Brain injury : [BI]
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Brain injury : [BI] · Jan 2013
Review Case ReportsSkull stab wound from a metal railroad nail perforating the right frontal lobe.
Case report and review of literature. ⋯ Skull and brain stab wound lesions are highly infrequent, but evaluating the mechanism of injury and the successful medical and surgical treatment employed is illustrative of how post-traumatic recovery of this severe head injury can be achieved. The site of the injury and the position of the object were decisive for establishing an adequate diagnosis and prognosis. The patient reported an exemplary recovery without any secondary complications.
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Brain injury : [BI] · Jan 2013
Review Meta AnalysisMeta-analysis of Glasgow coma scale and simplified motor score in predicting traumatic brain injury outcomes.
To perform a systematic review and meta-analysis to compare the simplified motor score (SMS) and Glasgow Coma Scale (GCS) in predicting outcomes in patients with traumatic brain injury (TBI). ⋯ In patients with TBI, SMS predicts different outcomes with similar accuracy as GCS except mortality. However, due to heterogeneity and limited numbers of studies, further prospective studies are required.
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Brain injury : [BI] · Jan 2013
Review Meta Analysis Comparative StudyMortality among older adults after a traumatic brain injury: a meta-analysis.
To examine mortality rates among older adults (≥60 years) post-traumatic brain injury (TBI). ⋯ These mortality rates associated with moderate and severe injuries may be attributed to complications, chronic disease prevalence, conservative management techniques or the consequences of biological ageing.
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Brain injury : [BI] · Jan 2013
Review Case ReportsCase series evidence for improvement of executive functions after late cranioplasty.
Craniectomy, used to relieve refractory intracranial pressure in traumatic brain injury (TBI), may cause cognitive deficits which could be improved by skull breach repair. This paper studied whether late cranioplasty improves a specific pattern of cognitive functions. ⋯ The cognitive improvement induced by cranioplasty, even when performed after a long interval from craniectomy, may be due to the restoration of physiological cerebrospinal fluid circulation which, in turn, allows an efficient brain volume transmission signal circulation. The restoration of this essential way of signal communication seems to affect large-scale neuronal networks responsible for the executive functions.
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Brain injury : [BI] · Jan 2013
ReviewThe current role of decompressive craniectomy in the management of neurological emergencies.
Decompressive craniectomy has been used as a lifesaving procedure for many neurological emergencies, including traumatic brain injury, ischaemic stroke, subarachnoid haemorrhage, cerebrovenous thrombosis, severe intracranial infection, inflammatory demyelination and encephalopathy. The evidence to support using decompressive craniectomy in these situations is, however, limited. Decompressive craniectomy has only been evaluated by randomized controlled trials in traumatic brain injury and ischaemic stroke and, even so, its benefits and risks in these situations remain elusive. If one considers a modified Rankin Scale of 4 or 5 or dependency in daily activity as an unfavourable outcome, decompressive craniectomy is associated with an increased risk of survivors with unfavourable outcome (relative risk [RR] = 2.9, 95% confidence interval [CI] = 1.5-5.8, p = 0.002, I(2 )= 0%; number needed to operate to increase an unfavourable outcome = 3.5, 95% CI = 2.4-7.4), but not the number of survivors with a favourable outcome (RR = 1.5, 95% CI = 0.9-2.6, p = 0.13, I(2 )= 0%).