos smegenų traumos priežastys: kritimai (40,7%), eismo nelaimės (20,5%) ir smurtiniai sužalojimai (19%). Lengvų galvos smegenų traumų (pagal Glasgow komų skalę (GKS) 13–15 balų) pasitaikė 67,8% atvejų, vidutinio sunkumo (GKS 9–12 balų) buvo 15,2%, o sunkių galvos smegenų traumų (GKS < 8 balai) – 17%. Remiantis radiologiniais duomenimis dažniausiai buvo diagnozuojama subduralinė kraujosruva (29,1%), kiek rečiau – trauminė subarachnoidinė kraujosruva (19,5%). Net 86,4% baigtis buvo gera (pagal Glasgow baigčių skalę 4–5 balai), 6,4% pacientų, patyrusių galvos smegenų traumą, neišgyveno. Išvados Galvos smegenų traumą reikšmingai dažniau patiria 20–59 metų vyrai. Dažniausia traumos priežastis – kritimai. Vilniaus ligoninėse dažniausiai gydomi pacientai, patyrę lengvą galvos smegenų traumą (GKS 15–13 balų). Net trys ketvirtadaliai baigčių yra labai geros. Pusė žmonių, patyrusių sunkią galvos traumą (GKS 3 balai), neišgyvena. Pasitvirtino ankstyvieji galvos smegenų traumos prognoziniai veiksniai: atvykimo GKS, amžius, vyzdžių skersmuo ir jų reakcija į šviesą, pakitimai galvos kompiuterinėje tomogramoje. Vilniaus ligoninėje hospitalizuojama santykinai daugiau lengvą galvos smegenų traumą patyrusių pacientų negu kitose pasaulio klinikose. Pagrindiniai žodžiai: galvos trauma, galvos smegenų trauma, neurochirurgija, epidemiologija The epidemiology of in-hospital-treated brain traumas in Vilnius city and region AIDANAS PREIKŠAITIS, SAULIUS ROČKAVilnius University, Faculty of Medicine, M. K. Čiurlionio str. 21, LT-03101 Vilnius, LithuaniaVilnius University, Clinic of Neurology and Neurosurgery, Department of Neurosurgery,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected]; [email protected] Background / objective Every fifteen seconds a head injury happens in the world, and every twelve minutes it causes a death. Most individuals younger than 40 years die due to external causes including different traumas. Deaths caused by traumatic brain injury comprise about 30% of all traumatic deaths. This study has been planned because of the unclear epidemiology of traumatic brain injuries in our country. Patients and methods A retrospective study was carried out at Vilnius University Emergency Hospital. 622 hospitalized traumatic brain injury patients were enrolled in the study. The data were stored in a personal computer and analyzed using Microsoft Excel 2003 and SPSS 10 statistical package. Results The male gender was dominant among the brain-injured. 72.5% of these patients were 20–59 years of age. Most frequent causes of traumatic brain injuries were falls (40.7%), traffic accidents (20.5%) and assaults (19%). Mild traumatic brain injuries (Glasgow Coma Scale (GCS) 13–15) were proved in 67.8%, moderate (GCS 9–12) in 15.2% and severe (GCS < 8) – in 17.0% of cases. Radiological evaluation revealed subdural hemorrhage in 29.1% and traumatic subarachnoid hemorrhage in 19.5% of victims. Good outcomes (according to GOS 4–5) were reGBStered in 86.4% patients, 6.4% patients did not survive. Conclusions Traumatic brain injuries in males were three times more frequent than in females. The age group of 20–59 years was prevalent. The most frequent cause of trauma was fall. Mild traumatic brain injuries (GCS 15–13) prevailed in Vilnius among the in-hospital patients. Three quarters of the outcomes were very good. Half of the patients brought in with three-point coma did not survive. The following early prognostic factors of traumatic brain injury were approved: GCS score, age, pupils diameter and light reflex, CT features. It was established that hospitalization of mild traumatic brain injuries in Lithuania was more frequent than in neurosurgical departments of other countries. Keywords: head injury, traumatic brain injury, neurosurgery, epidemiology

scholarly journals A model of longitudinal hemodynamic alterations after mild traumatic brain injury in adolescents

2019 ◽  
Vol 3 ◽  
pp. 205970021983865
Author(s):  
Corey M Thibeault ◽  
Samuel Thorpe ◽  
Nicolas Canac ◽  
Michael J O’Brien ◽  
Mina Ranjbaran ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Diagnostic Tool ◽  
Brain Injuries ◽  
Transcranial Doppler Ultrasound ◽  
Traumatic Brain Injuries ◽  
Traumatic Injuries ◽  
Adolescent Population ◽  
Inverse Models

There is an unquestionable need for quantitative biomarkers of mild traumatic brain injuries. Something that is particularly true for adolescents – where the recovery from these injuries is still poorly understood. However, within this population, it is clear that the vasculature is distinctly affected by a mild traumatic brain injury. In addition, our group recently demonstrated how that effect appears to show a progression of alterations similar but in contrast to that found in severe traumatic injuries. Through measuring an adolescent population with transcranial Doppler ultrasound during a hypercapnia challenge, multiple phases of hemodynamic dysfunction were suggested. Here, we create a generalized model of the hemodynamic responses by fitting a set of inverse models to the dominant features from that work. The resulting model helps define the multiple phases of hemodynamic recovery after a mild traumatic brain injury. This can eventually be generalized, potentially providing a diagnostic tool for clinicians tracking patient’s recovery, and ultimately, resulting in more informed decisions and better outcomes.

COMPARATIVE ASSESSMENT OF SURGICAL TREATMENT ACUTE INTRACRANIAL HEMATOMAS ACCORDING TO THE HOSPITAL

Vestnik ◽  
2021 ◽  
pp. 122-125
Author(s):  
Е.К. Дюсембеков ◽  
А.Р. Халимов ◽  
И.Т. Курмаев ◽  
В.К. Тян ◽  
А.Ш. Мирзабеков ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Surgical Treatment ◽  
Brain Injury ◽  
Postoperative Mortality ◽  
Comparative Assessment ◽  
Neurosurgical Procedures ◽  
Acute Management ◽  
Intracranial Hematomas ◽  
The Dead

Представлены результаты хирургического лечения пациентов с острыми внутричерепными гематомами в различные периоды времени: 522 пострадавших были оперированы в период с 2011 по 2015 гг.; 498 пациентов были оперированы с 2016 по 2020 гг. В последний период экстренных нейрохирургических больных стали принимать дополнительно в трех стационарах, согласно районированию. Отмечено снижение числа пациентов, поступивших в фазе клинической декомпенсации, что можно объяснить сроками доставки в стационар с ближайших районов. Уменьшилась послеоперационная летальность до 17,3% (22,4% в первой группе). Среди умерших пациентов преобладают лица пенсионного возраста (46,5%). 59,3% погибших пациентов прожили менее трех суток. There is outcome surgical treatment of patients with acute intracranial hematomas at different times: 522 surgeries performed from 2011 to 2015; 498 ones underwent operation during 2016-2020. Recently, emergency neurosurgical procedures have been taking additionally in three hospitals in accordance with neighborhood. We can see decrease of patients with acute management of decompensation traumatic brain injury. This can be explained by their delivery to the nearest hospital. Postoperative mortality reduced to 17.3% (22.4% in the first group). Retirement patients predominate among the dead (46,5%). 59.3% of the mortality defined as less than three days.

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