Articles: brain-injuries.
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Eur J Trauma Emerg Surg · Jan 2025
Dose-dependent association of hyperoxia and decreased favorable outcomes in mechanically ventilated patients with traumatic brain injury, a retrospective cohort study.
In patients with traumatic brain injury (TBI), adequate oxygenation is crucial to optimize survival and neurological outcome. However, supranormal oxygen partial pressure (PaO2) only leads to minor increase in cerebral oxygen delivery but can cause numerous pathophysiological disturbances. Therefore, we aimed to study effects of hyperoxia on patient outcome and identify optimum PaO2 ranges. ⋯ In this cohort, hyperoxia within 72 h after admission was dose-dependently associated with an unfavorable neurological outcome after 3-6 months.
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Eur J Trauma Emerg Surg · Jan 2025
Review Meta AnalysisSurgical intervention in traumatic brain injury: a systematic review and meta-analysis of decompressive craniotomy.
Traumatic brain injury (TBI) is considered a major cause of death globally, resulting from trauma. Decompressive craniectomy (DC) may improve functional outcomes in patients with TBI and its associated complications. This study was designed to determine safety and efficacy of DC in improving clinical outcomes in TBI patients compared to standard therapy. ⋯ This study presents evidence suggesting that DC is linked to a lower mortality rate, decreased ICP, and shorter hospital stays among patients with moderate to severe TBI. However, it did not show a significant impact on improving favorable clinical outcomes.
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Management of the patient with moderate to severe brain injury in any environment can be time consuming and resource intensive. These challenges are magnified while forward deployed in austere or hostile environments. This Joint Trauma System Clinical Practice Guideline provides recommendations for the treatment and medical management of casualties with moderate to severe head injuries in an environment where personnel, resources, and follow-on care are limited. These guidelines have been developed by acknowledging commonly recognized recommendations for neurosurgical and neuro-critical care patients and augmenting those evaluations and interventions based on the experience of neurosurgeons, trauma surgeons, and intensivists who have delivered care during recent coalition conflicts.
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J. Neurol. Neurosurg. Psychiatr. · Jan 2025
Poor long-term outcomes and abnormal neurodegeneration biomarkers after military traumatic brain injury: the ADVANCE study.
Traumatic brain injury (TBI) is common in military campaigns and is a risk factor for dementia. ArmeD SerVices TrAuma and RehabilitatioN OutComE-TBI (ADVANCE-TBI) aims to ascertain neurological outcomes in UK military personnel with major battlefield trauma, leveraging advances in quantification of axonal breakdown markers like neurofilament light (NfL), and astroglial marker glial fibrillar acidic protein (GFAP) in blood. We aimed to describe the causes, prevalence and consequences of TBI, and its fluid biomarker associations. ⋯ TBI affected nearly a fifth of trauma-exposed personnel, related to worse mental health, motor and functional outcomes, as well as elevated plasma GFAP levels 8 years post-injury. This was absent after extracranial trauma, and showed a dose-response relationship with the severity of the injury.