Articles: traumatic-brain-injuries.
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J Intensive Care Med · Feb 2017
Radiographic and Clinical Predictors of Cardiac Dysfunction Following Isolated Traumatic Brain Injury.
Although cardiac dysfunction after traumatic brain injury (TBI) has been described, there is little data regarding the association of radiographic severity and particular lesions of TBI with the development of cardiac dysfunction. We hypothesize that the Rotterdam or Marshall scores and particular TBI lesions are associated with the development of cardiac dysfunction after isolated TBI. ⋯ No specific radiographic variable was found to be an independent predictor of cardiac dysfunction. Further study into clinical or radiological features that would warrant an echocardiogram is warranted, as it may direct patient management.
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Epilepsy & behavior : E&B · Feb 2017
Review Meta AnalysisRisk factors for posttraumatic epilepsy: A systematic review and meta-analysis.
A systematic review and meta-analysis was performed to identify risk factors for posttraumatic epilepsy (PTE). ⋯ The current meta-analysis identified potential risk factors for PTE. The results may contribute to better prevention strategies and treatments for PTE.
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Plasma-based resuscitation improves outcomes in trauma patients with hemorrhagic shock, while large-animal and limited clinical data suggest that it also improves outcomes and is neuroprotective in the setting of combined hemorrhage and traumatic brain injury. However, the choice of initial resuscitation fluid, including the role of plasma, is unclear for patients after isolated traumatic brain injury. ⋯ Although early plasma transfusion was not associated with improved in-hospital survival for all isolated traumatic brain injury patients, early plasma was associated with increased in-hospital survival in those with multifocal intracranial hemorrhage.
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Patients with severe traumatic brain injury or large intracranial space-occupying lesions (spontaneous cerebral hemorrhage, infarction, or tumor) commonly present to the neurocritical care unit with an altered mental status. Many experience progressive stupor and coma from mass effects and transtentorial brain herniation compromising the ascending arousal (reticular activating) system. ⋯ In this critical review, we discuss the ascending arousal system, brain herniation, and shortcomings of our current management including the neurological exam, intracranial pressure monitoring, and neuroimaging. We present a rationale for the development of nurse-friendly-continuous, automated, and alarmed-evoked potential monitoring, based upon the clinical and experimental literature, advances in the prognostication of cerebral anoxia, and intraoperative neurophysiological monitoring.
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Assessment of the association between illegal possession of weapon and assault on school property among adolescents with and without a history of traumatic brain injury (TBI) while assessing risk factors for these outcomes. ⋯ Previously it was thought that alcohol and drugs were the main contributors to school violence. Here we show that history of TBIs is yet another significant predictor of violence at school among adolescents. The results suggest that school vigilance and combined violence and TBI prevention, treatment and rehabilitation programs in this population are warranted.