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Latest & greatest articles for traumatic brain injury
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Tranexamic acid is safe to use following mild-to-moderate traumaticbraininjury. The studyThe CRASH-3 Trial Collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumaticbraininjury (CRASH-3): a randomised, placebo-controlled trial.Lancet 2019;394:1713-23.This trial was funded by NIHR Health Technology Assessment Programme (project number 14/190/01), JP Moulton Charitable Trust, Department of Health and Social (...) Care, Department for International Development, Global Challenges Research Fund, Medical Research Council, and the Wellcome Trust (Joint Global Health Trials scheme).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000870/tranexamic-acid-following-mild-to-moderate-traumatic-brain-injury-is-safe-and-reduces-deaths.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group
Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumaticbraininjury (CRASH-3): a randomised, placebo-controlled trial. Tranexamic acid reduces surgical bleeding and decreases mortality in patients with traumatic extracranial bleeding. Intracranial bleeding is common after traumaticbraininjury (TBI) and can cause brain herniation and death. We aimed to assess the effects of tranexamic acid in patients with TBI.This (...) randomised, placebo-controlled trial was done in 175 hospitals in 29 countries. Adults with TBI who were within 3 h of injury, had a Glasgow Coma Scale (GCS) score of 12 or lower or any intracranial bleeding on CT scan, and no major extracranial bleeding were eligible. The time window for eligibility was originally 8 h but in 2016 the protocol was changed to limit recruitment to patients within 3 h of injury. This change was made blind to the trial data, in response to external evidence suggesting
Feasibility and Accuracy of Fast MRI Versus CT for TraumaticBrainInjury in Young Children Computed tomography (CT) is commonly used for children when there is concern for traumaticbraininjury (TBI) and is a significant source of ionizing radiation. Our objective was to determine the feasibility and accuracy of fast MRI (motion-tolerant MRI sequences performed without sedation) in young children.In this prospective cohort study, we attempted fast MRI in children <6 years old who had head CT (...) performed and were seen in the emergency department of a single, level 1 pediatric trauma center. Fast MRI sequences included 3T axial and sagittal T2 single-shot turbo spin echo, axial T1 turbo field echo, axial fluid-attenuated inversion recovery, axial gradient echo, and axial diffusion-weighted single-shot turbo spin echo planar imaging. Feasibility was assessed by completion rate and imaging time. Fast MRI accuracy was measured against CT findings of TBI, including skull fracture, intracranial
Comparison of Effects of Manual and Mechanical Airway Clearance Techniques on Intracranial Pressure in Patients With Severe TraumaticBrainInjury on a Ventilator: Randomized, Crossover Trial Physical therapist intervention can play a significant role in the prevention of mechanical and infectious complications in patients with traumaticbraininjury (TBI) who are mechanically ventilated.The objective of this study was to observe and compare the effects of manual and mechanical airway clearance (...) techniques on intracranial pressure (ICP) and hemodynamics in patients with severe TBI.The design was a prospective, randomized, crossover trial.The setting was a neurointensive care unit at a level 1 trauma center.Forty-six adult patients aged 18 to 75 years, of either sex, with severe TBI, receiving mechanical ventilatory support with continuous ICP monitoring, and undergoing regular airway clearance techniques participated in this study.Two techniques were performed by a single trained physical
Can the important braininjury criteria predict neurosurgical intervention in mild traumaticbraininjury? A validation study. There is variability in the management of patients presenting to the emergency department (ED) with mild traumaticbraininjury (MTBI) and abnormal findings on their initial head computed tomography (CT). The main objective of this study was to validate the value of the Important BrainInjury (IBI) criteria, introduced by the Canadian CT-Head Rule, in predicting
Message S100B serum biomarker has high sensitivity and negative predictive value for detecting traumaticintracranial lesions in children with mild traumaticbraininjury. However, how to incorporate this into existing risk-stratification tools is unclear, and reduced availability of the test currently limits its practical application in the emergency department (ED). Methods Data Sources The authors searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, Scopus (...) . The 8 included studies comprised 601 children with mild traumaticbraininjury who underwent serum S100B biomarker testing compared with head CT or clinical follow-up as the references standard. S100B levels for detecting traumaticintracranial lesions in children with mild traumaticbraininjury had a pooled sensitivity of 100% (95% CI 98% to 100%) and negative predictive value of 100% (95% CI 99% to 100%), whereas the pooled specificity was 41% (95% CI 26% to 57%), with significant heterogeneity
Systematic Review - Relationship of Deployment-related Mild TraumaticBrainInjury to Posttraumatic Stress Disorder, Depressive Disorders, Substance Use Disorders, Suicidal Ideation, and Anxiety Disorders 4 March 2019 Prepared for: Department of Veterans Affairs Veterans Health Administration Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence Synthesis Program (ESP) Center Portland VA Medical Center Portland, OR Mark Helfand, MD, MPH, MS, Director (...) Relationship of Deployment-related Mild TraumaticBrainInjury to Posttraumatic Stress Disorder, Depressive Disorders, Substance Use Disorders, Suicidal Ideation, and Anxiety Disorders: A Systematic Review Authors: Principal Investigator: Nancy Greer, PhD Timothy J. Wilt, MD, MPH Co-Investigators: Princess Ackland, PhD, MSPH Roderick MacDonald, MS Nina Sayer, PhD Michele Spoont, PhD Brent Taylor, PhD Research Assistants: Lauren McKenzie, MPH Christina Rosebush, MPH Evidence Synthesis Program 4 Relationship
Evidence Brief: TraumaticBrainInjury and Dementia Management Briefs eBrief-no150 -- TraumaticBrainInjury and Dementia Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no150 -- TraumaticBrainInjury and Dementia Health Services Research & Development Management eBrief no. 150 » Issue 150 March 2019 The report is a product of the VA/HSR&D Evidence Synthesis Program. Evidence (...) Brief: TraumaticBrainInjury and Dementia Traumaticbraininjury (TBI) is a common condition among both civilian and military populations. While some TBIs cause acute symptoms that resolve over several weeks or months, evidence accumulated over nearly three decades suggests that TBI may lead to chronic neurodegenerative diseases such as dementia. More public awareness about TBI in active-duty service members as a risk factor for earlier onset of dementia and/or of Chronic Traumatic Encephalopathy
. 1996;6(2):97-101. Ryan AJ. Intracranialinjuries resulting from boxing. Clin Sports Med. 1998;17(1):155-168. doi:10.1016/S0278-5919(05)70070-3. Blennow K, Hardy J, Zetterberg H. The neuropathology and neurobiology of traumaticbraininjury. Neuron. 2012;76(5):886-899. doi:10.1016/j.neuron.2012.11.021. McCrory P, Feddermann-Demont N, Dvorak J, et al. What is the definition of sports-related concussion: a systematic review. Br J Sports Med. 2017;51(11):877–887. doi:10.1136/bjsports-2016-097393. Baugh (...) Is traumaticbraininjury preventable in amateur boxing competition? Is TraumaticBrainInjury Preventable in Amateur Boxing Competition? – Clinical Correlations Search Is TraumaticBrainInjury Preventable in Amateur Boxing Competition? January 18, 2019 5 min read By Kevin Rezzadeh Peer Reviewed Injuries associated with amateur . 1 While many of the superficial wounds and bone fractures can completely heal, brain damage secondary to boxing has also been well 2 Boxers are at risk for sequelae
TraumaticBrainInjury and Dementia 4 February 2019 Prepared for: Department of Veterans Affairs Veterans Health Administration Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence Synthesis Program (ESP) Coordinating Center Portland VA Health Care System Portland, OR Mark Helfand, MD, MPH, MS, Director Evidence Brief: TraumaticBrainInjury and Dementia Authors: Kim Peterson, MS Stephanie Veazie, MPH Donald Bourne, MPH Johanna Anderson, MPH Evidence (...) , Veazie S, Bourne D, Anderson J. Evidence Brief: TraumaticBrainInjury and Dementia. VA ESP Project #09-199; 2019. Posted final reports are located on the ESP search page. This report is based on research conducted by the Evidence Synthesis Program (ESP) Center located at the Portland VA Health Care System, Portland, OR, funded by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development. The findings and conclusions in this document are those
include the following: Maas AI, Stocchetti N, Bullock R. Moderate and severe traumaticbraininjury in adults. Lancet Neurol. 2008 Aug;7(8):728-41. http://www.ncbi.nlm.nih.gov/pubmed/18635021?tool=bestpractice.com Cerebral oedema Increased intracranial pressure (ICP) Haemorrhage Seizures Ischaemia Infection. Epidemiology of TBI TBI is a substantial cause of morbidity and mortality, leading to more than 2 million accident and emergency department visits annually in the US, Coronado VG, McGuire LC (...) /pubmed/11356436?tool=bestpractice.com After traumaticbraininjury, there is an inverse relationship between the GCS score and the incidence of positive findings on CT; in fact, the rate of intracranialinjury (ICI) and need for neurosurgical intervention doubles when the GCS drops from 15 to 14. Smits M, Dippel DW, Steyerberg EW, et al. Predicting intracranialtraumatic findings on computed tomography in patients with minor head injury: the CHIP prediction rule. Ann Intern Med. 2007;146(6):397-405
Incidence of emergency department presentations for traumaticbraininjury in Indigenous and non-Indigenous residents aged 15â€“64 over the 9-year period 2007â€“2015 in North Queensland, Australia Traumaticbraininjury (TBI) is a leading cause of disability worldwide. Previous studies have shown that males have a higher incidence than females, and Indigenous populations have a higher rate than non-Indigenous. To date, no study has compared the incidence rate of TBI between Indigenous and non
group and 111 (49.1%) in the normothermia group (risk difference, 0.4% [95% CI, -9.4% to 8.7%]; relative risk with hypothermia, 0.99 [95% CI, 0.82-1.19]; P = .94). In the hypothermia and normothermia groups, the rates of pneumonia were 55.0% vs 51.3%, respectively, and rates of increased intracranial bleeding were 18.1% vs 15.4%, respectively.Among patients with severe traumaticbraininjury, early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months (...) Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe TraumaticBrainInjury: The POLAR Randomized Clinical Trial. After severe traumaticbraininjury, induction of prophylactic hypothermia has been suggested to be neuroprotective and improve long-term neurologic outcomes.To determine the effectiveness of early prophylactic hypothermia compared with normothermic management of patients after severe traumaticbrain injury.The Prophylactic Hypothermia
Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild TraumaticBrainInjury Among Children Mild traumaticbraininjury (mTBI), or concussion, in children is a rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for mTBI over the past decade. However, no evidence-based clinical guidelines have been developed to date for diagnosing and managing pediatric mTBI in the United (...) States.To provide a guideline based on a previous systematic review of the literature to obtain and assess evidence toward developing clinical recommendations for health care professionals related to the diagnosis, prognosis, and management/treatment of pediatric mTBI.The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control Board of Scientific Counselors, a federal advisory committee, established the Pediatric Mild TraumaticBrainInjury Guideline Workgroup
The effects of vestibular rehabilitation on dizziness and balance problems in patients after traumaticbraininjury: a randomized controlled trial To investigate the effects of group-based vestibular rehabilitation in patients with traumaticbrain injury.A single-blind randomized controlled trial.University Hospital (recruitment and baseline assessments) and Metropolitan University (experimental intervention).A total of 65 patients (45 women) with mild-to-moderate traumaticbraininjury (mean (...) , 95% CI: 1.4-6.0). At the second follow-up, no significant between-group differences were found. No significant between-group differences in the other outcomes were found at the two follow-ups.The intervention appeared to speed up recovery for patients with dizziness and balance problems after traumaticbraininjury. However, the benefits had dissipated two months after the end of the intervention.
Association Between TraumaticBrainInjury and Risk of Suicide. Traumaticbraininjuries (TBIs) can have serious long-term consequences, including psychiatric disorders. However, few studies have assessed the association between TBI and risk of suicide.To examine the association between TBI and subsequent suicide.Retrospective cohort study using nationwide registers covering 7 418 391 individuals (≥10 years) living in Denmark (1980-2014) with 164 265 624 person-years' follow-up; 567 823 (7.6 (...) %) had a medical contact for TBI. Data were analyzed using Poisson regression adjusted for relevant covariates, including fractures not involving the skull, psychiatric diagnoses, and deliberate self-harm.Medical contacts for TBI recorded in the National Patient Register (1977-2014) as mild TBI (concussion), skull fracture without documented TBI, and severe TBI (head injuries with evidence of structural braininjury).Suicide recorded in the Danish Cause of Death register until December 31, 2014