Articles: brain-injuries.
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Acta Neurochir. Suppl. · Jan 2013
Randomized Controlled TrialGlobal cerebral atrophy after subarachnoid hemorrhage: a possible marker of acute brain injury and assessment of its impact on outcome.
There is a correlation between poor neuropsychological outcome and focal regions of atrophy in patients with subarachnoid hemorrhage (SAH). No study has investigated the impact of global brain atrophy on outcome after SAH. In other neurological disorders, such as multiple sclerosis, a correlation has been found between global atrophy and outcome. ⋯ Relationships were modeled using univariate and multivariate analysis. Age, female gender, and higher body temperature during the patient's stay in the intensive care unit were significantly correlated with brain atrophy. Greater brain atrophy significantly correlated with poor outcome (modified Rankin scale), more severe neurological deficits on the National Institute of Health Stroke Scale (NIHSS), and poorer health status (EQ-5D).
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Randomized Controlled Trial
Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial.
Traumatic brain injury (TBI) is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments. ⋯ HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage.
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Neuropsychol Rehabil · Jan 2013
Randomized Controlled Trial Multicenter StudyEffectiveness of an electronic cognitive aid in patients with acquired brain injury: a multicentre randomised parallel-group study.
The objective of the study was to examine the effectiveness of a customised personal digital assistant (PDA) as a cognitive aid for people with acquired brain injury, using a randomised parallel-group study. The participants were 34 patients with acquired brain injury in a cognitive rehabilitation setting. The experimental group used a customised PDA, while the control group received care-as-usual (paper-and-pencil aids). ⋯ Both groups showed a significant increase in goal attainment (GAS) (p < .001). There were no significant differences between the groups at T1 or T2 on any of the other outcome measures. It was concluded that the customised PDA was as effective as paper-and-pencil aids, and may therefore serve as a useful alternative when choosing the optimal rehabilitation strategy for a patient.
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Brain injury : [BI] · Jan 2013
Randomized Controlled TrialEffect of COMT Val158Met genotype on attention and response to methylphenidate following traumatic brain injury.
To investigate whether COMT Val158Met allele status was associated with (i) attentional performance and (ii) response to methylphenidate (MP) following traumatic brain injury (TBI). ⋯ COMT allele status was not strongly associated with attentional performance or response to MP in the TBI sample. The met/met group, whilst performing slowly, had relatively preserved strategic control of attention.
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Randomized Controlled Trial Multicenter Study
Study of therapeutic hypothermia (32 to 35°C) for intracranial pressure reduction after traumatic brain injury (the Eurotherm3235Trial): outcome of the pilot phase of the trial.
Clinical trials in traumatic brain injury (TBI) are challenging. Previous trials of complex interventions were conducted in high-income countries, reported long lead times for site setup and low screened-to-recruitment rates.In this report we evaluate the internal pilot phase of an international, multicentre TBI trial of a complex intervention to assess: design and implementation of an online case report form; feasibility of recruitment (sites and patients); feasibility and effectiveness of delivery of the protocol. ⋯ The pilot data demonstrated good feasibility for this large international multicentre randomized controlled trial of hypothermia to control intracranial pressure. The sample size was reduced to 600 patients because of homogeneity of the patient group and we showed an optimized cooling intervention could be delivered.