Articles: traumatic-brain-injuries.
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In this article, we explore the current literature on traumatic brain injury (TBI) in survivors of intimate partner violence (IPV) and evaluate the barriers to studying this vulnerable population. ⋯ Research on TBI and IPV is limited by multiple factors including mistrust of the healthcare system by survivors, lack of awareness by community advocates, and insufficient funding by public entities. As such, most investigations are small population, retrospective, and qualitative. Quantitative research addressing the scope of TBI in IPV found reported rates ranging from 19 to 100% of survivors experiencing neurological injury at the hands of a violent partner. The principals of trauma-informed healthcare should guide both neurological care for survivors as well as future studies on TBI and IPV, with an emphasis on community-based participatory research.
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Journal of neurosurgery · Jan 2025
Predictive factors for traumatic cerebral contusion volume, expansion, and outcomes.
Traumatic hemorrhagic cerebral contusions are a well-established cause of morbidity and mortality in neurosurgery. This study aimed to determine prognostic factors for long-term functional outcomes and longitudinal contusion volume changes in traumatic brain injury (TBI) patients. ⋯ Functional outcomes in traumatic cerebral contusion patients may be associated with age and admission GCS score, and verbal GCS score may predict initial contusion volume and contusion expansion. These findings supplement an evolving understanding of factors that influence outcomes in patients with cerebral contusions, and further study into the utility of GCS to guide these decisions could help to guide the clinical management of these highly complex patients.
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External lumbar drainage (ELD) of cerebrospinal fluid may help control intracranial pressure following a traumatic brain injury. We aimed to assess the efficacy and safety of ELD in post-traumatic intracranial hypertension (IH). ⋯ ELD appears in our cohort to be a safe and effective strategy to control post-traumatic IH, with an acceptable benefit-risk ratio. Our analysis even suggests a potential outcome improvement in patients treated by ELD compared with those having no cerebrospinal fluid drainage.
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Paediatric anaesthesia · Jan 2025
Trauma-induced coagulopathy across age pediatric groups: A retrospective cohort study evaluating testing and frequency.
Trauma-induced coagulopathy (TIC) is associated with negative outcomes. Pediatric TIC has been described most often in older children. Children undergo normal developmental hemostasis, but it is unknown how this process impacts the risk of TIC across childhood. ⋯ Significant sampling bias exists in clinical data collection among injured children and adolescents. Contrary to previous reports and using age-specific TIC criteria, younger children are not at lower risk of TIC than older children when controlling for injury severity.
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Prolonged field care is a military adaptation of tactical combat casualty care providing extended prehospital management during delayed extrication. Effects of addition of valproic acid (VPA) to fresh-frozen plasma (FFP) in a prolonged field care model of hemorrhagic shock and traumatic brain injury are not known. We hypothesized that VPA is associated with decreased neurological impairment, and its protective changes are detected at the transcriptomic level. ⋯ The addition of FFP to the resuscitation protocol resulted in a significant reduction in crystalloid requirements. Both the NS + FFP and NS + FFP + VPA groups showed improved neurological recovery compared with NS alone and had distinctive transcriptomic profiles in injured brains at 72 hours. The mitochondrially encoded ATP synthase membrane subunit 8 gene, involved in worsening ischemia following brain injury, was downregulated in VPA-treated animals.