scholarly journals Glasgow Coma Scale Improvement after Lidocaine Infusion in Moderate Traumatic Brain Injury

2016 ◽  
Vol 7 (8) ◽  
Author(s):  
Diana Christine Lalenoh ◽  
Dewi Yulianti Bisri
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Coma Scale ◽  
Moderate Traumatic Brain Injury

A Child Presenting with a Glasgow Coma Scale Score of 13: Mild or Moderate Traumatic Brain Injury? A Narrative Review

2021 ◽  
Author(s):  
Gerard Hageman ◽  
Jik Nihom
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
English Language ◽  
Abusive Head Trauma ◽  
High Energy ◽  
Coma Scale ◽  
Moderate Traumatic Brain Injury

Abstract Objective The objective of this article was to compare children with traumatic brain injury (TBI) and Glasgow Coma Scale score (GCS) 13 with children presenting with GCS 14 and 15 and GCS 9 to 12. Data Source We searched PubMed for clinical studies of children of 0 to 18 years of age with mild TBI (mTBI) and moderate TBI, published in English language in the period of 2000 to 2020. Study Selection We selected studies sub-classifying children with GCS 13 in comparison with GCS 14 and 15 and 9 to 12. We excluded reviews, meta-analyses, non-U.S./European population studies, studies of abusive head trauma, and severe TBI. Data Synthesis Most children (>85%) with an mTBI present at the emergency department with an initial GCS 15. A minority of only 5% present with GCS 13, 40% of which sustain a high-energy trauma. Compared with GCS 15, they present with a longer duration of unconsciousness and of post-traumatic amnesia. More often head computerized tomography scans show abnormalities (in 9–16%), leading to neurosurgical intervention in 3 to 8%. Also, higher rates of severe extracranial injury are reported. Admission is indicated in more than 90%, with a median length of hospitalization of more than 4 days and 28% requiring intensive care unit level care. These data are more consistent with children with GCS 9 to 12. In children with GCS 15, all these numbers are much lower. Conclusion We advocate classifying children with GCS 13 as moderate TBI and treat them accordingly.

Effect of Memantine on Serum Levels of Neuron-Specific Enolase and on the Glasgow Coma Scale in Patients With Moderate Traumatic Brain Injury

2017 ◽  
Vol 58 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Majid Mokhtari ◽  
Hossein Nayeb-Aghaei ◽  
Mehran Kouchek ◽  
Mir Mohammad Miri ◽  
Reza Goharani ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Neuron Specific Enolase ◽  
Serum Levels ◽  
Coma Scale ◽  
Moderate Traumatic Brain Injury

scholarly journals Modulated Neuroprotection in Unresponsive Wakefulness Syndrome after Severe Traumatic Brain Injury

2021 ◽  
Vol 11 (8) ◽  
pp. 1044
Author(s):  
Cristina Daia ◽  
Cristian Scheau ◽  
Aura Spinu ◽  
Ioana Andone ◽  
Cristina Popescu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Severe Traumatic Brain Injury ◽  
Functional Independence ◽  
Unresponsive Wakefulness Syndrome ◽  
Coma Scale ◽  
Severe Tbi ◽  
Neuroprotective Treatment ◽  
Gcs Score

Background: We aimed to assess the effects of modulated neuroprotection with intermittent administration in patients with unresponsive wakefulness syndrome (UWS) after severe traumatic brain injury (TBI). Methods: Retrospective analysis of 60 patients divided into two groups, with and without neuroprotective treatment with Actovegin, Cerebrolysin, pyritinol, L-phosphothreonine, L-glutamine, hydroxocobalamin, alpha-lipoic acid, carotene, DL-α-tocopherol, ascorbic acid, thiamine, pyridoxine, cyanocobalamin, Q 10 coenzyme, and L-carnitine alongside standard treatment. Main outcome measures: Glasgow Coma Scale (GCS) after TBI, Extended Glasgow Coma Scale (GOS E), Disability Rankin Scale (DRS), Functional Independence Measurement (FIM), and Montreal Cognitive Assessment (MOCA), all assessed at 1, 3, 6, 12, and 24 months after TBI. Results: Patients receiving neuroprotective treatment recovered more rapidly from UWS than controls (p = 0.007) passing through a state of minimal consciousness and gradually progressing until the final evaluation (p = 0.000), towards a high cognitive level MOCA = 22 ± 6 points, upper moderate disability GOS-E = 6 ± 1, DRS = 6 ± 4, and an assisted gait, FIM =101 ± 25. The improvement in cognitive and physical functioning was strongly correlated with lower UWS duration (−0.8532) and higher GCS score (0.9803). Conclusion: Modulated long-term neuroprotection may be the therapeutic key for patients to overcome UWS after severe TBI.

Identifying Posttraumatic Amnesia in Individuals With a Glasgow Coma Scale of 15 After Mild Traumatic Brain Injury

2015 ◽  
Vol 96 (5) ◽  
pp. 956-959 ◽  
Author(s):  
Susanne Meares ◽  
E. Arthur Shores ◽  
Tracy Smyth ◽  
Jennifer Batchelor ◽  
Margaret Murphy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Mild Traumatic Brain Injury ◽  
Coma Scale ◽  
Posttraumatic Amnesia

What is a Concussion?

2014 ◽  
pp. 3-4
Author(s):  
David L Brody
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Ct Scan ◽  
Clinical Diagnosis ◽  
Daily Basis ◽  
Coma Scale ◽  
Life Threatening ◽  
Lab Test ◽  
The Brain

A concussion is a traumatic brain injury, but not an immediately life threatening one. A traumatic brain injury occurs when a sudden force is applied to the brain from outside. But not every force causes a concussion. In fact, most do not. The scalp, skull, and dura do a pretty good job protecting our brains from most of what happens to us on a daily basis. A traumatic brain injury means that the force applied to the brain caused a disruption in the brain’s structure, an impairment of the brain’s function, or both. A CT scan or an MRI scan may be negative, but this does not mean that there has not been a concussion. Traumatic brain injury, especially concussion, is a clinical diagnosis, not based on any lab test or scan. Typically, patients with concussion have Glasgow Coma Scale between 13 and 15.

Transcranial Doppler to Screen on Admission Patients With Mild to Moderate Traumatic Brain Injury

Neurosurgery ◽  
2011 ◽  
Vol 68 (6) ◽  
pp. 1603-1610 ◽  
Author(s):  
Pierre Bouzat ◽  
Gilles Francony ◽  
Philippe Declety ◽  
Céline Genty ◽  
Affif Kaddour ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
At Risk ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Pulsatility Index ◽  
Area Under Curve ◽  
Moderate Traumatic Brain Injury ◽  
Patients At Risk

Abstract BACKGROUND: Detecting patients at risk for secondary neurological deterioration (SND) after mild to moderate traumatic brain injury is challenging. OBJECTIVE: To assess the diagnostic accuracy of transcranial Doppler (TCD) on admission in screening these patients. METHODS: This prospective, observational cohort study enrolled 98 traumatic brain injury patients with an initial Glasgow Coma Scale score of 9 to 15 whose initial computed tomography (CT) scan showed either absent or mild lesions according to the Trauma Coma Data Bank (TCDB) classification, ie, TCDB I and TCDB II, respectively. TCD measurements of the 2 middle cerebral arteries were obtained on admission under stable conditions in all patients. Neurological outcome was reassessed on day 7. RESULTS: Of the 98 patients, 21 showed SND, ie, a decrease of ≥ 2 points from the initial Glasgow Coma Scale or requiring any treatment for neurological deterioration. Diastolic cerebral blood flow velocities and pulsatility index measurements were different between patients with SND and patients with no SND. Using receiver-operating characteristic analysis, we found the best threshold limits to be 25 cm/s (sensitivity, 92%; specificity, 76%; area under curve, 0.93) for diastolic cerebral blood flow velocity and 1.25 (sensitivity, 90%; specificity, 91%; area under curve, 0.95) for pulsatility index. According to a recursive-partitioning analysis, TCDB classification and TCD measurements were the most discriminative among variables to detect patients at risk for SND. CONCLUSION: In patients with no severe brain lesions on CT after mild to moderate traumatic brain injury, TCD on admission, in complement with brain CT scan, could accurately screen patients at risk for SND.

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