Comparison of Lymphocyte Neutrophil Ratio in Head Injury Patients with Blood and without Intracranial Bleeding in Dr. M. Djamil Hospital

A B S T R A C TBackground: Head injuries occur every 15 seconds worldwide, with patientsdying every 12 minutes. The value of the Neutrophil Lymphocyte Ratio (NLR) is afactor that influences the assessment and prognostic value of patients withintracranial hemorrhage and without intracranial hemorrhage in head injury.The aim of this study was to determine the relationship between increased NLRbased on the severity of head injury patients with or without intracranialhemorrhage. Methods: This study is a retrospective cross sectional study of headinjury patients with hemorrhage and without intracranial hemorrhage who weretreated at Dr. M. Djamil Hospital Padang in 2020 from May to December 2020.Data was collected in the Medical Records Department of Dr. M. Djamil HospitalPadang who met the inclusion and exclusion criteria. Results : A total of 92patients were included in the inclusion criteria for this study. The results showedthat the mean NLR value in head injury patients was 11.72 with a variation of7.31. The mean NLR level based on the severity of mild head injury was 10.15with a variation of 6.38. The mean NLR level of moderate head injury severity was12.70 with a variation of 7.09. The mean NLR level of severe head injury, was14.69 with a variation of 9.30. The results showed that there was no difference inthe mean of NLR levels in mild head injury patients with hemorrhage and withoutintracranial hemorrhage. The results showed that there was a significantrelationship between NLR levels in moderate head injury patients withhemorrhage (14.20) and without intracranial hemorrhage (7.20) (p value = 0.029),whereas in severe head injury it could not be assessed because there was nosample without hemorrhage. Conclusion: There is an association betweenincreased NLR and intracranial bleeding in moderate head injury patients

Unravelling the mechanisms of blood–brain barrier dysfunction in repetitive mild head injury

This scientific commentary refers to ‘Slow blood-to-brain transport underlies enduring barrier dysfunction in American football players’, by Veksler et al. (doi:10.1093/brain/awaa140).

Karakteristik Hasil CT-Scan Kepala pada Penderita Cedera Kepala di Rumah Sakit Dr.H.Abdul Moeloek periode Januari – Desember Tahun 2018

Computerized Tomography (CT) -Scans examination are the main choice modalities in patients with acute head injuries because they are able to view the entire brain tissues and accurately distinguish the nature and presence of intracranial lesions and Extracranial. This study aim to determine the characteristics of results CT-Scan head on the patient's head injury at Dr.H.Abdul Moeloek Hospital January to December Period 2018. The research is a descriptive study with a crosssectional approach. The samples in this study were all records of medical head injury patients at Dr.H.Abdul Moeloek Hospital in January – December 2018 based on the formula Slovin as many as 182 respondents. The sampling techniques in the study used purposive sampling techniques. Data analysis using univariate analysis. From 182 respondents known prevalence of the age of the patient's head injury is 16-25 years as many as 82 respondents (45.1%), male gender 119 respondents (65.4%), a mild head injury of 105 respondents (57.7%). A normal CT-Scan overview of 99 respondents (54.4%) With a valid description (subarachnoid hemorrhage) as much as 25 respondents (13.7%). Characteristics of results CT-Scan head at the head injury sufferer of most ages 16-25 years, most male gender, most dominant mild head injuries and CT-Scan results most commonly present normal results with description SAH (subarachnoid hemorrhage).

A study of serum cortisol levels in acute head injury patients

IntroductionAdrenal insufficiency has a great impact on the prognosis of patients with traumatic brain injury. In healthy persons during normal day-to-day activity, the concentration of plasma cortisol is high in the morning, decreases during the day and rises again during night. But this diurnal rhythm is abolished in long-term unconscious patients and in those with disturbed sleep cycles. In addition, patients with central nervous system disease, who are conscious but have lesions in the temporal lobe, and the pretectal or hypothalamus area, demonstrate abnormal rhythms.MethodsThis cross-sectional study recruited 33 consecutive patients attending emergency medical departments of Prathima Institute of Medical Sciences Hospital between July 2017 and April 2018 with mild to severe traumatic head injury within 6 h of injury. The selected patients were mainly divided into three groups depending on the Glasgow Coma Scale (GCS) [mild head injury (14–15); moderate head injury (9–13); severe head injury (3–8)]. In each group, 11 patients were selected. GCS was calculated at the time of admission. The adrenal function of the patients was assessed by using the serum cortisol tests.ResultsIn this comparative study of acute head injury among three groups, males are more prone to injury than females, with 81%, 90% and 72% in mild, moderate and severe injuries, respectively. The result mainly shows that the mean cortisol levels estimated were significantly increased in mild head injury and were with greater increase in cases of moderate & severe head injuries. Statistically significant positive correlation was observed between serum cortisol & GCS levels.ConclusionsIn this study of serum cortisol levels in head injury patients, we observed that there is increase in the serum cortisol level immediately after trauma. The increase is linearly related with the severity of head injury. Hence performing serum cortisol test is recommended for the assessment of adrenal function in patients with traumatic head injury.

Prognostic value of results of the neuro-ophthalmological examination in mild traumatic brain injury

Object of the study consisted in 110 patients with mild brain injury. Age of the injured persons was from 17 to 82 years old. Males accounted for 77 people (77,0%), females — 23 (23,0%). The aim of the study was to consider clinical and functional disorders of the ocular fundus and visual analyzer and to develop and substantiate pathogenetic direction in the prevention of optic nerve atrophy with estimation of its efficiency in the acute period of mild brain injury. Obtained results and their novelty. Decrease in visual acuity due to retinal damage was observed in 5,5% of patients with mild head injury in combination with eye contusion. Narrowing of borders of the indirect vision according to the bitemporal pattern in 7 cases of mild brain injury was accompanied by decrease in visual acuity within the range 0,4–0,7 and optic disc blanching with its distinct borders.