Intensive Care Treatment in Traumatic Brain Injury

Dilmen, Özlem Korkmaz; Akçıl, Eren Fatma; Tunalı, Yusuf

doi:10.5152/tjar.2014.26680

Cited by 10 publications

(5 citation statements)

References 26 publications

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“…TBI may develop due to primary effect of the trauma or as a result of secondary effects such as hypoxia, hyperkapnia, hypotension, increase in intracranial pressure, and hyperglycemia 3 . Although it is not possible to avoid primary TBI due to acute effects of the impact, brain damage may be reduced by minimizing metabolic causes and cerebral edema in secondary injuries.…”

Section: Introductionmentioning

confidence: 99%

The association between intracranial pressure and optic nerve sheath diameter on patients with head trauma

Çelik

Demiryürek

2021

Arq. Neuro-Psiquiatr.

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Background: Although intracranial pressure (ICP) monitoring is the gold standard method for measuring intracranial pressure after traumatic brain injury, optic nerve sheath diameter (ONSD) measurement with ultrasound (US) is also used in the evaluation of ICP. Objective: To investigate the association between a series of OSND measurements by US and changes in clinical presentation of the patient. Methods: Prospective study including 162 patients with traumatic brain injury. Age, sex, cerebral CT findings, ONSD levels by US at minutes 0, 60, and 120, Glasgow Coma Scale (GCS) within same period, change of consciousness, treatment, and mortality data were reviewed. The association of ONSD levels with GCS, change of consciousness, treatment, and mortality was evaluated. Results: There was no difference in ONSD changes in the patients’ sample within the period (p=0.326). ONSD significantly increased in patients who died (p<0.001), but not in those who survived (p=0.938). There was no significant change in ONSD of the patients who received anti-edema therapy (p=801), but significantly increased ONSD values were found in those who received anti-edema therapy (p=0.03). Patients without change of consciousness did not have any significant change in ONSD (p=0.672), but ONSD values increased in patients who consciousness became worse, and decreased in those who presented a recovery (respectively, p<0.001, p=0.002). A negative correlation was detected between ONSD values and GSC values measured at primary, secondary, and tertiary time periods (for all p<0.001). Conclusions: ONSD follow-up may be useful to monitor ICP increase in patients with acute traumatic brain injury.

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Section: Introductionmentioning

confidence: 99%

The association between intracranial pressure and optic nerve sheath diameter on patients with head trauma

Çelik

Demiryürek

2021

Arq. Neuro-Psiquiatr.

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“…Providing optimum ventilation without causing further rise in ICP is mandatory in patients with intracranial pathology. Although the most common reason for secondary brain injury following intracranial pathology is hypoxemia, dealing with hypoxemia would be difficult in clinical practice [ 5 ]. Administration of high fraction of oxygen can cause absorption atelectasis that leads to worsening hypoxemia.…”

Section: Discussionmentioning

confidence: 99%

Effect of different positive end expiratory pressure levels on optic nerve sheath diameter in patients with or without midline shift who are undergoing supratentorial craniotomy

Fenerci,

Akcil,

Tunali

et al. 2024

Acta Neurochir

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Purpose In general, high levels of PEEP application is avoided in patients undergoing craniotomy to prevent a rise in ICP. But that approach would increase the risk of secondary brain injury especially in hypoxemic patients. Because the optic nerve sheath is distensible, a rise in ICP is associated with an increase in the optic nerve sheath diameter (ONSD). The cutoff value for elevated ICP assessed by ONSD is between 5.6 and 6.3 mm. We aimed to evaluate the effect of different PEEP levels on ONSD and compare the effect of different PEEP levels in patients with and without intracranial midline shift. Methods This prospective observational study was performed in aged 18–70 years, ASA I–III, 80 patients who were undergoing supratentorial craniotomy. After the induction of general anesthesia, the ONSD’s were measured by the linear transducer from 3 mm below the globe at PEEP values of 0–5–10 cmH2O. The ONSD were compered between patients with (n = 7) and without midline shift (n = 73) at different PEEP values. Results The increases in ONSD due to increase in PEEP level were determined (p < 0.001). No difference was found in the comparison of ONSD between patients with and without midline shift in different PEEP values (p = 0.329, 0.535, 0.410 respectively). But application of 10 cmH2O PEEP in patients with a midline shift increased the mean ONSD value to 5.73 mm. This value is roughly 0.1 mm higher than the lower limit of the ONSD cutoff value. Conclusions The ONSD in adults undergoing supratentorial tumor craniotomy, PEEP values up to 5 cmH2O, appears not to be associated with an ICP increase; however, the ONSD exceeded the cutoff for increased ICP when a PEEP of 10 cmH2O was applied in patients with midline shift.

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“…In this study, the effect of rutin on the secondary phase of TBI was evaluated. Treatment of head trauma usually aims at preventing secondary damage; prevention of secondary brain injury significantly reduces morbidity and mortality (16). Identification of novel therapeutic targets for the treatment of cellular injury would be beneficial to eliminate or reduce disability from nervous system trauma (17).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Rutin on Experimental Traumatic Brain Injury and Edema in Rats

Yuceli

Yazıcı

Mammadov

et al. 2020

In Vivo

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Background/Aim: The aim of the study was to evaluate the effect of rutin, which is a vitamin P1 flavonoid with anti-inflammatory and anti-edema effects, on traumatic brain injury (TBI) and edema in rats. Materials and Methods: Rats were divided into 3 groups as sham group without brain trauma (SG), brain trauma without medication (BT) group and Rutin treated brain trauma (RBT) group. Fifty mg/kg rutin was administered to the RBT group once a day for three days. On the fourth day, rats were sacrificed. Extracted brain tissues were examined biochemically and histopathologically. Results: We found that the levels of malondialdehyde, nuclear factorkappa B and tumor necrosis factor-alpha decreased, and those of total glutathione increased significantly. Furthermore, rutin administration reduced pyramidal neuron degeneration and poly-morpho-nuclear-leucocyte accumulation due to trauma in brain tissue, while eliminating edema. Conclusion: Rutin might be effective in the treatment of TBI and TBI-related brain edema.

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Intensive Care Treatment in Traumatic Brain Injury

Cited by 10 publications

References 26 publications

The association between intracranial pressure and optic nerve sheath diameter on patients with head trauma

The association between intracranial pressure and optic nerve sheath diameter on patients with head trauma

Effect of different positive end expiratory pressure levels on optic nerve sheath diameter in patients with or without midline shift who are undergoing supratentorial craniotomy

The Effect of Rutin on Experimental Traumatic Brain Injury and Edema in Rats

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