Articles: brain-injuries.
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External lumbar drainage (ELD) of cerebrospinal fluid may help control intracranial pressure following a traumatic brain injury. We aimed to assess the efficacy and safety of ELD in post-traumatic intracranial hypertension (IH). ⋯ ELD appears in our cohort to be a safe and effective strategy to control post-traumatic IH, with an acceptable benefit-risk ratio. Our analysis even suggests a potential outcome improvement in patients treated by ELD compared with those having no cerebrospinal fluid drainage.
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Prolonged field care is a military adaptation of tactical combat casualty care providing extended prehospital management during delayed extrication. Effects of addition of valproic acid (VPA) to fresh-frozen plasma (FFP) in a prolonged field care model of hemorrhagic shock and traumatic brain injury are not known. We hypothesized that VPA is associated with decreased neurological impairment, and its protective changes are detected at the transcriptomic level. ⋯ The addition of FFP to the resuscitation protocol resulted in a significant reduction in crystalloid requirements. Both the NS + FFP and NS + FFP + VPA groups showed improved neurological recovery compared with NS alone and had distinctive transcriptomic profiles in injured brains at 72 hours. The mitochondrially encoded ATP synthase membrane subunit 8 gene, involved in worsening ischemia following brain injury, was downregulated in VPA-treated animals.
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Journal of neurotrauma · Jan 2025
Intravenous Immunomodulatory Nanoparticles Prevent Secondary Damage after Traumatic Brain Injury.
After traumatic brain injury (TBI), monocyte/macrophage infiltration is a key early step in the development of an inflammatory cascade that leads to substantial secondary damage. Intravenous (IV) immunomodulatory nanoparticle (IMP) administration after TBI limits inflammatory cell infiltration and reduces both behavioral decline and lesion size without any noticeable toxicity. Here we show that there is a dose-response relationship between the amount of IMP administered and tissue damage which plateaus at a well-tolerated dose. ⋯ Thus, IMP treatment within 6 h after TBI limits inflammatory responses and gliosis, improves anatomical and behavioral outcomes and prevents detrimental changes in gene expression in both neural and non-neural cellular elements of the brain. IMPs are non-toxic and are made of an FDA-approved material that is stable at room temperature. They could easily be given IV immediately after TBI in the field by emergency medical technicians or in the emergency room to prevent secondary damage, thereby improving outcomes.
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Journal of women's health · Jan 2025
Traumatic Brain Injury and Posttraumatic Stress Disorder Are Associated with Physical Health Burden among Post-9/11 Women Veterans.
Background: Little research focuses on physical health outcomes of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) among post-9/11 women veterans (WVs). This study examined lifetime TBI, current PTSD, and their associations with biomarkers of cardiometabolic health, sleep, pain, and functional disability among post-9/11 WVs. Methods: WVs (n = 90) from the Translational Research Center for TBI and Stress Disorders longitudinal cohort study were included in this study. ⋯ PTSD was significantly associated with lower total functioning and each of its subdomains (βs = -0.58 to 0.63; ps = <0.001 to 0.02). Lifetime TBI was significantly associated with total functioning, mobility, and life/work (βs = -0.20 to 0.30; ps = <0.01 to 0.02). Conclusions: These findings highlight the importance of screening for lifetime TBI and cardiovascular disease for WVs and support transdiagnostic treatment approaches targeting physical health outcomes.
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Journal of neurotrauma · Jan 2025
Supra-Prophylactic Doses of Enoxaparin Reduces Fibrin Deposition Without Exacerbation of Intracerebral Hemorrhage in a Rat Model of Penetrating Traumatic Brain Injury.
Deep vein thrombosis and pulmonary embolism prophylaxis is an important part of trauma care. Despite an increased risk of thrombotic complications, the use of venous thrombosis chemoprophylaxis in penetrating traumatic brain injury (pTBI) patients is met with reluctance from neurosurgeons because of concern for the exacerbation of intracerebral hemorrhage. The objective of this study was to provide initial pre-clinical evidence of the effects of Lovenox (LVX) administration following pTBI with significant intracerebral hemorrhage. ⋯ However, LVX elicited a significant reduction in fibrin deposition in the ipsilateral striatum and lesion site at 7 days post-injury (p < 0.05). Serum levels of beta-amyloid were decreased at 7 days following LVX treatment (p < 0.05) which may indicate neuroprotective effects but was not correlated to brain levels. The results presented indicate that administration of LVX at a dose capable of inducing anticoagulation is safe in a rodent model of pTBI without exacerbation of intracerebral hemorrhage within the first 7 days of injury.