Traumatic Brain Injury: A Perspective on the Silent Epidemic

Alkhaibary, Ali; Alshalawi, Abdulaziz; Althaqafi, Raad M M; Alghuraybi, Abdullah A; Basalamah, Ali; Shammaa, Ahmed M; Altalhy, Ali A; Abdelrahman, Tarig

doi:10.7759/cureus.15318

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…K raniocerebralne povrede (traumatic brain injury -TBI) nalaze se u "tihoj globalnoj epidemiji", jer predstavljaju vodeći uzrok smrti mladih muškaraca u razvijenim zemljama i glavni uzrok invaliditeta, morbiditeta i mortaliteta širom sveta 1,2 . Klasifikacija težine TBI, izvršena je prema Glazgov koma skali (GCS) na blagu , umerenu i tešku .…”

Section: Uvodunclassified

Intensive care management of traumatic brain injury: How can mnemonics help?

Damnjanović¹,

Stanisavljević²,

Hadžibegović³

et al. 2022

Serb J Anest Inten Therapy

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Traumatic brain injury (TBI) is considered to be a "silent global epidemic" and is the leading cause of death in young males in developed countries, major cause of disability, morbidity, and mortality worldwide. The classification of TBI severity was performed using the Glasgow coma scale (GCS) into mild (GCS = 15-13), moderate (GCS = 12-9), and severe (GCS = 8-3). Despite developments in modern intensive care, improvements in resuscitation and vital organ support, the management of critically ill patients with traumatic brain injury presents a challenge to all members of the critical care team. Since severe head injury is often associated with poor functional outcomes due to secondary brain insults, the benefits of intensive treatment and care may not become apparent until months or years later during rehabilitation after injury. Due to the complexity and specificity of TBI, implementation of an easy-to-remember mnemonic can significantly help anesthesiologists and clinicians in conducting intensive therapy. Mnemonic GOST CAP was implementing to help with treatment of patients with primary craniocerebral trauma and prevention of secondary brain injury. GOST CAP acronym emphasizes the significance of glycemic control in neurotrauma, maintaining haemoglobin levels, oxygen support, sodium concentration, temperature maintenance, pain and agitation control, arterial blood pressure control in maintaining cerebral perfusion pressure, and partial pressure of CO2 control. The aim of this paper is to display acronyms that address the most important steps in treating patients with TBI.

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Section: Uvodunclassified

Intensive care management of traumatic brain injury: How can mnemonics help?

Damnjanović¹,

Stanisavljević²,

Hadžibegović³

et al. 2022

Serb J Anest Inten Therapy

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“…Traumatic brain injury (TBI) is a significant source of disability, with a global annual incidence of 69 million [ 1 ], and may lead to long-lasting neurological deficits and a decreased quality of life for patients across injury severities. Approximately 80% of TBIs are considered mild [ 2 ]; mild TBI (mTBI) has been known as the silent epidemic because of its load on acute healthcare [ 3 , 4 ]. Following the primary injury phase, TBI is characterized by complex secondary cascades that include oxidative stress [ 5 ], excitotoxicity [ 6 ], blood–brain barrier (BBB) damage [ 7 ], plasma membrane damage [ 8 ], cell death [ 9 ], neuroinflammation [ 10 ], and lipid dysregulation [ 11 ] in the acute, subacute, and chronic phases after injury.…”

Section: Introductionmentioning

confidence: 99%

Integrative Analysis of Cytokine and Lipidomics Datasets Following Mild Traumatic Brain Injury in Rats

Pulliam,

Pybus,

Gaul

et al. 2024

Metabolites

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Traumatic brain injury (TBI) is a significant source of disability in the United States and around the world and may lead to long-lasting cognitive deficits and a decreased quality of life for patients across injury severities. Following the primary injury phase, TBI is characterized by complex secondary cascades that involve altered homeostasis and metabolism, faulty signaling, neuroinflammation, and lipid dysfunction. The objectives of the present study were to (1) assess potential correlations between lipidome and cytokine changes after closed-head mild TBI (mTBI), and (2) examine the reproducibility of our acute lipidomic profiles following TBI. Cortices from 54 Sprague Dawley male and female rats were analyzed by ultra-high-performance liquid chromatography mass spectrometry (LC-MS) in both positive and negative ionization modes and multiplex cytokine analysis after single (smTBI) or repetitive (rmTBI) closed-head impacts, or sham conditions. Tissue age was a variable, given that two cohorts (n = 26 and n = 28) were initially run a year-and-a-half apart, creating inter-batch variations. We annotated the lipidome datasets using an in-house data dictionary based on exact masses of precursor and fragment ions and removed features with statistically significant differences between sham control batches. Our results indicate that lipids with high-fold change between injury groups moderately correlate with the cytokines eotaxin, IP-10, and TNF-α. Additionally, we show a significant decrease in the pro-inflammatory markers IL-1β and IP-10, TNF-α, and RANTES in the rmTBI samples relative to the sham control. We discuss the major challenges in correlating high dimensional lipidomic data with functional cytokine profiles and the implications for understanding the biological significance of two related but disparate analysis modes in the study of TBI, an inherently heterogeneous neurological disorder.

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“…Traumatic brain injury (TBI) is a silent public health epidemic mainly involving the productive age group. 1 Sixty-nine million people suffer TBI each year, with the Southeast Asian and Western Pacific regions having maximum incidence. 2 Many survivors live with major disabilities, resulting in significant socioeconomic burden.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of plasma interleukin 6 levels in severe traumatic brain injury

et al. 2023

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Background: Traumatic brain injury (TBI) results in a significant morbidity and mortality. Several inflammatory mediators are released after TBI. Some studies have shown inconclusive association between interleukin-6 (IL-6) and outcome following TBI. Aims and Objectives: The aim of the present study was to investigate the role of plasma IL-6 levels as a possible prognostic marker in patients with severe TBI. Materials and Methods: A total of 47 male patients with isolated severe TBI were included in a prospective observational study. Plasma IL-6 levels was measured at admission, 24 h and 48 h. Association of IL-6 levels with mortality and functional outcome were studied. The Glasgow outcome scale was used to assess functional outcomes. Results: Mean age was 44.4 years. Overall mortality of 42.6% was noted. Higher mortality was noted for patients beyond 50 years of age. Mean IL-6 levels at the time of admission was 306.285 pg/mL and 167.830 pg/mL at 24 h while 99.033 pg/mL at 48 h of admission Mean IL 6 levels were higher in patients with lower Glasgow coma scale (GCS), with a significant statistical association of GCS with IL-6 levels at admission and 24 h (P<0.001). 38 (80.85%) patients underwent surgical intervention. No statistical correlation was noted between IL-6 levels and mode of management. Significant IL-6 levels were seen in patients with worse clinical course at admission, 24 h and 48 h (P<0.0001). A level of 78 pg/mL was the appropriate cutoff to differentiate patient mortality as per receiver operating characteristic curve with Sensitivity of 1 and specificity of 0.8. Conclusion: IL-6 plasma concentrations are likely to be a useful parameter for assessing prognosis in severe TBI.

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Traumatic Brain Injury: A Perspective on the Silent Epidemic

Cited by 10 publications

References 27 publications

Intensive care management of traumatic brain injury: How can mnemonics help?

Intensive care management of traumatic brain injury: How can mnemonics help?

Integrative Analysis of Cytokine and Lipidomics Datasets Following Mild Traumatic Brain Injury in Rats

Prognostic value of plasma interleukin 6 levels in severe traumatic brain injury

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