A study of vasospasm in traumatic brain injury with subarachnoid hemorrhage

Introduction: Cerebral vasospasm (CV) is common following subarachnoid hemorrhage (SAH). However, its impact on neurological outcome, especially in head trauma, has not been yet elucidated. Controversy exists about the true relationship between TBI, SAH and Traumatic Vasospasm. Hence, this study aims to determine the association of vasospasm in TBI with SAH. Methods: This is Observational cross-sectional study with 124 head injury patients. 31 patients were excluded. Transcranial Doppler ultrasonography (TCD) was conducted on daily bases in all patients with traumatic brain injury (TBI). Vasospasm in the MCA and ACA was defined by a mean Flow velocity (FV) exceeding 120 cm/s and three times the mean FV of the ipsilateral ICA. Results: Among 93 included patients, 72 (77%) were male and 21 (23%) were female. Mean age was (35+10) years. Mean GCS score was (11+4.1). 61 (66%) patients suffered with severe head injury. Vasospasm was detected in 45 % (42) of the total patients. Vasospasm was severe among 4.3% (4 patients), and moderate among 65.6% (61 patients). Association was found between severity of trauma and the severity of vasospasm in MCA (r= 0.41 and 0.38, p value< 0.005) and in ACA (r =0.25, p value < 0.005). The presence of SAH is highly correlated with an amplified incidence of vasospasm. The patients who developed vasospasm, 55% (23) had SAH whereas 45% (19) didn’t have SAH, the corresponding p value is 0.04 which is significant. Conclusion: The high incidence of vasospasm is associated with SAH in severe TBI patients. Further studies are recommended to determine predictors of vasospasm in TBI patients with SAH.

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Factors Related To Outcome of Traumatic Brain Injury Patients at M Djamil Padang Hospital

BioScientia Medicina ◽

10.32539/bsm.v5i8.388 ◽

2021 ◽

Vol 5 (8) ◽

pp. 811-817

Author(s):

Nora Fitri ◽

Syarif Indra ◽

Hendra Permana

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Patient Outcomes ◽

Significant Relationship ◽

Traffic Accidents ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Major Threat

Background: Traumatic brain injury is still a major threat because it can cause global morbidity and mortality. Many factors can affect the outcome of a traumatic brain injury. Some conditions that can exacerbate traumatic brain injury include GCS conditions, blood pressure variability, and pupillary reflexes.Methods: The research was conducted in M. Djamil Padang Hospital from October 2020 to March 2021. The study design was a cross-sectional study in traumatic brain injury patients with ≤ 48 hours of onset and the aged between 18-60 years. The subjects in this study consisted of 66 subjects. At 6 weeks after onset, a GOS assessment was performed to assess patient outcomes. Statistical analysis was performed computerized with SPSS 22.0. P-value <0.05 was considered statistically significant. Results: Most of the patients were male (71.2%) with an average age of 36.41 ± 14,275 years, and the most common injury mechanism was traffic accidents (95.5%). There was a significant relationship between onset of incidence, hypotension, pupillary reflexes, and Rotterdam score with the outcome of traumatic brain injury patients (p<0.05) and there was no significant relationship between age, gender, and mechanism of injury with the outcome patients with traumatic brain injury. Conclution: The onset of events, hypotension, pupillary reflexes, and Rotterdam scores significantly affect the outcome patients of traumatic brain injury.

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Analysis of Traumatic brain injury related to Kite flying festival: An institutional study

Romanian Neurosurgery ◽

10.2478/romneu-2018-0044 ◽

2018 ◽

Vol 32 (2) ◽

pp. 355-358

Author(s):

Manish Jaiswal ◽

Somil Jaiswal ◽

Bal Krishna Ojha ◽

Sunil Kumar Singh ◽

Anil Chandra ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Brain Injuries ◽

Injury Severity ◽

Emergency Admission ◽

Cross Sectional Study ◽

Cross Sectional ◽

Depressed Fracture ◽

Injured Patients

Abstract Introduction: Makar Sankranti or Uttarayan is the kite flying festival in India. The festival marks the end of winter and the beginning of summer as the sun moves to the Tropic of Cancer bringing with it longer and warmer days. But it turns into a difficult day for those who are hospitalised after suffering from kite flying related injuries. Aims & Objectives: The objective of this cross sectional study was to review the demographics, causes injury, severity, treatment and outcome of traumatic brain injuries in victims of this kite flying festival who were admitted in department of Neurosurgery on the occasion this year in January. Patients & Methods: A total of 46 traumatic brain injured patients was admitted under Neurosurgery Services that day, out of which 18 cases were related to kite flying related injury. Data of these 18 patients were analysed and outcome were measured at discharge. Result: kite flying festival related neurotrauma increase 39% more emergency admission burden as compared to routine days in neuro-emergency ward. Most common cause of head injury among them was fall from roof. Majority of them had mild head injury. Associated injuries to other part of body were present in 46% patients. Conclusion: Children were most affected due to unsupervised kite flying on roof and road side catching of kites. Depressed fracture was commonest type of traumatic brain injury. Strict attention to safety measures and parental supervision while flying kites can avoid many preventable injuries to life.

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Factors Related To Outcome of Traumatic Brain Injury Patients at M Djamil Padang Hospital

BioScientia Medicina ◽

10.32539/bsm.v5i4.388 ◽

2021 ◽

Vol 5 (4) ◽

pp. 1095-1101

Author(s):

Nora Fitri ◽

Syarif Indra ◽

Hendra Permana

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Patient Outcomes ◽

Significant Relationship ◽

Traffic Accidents ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Major Threat

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Outcome Prediction in Patients of Traumatic Brain Injury Based on Midline Shift on CT Scan of Brain

Indian Journal of Neurosurgery ◽

10.1055/s-0040-1716990 ◽

2021 ◽

Author(s):

Shrikant Govindrao Palekar ◽

Manish Jaiswal ◽

Mandar Patil ◽

Vijay Malpathak

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Ct Scan ◽

Treatment Protocol ◽

Emergency Setting ◽

Midline Shift ◽

Ct Head ◽

Clinical Tools ◽

Gcs Score

Abstract Background Clinicians treating patients with head injury often take decisions based on their assessment of prognosis. Assessment of prognosis could help communication with a patient and the family. One of the most widely used clinical tools for such prediction is the Glasgow coma scale (GCS); however, the tool has a limitation with regard to its use in patients who are under sedation, are intubated, or under the influence of alcohol or psychoactive drugs. CT scan findings such as status of basal cistern, midline shift, associated traumatic subarachnoid hemorrhage (SAH), and intraventricular hemorrhage are useful indicators in predicting outcome and also considered as valid options for prognostication of the patients with traumatic brain injury (TBI), especially in emergency setting. Materials and Methods 108 patients of head injury were assessed at admission with clinical examination, history, and CT scan of brain. CT findings were classified according to type of lesion and midline shift correlated to GCS score at admission. All the subjects in this study were managed with an identical treatment protocol. Outcome of these patients were assessed on GCS score at discharge. Result Among patients with severe GCS, 51% had midline shift. The degree of midline shift in CT head was a statistically significant determinant of outcome (p = 0.023). Seventeen out of 48 patients (35.4%) with midline shift had poor outcome as compared with 8 out of 60 patients (13.3%) with no midline shift. Conclusion In patients with TBI, the degree of midline shift on CT scan was significantly related to the severity of head injury and resulted in poor clinical outcome.

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CNS disease-related protein variants as blood-based biomarkers in traumatic brain injury

Neurology ◽

10.1212/wnl.0000000000006322 ◽

2018 ◽

Vol 91 (15) ◽

pp. 702-709 ◽

Cited By ~ 1

Author(s):

Stephanie M. Williams ◽

Carrie Peltz ◽

Kristine Yaffe ◽

Philip Schulz ◽

Michael R. Sierks

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Neurodegenerative Diseases ◽

Cross Sectional Study ◽

Single Chain ◽

Characteristic Analysis ◽

Cross Sectional ◽

Increased Risk ◽

Elisa Format ◽

Protein Variants

ObjectiveTo utilize a panel of 11 single chain variable fragments (scFvs) that selectively bind disease-related variants of TAR DNA-binding protein (TDP)-43, β-amyloid, tau, and α-synuclein to assess damage following traumatic brain injury (TBI), and determine if the presence of protein variants could account for the increased risk of various neurodegenerative diseases following TBI.MethodsWe utilized the panel of 11 scFvs in a sensitive ELISA format to analyze sera from 43 older veterans, 25 who had experienced at least 1 TBI incident during their lifetime (∼29.4 years after TBI), and 18 controls who did not incur TBI, in a cross-sectional study.ResultsEach of the 11 scFvs individually could significantly distinguish between TBI and control samples, though they did not detect each TBI sample. Comparing the levels of all 11 variants, all 25 TBI cases displayed higher reactivity compared to the controls and receiver operating characteristic analysis revealed 100% sensitivity and specificity. Higher total protein variants levels correlated with TBI severity and with loss of consciousness. Oligomeric tau levels distinguished between single and multiple TBI incidents. While all TBI cases were readily selected with the panel, the binding pattern varied from patient to patient, suggesting subgroups that are at increased risk for different neurodegenerative diseases.ConclusionThe panel of protein variants-specific scFvs can be used to identify blood-based biomarkers indicative of TBI even 20 years or more after the initial TBI. Being able to identify subgroups of biomarker profiles allows for the possibility of individually targeted treatments.

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Factors Affecting the Surgical Outcome in Extradural Hematoma in Punjab Institute of Neurosciences, Lahore, Pakistan

Nepal Journal of Neuroscience ◽

10.3126/njn.v14i3.20519 ◽

2017 ◽

Vol 14 (3) ◽

pp. 13-18 ◽

Cited By ~ 1

Author(s):

Azam Niaz ◽

Muhammad Hammad Nasir ◽

Kiran Niraula ◽

Sumra Majeed ◽

Joshan Neupane ◽

...

Keyword(s):

Head Injury ◽

Surgical Outcome ◽

Cross Sectional Study ◽

P Value ◽

Affecting Factors ◽

Extradural Hematoma ◽

Hematoma Volume ◽

Cross Sectional ◽

Factors Affecting ◽

Surgical Evacuation

Head injury is a leading cause of death in young age group. Extra Dural hematoma, a complication of head injury, is often fatal if not treated in time. The surgical outcome of EDH is dependent upon many variables including preoperative GCS, time between injury and surgery, associated intracranial injuries, anisocoria and hematoma volume. In order to reduce the mortality near to nil, it is essential to determine the magnitude of effect of affecting factors on surgical outcome which will also help us in preoperative counseling and prioritizing the operative candidates. This study was conducted determine the factors affecting surgical outcome of traumatic intracranial extradural Hematoma in Punjab Institute of Neurosciences/ Lahore general hospital, Lahore. It was a Cross sectional study conducted for 3 years from 28th May 2012 to 28th May 2015.The study was conducted on the patients admitted through emergency and diagnosed as Extramural hematoma. These patients underwent surgical evacuation of EDH on emergent basis and outcome was measured by Glasgow Outcome Scale (GOS) after 48 hours of surgery. Using GOS, good surgical outcome was observed in 80.9% (157 out of 194) patients. Preoperative GCS, anisocoria, hematoma volume, associated intracranial injuries and time between injury and surgery were the factors affecting the outcome significantly (p value=0.000) while age and sex of the patient had no significant effect. In Conclusion, good surgical outcome is associated with patients with solitary Extra Dural Hematoma of volume less than 60 ml, preoperative GCS more than 8, absence of anisocoria and undergoing surgical evacuation within 6 hours of injury. Nepal Journal of Neuroscience, Volume 14, Number 3, 2017, Page: 13-18

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Emotion Perception and Alexithymia in People With Severe Traumatic Brain Injury: One Disorder or Two? A Preliminary Investigation

Brain Impairment ◽

10.1375/brim.12.3.165 ◽

2011 ◽

Vol 12 (3) ◽

pp. 165-178 ◽

Cited By ~ 8

Author(s):

Skye McDonald ◽

Julia Rosenfeld ◽

Julie D. Henry ◽

Leanne Togher ◽

Robyn Tate ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Brain Injuries ◽

Preliminary Investigation ◽

Emotion Perception ◽

Poor Performance ◽

Cross Sectional Study ◽

Primary Objective ◽

Cross Sectional

AbstractPrimary objective:Recent research studies attest to the presence of deficits in emotion perception following severe traumatic brain injury (TBI). Additionally, a growing number of studies report significant levels of alexithymia (disorder of emotional cognition) following TBI. This research aimed to examine the relation between the two, while assessing the influence of posttraumatic stress disorder (PTSD).Design:Cross-sectional study examining levels of alexithymia, emotion perception disorders and PTSD and their association, in 20 people with severe, chronic TBI and 20 adults without brain injuries.Methods:Participants were assessed on the Toronto Alexithymia — 20 Scale, the Posttraumatic Diagnostic Scale and on two emotion perception tasks: matching and labelling of photos depicting the 6 basic emotions.Results:The group with TBI were impaired relative to controls when matching facial expressions. Their performance on ‘fear’ was especially poor. Performance on labelling was similar in pattern, although failed to reach significance. There was no association between poor performance on fear, or other negative expressions, and either PTSD or alexithymia symptoms in the TBI group.Conclusions:Alexithymia, as assessed by the TAS-20, taps a constellation of difficulties that do not appear to include difficulties with emotion perception in people with traumatic brain injuries.

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Systolic blood pressure lower than the heart rate indicates a poor outcome in patients with severe isolated traumatic brain injury: A cross-sectional study

International Journal of Surgery ◽

10.1016/j.ijsu.2018.11.030 ◽

2019 ◽

Vol 61 ◽

pp. 48-52 ◽

Cited By ~ 1

Author(s):

Jin-Fu Huang ◽

Yu-Chin Tsai ◽

Cheng-Shyuan Rau ◽

Shiun-Yuan Hsu ◽

Peng-Chen Chien ◽

...

Keyword(s):

Blood Pressure ◽

Traumatic Brain Injury ◽

Heart Rate ◽

Brain Injury ◽

Systolic Blood Pressure ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Poor Outcome

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Hospital admission and readmission among homeless patients with neurologic disease: Retraction and replacement

Neurology ◽

10.1212/wnl.0000000000007645 ◽

2019 ◽

Vol 92 (24) ◽

pp. e2822-e2831 ◽

Cited By ~ 7

Author(s):

Nicole Rosendale ◽

Elan L. Guterman ◽

John P. Betjemann ◽

S. Andrew Josephson ◽

Vanja C. Douglas

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Primary Outcome ◽

Cross Sectional Study ◽

Primary Diagnosis ◽

Hospital Level ◽

Cross Sectional ◽

Using Data ◽

Patients With Epilepsy ◽

Inpatient Database

ObjectiveTo characterize the most common neurologic diagnoses leading to hospitalization for homeless compared to housed individuals and to assess whether homelessness is an independent risk factor for 30-day readmission after an admission for a neurologic illness.MethodsWe performed a retrospective serial cross-sectional study using data from the Healthcare Cost and Utilization Project California State Inpatient Database from 2006 to 2011. Adult patients with a primary neurologic discharge diagnosis were included. The primary outcome was 30-day readmission. We used multilevel logistic regression to examine the association between homelessness and readmission after adjustment for patient factors.ResultsWe identified 1,082,347 patients with a neurologic primary diagnosis. The rate of homelessness was 0.37%. The most common indications for hospitalization among homeless patients were seizure and traumatic brain injury, both of which were more common in the homeless compared to housed population (19.3% vs 8.1% and 31.9% vs 9.2%, respectively, p < 0.001). A multilevel mixed-effects model controlling for patient age, sex, race, insurance type, comorbid conditions, and clustering on the hospital level found that homelessness was associated with increased 30-day readmission (odds ratio 1.5, 95% confidence interval 1.4–1.6, p < 0.001). This association persisted after this analysis was repeated within specific diagnoses (patients with epilepsy, trauma, encephalopathy, and neuromuscular disease).ConclusionThe most common neurologic reasons for admission among homeless patients are seizure and traumatic brain injury; these patients are at high risk for readmission. Future interventions should target the drivers of readmissions in this vulnerable population.

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