scholarly journals Coagulation disorder in moderate to severe traumatic brain injuries

2014 ◽  
Vol 6 (3) ◽  
pp. 22-25 ◽  
Author(s):  
Ajit Shrestha ◽  
Ramesh Man Joshi ◽  
Upendra P. Devkota
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
International Normalized Ratio ◽  
Traumatic Brain Injuries ◽  
Coagulation Disorder ◽  
Secondary Brain Injury ◽  
Multivariate Statistical ◽  
Moderate Traumatic Brain Injury

Background: Significant proportions of patients presenting with moderate to severe traumatic brain injuries are diagnosed as having coagulation disorder and subsequent secondary brain injury. We evaluated the incidence of coagulopathy in patient with moderate to severe traumatic brain injury in this study.Methods: A prospective study of 100 patients with moderate to severe traumatic brain injury was carried out over a period of 2 years. Platelet count (PC), Bleeding time (BT), Clotting time (CT), Prothrombin time (PT), International Normalized ratio (INR), activated partial thromboplastin time (aPTT) and Fibrin degradation product (FDP) were measured at the time of admission and 12 hourly for 7 days. Daily D-dimer evaluation for DIC was performed in those who had abnormal value in any one of these parameters. Coagulopathy was classified as collectively 3 abnormal parameters.Results: Among the 100 patients, 43% had severe and 57% had moderate traumatic brain injury. Coagulopathy was detected in 63% of total patients; 76.7 % (33/43) among severe traumatic brain injury and 52.7 % (30/57) among moderate (p 0.013). Multivariate statistical analysis showed deranged FDP as a significant individual predictor of coagulopathy among others (p < 0.001, Odds ratio 166.25; 95% confidence interval 31.7 + 869.7).Conclusion: Coagulopathy is common in patients with moderate to severe traumatic brain injury. Evaluation of FDP can significantly predict coagulopathy in traumatic brain injury patients.DOI: http://dx.doi.org/10.3126/ajms.v6i3.10730 Asian Journal of Medical Sciences Vol.6(3) 2015 22-25

Prothrombin Complex Concentrate Use in Coagulopathy of Lethal Brain Injuries Increases Organ Donation

2014 ◽  
Vol 80 (4) ◽  
pp. 335-338 ◽  
Author(s):  
Bellal Joseph ◽  
Hassan Aziz ◽  
Viraj Pandit ◽  
Daniel Hays ◽  
Narong Kulvatunyou ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Organ Donation ◽  
Prothrombin Complex Concentrate ◽  
Brain Injuries ◽  
Cost Effective ◽  
Gunshot Wounds ◽  
International Normalized Ratio ◽  
Traumatic Brain Injuries ◽  
Time Of Admission

Coagulopathy is a defined barrier for organ donation in patients with lethal traumatic brain injuries. The purpose of this study was to document our experience with the use of prothrombin complex concentrate (PCC) to facilitate organ donation in patients with lethal traumatic brain injuries. We performed a 4-year retrospective analysis of all patients with devastating gunshot wounds to the brain. The data were analyzed for demographics, change in international normalized ratio (INR), and subsequent organ donation. The primary end point was organ donation. Eighty-eight patients with lethal traumatic brain injury were identified from the trauma registry of whom 13 were coagulopathic at the time of admission (mean INR 2.2 ± 0.8). Of these 13 patients, 10 patients received PCC in an effort to reverse their coagulopathy. Mean INR before PCC administration was 2.01 ± 0.7 and 1.1 ± 0.7 after administration ( P < 0.006). Correction of coagulopathy was attained in 70 per cent (seven of 10) patients. Of these seven patients, consent for donation was obtained in six patients and resulted in 19 solid organs being procured. The cost of PCC per patient was $1022 ± 544. PCC effectively reveres coagulopathy associated with lethal traumatic brain injury and enabled patients to proceed to organ donation. Although various methodologies exist for the treatment of coagulopathy to facilitate organ donation, PCC provides a rapid and cost-effective therapy for reversal of coagulopathy in patients with lethal traumatic brain injuries.

scholarly journals Profil pasien cedera kepala sedang dan berat yang dirawat di ICU dan HCU

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Maria L. Rawis ◽  
Diana Ch. Lalenoh ◽  
Lucky T. Kumaat
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Medical Record ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Probability Sampling ◽  
Purposive Sampling

Abstract: Traumatic brain injuries are still the leading cause of death and disability, and require care on Intensive Care Unit (ICU). A traumatic brain injury caused by mechanical mass from outside the body, leads to impaired cognitive and psychosocial function that can occur temporarily or permanently, and can cause loss of consciousness. This study aims to determine the profile of the patients with moderate and severe traumatic brain injuries treated in ICU and HCU, using retrospective descriptive study conducted in September to November 2016 in the Medical Record department of Prof. Dr. R.D. Kandou, Manado. The sample size was determined by non-probability sampling method, a purposive sampling. Samples are ICU and HCU patients with the diagnosis of moderate to severe traumatic brain injury, who meet the inclusion criteria in the medical record of the data period September 2015 to August 2016. From the obtained sample of 40 patients, males dominate the gender category with 33 cases (83%). SIRS complications found in 23 cases (57.5%). Most patients are treated within 1–7 days, which also become the most patients who died within their length of stay. Patients who dies account for a total of 25 patients (62.5%) and most died after > 48 hours (72%) of treatment; out of the 25 deceased patients, 18 among them (45%) died from severe traumatic brain injury. Conclusion: The mortality rate is highest on severe head injury; most patients died after > 48 hours in the ICU and the HCU.Keywords: moderate traumatic brain injury, severe traumatic brain injury Abstrak: Cedera kepala masih merupakan penyebab utama kematian dan kecacatan, dan memerlukan perawatan Intensive Care Unit (ICU). Cedera kepala disebabkan oleh massa mekanik dari luar tubuh yang mengakibatkan gangguan fungsi kognitif dan psikososial, dapat terjadi sementara atau permanen, dan dapat menyebabkan penurunan kesadaran. Penelitian ini bertujuan untuk mengetahui profil pasien cedera kepala sedang dan berat yang dirawat pada ICU dan HCU, menggunakan metode penelitian deskriptif retrospektif yang dilakukan pada September sampai dengan November 2016 di Instalasi Rekam Medik RSUP Prof. Dr. R.D. Kandou, Manado. Besar sampel ditentukan dengan metode non probability sampling yaitu purposive sampling. Sampel penelitian adalah pasien ICU dan HCU dengan diagnosa cedera kepala sedang dan berat yang memenuhi kriteria inklusi pada data Rekam Medik periode September 2015 sampai dengan Agustus 2016. Hasil penelitian didapatkan jumlah sampel 40 pasien, dengan jenis kelamin terbanyak laki-laki 33 orang (83%). Komplikasi SIRS ditemui pada 23 kasus (57,5%). Paling banyak pasien dirawat pada 1–7 hari dan pasien yang meninggal dunia terbanyak pada lama rawat 1–7 hari. Pasien meninggal dunia berjumlah 25 orang (62,5%) dan terbanyak meninggal dunia setelah > 48 jam (72%); dari 25 orang yang meninggal dunia pasien dengan cedera kepala berat sebanyak 18 orang (45%). Simpulan: Angka mortalitas tertinggi ada pada cedera kepala berat, dan pasien meninggal dunia paling banyak setelah > 48 jam di ICU dan HCU. Kata kunci: cedera kepala sedang, cedera kepala berat

Assessing Social Skills in People With Very Severe Traumatic Brain Injury: Validity of the Social Performance Survey Schedule (SPSS)

2008 ◽  
Vol 9 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Esther Long ◽  
Skye McDonald ◽  
Robyn Tate ◽  
Leanne Togher ◽  
Cristina Bornhofen
Keyword(s):  
Traumatic Brain Injury ◽  
Social Skills ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Social Performance ◽  
Traumatic Brain Injuries ◽  
Prosocial Behaviour ◽  
Normative Sample ◽  
The Social

AbstractThe current study was designed to determine whether the Social Performance Survey Schedule (SPSS; Lowe & Cautela, 1978) is a useful measure of social skills in people with traumatic brain injuries (TBI). Forty-nine adults with TBI were compared on the SPSS to 190 adults without injuries. The validity of the SPSS was also investigated in relation to another measure of social performance, the first scale of the Katz Adjustment Scale (KAS-R1; Katz & Lyerly, 1963) and a broad measure of social function (the SPRS; Tate, Hodgkinson, Veerabangsa, & Maggiotto, 1999). Individuals with TBI had significantly lower scores on the positive scale of the SPSS than nonbrain-injured individuals. They did not have lower scores on the SPSS negative scale relative to the normative sample. Significant correlations with the KAS-R1 and SPRS provided evidence for the construct and criterion validity of SPSS within this population. In conclusion, this study suggests that where an appropriate normative sample is used, the positive subscale of the SPSS is a sound measure for detecting the extent and nature of deficits in prosocial behaviour seen in TBI, but raises the question as to how we define negative behaviours in the 21st century on scales such as the SPSS.

scholarly journals Acute Concussion versus Catastrophic Brain Injury

Concussion ◽  
2019 ◽  
pp. 37-40
Author(s):  
Brian Hainline ◽  
Lindsey J. Gurin ◽  
Daniel M. Torres
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Emergency Medical Services ◽  
Mild Traumatic Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Action Plan ◽  
Traumatic Brain Injuries ◽  
Severe Brain Injury ◽  
Low Threshold

Concussion is considered a type of mild traumatic brain injury, and may exist on a continuum with moderate and severe brain injury. If an individual has suffered an injury severe enough to cause a concussion, there should be a low threshold for also suspecting a more severe traumatic brain injury. In contact/collision sports, it is desirable to have an emergency action plan in place for catastrophic injuries that include moderate or severe traumatic brain injuries. Emergency medical services should be activated for suspected moderate and severe traumatic brain injuries.

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 [...]

Optimising the management of severe Traumatic Brain Injury in the military maritime environment

2014 ◽  
Vol 100 (3) ◽  
pp. 293-300
Author(s):  
IA Edgar ◽  
G Hadjipavlou ◽  
JE Smith
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Healthcare Systems ◽  
Secondary Brain Injury ◽  
Eye Protection ◽  
Alternative Approaches ◽  
The Military ◽  
Primary Injury ◽  
Maritime Environment

AbstractSevere Traumatic Brain Injury (sTBI) is a devastating cause of morbidity and mortality, especially among those aged less than 45 years. Advances in clinical practice continue to focus on preventing primary injury through developing ballistic head and eye protection, and through minimising secondary brain injury (secondary prevention).Managing sTBI is challenging in well-developed, well-resourced healthcare systems. Achieving management aims in the military maritime environment poses even greater challenges.Strategies for the management of sTBI in the maritime environment should be in keeping with current best evidence. Provision of specialist interventions for sTBI in military maritime environments may require alternative approaches matched to the skills of the staff and environmental restrictions.

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

Severe Traumatic Brain Injury

2018 ◽  
Author(s):  
Ryan Martin ◽  
Lara Zimmermann ◽  
Kee D. Kim ◽  
Marike Zwienenberg ◽  
Kiarash Shahlaie
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Severe Traumatic Brain Injury ◽  
Neurocritical Care ◽  
Secondary Brain Injury ◽  
Brain Oxygenation ◽  
Barbiturate Coma ◽  
Blast Traumatic Brain Injury ◽  
Penetrating Traumatic Brain Injury

Traumatic brain injury remains a leading cause of death and disability worldwide. Patients with severe traumatic brain injury are best treated with a multidisciplinary, evidence-based, protocol-directed approach, which has been shown to decrease mortality and improve functional outcomes. Therapy is directed at the prevention of secondary brain injury through optimizing cerebral blood flow and the delivery of metabolic fuel (ie, oxygen and glucose). This is accomplished through the measurement and treatment of elevated intracranial pressure (ICP), the strict avoidance of hypotension and hypoxemia, and in some instances, surgical management. The treatment of elevated ICP is approached in a protocolized, tiered manner, with escalation of care occurring in the setting of refractory intracranial hypertension, culminating in either decompressive surgery or barbiturate coma. With such an approach, the rates of mortality secondary to traumatic brain injury are declining despite an increasing incidence of traumatic brain injury. This review contains 3 figures, 5 tables and 69 reference Key Words: blast traumatic brain injury, brain oxygenation, cerebral perfusion pressure, decompressive craniectomy, hyperosmolar therapy, intracranial pressure, neurocritical care, penetrating traumatic brain injury, severe traumatic brain injury

Bilateral chorea following severe traumatic brain injury treated with risperidone

2021 ◽  
Vol 14 (5) ◽  
pp. e241929
Author(s):  
Daniel Krasna ◽  
Erica Montgomery ◽  
Jacob Koffer ◽  
Miriam Segal
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Movement Disorders ◽  
Daily Living ◽  
Brain Injuries ◽  
Treatment Guidelines ◽  
Case Reports ◽  
Burden Of Care ◽  
History Of

A functionally independent man in his 20s with a history of intellectual disability and epilepsy and family history of Huntington’s disease suffered a severe traumatic brain injury. Postinjury, bilateral chorea rendered him dependent for all activities of daily living. Risperidone provided a significant reduction of chorea, decreasing the overall burden of care. Movement disorders are a common sequela of brain injury. Currently, there are no best treatment guidelines for chorea in patients with brain injury. To the authors’ knowledge there have been no case reports describing the effects of brain injury on patients with a primary movement disorder. Risperidone was an effective treatment in this case. Further research is needed to establish guidelines for treatment of movement disorders following brain injury and to better understand the effect of brain injuries on primary movement disorders.

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