Early Diagnosis and Management of Cerebral Venous Flow Obstruction Secondary to Transsinus Fracture after Traumatic Brain Injury

AbstractTraumatic brain injury (TBI) is a global cause of morbidity and mortality. Initial management and risk stratification of patients with TBI is made difficult by the relative insensitivity of screening radiographic studies as well as by the absence of a widely available, noninvasive diagnostic biomarker. In particular, a blood-based biomarker assay could provide a quick and minimally invasive process to stratify risk and guide early management strategies in patients with mild TBI (mTBI). Analysis of circulating exosomes allows the potential for rapid and specific identification of tissue injury. By applying acoustofluidic exosome separation—which uses a combination of microfluidics and acoustics to separate bioparticles based on differences in size and acoustic properties—we successfully isolated exosomes from plasma samples obtained from mice after TBI. Acoustofluidic isolation eliminated interference from other blood components, making it possible to detect exosomal biomarkers for TBI via flow cytometry. Flow cytometry analysis indicated that exosomal biomarkers for TBI increase in the first 24 h following head trauma, indicating the potential of using circulating exosomes for the rapid diagnosis of TBI. Elevated levels of TBI biomarkers were only detected in the samples separated via acoustofluidics; no changes were observed in the analysis of the raw plasma sample. This finding demonstrated the necessity of sample purification prior to exosomal biomarker analysis. Since acoustofluidic exosome separation can easily be integrated with downstream analysis methods, it shows great potential for improving early diagnosis and treatment decisions associated with TBI.

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Early diagnosis of mortality using admission CT perfusion in severe traumatic brain injury patients (ACT-TBI): protocol for a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2020-047305 ◽

2021 ◽

Vol 11 (6) ◽

pp. e047305

Author(s):

Susan Alcock ◽

Divjeet Batoo ◽

Sudharsana Rao Ande ◽

Rob Grierson ◽

Marco Essig ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Cohort Study ◽

Brain Injury ◽

Early Diagnosis ◽

Hospital Mortality ◽

Brain Death ◽

Severe Traumatic Brain Injury ◽

Health Research ◽

Ct Perfusion ◽

Severe Tbi

IntroductionSevere traumatic brain injury (TBI) is a catastrophic neurological condition with significant economic burden. Early in-hospital mortality (<48 hours) with severe TBI is estimated at 50%. Several clinical examinations exist to determine brain death; however, most are difficult to elicit in the acute setting in patients with severe TBI. Having a definitive assessment tool would help predict early in-hospital mortality in this population. CT perfusion (CTP) has shown promise diagnosing early in-hospital mortality in patients with severe TBI and other populations. The purpose of this study is to validate admission CTP features of brain death relative to the clinical examination outcome for characterizing early in-hospital mortality in patients with severe TBI.Methods and analysisThe Early Diagnosis of Mortality using Admission CT Perfusion in Severe Traumatic Brain Injury Patients study, is a prospective cohort study in patients with severe TBI funded by a grant from the Canadian Institute of Health Research. Adults aged 18 or older, with evidence of a severe TBI (Glasgow Coma Scale score ≤8 before initial resuscitation) and, on mechanical ventilation at the time of imaging are eligible. Patients will undergo CTP at the time of first imaging on their hospital admission. Admission CTP compares with the reference standard of an accepted bedside clinical assessment for brainstem function. Deferred consent will be used. The primary outcome is a binary outcome of mortality (dead) or survival (not dead) in the first 48 hours of admission. The planned sample size for achieving a sensitivity of 75% and a specificity of 95% with a CI of ±5% is 200 patients.Ethics and disseminationThis study has been approved by the University of Manitoba Health Research Ethics Board. The findings from our study will be disseminated through peer-reviewed journals and presentations at local rounds, national and international conferences. The public will be informed through forums at the end of the study.Trial registration numberNCT04318665

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Automatic EEG processing for the early diagnosis of Traumatic Brain Injury

2016 World Automation Congress (WAC) ◽

10.1109/wac.2016.7582957 ◽

2016 ◽

Cited By ~ 2

Author(s):

Bruno Albert ◽

Jingjing Zhang ◽

Alexandre Noyvirt ◽

Rossitza Setchi ◽

Haldor Sjaaheim ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Early Diagnosis

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Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children

JAMA Pediatrics ◽

10.1001/jamapediatrics.2018.2853 ◽

2018 ◽

Vol 172 (11) ◽

pp. e182853 ◽

Cited By ~ 114

Author(s):

Angela Lumba-Brown ◽

Keith Owen Yeates ◽

Kelly Sarmiento ◽

Matthew J. Breiding ◽

Tamara M. Haegerich ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Disease Control ◽

Mild Traumatic Brain Injury ◽

Diagnosis And Management ◽

Prevention Guideline ◽

Control And Prevention ◽

Centers For Disease Control

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Risk factors and early diagnosis of cerebral venous sinus occlusion secondary to traumatic brain injury

Neurology India ◽

10.4103/0028-3886.170067 ◽

2015 ◽

Vol 63 (6) ◽

pp. 881 ◽

Cited By ~ 5

Author(s):

Shousen Wang ◽

Jun Li ◽

Liangfeng Wei ◽

Bingyang Xu ◽

Xiaojun Zhang

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Early Diagnosis ◽

Venous Sinus

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Hyponatremia in the Neurologically Ill Patient: A Review

The Neurohospitalist ◽

10.1177/1941874419895124 ◽

2020 ◽

Vol 10 (3) ◽

pp. 208-216

Author(s):

David P. Lerner ◽

Starane A. Shepherd ◽

Ayush Batra

Keyword(s):

Traumatic Brain Injury ◽

Subarachnoid Hemorrhage ◽

Brain Injury ◽

Early Diagnosis ◽

Neurological Disorders ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Treatment Strategies ◽

Diagnosis And Treatment ◽

Systemic Complications ◽

Acute Presentation

Hyponatremia is a well-known disorder commonly faced by clinicians managing neurologically ill patients. Neurological disorders are often associated with hyponatremia during their acute presentation and can be associated with specific neurologic etiologies and symptoms. Patients may present with hyponatremia with traumatic brain injury, develop hyponatremia subacutely following aneurysmal subarachnoid hemorrhage, or may manifest with seizures due to hyponatremia itself. Clinicians caring for the neurologically ill patient should be well versed in identifying these early signs, symptoms, and etiologies of hyponatremia. Early diagnosis and treatment can potentially avoid neurologic and systemic complications in these patients and improve outcomes. This review focuses on the causes and findings of hyponatremia in the neurologically ill patient and discusses the pathophysiology, diagnoses, and treatment strategies for commonly encountered etiologies.

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