Articles: traumatic-brain-injuries.
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Frailty, a decline in physiological reserve, prognosticates poorer outcomes for several neurosurgical conditions. However, the impact of frailty on traumatic brain injury outcomes is not well characterized. ⋯ For patients with tICH, frailty predicted higher mortality and morbidity, independent of age or injury severity.
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Elderly trauma victims whose care is shared between surgeons and physicians have improved clinical outcomes and shorter hospital lengths of stay (LOS). To test whether a similar benefit can be gained for patients suffering traumatic brain injury (TBI), a quality improvement project (QIP) was run in which a neurologist was enrolled into the pre-existing neurotrauma team. ⋯ The two cohorts were well matched for age, gender, mechanism of injury, Glasgow coma score and types of injury. The QIP was not associated with a reduction in mortality but was associated with a significant reduction in mean LOS (from 25.7 days to 17.5 days; p=0.04) and a reduction in readmissions (from seven to zero patients; p=0.01).
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Acta clinica Croatica · Nov 2022
Review Case ReportsSURGICAL MANAGEMENT OF A PENETRATING BRAIN WOUND AND ASSOCIATED PERFORATING OCULAR INJURY CAUSED BY A LOW-VELOCITY SHARP METALLIC OBJECT: A CASE REPORT AND LITERATURE REVIEW.
Penetrating traumatic brain injury accompanied by perforating ocular injury caused by low-velocity foreign bodies is a life-threatening condition, a surgical emergency and a major challenge in surgical practice, representing a severe subtype of non-missile traumatic brain injury, which is a relatively rare pathology among civilians. Optimal management of such an injury remains controversial, requiring full understanding of its pathophysiology and a multidisciplinary expert approach. Herein, we report a case of penetrating brain and associated perforating eye injury and discuss relevant literature providing further insight into this demanding complex multi-organ injury. ⋯ The vision to his left eye was completely and permanently lost. In conclusion, management of non-missile transorbital penetrating brain injury can be satisfactory when proper clinical and radiologic evaluation, and amply, less radical surgical approach is performed early. A multidisciplinary routine is a prerequisite in achieving a favorable management outcome.
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Intensive care medicine · Nov 2022
Observational StudyExtubation in neurocritical care patients: the ENIO international prospective study.
Neurocritical care patients receive prolonged invasive mechanical ventilation (IMV), but there is poor specific information in this high-risk population about the liberation strategies of invasive mechanical ventilation. ⋯ In neurocritical care patients, extubation failure is high and is associated with unfavourable outcomes. A score could predict extubation success in multiple settings. However, it will be mandatory to validate our findings in another prospective independent cohort.