Imaging Evaluation of Acute Traumatic Brain Injury

Mutch, Christopher A.; Talbott, Jason F.; Gean, Alisa D.

doi:10.1016/j.nec.2016.05.011

Cited by 124 publications

(92 citation statements)

References 159 publications

(242 reference statements)

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“…Often, a computed tomography scan does not reveal this, even though the patient may be symptomatic or comatose. Magnetic resonance imaging is the preferred neuroimaging technique if DAI is suspected . Advanced magnetic resonance imaging techniques such as diffuse tensor imaging and susceptibility weighted imaging are even more capable in identifying these lesions …”

Section: Mechanisms and Complications Of Injurymentioning

confidence: 99%

“…They are frequently hemorrhagic, due to vascular damage, and may worsen, or “blossom,” with resuscitation. One can also see coup‐contrecoup lesions that result when the brain impacts both side of the skull due to rebound …”

Section: Mechanisms and Complications Of Injurymentioning

confidence: 99%

“…One can also see coup-contrecoup lesions that result when the brain impacts both side of the skull due to rebound. 22,23 Hemorrhagic conversion of a contusion often leads to clinical worsening. Following TBI, the highest risk is within the first 9 hours.…”

Section: Cortical Contusionsmentioning

confidence: 99%

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Management of moderate and severe traumatic brain injury

2019

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Traumatic brain injury (TBI) is a common disorder with high morbidity and mortality, accounting for one in every three deaths due to injury. Older adults are especially vulnerable. They have the highest rates of TBI‐related hospitalization and death. There are about 2.5 to 6.5 million US citizens living with TBI‐related disabilities. The cost of care is very high. Aside from prevention, little can be done for the initial primary injury of neurotrauma. The tissue damage incurred directly from the inciting event, for example, a blow to the head or bullet penetration, is largely complete by the time medical care can be instituted. However, this event will give rise to secondary injury, which consists of a cascade of changes on a cellular and molecular level, including cellular swelling, loss of membrane gradients, influx of immune and inflammatory mediators, excitotoxic transmitter release, and changes in calcium dynamics. Clinicians can intercede with interventions to improve outcome in the mitigating secondary injury. The fundamental concepts in critical care management of moderate and severe TBI focus on alleviating intracranial pressure and avoiding hypotension and hypoxia. In addition to these important considerations, mechanical ventilation, appropriate transfusion of blood products, management of paroxysmal sympathetic hyperactivity, using nutrition as a therapy, and, of course, venous thromboembolism and seizure prevention are all essential in the management of moderate to severe TBI patients. These concepts will be reviewed using the recent 2016 Brain Trauma Foundation Guidelines to discuss best practices and identify future research priorities.

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Section: Mechanisms and Complications Of Injurymentioning

confidence: 99%

Section: Mechanisms and Complications Of Injurymentioning

confidence: 99%

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Management of moderate and severe traumatic brain injury

2019

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“…motor-vehicle or motorcycle accidents in 56.5% (n = 52) of the patients, high level-falls in 21.75% (n = 20) of the patients, and sports injuries or other accidents in 21.75% (n = 20) of the patients. According to the GCS scores; 87 patients had a mild brain injury (GCS:13-15), 3 patients had a moderate brain injury (GCS:9-12), and 2 patients had severe brain injury (GCS: [3][4][5][6][7][8]. The time elapsed from the time of the trauma until the collection of the blood samples was observed to be within the first hour in more than half of the patients.…”

Section: Resultsmentioning

confidence: 99%

The Role of Allopregnanolone Levels in Traumatic Brain Injury in Children and Adults and the Correlation of Its Levels with Computerized Tomography Images of the Brain

Coşkun

Beceren

Bedel³

2020

Indian Journal of Neurosurgery

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Aim Allopregnanolone (AP) is a steroid of progesterone origin and it can readily pass through the blood–brain barrier. The aim of this study was to determine the AP levels occurring after head trauma in children and adults and to compare these results to the findings observed in the computed tomography (CT) of the respective individuals. Materials and Methods This study was conducted in the period from April 2018 to December 2018 on 92 patients admitted with isolated head trauma and on 80 healthy individuals in similar gender and age groups. The age, gender, and Glasgow Coma Scores of the patients; the cause of the head trauma; and the findings from CT imaging were recorded. Results The levels of AP were significantly lower in the head trauma patients both in the adult and pediatric groups compared with the healthy control groups of respective ages (p < 0.001). Furthermore, the levels of AP were significantly lower in both the pediatric and adult patients with identified pathologies in the CT images compared with their counterpart control groups (p < 0.001). In predicting an existing pathology in the CT, an AP level of > 138.5 was found to be 85.7% sensitive and 85.3% specific in the pediatric patients, and an AP level of >118.3 was 75% sensitive and 83.5% specific in the adult patients. Conclusion The levels of AP in head trauma patients were reduced in both the pediatric and adult patients and these low levels increase the likelihood of detecting pathology in CT images.

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“…She has no signs or symptoms of serious pathology and is not anticoagulated. Literature suggests that in minor head injury, less than 10% of all patients will have an abnormality on CT scan, and very few of these will have an injury requiring neurosurgical intervention (Fig. ).…”

Section: A Bump On the Headmentioning

confidence: 99%

Review article: A primer for clinical researchers in the emergency department: Part XI. Inertia before investigation: Pre‐test probability in emergency medicine

Pellatt

Purdy

Keijzers

2020

Emerg Medicine Australasia

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In this series, we address research topics in emergency medicine. Rational clinical decision making is based on knowledge of the disease prevalence, clinical assessment features and test characteristics such as sensitivity and specificity. The concept of pre-test probability is important as it will allow the clinician and patient decide together if a 'test threshold' or 'treatment threshold' has been reached, or if further investigations are required to make such a decision. This research primer uses three case scenarios to explore these concepts.• Clinical decision making and test ordering are influenced by disease prevalence and test characteristics. • This paper illustrates how PTP can inform clinical decision making using the concepts of test threshold and treatment threshold.

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Imaging Evaluation of Acute Traumatic Brain Injury

Cited by 124 publications

References 159 publications

Management of moderate and severe traumatic brain injury

Management of moderate and severe traumatic brain injury

The Role of Allopregnanolone Levels in Traumatic Brain Injury in Children and Adults and the Correlation of Its Levels with Computerized Tomography Images of the Brain

Review article: A primer for clinical researchers in the emergency department: Part XI. Inertia before investigation: Pre‐test probability in emergency medicine

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