Articles: trauma.
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NeuroImage. Clinical · Jan 2012
ReviewNeuroimaging of structural pathology and connectomics in traumatic brain injury: Toward personalized outcome prediction.
Recent contributions to the body of knowledge on traumatic brain injury (TBI) favor the view that multimodal neuroimaging using structural and functional magnetic resonance imaging (MRI and fMRI, respectively) as well as diffusion tensor imaging (DTI) has excellent potential to identify novel biomarkers and predictors of TBI outcome. This is particularly the case when such methods are appropriately combined with volumetric/morphometric analysis of brain structures and with the exploration of TBI-related changes in brain network properties at the level of the connectome. ⋯ The themes being explored cover notable trends in this area of research, including (1) the role of advanced MRI processing methods in the analysis of structural pathology, (2) the use of brain connectomics and network analysis to identify outcome biomarkers, and (3) the application of multivariate statistics to predict outcome using neuroimaging metrics. The goal of the review is to draw the community's attention to these recent advances on TBI outcome prediction methods and to encourage the development of new methodologies whereby structural neuroimaging can be used to identify biomarkers of TBI outcome.
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In modern life, the incidence of traumatic injuries increases daily. In accidents which lead to trauma, massive bleeding is the main cause of death. Nowadays, many different chemical and herbal agents are available for quick control of bleeding. ⋯ In this study, it seems that activity of "Quikclot" in cessation of bleeding of large arterial vessels was slightly better than "Chitohem". Due to limitations which we had in this study, further studies are necessary to show the actual differences between these agents and their side effects.
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J Trauma Manag Outcomes · Jan 2012
Calculating trauma triage precision: effects of different definitions of major trauma.
Triage is the process of classifying patients according to injury severity and determining the priority for further treatment. Although the term "major trauma" represents the reference against which over- and undertriage rates are calculated, its definition is inconsistent in the current literature. This study aimed to investigate the effects of different definitions of major trauma on the calculation of perceived over- and undertriage rates in a Norwegian trauma cohort. ⋯ Although the proportion of patients who were defined as having sustained major trauma increased when NISS-based definitions were substituted for ISS-based definitions, the outcomes of the triage precision calculations did not differ significantly between the two scales. Additionally, expanding the purely anatomic definition of major trauma by including proximal penetrating injury, 30-day mortality, ICU LOS greater than 2 days and transferred intubated out of the hospital at ≤2 days did not significantly influence the perceived triage precision. We recommend that triage precision calculations should include anatomical injury scaling according to NISS. To further enhance comparability of trauma triage calculations, researchers should establish a consensus on a uniform definition of major trauma.
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A case of communicating carotid-cavernous sinus fistula (CCF) after minor closed head injury is presented. ⋯ Carotid-cavernous sinus fistula is a rare condition that is usually caused by blunt or penetrating trauma to the head, but can develop spontaneously in about one fourth of patients with CCF. The connection between the carotid artery and cavernous sinus leads to increased pressure in the cavernous sinus and compression of its contents, and thereby produces the clinical symptoms and signs seen. Diagnosis depends on clinical examination and neuroimaging techniques. The aim of management is to reduce the pressure within the cavernous sinus, which results in gradual resolution of symptoms.