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Management of Severe Head Injury

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41. Pre-Trauma Center Management of Intracranial Pressure in Severe Pediatric Traumatic Brain Injury. (PubMed)

Pre-Trauma Center Management of Intracranial Pressure in Severe Pediatric Traumatic Brain Injury. Pre-trauma center care is a critical component in severe pediatric traumatic brain injury (TBI). For geographically large trauma catchment areas, optimizing increased intracranial pressure (ICP) management may potentially improve outcomes. This retrospective study examined ICP management in nontrauma centers and during interfacility transport to the trauma center.Charts from a pediatric level I (...) -five patients (74%) had increased ICP upon admission at trauma center, 48% experienced ICPs greater than 20 cm H2O within 12 hours of admission, 12% required an urgent craniotomy, and 16% had herniation syndromes on neuroimaging. Pre-trauma center ICP management included osmotherapy and head-of-bed elevation. Sixty-four percent of patients with increased ICP at trauma center admission received pre-trauma center ICP management.Early increased ICP is a common presentation of severe pediatric TBI

2016 Pediatric Emergency Care

42. Outcomes after Traumatic Brain Injury with Concomitant Severe Extracranial Injuries (PubMed)

Outcomes after Traumatic Brain Injury with Concomitant Severe Extracranial Injuries Traumatic brain injury (TBI) is a leading cause of death and disability in trauma patients. Patients with TBI frequently sustain concomitant injuries in extracranial regions. The effect of severe extracranial injury (SEI) on the outcome of TBI is controversial. For 8 years, we retrospectively enrolled 485 patients with the blunt head injury with head abbreviated injury scale (AIS) ≧ 3. SEI was defined as AIS ≧ 3 (...) injuries in the face, chest, abdomen, and pelvis/extremities. Vital signs and coagulation parameter values were also extracted from the database. Total patients were dichotomized into isolated TBI (n = 343) and TBI associated with SEI (n = 142). The differences in severity and outcome between these two groups were analyzed. To assess the relation between outcome and any variables showing significant differences in univariate analysis, we included the parameters in univariable and multivariable logistic

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2018 Neurologia medico-chirurgica

43. Acute kidney injury: prevention, detection and management

, assessment, initial treatment and referral for renal replacement therapy. The inpatient mortality of acute kidney injury varies considerably, depending on its severity, setting (intensive care or not), and many other Acute kidney injury: prevention, detection and management (CG169) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 38patient-related factors, but in the UK might typically be 25–30% or more. In view (...) = 90 Kidney damage, normal or increased GFR Kidney damage (presence of structural abnormalities and/or persistent haematuria, proteinuria or microalbuminuria) for = 3 months 2 60-89 Kidney damage, mildly reduced GFR 3A 45-59 Moderately reduced GFR ± other evidence of kidney damage GFR < 60 ml/min for = 3 months ± kidney damage 3B 30-44 4 15-29 Severely reduced GFR ± other evidence of kidney damage 5 < 15 Established kidney failure Acute kidney injury: prevention, detection and management (CG169) ©

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

44. Observation is unnecessary following a normal CT brain in warfarinised head injuries: an update

for ethical reasons, or routinely before discharge. Clinical follow-up though to elicit clinically important outcomes. Warfarin users more aware of risks and so more likely to present with less severe mechanisms of injury In-hospital mortality after immediate TICH (warfarin group) 8/37 (21.6%) [95% CI 9.8-38.2] Neurosurgical intervention after immediate TICH (warfarin group) 5/37 (13.5%) [95% CI 4.5-28.8] DICH (TICH within 2/52 after initially normal CT in absence of further head trauma (warfarin group) 4 (...) here, but the larger studies described should reassure us as to the very low risk of DICH, particularly with an initial INR Editor Comment aOR, adjusted OR; AUC, area under the curve; CTB, CT brain; DICH, delayed intracranial haemorrhage; ED, emergency department; FFP, fresh frozen plasma; GCS, Glasgow Coma Score; ICU, intensive care unit; INR, International Normalised Ratio; ISS, injury severity score; LOC, loss of consciousness; LOS, length of stay; MHI, minor head injury; MOI, mechanism

2014 BestBETS

45. Coagulopathy as a risk factor in warfarinised head injury patients

reduce ICH progression and improve mortality. Therefore, both the clinical picture and the INR have not shown to be effective at ruling out ICH in the asymptomatic WHI patient. It is, nevertheless, an important investigation in this setting, as an early check has been shown to allow rapid time to reversal of the INR with ICH. Importantly, Nishijima et al (2013) and Rendell and Batchelor (2013) found that there was no ‘low-risk group’ of warfarinised head injury patients safely managed without CT (...) ; PPV = positive predictive value; NPV = negative predictive value; GCS = Glasgow coma score; LOC = loss of consciousness; RR = relative risk; LOS = length of stay; WHI = warfarinised head injury; ISS = injury severity score; MOI = mechanism of injury; DICH = delayed intracranial haemorrhage; FFP = fresh frozen plasma; TICH = traumatic intracranial haemorrhage; IQR = interquartile range. Clinical Bottom Line With the low-risk patient, the level of coagulopathy does not seem to confer an obvious

2014 BestBETS

46. Platelet Inhibitor Treated Patients With Head Injury Trauma Meeting NICE Criteria : is the CT-scan Mandatory ?

Platelet Inhibitor Treated Patients With Head Injury Trauma Meeting NICE Criteria : is the CT-scan Mandatory ? Platelet Inhibitor Treated Patients With Head Injury Trauma Meeting NICE Criteria : is the CT-scan Mandatory ? - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved (...) several conditions including taking antiplatelet inhibitors. However, the real risk of cerebral haemorrhage for theses cases is controversial in litterature. In parallel, more and more patients undergoing antiplatelet inhibitor's treatment are seen in emergencies after a head injury trauma. In routine protocol at the emergency rooms, these patients are seen for a clinical exam and next submitted to a CT-scanner. If the clinician can't detect a cerebral haemorrage, the patient will return at home

2018 Clinical Trials

47. Health-related quality of life in prisoners with attention-deficit hyperactivity disorder and head injury. (PubMed)

of the association upon health-related quality of life (HRQoL) and service use among imprisoned adults.An observational study was performed in 2011-2013, at Porterfield Prison, Inverness, United Kingdom (UK). The all male sample included 390 adult prison inmates with capacity to consent and no history of moderate or severe intellectual disability. Head injury was measured with a series of self-reported questions, addressing history of hits to the head: frequency, severity, loss of consciousness (LOC (...) Health-related quality of life in prisoners with attention-deficit hyperactivity disorder and head injury. Attention-deficit hyperactivity disorder (ADHD) and head injury (including traumatic brain injury (TBI)) manifest in high levels across prison samples and guidance from the National Institute for Health and Care Excellence notes that people with acquired brain injury may have increased prevalence of ADHD. We aimed to examine the association of ADHD with TBI and the impact

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2018 BMC Psychiatry

48. Is There a Worse Outcome When the Systolic Blood Pressure is Lower Than Heart Rate in Those Adult Trauma Patients With Isolated Head/Neck Injury

Is There a Worse Outcome When the Systolic Blood Pressure is Lower Than Heart Rate in Those Adult Trauma Patients With Isolated Head/Neck Injury Is There a Worse Outcome When the Systolic Blood Pressure is Lower Than Heart Rate in Those Adult Trauma Patients With Isolated Head/Neck Injury - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save (...) to 100 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Sampling Method: Probability Sample Study Population Adult patients having isolated TBI with a head abbreviated injury scale (AIS) ≥ 3 and without severe injury to other regions (other AIS ≤ 1) were included. We excluded patients younger than 18 or older than 65 years of age. Patients were grouped and analyzed according to RSI (< 1 or ≥ 1). Criteria Inclusion Criteria: Adult patients having isolated TBI

2018 Clinical Trials

49. rTMS Treatment of Persistent Headache and Post Concussion Symptoms Attributed to Mild Traumatic Injury to the Head

rTMS Treatment of Persistent Headache and Post Concussion Symptoms Attributed to Mild Traumatic Injury to the Head rTMS Treatment of Persistent Headache and Post Concussion Symptoms Attributed to Mild Traumatic Injury to the Head - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number (...) of saved studies (100). Please remove one or more studies before adding more. rTMS Treatment of Persistent Headache and Post Concussion Symptoms Attributed to Mild Traumatic Injury to the Head (TOPiCS-rTMS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03691272 Recruitment Status : Active

2018 Clinical Trials

50. Management of the paediatric patient with acute head trauma

Management of the paediatric patient with acute head trauma Head trauma leading to brain injury is an important cause of morbidity and mortality in childhood. Injury severity is related to the mechanism of trauma, which itself varies with age. The vast majority of head trauma in paediatric patients is mild, requires no specific therapy and leaves no sequelae. However, it is important to identify individuals at risk of significant injury, and thus in need of specific evaluation. The purpose (...) of this statement is to describe issues related to head trauma in infants, children and youth, including clinical manifestations, initial management priorities, guidelines for imaging, and subsequent observation and treatment. It addresses the evaluation of patients with acute trauma to the head at the time of initial assessment; it does not describe the subsequent management of such patients in the paediatric intensive care unit. Key Words : CT scan; Head trauma; Skull x-rays; Prevention; Traumatic brain

2013 Canadian Paediatric Society

51. Severity-dependent differences in early management of thoracic trauma in severely injured patients - Analysis based on the TraumaRegister DGU®. (PubMed)

of different thoracic trauma severity in severely injured patients and identify related differences in prehospital and early clinical management. This may help to anticipate necessary treatment for chest injuries.Patients documented between 2002 and 2012 in the TraumaRegister DGU®, aged ≥ 16 years, determined Injury Severity Score ≥ 16, and documentation from European trauma centers were analyzed. Isolated brain injury and severe head injury (Abbreviated Injury ScaleHead ≥ 4) led to patient exclusion (...) Severity-dependent differences in early management of thoracic trauma in severely injured patients - Analysis based on the TraumaRegister DGU®. Major trauma is associated with chest injuries in nearly 50% of multiple injuries. Thoracic trauma is a relevant source of comorbidity throughout the period of multiply-injured patient care and may require swift and well-thought-out interventions in order to avert a deleterious outcome. In this epidemiological study we seek to characterize groups

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2017 Scandinavian journal of trauma, resuscitation and emergency medicine

52. Early Management of Retained Hemothorax in Blunt Head and Chest Trauma. (PubMed)

Early Management of Retained Hemothorax in Blunt Head and Chest Trauma. Major blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3-4 days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed (...) thoracic surgeries.From May 2005 to February 2012, 61 patients with major blunt injuries to the chest and head were prospectively enrolled. These patients had an intracranial hemorrhage without indications of craniotomy. All the patients received video-assisted thoracoscopic surgery (VATS) due to retained hemothorax or pneumothorax. Patients were divided into two groups according to the time from trauma to operation, this being within 4 days for Group 1 and more than 4 days for Group 2. The clinical

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2018 World Journal of Surgery

53. Decision-making criteria for CT head scans on patients not on anti-coagulants

-coagulants. In an extension of the rapid review request, the Committee are also investigating post-fall management, specific to the use of brain CT scans after a fall for non-anticoagulated patients. Objective To provide a review of guidelines and synthesised evidence around the use of brain CT scans after a fall. For the purpose of the review, post-fall guidelines and literature around minor head injuries will be included. Search Strategy A recent CCE scoping review: Head Injury and Patients (...) documents. Two documents were published by the National Institute of Health and Care Excellence (NICE), one of which was a high quality evidence based guideline [2] ; two guideline documents for the post-fall multidisciplinary management of inpatients in WA healthcare settings [3] and ACR Appropriateness Criteria in the management of head trauma, respectively [4] ; and one review of evidence on the indications for CT scans in minor head injuries [5] . Table 2 provides a summary of the included documents

2019 Monash Health Evidence Reviews

54. Managing behavioural and mental health outcomes following a traumatic brain injury

and symptoms of a TBI, specifically a SRC, often dissipate to the point of clinical recovery within several weeks after injury, the long-term behavioural effects of childhood head trauma are misunderstood. 1,4,5 These effects may not present themselves until later in life, perhaps effecting the quality of life well into adulthood. 1,2,4,5 As healthcare providers in sports medicine, we must continue to evolve our practice regarding mental and behavioural health by exploring all aspects of the patient (...) Managing behavioural and mental health outcomes following a traumatic brain injury Managing behavioural and mental health outcomes following a traumatic brain injury | BJSM blog - social media's leading SEM voice by By Sadie R. Morway, Zachary K. Winkelmann , Kenneth E. Games It is crucial to examine the long-term effects following a traumatic brain injury (TBI) in sports medicine. This is especially important for children given the sensitive development of the brain during childhood

2018 British Journal of Sports Medicine Blog

55. Head injury

or severity of symptoms. Have I got the right topic? Have I got the right topic? From birth onwards. This CKS topic covers the management people with head injury in primary care. There are separate CKS topics on , , , , , , and . This CKS topic does not cover the management of other trauma that may be associated with the head injury, or the management of head injury in secondary care. The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first (...) neurological signs. There are concerns or uncertainty about the nature or severity of symptoms. Basis for recommendation Basis for recommendation The recommendations on how to follow up a person with a head injury with ongoing symptoms and signs are based on the Scottish Intercollegiate Guideline Networks (SIGN) clinical guidelines Early management of patients with a head injury [ ] and Brain injury rehabilitation in adults [ ]; and expert opinion in review articles [ ; ]. Emergency referral to hospital

2016 NICE Clinical Knowledge Summaries

56. Intensive care treatments associated with favorable discharge outcomes in Argentine children with severe traumatic brain injury: For the South American Guideline Adherence Group. (PubMed)

Intensive care treatments associated with favorable discharge outcomes in Argentine children with severe traumatic brain injury: For the South American Guideline Adherence Group. Little is known about the critical care management of children with traumatic brain injury (TBI) in low middle income countries. We aimed to identify indicators of intensive care unit (ICU) treatments associated with favorable outcomes in Argentine children with severe TBI.We conducted a secondary analysis of data from (...) patients previously enrolled in a prospective seven center study of children with severe TBI who were admitted to an ICU in one of the seven study centers. Severe TBI was defined by head AIS ≥ 3, head CT with traumatic lesion, and admission GCS < 9. Seven indicators of best practice TBI care were examined. The primary outcome was discharge Pediatric Cerebral Performance Category Scale [PCPC] and Pediatric Overall Performance category Scale [POPC]. We also examined variation in ICU care and in-patient

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2017 PLoS ONE

57. Intracranial pressure monitoring in severe blunt head trauma: does the type of monitoring device matter? (PubMed)

Intracranial pressure monitoring in severe blunt head trauma: does the type of monitoring device matter? OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose (...) of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma. METHODS This retrospective observational study was based on the American College of Surgeons Trauma Quality Improvement Program database, which was searched for all patients with isolated severe blunt head injury who had an ICP monitor placed in the 2-year period from 2013 to 2014. Extracted variables included demographics, comorbidities, mechanisms of injury, head injury

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2017 Journal of Neurosurgery

58. Serum S100B Protein Assay in Mild Head Injury

Serum S100B Protein Assay in Mild Head Injury Serum S100B Protein Assay in Mild Head Injury - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Serum S100B Protein Assay in Mild Head Injury (TCLAS-100B (...) : Cohort Time Perspective: Prospective Official Title: Evaluation of the Serum S100B Protein Assay in the Management of Mild Head Injury Under Anticoagulation Estimated Study Start Date : March 1, 2018 Estimated Primary Completion Date : March 1, 2020 Estimated Study Completion Date : July 1, 2020 Resource links provided by the National Library of Medicine related topics: Groups and Cohorts Go to Intervention Details: Diagnostic Test: serum S100B protein assay measurement serum S100B protein assay

2017 Clinical Trials

59. PATTERN OF REFERRALS OF HEAD INJURY TO THE UNIVERSITY COLLEGE HOSPITAL, IBADAN (PubMed)

PATTERN OF REFERRALS OF HEAD INJURY TO THE UNIVERSITY COLLEGE HOSPITAL, IBADAN Although there are now many neurosurgical units in Nigeria, cases of head injury (HI) continue to present in the University College Hospital, UCH, Ibadan, from hospitals all over the country.This report aims to highlight the contemporary patterns of referrals of cases of head injury for neurosurgery in Ibadan.The study emanated from an analysis of registry of cases of head injury managed in our practice covering a 7 (...) in other health facilities in four out of Nigeria's six geopolitical zones including other teaching hospitals with practicing neurosurgeons. The reasons for these inter-hospital, inter-state referrals included absence of neurosurgical expertise (67%) or lack of other logistics like neuroimaging, bed space and intensive care unit services. Head Injury was caused by road accidents in more than 85% of the cases. The patients referred inter-state had more severe injuries, more delayed attainment

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2017 Annals of Ibadan postgraduate medicine

60. Antioxidants in experimental ischemia-reperfusion injury of the testis: Where are we heading towards? (PubMed)

Antioxidants in experimental ischemia-reperfusion injury of the testis: Where are we heading towards? Testicular torsion (TT) is a medical emergency that primary affects newborns and young adolescents. It causes testicular injury due to the torsion of the spermatic cord and its components, initially in the venous blood flow and finally in the arterial blood flow. Prompt diagnosis and early surgical management are necessary in managing this urgent situation. The process of the pathophysiological (...) events in ischemia-reperfusion is multifactorial and deals with the perception of the oxidative stress responsible for the consequences of ischemia/reperfusion (I/R) stress following TT. Duration and severity of torsion also play a significant role in the oxidative stress. A detrimental result of the defense system of the testes takes place resulting finally in testicular atrophy and impaired function. Antioxidant factors have been experimentally studied in an effort to front this state. They have

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2017 World journal of methodology

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