Articles: traumatic-brain-injuries.
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Traumatic brain injury (TBI) presents significant challenges in prehospital care, particularly during on-scene triage, where accurate decision-making is crucial for improving patient outcomes. This study, part of a mixed-methods project, aims to explore these challenges and identify gaps in current on-scene triage practices. Additionally, it seeks to understand paramedics' perspectives on potential diagnostic tools such as brain biomarkers, near-infrared spectroscopy, and decision aids. ⋯ This study provides critical insights into the complexities of on-scene prehospital triage for patients with suspected TBI. Key recommendations include developing specific triage tools, exploring advanced technologies to support on-scene decision-making, enhancing paramedic training on TBI recognition, and addressing both barriers and facilitators to the implementation of new diagnostic technologies.
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Traumatic brain injury remains a significant concern in public health, affecting millions of individuals globally and leading to long-term cognitive and physical impairments. Historically, research in this field has primarily focused on male subjects, often neglecting to consider the substantial biomechanical and anatomical differences between genders and individuals of varying ages. The present study investigates sex-specific biomechanical responses to head impacts in real-world accidents, employing an advanced female finite element head model, with a particular focus on critical brain structures such as the corpus callosum and pituitary gland. ⋯ The smallest percentiles exhibited a higher risk of strain-related injury, while larger individuals demonstrated higher strain levels in key brain regions under similar impact conditions. Additionally, it was evaluated the efficacy of a safety helmet in a work-related scenario. These findings highlight the importance of subject-specific analyses in understanding TBIs and emphasise the need for continued refinement of FEHMs to improve the accuracy of injury prediction.
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Journal of neurotrauma · Jan 2025
Attenuation of Blood-Brain Barrier Disruption in Traumatic Brain Injury via Inhibition of NKCC1 Cotransporter: Insights into the NF-κB/NLRP3 Signaling Pathway.
Following traumatic brain injury (TBI), inhibition of the Na+-K+-Cl- cotransporter1 (NKCC1) has been observed to alleviate damage to the blood-brain barrier (BBB). However, the underlying mechanism for this effect remains unclear. This study aimed to investigate the mechanisms by which inhibiting the NKCC1 attenuates disruption of BBB integrity in TBI. ⋯ Following TBI, an upregulation of NLRP3 inflammasome was observed in microglia, astrocytes, vascular endothelial cells, and neurons. Furthermore, inhibiting NKCC1 resulted in a decrease in the positive rate of NLRP3 inflammasome in microglia and the levels of inflammatory cytokines IL-1β and MMP-9 after TBI, which correlated with BBB damage and the development of cerebral edema. These findings demonstrate that the suppression of the NKCC1 cotransporter protein alleviates BBB disruption through the NF-κB/NLRP3 signaling pathway following TBI.
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Comparative Study
Headache after pediatric traumatic brain injury: a comparison between a post-acute sample of children and adolescents and general population.
Headache is one of the most common post-concussion symptoms following pediatric traumatic brain injury (TBI). To better understand its impact on young individuals, this study aims to investigate the prevalence of headache in a German-speaking post-acute pediatric TBI sample and compare it with the general population. In addition, factors associated with the development of pediatric post-TBI headache are investigated to improve the understanding of this condition. ⋯ The results of this study suggest that the prevalence of headache in the post-acute phase of pediatric TBI is not significantly different from that in the matched non-TBI population, indicating good recovery from injury. However, due to its high prevalence, follow-up screening for this common TBI symptom, especially in adolescents, may be helpful to prevent further chronification.