Articles: traumatic-brain-injuries.
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Pediatr Crit Care Me · Dec 2016
Multicenter Study Observational StudyFunctional Status Scale in Children With Traumatic Brain Injury: A Prospective Cohort Study.
In children with traumatic brain injury, 1) to describe the hospital discharge functional outcome and change from baseline function using the Functional Status Scale and 2) to determine any associations between discharge Functional Status Scale and age, injury mechanism, neurologic examination, imaging, and other predictors of outcome. ⋯ More than one-third of survivors, and approximately half of survivors with severe traumatic brain injury, will have new morbidity. Hospital discharge Functional Status Scale, change from baseline Functional Status Scale, and new morbidity acquisition can be used as outcome measures for hospital-based care process improvement initiatives and interventional studies of children with traumatic brain injury.
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Photomed Laser Surg · Dec 2016
ReviewTranscranial, Red/Near-Infrared Light-Emitting Diode Therapy to Improve Cognition in Chronic Traumatic Brain Injury.
We review the general topic of traumatic brain injury (TBI) and our research utilizing transcranial photobiomodulation (tPBM) to improve cognition in chronic TBI using red/near-infrared (NIR) light-emitting diodes (LEDs) to deliver light to the head. tPBM improves mitochondrial function increasing oxygen consumption, production of adenosine triphosphate (ATP), and improving cellular energy stores. Nitric oxide is released from the cells increasing regional blood flow in the brain. Review of published studies: In our previously published study, 11 chronic TBI patients with closed-head TBI caused by different accidents (motor vehicle accident, sports-related, improvised explosive device blast injury) and exhibiting long-lasting cognitive dysfunction received 18 outpatient treatments (Monday, Wednesday, Friday for 6 weeks) starting at 10 months to 8 years post-TBI. ⋯ Actigraphy sleep data showed increased time asleep (on average one additional hour per night) after the 18th tLED or iLED treatment. LED treatments may be performed in the home. Sham-controlled studies with veterans who have cognitive dysfunction from Gulf War Illness, blast TBI, and TBI/PTSD are currently ongoing.
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Journal of neurotrauma · Dec 2016
ReviewInhibition of glycogen synthase kinase-3: an emerging target in the treatment of traumatic brain injury.
Although traumatic brain injury (TBI) has been a major public health concern for decades, the pathophysiological mechanism of TBI is not clearly understood, and an effective medical treatment of TBI is not available at present. Of particular concern is sustained TBI, which has a strong tendency to take a deteriorating neurodegenerative course into chronic traumatic encephalopathy (CTE) and dementia, including Alzheimer's disease. Tauopathy and beta amyloid (Aβ) plaques are known to be the key pathological markers of TBI, which contribute to the progressive deterioration associated with TBI such as CTE and Alzheimer's disease. ⋯ GSK-3 inhibition studies using rodent TBI models demonstrate that GSK-3 inhibition produces diverse neuroprotective actions such as reducing the size of the traumatic injury, tauopathy, Aβ accumulation, and neuronal death, by releasing and activating neuroprotective substrates from GSK-3 inhibition. These effects are correlated with reduced TBI-induced behavioral and cognitive symptoms. Here, we review studies on the therapeutic effects of GSK-3 inhibition in TBI rodent models, and critically discuss the issues that these studies address.
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Numerous injury criteria have been developed to predict brain injury using the kinematic response of the head during impact. Each criterion utilizes a metric that is some mathematical combination of the velocity and/or acceleration components of translational and/or rotational head motion. Early metrics were based on linear acceleration of the head, but recent injury criteria have shifted towards rotational-based metrics. ⋯ Correlations between brain strain and metrics based on angular velocity were highest among those evaluated, while metrics based on linear acceleration were least correlative. BrIC and RVCI were the kinematic metrics with the highest overall correlation; however, each metric had limitations in certain impact conditions. The results of this study suggest that rotational head kinematics are the most important parameters for brain injury criteria.
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Observational Study
Diffusion Tensor Imaging: A Possible Biomarker in Severe Traumatic Brain Injury and Aneurysmal Subarachnoid Hemorrhage?
A great need exists in traumatic brain injury (TBI) and aneurysmal subarachnoid hemorrhage (aSAH) for objective biomarkers to better characterize the disease process and to serve as early endpoints in clinical studies. Diffusion tensor imaging (DTI) has shown promise in TBI, but much less is known about aSAH. ⋯ aSAH, aneurysmal subarachnoid hemorrhageDTI, diffusion tensor imagingFA, fractional anisotropyGOSE, Glasgow Outcome Scale ExtendedTBI, traumatic brain injuryTE, echo timeTR, repetition time.