Articles: brain-injuries.
-
Journal of neurotrauma · Mar 2009
Randomized Controlled Trial Multicenter StudyMulticenter trial of early hypothermia in severe brain injury.
The North American Brain Injury Study: Hypothermia IIR (NABIS:H IIR) is a randomized clinical trial designed to enroll 240 patients with severe brain injury between the ages of 16 and 45 years. The primary outcome measure is the dichotomized Glasgow Outcome Scale (GOS) at 6 months after injury. The study has the power to detect a 17.5% absolute difference in the percentage of patients with a good outcome with a power of 80%. ⋯ Patients enrolled in the normothermia arm receive standard management at normothermia. As of December 2007, 74 patients had been randomized into phase II of the protocol. Patients in the hypothermia arm reached 35 degrees C in 2.7 +/- 1.1 (SD) h after injury and reached 33 degrees C at 4.4 +/- 1.5 h after injury.
-
Critical care medicine · Feb 2009
Randomized Controlled Trial Multicenter StudyTherapeutic hypothermia preserves antioxidant defenses after severe traumatic brain injury in infants and children.
Oxidative stress contributes to secondary damage after traumatic brain injury (TBI). Hypothermia decreases endogenous antioxidant consumption and lipid peroxidation after experimental cerebral injury. Our objective was to determine the effect of therapeutic hypothermia on oxidative damage after severe TBI in infants and children randomized to moderate hypothermia vs. normothermia. ⋯ To our knowledge, this is the first study demonstrating that hypothermia attenuates oxidative stress after severe TBI in infants and children. Our data also support the concept that CSF represents a valuable tool for monitoring treatment effects on oxidative stress after TBI.
-
Multicenter Study Comparative Study
Family burden after traumatic brain injury in children.
Traumatic brain injury has a substantial impact on caregivers. This study describes the burden experienced by caregivers of children with traumatic brain injury and examines the relationship between child functioning and family burden during the first year after injury. ⋯ Caregivers are more likely to report family burden problems when child functioning is poorer and health care needs are unmet. Improved identification and provision of services is a potentially modifiable factor that may decrease family burden after pediatric traumatic brain injury.
-
Journal of neurology · Jan 2009
Multicenter StudyExplorative investigation of biomarkers of brain damage and coagulation system activation in clinical stroke differentiation.
A simple and accurate method of differentiating ischemic stroke and intracerebral hemorrhage (ICH) is potentially useful to facilitate acute therapeutic management. Blood measurements of biomarkers of brain damage and activation of the coagulation system may potentially serve as novel diagnostic tools for stroke subtypes. ⋯ This exploratory study indicated that blood levels of biomarkers GFAP and APC-PCI, prior to neuroimaging, may rule out ICH in a mixed stroke population.
-
To determine the influence of minority status on job stability after traumatic brain injury (TBI). ⋯ Minority status is an independent predictor of short-term job stability after TBI. Minority TBI survivors were more likely than Caucasians to be unemployed or unstably employed. Rehabilitation professionals should develop employment interventions that will address the specific needs of these racial/ethnic groups and facilitate optimal employment outcomes for minority TBI survivors.