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Management of Severe Head Injury

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61. 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

62. 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

63. 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

64. 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

65. 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

66. 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

67. PROphylaxis for Venous ThromboEmbolism in Severe Traumatic Brain Injury (PROTEST)

PROphylaxis for Venous ThromboEmbolism in Severe Traumatic Brain Injury (PROTEST) PROphylaxis for Venous ThromboEmbolism in Severe Traumatic Brain Injury (PROTEST) - 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 (...) Brain Injury Drug: Dalteparin Drug: Saline Phase 3 Detailed Description: Patients with severe brain injury are at risk for developing blood clots in their legs, which can travel to the lungs. This potentially serious complication is known as venous thromboembolism (VTE). Anticoagulants are commonly used to prevent VTE in hospital patients. However, in patients with major head injury, anticoagulant prevention is commonly delayed for the fear that it can potentially lead to further bleeding

2018 Clinical Trials

68. Intracranial Pressure Monitoring in Sever Traumatic Brain Injury Single Center Experience

Intracranial Pressure Monitoring in Sever Traumatic Brain Injury Single Center Experience Intracranial Pressure Monitoring in Sever Traumatic Brain Injury Single Center Experience - 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. Intracranial Pressure Monitoring in Sever Traumatic Brain Injury Single Center Experience 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03721003 Recruitment Status : Not yet recruiting First

2018 Clinical Trials

69. Early management of patients with a head injury

of computed tomography (CT) scanning resources have been taken into account in subsequent guidelines. In 1984 the Harrogate guidelines made suggestions on the early management of patients with a head injury, 14 followed in 1999 by the Galasko report from the Royal College of Surgeons. 15 SIGN published SIGN 46: Early management of patients with a head injury in August 2000. 3 Since publication of SIGN 46 there have been developments in several aspects of head injury management, including imaging, transfer (...) should be followed up after discharge. The guideline does not discuss the detailed management of more severe head injuries, either pre- or in-hospital, which are already incorporated into guidelines from the American College of Surgeons, 4 the American Association of Neurosurgeons/Brain Trauma Foundation, 18 the European Brain Injury Consortium, 19 the Association of Anaesthetists/British Neuroanaesthesia Society, 20 and the Society of British Neurological Surgeons. 21 1.2.2 TARGET USERS

2009 SIGN

70. Head and neck imaging

Health. All Rights Reserved. 12 - MRI orbit, face, and neck (soft tissue) - CT paranasal sinuses and maxillofacial area - CT soft tissue neck Trauma Trauma Advanced imaging is considered medically necessary for traumatic injury to the head and neck region when the results of imaging are essential to establish a diagnosis and/or direct management. IMAGING STUDY - CT orbit, sella, or posterior fossa and outer, middle or inner ear - MRI orbit, face, and neck (soft tissue) - CT paranasal sinuses (...) is required. Congenital and Developmental Conditions Advanced imaging is considered medically necessary for diagnosis and management of congenital and developmental conditions in the head and neck region when the results of imaging will impact treatment. IMAGING STUDY - CT orbit, sella, or posterior fossa and outer, middle or inner ear - MRI orbit, face and neck (soft tissue) - CT paranasal sinuses and maxillofacial area - CT soft tissue neck Infection and Inflammatory Conditions Sinusitis/rhinosinusitis

2019 AIM Specialty Health

71. Head Trauma- Child

the importance of several clinical risk factors. There are contradictory reports concerning the probability of traumatic head injury in children with headache, vomiting, loss of consciousness, and severe mechanisms of injury [10,26,27]. Kupperman et al determined a <1% risk of significant TBI in children with these factors, although other studies have reported a higher incidence of injury [3,23,25,28]. The discrepancies are likely due to differences in the degree or duration of headache, number of emesis (...) %) [7]. In a study of more than 10,000 patients <2 years ACR Appropriateness Criteria ® 7 Head Trauma — Child old, PECARN demonstrated a 100% negative predictive value and 100% sensitivity for TBI using the assessment criteria of normal mental status, no scalp hematoma except frontal, no loss of consciousness, no severe injury mechanism, no palpable skull fracture, and acting normally according to the parents. However, there remains some uncertainty regarding which clinical findings may constitute

2019 American College of Radiology

72. Management of Traumatic Brain Injury

, et al. Further experience in the management of severe head injury. J Neurosurg 1981; 54:289-299. Alali, A.S., Fowler, R.A., Mainprize, T.G., et al. Intracranial pressure monitoring in severe traumatic brain injury: results from the American College of Surgeons Trauma Quality Improvement Program. J Neurotrauma 30, 1737- 1746, 2013. Chesnut RM, Temkin N, Carney N et al. A trial of intracranial pressure monitoring in traumatic brain injury. N Engl J Med 367:2471-81, 2012. Chesnut RM. Intracranial (...) van den Brink, W. A., H. van Santbrink, E. W. Steyerberg, C. J. Avezaat, J. A. Suazo, C. Hogesteeger, W. J. Jansen, L. M. Kloos, J. Vermeulen and A. I. Maas. Brain oxygen tension in severe head injury. Neurosurgery 46(4): 868- 876; discussion 876-868. 2000 Surgical Management Bullock RM, Chesnut R, Ghajar JBG, Gordon D, Hartl R,Newell DW, Servadei, F, Walters, BC, Wilberger JE. Guidelines for the Surgical Management of Traumatic Brain Injury. Neurosurgery, Supplement, Volume 58, Number 3. 2006

2015 American College of Surgeons

73. Effects of Early Musical Intervention on Prevalence and Severity of Paroxysmal Sympathetic Hyperactivity After Severe Traumatic Brain Injury

Effects of Early Musical Intervention on Prevalence and Severity of Paroxysmal Sympathetic Hyperactivity After Severe Traumatic Brain Injury Effects of Early Musical Intervention on Prevalence and Severity of Paroxysmal Sympathetic Hyperactivity After Severe Traumatic Brain 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. Effects of Early Musical Intervention on Prevalence and Severity of Paroxysmal Sympathetic Hyperactivity After Severe Traumatic Brain Injury (MUSIC-TCNV) 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. of clinical studies

2016 Clinical Trials

74. Neurogenic pulmonary edema after severe head injury: a transpulmonary thermodilution study. (PubMed)

Neurogenic pulmonary edema after severe head injury: a transpulmonary thermodilution study. Neurogenic pulmonary edema (NPE) is a possible complication of severe central nervous system insult. Its physiopathology is still debated. We report a fatal case of a 55-year-old man who was admitted because of severe head injury. The diagnosis of NPE was considered according to clinical and radiologic findings. Transpulmonary thermodilution study showed decreased stroke volume index and cardiac function (...) index. Indexed extravascular lung water was increased as well as pulmonary vascular permeability index. The impairment of the left ventricular function was confirmed by the echocardiographic study. Our case suggests that NPE imply both cardiac dysfunction and lung injury. Thus, transpulmonary thermodilution can be helpful in managing fluid balance and the choice of vasopressors in patients with life-threatening NPE.

2015 American Journal of Emergency Medicine

75. Early Tracheostomy Versus Standard of Care in Patients With Severe Head Injury

Early Tracheostomy Versus Standard of Care in Patients With Severe Head Injury Early Tracheostomy Versus Standard of Care in Patients With Severe 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 (...) Procedure: Tracheostomy Not Applicable Detailed Description: Introduction; Most patients with severe head injury cannot protect their airway, have excessive secretions and inadequate spontaneous breathing which contributes to cerebral hypoxia. Thus, in their initial management the airway is secured with either an endotracheal tube (ETT) or a tracheostomy. In Mulago Hospital some of these patients are intubated and then subjected to the wait and see strategy of delayed or no tracheostomy, very few

2015 Clinical Trials

76. Intracranial pressure monitoring in severe traumatic brain injuries: a closer look at level 1 trauma centers in the United States. (PubMed)

College of Surgeons Trauma Quality Improvement Program database was queried for all patients admitted to level I trauma centers with isolated blunt severe TBI (AIS>3, GCS<9) who met criteria for ICP monitoring. Patients who had severe extracranial injuries, craniectomy, or death in the first 24h were excluded. Comparison between groups with and without ICP monitoring was made, analyzing demographics, comorbidities, mechanism of injury, head Abbreviated Injury Scale (AIS), vital signs on admission (...) Intracranial pressure monitoring in severe traumatic brain injuries: a closer look at level 1 trauma centers in the United States. The Brain Trauma Foundation (BTF) recently updated recommendations for intracranial pressure (ICP) monitoring in severe traumatic brain injury (TBI). The effect of ICP monitoring on outcomes is controversial, and compliance with BTF guidelines is variable. The purpose of this study was to assess both compliance and outcomes at level I trauma centers.The American

2017 Injury

77. Perfusion Abnormalities are Frequently Detected by Early CT Perfusion and Predict Unfavourable Outcome Following Severe Traumatic Brain Injury. (PubMed)

Perfusion Abnormalities are Frequently Detected by Early CT Perfusion and Predict Unfavourable Outcome Following Severe Traumatic Brain Injury. In patients with severe traumatic brain injury (TBI), early CT perfusion (CTP) provides additional information beyond the non-contrast CT (NCCT) and may alter clinical management. We hypothesized that this information may prognosticate functional outcome.Five-year prospective observational study was performed in a level-1 trauma centre on consecutive (...) predicting model for unfavourable outcome.Fifty patients were investigated with CTP (one excluded for the absence of TBI) [male: 80%, median age: 35 (23-55), prehospital intubation: 7 (14.2%); median GCS: 5 (3-7); median injury severity score: 29 (20-36); median head and neck abbreviated injury scale: 4 (4-5); median days in ICU: 10 (5-15)]. Thirty (50.8%) patients had an unfavourable outcome. GCS was a moderate predictor of unfavourable outcome (AUC = 0.74), while CTP variables showed greater predictive

2017 World Journal of Surgery

78. Risk Factors and Common Preventive Measures for Ventilator Associated Pneumonia in Patients With Severe Traumatic Brain Injury

Risk Factors and Common Preventive Measures for Ventilator Associated Pneumonia in Patients With Severe Traumatic Brain Injury Risk Factors and Common Preventive Measures for Ventilator Associated Pneumonia in Patients With Severe Traumatic Brain 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. Risk Factors and Common Preventive Measures for Ventilator Associated Pneumonia in Patients With Severe Traumatic Brain Injury 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. of clinical studies and talk to your health care provider before participating. Read our

2017 Clinical Trials

79. Transcranial LED Therapy for Severe Acute Traumatic Brain Injury (PubMed)

Transcranial LED Therapy for Severe Acute Traumatic Brain Injury Transcranial LED Therapy for Severe Acute Traumatic Brain 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. Transcranial LED Therapy (...) for Severe Acute Traumatic Brain Injury (LED-TBI) 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03281759 Recruitment Status : Recruiting First Posted : September 13, 2017 Last Update Posted : September 13, 2017 See Sponsor

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2017 Clinical Trials

80. Effect of Antisecretory Factor, Given as a Food Supplement to Adult Patients With Severe Traumatic Brain Injury

Effect of Antisecretory Factor, Given as a Food Supplement to Adult Patients With Severe Traumatic Brain Injury Effect of Antisecretory Factor, Given as a Food Supplement to Adult Patients With Severe Traumatic Brain 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 (...) this and thus reduce cerebral edema in traumatic brain injury. Furthermore, the reduction of cerebral edema is hypothesized to decrease intracranial pressure, reduce the development of secondary brain damage and subsequently reduce treatment intensity levels and death. Aims and Objectives Though, the number of patients with severe traumatic head injury in Sweden is decreasing and the need for a larger, randomized trial in a centre with large volumes of traumatic brain injury is needed The primary focus

2017 Clinical Trials

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