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.

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 Ulinastatin alleviates traumatic brain injury by reducing endothelin-1

2020 ◽  
Vol 12 (1) ◽  
pp. 001-008
Author(s):  
Ting Liu ◽  
Xing-Zhi Liao ◽  
Mai-Tao Zhou
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Western Blot ◽  
Water Content ◽  
Brain Edema ◽  
Rat Model ◽  
Neurosurgical Procedures ◽  
Brain Water Content ◽  
The Brain ◽  
Brain Water

Abstract Background Brain edema is one of the major causes of fatality and disability associated with injury and neurosurgical procedures. The goal of this study was to evaluate the effect of ulinastatin (UTI), a protease inhibitor, on astrocytes in a rat model of traumatic brain injury (TBI). Methodology A rat model of TBI was established. Animals were randomly divided into 2 groups – one group was treated with normal saline and the second group was treated with UTI (50,000 U/kg). The brain water content and permeability of the blood–brain barrier were assessed in the two groups along with a sham group (no TBI). Expression of the glial fibrillary acidic protein, endthelin-1 (ET-1), vascular endothelial growth factor (VEGF), and matrix metalloproteinase 9 (MMP-9) were measured by immunohistochemistry and western blot. Effect of UTI on ERK and PI3K/AKT signaling pathways was measured by western blot. Results UTI significantly decreased the brain water content and extravasation of the Evans blue dye. This attenuation was associated with decreased activation of the astrocytes and ET-1. UTI treatment decreased ERK and Akt activation and inhibited the expression of pro-inflammatory VEGF and MMP-9. Conclusion UTI can alleviate brain edema resulting from TBI by inhibiting astrocyte activation and ET-1 production.

scholarly journals Intraoperative hypothermia during vascular neurosurgical procedures

2009 ◽  
Vol 26 (5) ◽  
pp. E24 ◽  
Author(s):  
Raymond Choi ◽  
Robert H. Andres ◽  
Gary K. Steinberg ◽  
Raphael Guzman
Keyword(s):  
Traumatic Brain Injury ◽  
Clinical Trials ◽  
Brain Injury ◽  
Animal Models ◽  
Mild Hypothermia ◽  
Scientific Evidence ◽  
Neurosurgical Procedures ◽  
Ischemic Damage ◽  
Intraoperative Hypothermia ◽  
Improved Outcomes

Increasing evidence in animal models and clinical trials for stroke, hypoxic encephalopathy for children, and traumatic brain injury have shown that mild hypothermia may attenuate ischemic damage and improve neurological outcome. However, it is less clear if mild intraoperative hypothermia during vascular neurosurgical procedures results in improved outcomes for patients. This review examines the scientific evidence behind hypothermia as a treatment and discusses factors that may be important for the use of this adjuvant technique, including cooling temperature, duration of hypothermia, and rate of rewarming.

scholarly journals Glasgow outcome scale at hospital discharge as a prognostic index in patients with severe traumatic brain injury

2012 ◽  
Vol 70 (8) ◽  
pp. 604-608 ◽  
Author(s):  
Rosmari A.R.A. Oliveira ◽  
Sebastião Araújo ◽  
Antonio L.E. Falcão ◽  
Silvia M.T.P. Soares ◽  
Carolina Kosour ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Medical Records ◽  
Glasgow Outcome Scale ◽  
Vegetative State ◽  
Prognostic Index ◽  
Prognostic Indicator ◽  
Neurosurgical Procedures ◽  
Severe Tbi ◽  
Two Measures

OBJECTIVE: Evaluate the Glasgow outcome scale (GOS) at discharge (GOS-HD) as a prognostic indicator in patients with traumatic brain injury (TBI). METHOD: Retrospective data were collected of 45 patients, with Glasgow coma scale <8, age 25±10 years, 36 men, from medical records. Later, at home visit, two measures were scored: GOS-HD (according to information from family members) and GOS LATE (12 months after TBI). RESULTS: At discharge, the ERG showed: vegetative state (VS) in 2 (4%), severe disability (SD) in 27 (60%), moderate disability (MD) in 15 (33%) and good recovery (GR) in 1 (2%). After 12 months: death in 5 (11%), VS in 1 (2%), SD in 7 (16%), MD in 9 (20%) and GR in 23 (51%). Variables associated with poor outcome were: worse GOS-HD (p=0.03), neurosurgical procedures (p=0.008) and the kind of brain injury (p=0.009). CONCLUSION: The GOS-HD was indicator of prognosis in patients with severe TBI.

Surgical Treatment of Transtentorial Herniation After Traumatic Brain Injury

2012 ◽  
Vol 22 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Zhong-Min Li ◽  
Le-Xin Wang ◽  
Li-Cheng Jiang ◽  
Jian-Xin Zhu ◽  
Feng-Yang Geng ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Surgical Treatment ◽  
Brain Injury ◽  
Transtentorial Herniation

scholarly journals Opioids and cerebral physiology in the acute management of traumatic brain injury: a systematic review

Brain Injury ◽  
2019 ◽  
Vol 33 (5) ◽  
pp. 559-566
Author(s):  
Joshua Wiener ◽  
Amanda McIntyre ◽  
Shannon Janzen ◽  
Magdalena Mirkowski ◽  
Heather M. MacKenzie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Management ◽  
Cerebral Physiology

scholarly journals Early management of traumatic brain injury in a Tertiary hospital in Central Kenya: A clinical audit

2016 ◽  
Vol 7 (01) ◽  
pp. 97-101 ◽  
Author(s):  
Clifford Chacha Mwita ◽  
Johnstone Muthoka ◽  
Stephen Maina ◽  
Phillip Mulingwa ◽  
Samson Gwer
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Road Traffic ◽  
Clinical Audit ◽  
Tertiary Hospital ◽  
Poor Compliance ◽  
Sub Saharan Africa ◽  
Neurosurgical Procedures ◽  
Early Management ◽  
Central Kenya

ABSTRACT Background: Traumatic brain injury (TBI) is a major cause of death and disability worldwide and is mostly attributed to road traffic accidents in resource-poor areas. However, access to neurosurgical care is poor in these settings and patients in need of neurosurgical procedures are often managed by general practitioners or surgeons. Materials and Methods: A retrospective clinical audit of the initial management of patients with TBI in Thika Level 5 Hospital (TL5H), a Tertiary Hospital in Central Kenya. Seventeen audit criteria divided into five clinical domains were identified and patient case notes reviewed for compliance with each criterion. Data were analyzed separately for those below 13 years owing to differences in response to brain trauma in those below this age. Results: Overall, there was poor compliance with audit criteria in both groups. Among those below 13 years of age, only 3 out of 17 criteria achieved compliance and 4 out of 17 criteria achieved compliance for those above 13 years of age. Assessment for the need for a cervical radiograph (7.1% and 8.8% compliance) and administration of oxygen (21.4% and 20.6% compliance) had the worst performance in both groups. Conclusion: Poor compliance to audit criteria indicates the low quality of care for patients with TBI in TL5H. Quality improvement strategies with follow-up audits are needed to improve care. There is a need to develop and enforce evidence-based protocols and guidelines for use in the management of patients with TBI in sub-Saharan Africa.

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