Articles: traumatic-brain-injuries.
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The available data on the effectiveness of therapeutic hypothermia in different patient groups are heterogeneous. Although the benefits have been proven for some collectives, recommendations for the use of hypothermia treatment in other groups are based on less robust data and conclusions by analogy. This article gives a review of the current evidence of temperature management in all age groups and based on this state of knowledge, recommends active temperature management with the primary aim of strict normothermia (36-36.5 °C) for 72 hours after cardiopulmonary arrest or severe traumatic brain injury for children beyond the neonatal period.
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The effect of normobaric hyperoxia on brain oxygenation in the presence or absence of intact autoregulation has not been studied previously in acute traumatic brain injury (TBI). ⋯ In severe TBI, middle cerebral artery CBF velocity is not affected by hyperoxia in both the pathologic and the normal side. The cerebral oxygen saturation increased with increasing arterial hyperoxia in the operated cerebral hemisphere and remained within baseline range in the nonoperated hemisphere. Impairment in the cerebral autoregulation in the pathologic hemisphere contributes to this luxury oxygenation.
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In response to traumatic brain injury (TBI) microglia/macrophages and astrocytes release inflammatory mediators with dual effects on secondary brain damage progression. The neurotrophic and anti-inflammatory glycoprotein progranulin (PGRN) attenuates neuronal damage and microglia/macrophage activation in brain injury but mechanisms are still elusive. Here, we studied histopathology, neurology and gene expression of inflammatory markers in PGRN-deficient mice (Grn-/- ) 24 h and 5 days after experimental TBI. ⋯ Moreover, intracerebroventricular administration of rPGRN immediately before trauma reduced brain damage and neurological deficits, and restored normal levels of cytokine transcription, axonal injury and astrogliosis 5 days after TBI in Grn-/- mice. Our results show that endogenous and recombinant PGRN limit axonal injury and astrogliosis and suggest therapeutic potential of PGRN in TBI. GLIA 2017;65:278-292.
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J Trauma Acute Care Surg · Feb 2017
Performance of International Classification of Diseases-based injury severity measures used to predict in-hospital mortality and intensive care admission among traumatic brain-injured patients.
The International Classification of Diseases (ICD) is the main classification system used for population-based traumatic brain injury (TBI) surveillance activities but does not contain direct information on injury severity. International Classification of Diseases-based injury severity measures can be empirically derived or mapped to the Abbreviated Injury Scale, but no single approach has been formally recommended for TBI. ⋯ Prognostic study, level III.
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American family physician · Feb 2017
Randomized Controlled TrialSertraline Reduces Risk of Depression in Adults After Traumatic Brain Injury.