Articles: traumatic-brain-injuries.
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Critical care medicine · Aug 2024
Observational StudyVisualization of Cerebral Pressure Autoregulatory Insults in Traumatic Brain Injury.
The first aim was to investigate the combined effect of insult intensity and duration of the pressure reactivity index (PRx) and deviation from the autoregulatory cerebral perfusion pressure target (∆CPPopt = actual CPP - optimal CPP [CPPopt]) on outcome in traumatic brain injury. The second aim was to determine if PRx influenced the association between intracranial pressure (ICP), CPP, and ∆CPPopt with outcome. ⋯ Higher intensities for longer durations of positive PRx and negative ∆CPPopt correlated with worse outcome. Elevated ICP, low CPP, and negative ∆CPPopt were particularly associated with worse outcomes when the cerebral pressure autoregulation was concurrently impaired.
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Identifying covert consciousness in intensive care unit (ICU) patients with coma and other disorders of consciousness (DoC) is crucial for treatment decisions, but sensitive low-cost bedside markers are missing. We investigated whether automated pupillometry combined with passive and active cognitive paradigms can detect residual consciousness in ICU patients with DoC. ⋯ Automated pupillometry combined with mental arithmetic can identify cognitive efforts, and hence covert consciousness, in ICU patients with acute DoC.
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Collapse after out-of-hospital cardiac arrest (OHCA) can cause severe traumatic brain injury (TBI). We aimed to investigate the clinical characteristics and treatment strategies for patients with OHCA and TBI. ⋯ Delayed ICH occurred frequently. Individualized management is required based on the extent of brain and cardiac damage, including optimal TTM, PCI procedures, and antiplatelet medications. Early detection of ICH and emergency treatment are critical for multi-disciplinary collaboration.
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Eur J Trauma Emerg Surg · Aug 2024
Machine learning prediction models for in-hospital postoperative functional outcome after moderate-to-severe traumatic brain injury.
This study aims to utilize machine learning (ML) and logistic regression (LR) models to predict surgical outcomes among patients with traumatic brain injury (TBI) based on admission examination, assisting in making optimal surgical treatment decision for these patients. ⋯ The study concluded that ML models could provide rapid and accurate predictions for postoperative GOS outcomes at discharge following moderate-to-severe TBI. The study also highlighted the crucial role of routine blood tests in improving such predictions, and may contribute to the optimization of surgical treatment decision-making for patients with TBI.
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Horseback riding can cause severe brain and spinal injuries. This study aimed to identify the spectrum of neurosurgical injuries related to recreational horseback riding. ⋯ Most neurologic injuries involve isolated trauma to the head. Fifteen percent of the riders' falls were caused after the horse was impacted by a motor vehicle. Forty percent of the patients require admission and 21% undergo surgery. Ten percent of the patients had a poor mRS grade of 4- to 6 when discharged.