Traumatic brain injury in Greece: Report of a countrywide registry

Katsaragakis, Stylianos; Drimousis, Panagiotis; Toutouzas, Konstantinos; Stefanatou, Maria; Larentzakis, Andreas; Theodoraki, Maria E.; Stergiopoulos, Spyros; Theodorou, Dimitrios

doi:10.3109/02699051003789237

Cited by 9 publications

(4 citation statements)

References 19 publications

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“…Isolated injuries to the scalp, face or cervical spine and patients with birth injuries were excluded. HISS: 26 % minimal, 58 % mild, 3 % moderate, 13 % severe 207/105 (overall) hospital admission rate of 157/105 Ingebritsen et al (1998) [ 12 ] All head-injured patients referred first to University Hospital or admitted to any hospital department plus emergency department treated and discharged. Head injury defined as physical damage to the brain or skull by external force and GCS and Head Injury Severity Scale.…”

Section: Resultsmentioning

confidence: 99%

“…Male, 29 years. Female, 27 years 1.8:1.0 Heskestad et al (2009) [ 10 ] – 1.7:1.0 Rickels et al (2010) [ 27 ] – 1.4:1.0 Numminen (2011) [ 24 ] – 1.2:1.0 Katsaragakis et al (2010) [ 13 ] – 2.6:1.0 Szarpak & Madziala (2011) [ 37 ] 42 years 1.9:1.0 Male, 39 years Female, 47 years Pérez et al (2012) [ 25 ] – RTA: 2.7:1.0 Other injury: 1.7:1.0 Stocchetti et al (2012) [ 35 ] 45 years 2.85:1.0 Andelic et al (2012) [ 1 ] 46.7 years 3.35: 1.0. Male, 44.8 years Female, 53.2 years Mauritz et al (2014) [ 21 ] 44.5 years 1.4:1.0 Male, 40.9 years; female, 49.9 years Outpatients: male, 35.8 years; female, 38.6 years In-hospital deaths: 65.9 years; male, 62.5 years; female, 73.5 years Puljula et al (2013) [ 26 ] In 1999: overall, 44 years; male, 41 years; female, 52 years.…”

Section: Resultsmentioning

confidence: 99%

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Epidemiology of traumatic brain injury in Europe

et al. 2015

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BackgroundTraumatic brain injury (TBI) is a critical public health and socio-economic problem throughout the world, making epidemiological monitoring of incidence, prevalence and outcome of TBI necessary. We aimed to describe the epidemiology of traumatic brain injury in Europe and to evaluate the methodology of incidence studies.MethodWe performed a systematic review and meta-analyses of articles describing the epidemiology of TBI in European countries. A search was conducted in the PubMed electronic database using the terms: epidemiology, incidence, brain injur*, head injur* and Europe. Only articles published in English and reporting on data collected in Europe between 1990 and 2014 were included.ResultsIn total, 28 epidemiological studies on TBI from 16 European countries were identified in the literature. A great variation was found in case definitions and case ascertainment between studies. Falls and road traffic accidents (RTA) were the two most frequent causes of TBI, with falls being reported more frequently than RTA. In most of the studies a peak TBI incidence was seen in the oldest age groups. In the meta-analysis, an overall incidence rate of 262 per 100,000 for admitted TBI was derived.ConclusionsInterpretation of published epidemiologic studies is confounded by differences in inclusion criteria and case ascertainment. Nevertheless, changes in epidemiological patterns are found: falls are now the most common cause of TBI, most notably in elderly patients. Improvement of the quality of standardised data collection for TBI is mandatory for reliable monitoring of epidemiological trends and to inform appropriate targeting of prevention campaigns.Electronic supplementary materialThe online version of this article (doi:10.1007/s00701-015-2512-7) contains supplementary material, which is available to authorised users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Epidemiology of traumatic brain injury in Europe

et al. 2015

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“…Most people with TBI are of age between 15 -44 years old, though TBIs were found to be more lethal in the age group of 45-64 years old. 5,[7][8][9][10][11][12]…”

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Diagnosis, monitoring and prognosis of secondary brain damage in icu patients with traumatic brain injuries

Aikaterini¹,

Korfias²,

Papastavrou

2018

HealthResJ

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Traumatic brain injury (TBI) is the brain injury that occurs whenever a physical force that impacts the head leads to neuropathology. The types of primary TBI are penentrating TBI or non-penetrating TBI and it can lead to intracerebral contusions, hemorrhages or extra-axial hematomas. Patients with TBI can also have skull fractures or concussions. The injury severity can be classified in many ways but the most established and common used is the Glascow Coma Scale (GCS). However, with the GCS, each of the severity criteria has limitations and might mot be an accurate predictor of TBI severity and outcome when used alone. For this reason it is often used in conjunction with other parameters (Abbreviated Injury Scale - AIS). Secondary Brain Damage is the injury that occurs to the TBI patient not at the time of the accident, but during the following minutes, hours or days. There are many mechanisms that lead to development of cerebral edema, blood-brain barrier disruption, vasospasm, increase in volume of bleeding, contusions and intracranial hypertension. These mechanisms can act either in cellular level or systemic level. The cellular mechanisms that lead to secondary brain damage include necrosis or apoptosis, mitochondrial dysfunction, excitotoxicicty, formation of free radicals, changes in cerebral glucose metabolism and inflammation. The mechanisms at systemic level include hypoxia-cerebral oxygenation, hypo or hypertension, hypo or hyper-capnia, anemia, hyponatremia and hyper or hypoglycemia. The first tool to diagnose severe TBI and secondary brain injury is neurological assessment. Neuroimaging is one of the most important ways for diagnosis. Computed Tomography (CT scan), Magnetic Resonance Imaging (MRI), cerebral angiography, transcranial Doppler, CT perfusion, Xenon CT, MRI diffusion, MRI perfusion, MRI spectrometry and Positron Emission Tomography (PET) are possible ways of imaging that not only help in the diagnosis but give important information that help in choosing the correct management. Moreover, neuromonitoring, helps in the correct management of the patient.

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“…Traumatic brain injury (TBI) remains a major public health problem globally (1)(2)(3)(4)(5). The Centers for Disease Control and Prevention (CDC) has estimated that each year, approximately 1.5 million Americans survive a TBI, among whom approximately 230,000 are hospitalized.…”

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et al. 2012

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Traumatic brain injury (TBI) and hemorrhagic shock often occur concomitantly due to multiple injuries. Gastrointestinal dysfunction occurs frequently in patients with TBI. However, whether alterations in the gastrointestinal system are involved in modulating neuronal damage and recovery after TBI is largely neglected. Ghrelin is a "gut-brain" hormone with multiple functions including antiinflammation and antiapoptosis. The purpose of this study was to determine whether ghrelin attenuates brain injury in a rat model of TBI and uncontrolled hemorrhage (UH). To study this, brain injury was induced by dropping a 450-g weight from 1.5 m onto a steel helmet attached to the skull of male adult rats. Immediately after TBI, a midline laparotomy was performed and both lumbar veins were isolated and severed at the junction with the vena cava. At 45 min after TBI/UH, ghrelin (4, 8 or 16 nmol/rat) or 1 mL normal saline (vehicle) was intravenously administered. Brain levels of TNF-α and IL-6, and cleaved PARP-1 levels in the cortex were measured at 4 h after TBI/UH. Beam balance test, forelimb placing test and hindlimb placing test were used to assess sensorimotor and reflex function. In additional groups of animals, ghrelin (16 nmol/rat) or vehicle was subcutaneously (s.c.) administered daily for 10 d after TBI/UH. The animals were monitored for 28 d to record body weight changes, neurological severity scale and survival. Our results showed that ghrelin downregulated brain levels of TNF-α and IL-6, reduced cortical levels of cleaved PARP-1, improved sensorimotor and reflex functions, and decreased mortality after TBI/UH. Thus, ghrelin has a great potential to be further developed as an effective resuscitation approach for the trauma victims with brain injury and severe blood loss.

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Traumatic brain injury in Greece: Report of a countrywide registry

Abstract: TBI is a major element of trauma. Knowledge of the epidemiologic characteristics of the disease is imperative for adequate planning and future quality assessment.

Cited by 9 publications

References 19 publications

Epidemiology of traumatic brain injury in Europe

Epidemiology of traumatic brain injury in Europe

Diagnosis, monitoring and prognosis of secondary brain damage in icu patients with traumatic brain injuries

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