Latest & greatest articles for traumatic brain injury

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Top results for traumatic brain injury

121. Hyperosmolar Therapy in Pediatric Severe Traumatic Brain Injury-A Systematic Review. (Abstract)

intracranial pressure and improve clinical outcomes in pediatric severe traumatic brain injury, but the evidence is extremely fractured both in the method of treatment and in the evaluation of outcomes. Given the paucity of high-quality data, it is difficult to definitively conclude which agent is better or what treatment protocol to follow. (...) Hyperosmolar Therapy in Pediatric Severe Traumatic Brain Injury-A Systematic Review. Traumatic brain injury is a leading cause of hospital visits for children. Hyperosmolar therapy is often used to treat severe traumatic brain injury. Hypertonic saline is used predominantly, yet there remains disagreement about whether hypertonic saline or mannitol is more effective.Literature search was conducted using Pubmed, Cochrane, and Embase. Systematic review followed Preferred Reporting Items

2019 Critical Care Medicine

122. Hypertonic Saline Versus Mannitol for Traumatic Brain Injury: A Systematic Review and Meta-Analysis With Trial Sequential Analysis. (Abstract)

Hypertonic Saline Versus Mannitol for Traumatic Brain Injury: A Systematic Review and Meta-Analysis With Trial Sequential Analysis. Mannitol and hypertonic saline are widely used to treat raised intracranial pressure (ICP) after traumatic brain injury (TBI), but the clinical superiority of one over the other has not been demonstrated.According to the PRISMA statement, this meta-analysis reports on randomized controlled trials investigating hypertonic saline compared with mannitol (...) in the treatment of elevated ICP following TBI. The protocol for the literature searches (Medline, Embase, Central databases), quality assessment, endpoints (mortality, favorable outcome, brain perfusion parameters), and statistical analysis plan (including a trial sequential analysis) were prospectively specified and registered on the PROSPERO database (CRD42017057112).A total of 12 randomized controlled trials with 464 patients were eligible for inclusion in this analysis. Although there was a nonsignificant

2019 Journal of neurosurgical anesthesiology

123. Apolipoprotein E4 Polymorphism and Outcomes from Traumatic Brain Injury: A Living Systematic Review and Meta-Analysis. (Full text)

Apolipoprotein E4 Polymorphism and Outcomes from Traumatic Brain Injury: A Living Systematic Review and Meta-Analysis. The mortality of traumatic brain injury (TBI) has been largely static despite advances in monitoring and imaging techniques. Substantial variance exists in outcome, not fully accounted for by baseline characteristics or injury severity, and genetic factors likely play a role in this variance. The aims of this systematic review were to examine the evidence for a link between

2019 Journal of neurotrauma PubMed abstract

124. Genetic Influences on Patient-Oriented Outcomes in Traumatic Brain Injury: A Living Systematic Review of Non-Apolipoprotein E Single-Nucleotide Polymorphisms. (Full text)

Genetic Influences on Patient-Oriented Outcomes in Traumatic Brain Injury: A Living Systematic Review of Non-Apolipoprotein E Single-Nucleotide Polymorphisms. There is a growing literature on the impact of genetic variation on outcome in traumatic brain injury (TBI). Whereas a substantial proportion of these publications have focused on the apolipoprotein E (APOE) gene, several have explored the influence of other polymorphisms. We undertook a systematic review of the impact of single (...) -nucleotide polymorphisms (SNPs) in non-apolipoprotein E (non-APOE) genes associated with patient outcomes in adult TBI). We searched EMBASE, MEDLINE, CINAHL, and gray literature from inception to the beginning of August 2017 for studies of genetic variance in relation to patient outcomes in adult TBI. Sixty-eight articles were deemed eligible for inclusion into the systematic review. The SNPs described were in the following categories: neurotransmitter (NT) in 23, cytokine in nine, brain-derived

2019 Journal of neurotrauma PubMed abstract

125. A Systematic Review and Meta-Analysis on the Association Between Driving Ability and Neuropsychological Test Performances after Moderate to Severe Traumatic Brain Injury. (Abstract)

A Systematic Review and Meta-Analysis on the Association Between Driving Ability and Neuropsychological Test Performances after Moderate to Severe Traumatic Brain Injury. Guidelines on return-to-driving after traumatic brain injury (TBI) are scarce. Since driving requires the coordination of multiple cognitive, perceptual, and psychomotor functions, neuropsychological testing may offer an estimate of driving ability. To examine this, a meta-analysis of the relationship between (...) speed/attention (g = 0.48 [0.29-0.67]), and visual memory (g = 0.43 [0.14-0.71]). Of the individual tests, Useful Field of Vision (UFOV) divided attention (g = 1.12 [0.52-1.72]), Trail Making Test B (g = 0.75 [0.42-1.08]), and UFOV selective attention (g = 0.67 [0.22-1.12]) had the largest effects. The effect sizes for Choice Reaction Time test and Trail Making Test A were g = 0.63 (0.09-1.16) and g = 0.58 (0.10-1.06), respectively. Years post injury (β = 0.11 [0.02-0.21] and age (β = 0.05 [0.009

2019 Journal of the International Neuropsychological Society : JINS

126. The influence of sertraline on depressive disorder after traumatic brain injury: A meta-analysis of randomized controlled studies. (Abstract)

The influence of sertraline on depressive disorder after traumatic brain injury: A meta-analysis of randomized controlled studies. Sertraline showed some potential in alleviating depressive disorder after traumatic brain injury. This systematic review and meta-analysis was conducted to investigate the efficacy of sertraline on the treatment of depressive disorder after traumatic brain injury.The databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were (...) systematically searched for collecting the randomized controlled trials (RCTs) regarding the efficacy of sertraline for traumatic brain injury.This meta-analysis included five RCTs. The initial use of sertraline was within 8 weeks after traumatic brain injury. Compared with control group for traumatic brain injury, sertraline treatment showed no significant improvement on Hamilton Depression Rating Scale (HAM-D) (standard mean difference (Std. MD) = -0.08; 95% confidence interval (CI) = -0.45 to 0.28; P 

2019 American Journal of Emergency Medicine

127. Incidence and impact of withdrawal of life-sustaining therapies in clinical trials of severe traumatic brain injury: A systematic review. (Abstract)

Incidence and impact of withdrawal of life-sustaining therapies in clinical trials of severe traumatic brain injury: A systematic review. Background Most deaths following severe traumatic brain injury follow decisions to withdraw life-sustaining therapies. However, the incidence of the withdrawal of life-sustaining therapies and its potential impact on research data interpretation have been poorly characterized. The aim of this systematic review was to assess the reporting and the impact (...) of withdrawal of life-sustaining therapies in randomized clinical trials of patients with severe traumatic brain injury. Methods We searched Medline, Embase, Cochrane Central, BIOSIS, and CINAHL databases and references of included trials. All randomized controlled trials published between January 2002 and August 2015 in the six highest impact journals in general medicine, critical care medicine, and neurocritical care (total of 18 journals) were considered for eligibility. Randomized controlled trials were

2019 Clinical trials (London, England)

128. Systematic review protocol for facilitators and barriers to integrating health services for traumatic brain injury and mental health or addictions. (Full text)

Systematic review protocol for facilitators and barriers to integrating health services for traumatic brain injury and mental health or addictions. In the most populous province of Canada, one in five adults and one in six students report a lifetime history of traumatic brain injury (TBI). These individuals were also more likely to report elevated psychological distress and use illicit substances compared with those without TBI. The need for integrated health services has been recognised

2019 BMJ open PubMed abstract

129. Deficits in saccades and smooth-pursuit eye movements in adults with traumatic brain injury: a systematic review and meta-analysis. (Abstract)

Deficits in saccades and smooth-pursuit eye movements in adults with traumatic brain injury: a systematic review and meta-analysis. To conduct a review of literature and quantify the effect that traumatic brain injury (TBI) has on oculomotor functions (OM).A systematic review and meta-analysis was conducted from papers that objectively measured saccades and smooth-pursuit eye movements in mild and severe TBI.The overall impact of TBI on OM functions was moderate and significant with an effect (...) size of 0.42 from 181 OM case-control comparisons. The heterogeneity, determined using the random effect model, was found to be significant (Q (180) = 367, p < 0.0001, I2 = 51) owing to the variety of OM functions (reflexive saccades, antisaccades, memory-guided saccades, self-paced saccades and pursuits) measured and varying post-injury periods.The overall effect on OM functions were similar in mild and severe TBI despite differences in combined effect size of various OM functions. OM functions

2019 Brain Injury

130. Association between premorbid neuropsychological conditions and pediatric mild traumatic brain injury/concussion recovery time and symptom severity: a systematic review. (Abstract)

sustained a mild traumatic brain injury, also known as concussion. This necessitates inquiry for any associations that may exist, which may contribute to an enhanced understanding of injury recovery patterns.Participants included children ages six through 18 years with any diagnosed or self-reported premorbid neuropsychological condition(s) and mild traumatic brain injury/concussion. Participants with concomitant intracranial or extra-axial head injury found on diagnostic imaging were excluded. Outcomes (...) Association between premorbid neuropsychological conditions and pediatric mild traumatic brain injury/concussion recovery time and symptom severity: a systematic review. The objective of this review was to identify associations between premorbid neuropsychological conditions and pediatric mild traumatic brain injury/concussion recovery time and symptom severity.There is a lack of evidence-based clinical guidelines for the care of children with a premorbid neuropsychological condition who have

2019 JBI database of systematic reviews and implementation reports

131. The structural connectome in traumatic brain injury: A meta-analysis of graph metrics. (Full text)

The structural connectome in traumatic brain injury: A meta-analysis of graph metrics. Although recent structural connectivity studies of traumatic brain injury (TBI) have used graph theory to evaluate alterations in global integration and functional segregation, pooled analysis is needed to examine the robust patterns of change in graph metrics across studies. Following a systematic search, 15 studies met the inclusion criteria for review. Of these, ten studies were included in a random (...) -effects meta-analysis of global graph metrics, and subgroup analyses examined the confounding effects of severity and time since injury. The meta-analysis revealed significantly higher values of normalised clustering coefficient (gö=ö1.445, CI=[0.512, 2.378], pö=ö0.002) and longer characteristic path length (gö=ö0.514, CI=[0.190, 0.838], pö=ö0.002) in TBI patients compared with healthy controls. Our findings suggest that the TBI structural network has shifted away from the balanced small-world network

2019 Neuroscience and biobehavioral reviews PubMed abstract

132. The course and prognostic factors of cognitive outcomes after traumatic brain injury: A systematic review and meta-analysis. (Abstract)

The course and prognostic factors of cognitive outcomes after traumatic brain injury: A systematic review and meta-analysis. Despite indications that TBI may be a precursor of cognitive decline and subsequent development of Alzheimer's disease, little is known about the time course of this relationship and the factors involved. This systematic review summarizes the evidence pertinent to this subject matter. All English language studies of longitudinal design, and works cited within them, found (...) in six literature databases, were considered, and their quality assessed. Of 65 articles appraised, 44 studies were selected. Results were organized by timing of assessments, injury severity, and cognitive domains assessed. Differences in the course of cognitive performance were observed across injury severity groups and cognitive domains, with differential proportions of reports of improvement, decline, or no change over time. The evidence for genetic, sex-, age-, and injury-related factors

2019 Neuroscience and biobehavioral reviews

133. Continuous Near-Infrared Spectroscopy Monitoring in Adult Traumatic Brain Injury: A Systematic Review. (Abstract)

were identified. Forty-two studies exploring associations with neurophysiological parameters were included. Notwithstanding significant gaps in the currently available literature, our analysis suggests a link between NIRS-detected cerebral hypoxia during the acute phase of traumatic brain injury and poor functional outcome. NIRS measurements appear to reflect changes in intracranial pressure, invasively monitored brain tissue oxygen tension and various cerebrovascular reactivity indices although (...) Continuous Near-Infrared Spectroscopy Monitoring in Adult Traumatic Brain Injury: A Systematic Review. Near-infrared spectroscopy (NIRS) may provide a noninvasive way to monitor cerebral oxygenation in patients with traumatic brain injury, therein allowing for timely intervention aimed at reversing regional brain tissue hypoxia. We conducted a systematic review of NIRS-based oximetry measurements and their association with (A) patient functional outcome (B) other neurophysiological parameters

2019 Journal of neurosurgical anesthesiology

134. Pharmacological interventions for agitated behaviours in patients with traumatic brain injury: a systematic review. (Full text)

Pharmacological interventions for agitated behaviours in patients with traumatic brain injury: a systematic review. The aim of this systematic review was to assess the efficacy and safety of pharmacological agents in the management of agitated behaviours following traumatic brain injury (TBI).We performed a search strategy in PubMed, OvidMEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Google Scholar, Directory of Open Access Journals, LILACS, Web of Science and Prospero (up to 10 December (...) and olanzapine reduced irritability, aggressiveness and insomnia between weeks 1 and 3 of treatment. Amantadine showed variable effects and may increase the risk of agitation in the critically ill. In three studies evaluating safety outcomes, antipsychotics were associated with an increased duration of post-traumatic amnesia (PTA) in unadjusted analyses. Small sample sizes, heterogeneity and an unclear risk of bias were limits.Propranolol, methylphenidate, valproic acid and olanzapine may offer some benefit

2019 BMJ open PubMed abstract

135. In-hospital costs after severe traumatic brain injury: A systematic review and quality assessment. (Full text)

In-hospital costs after severe traumatic brain injury: A systematic review and quality assessment. The in-hospital treatment of patients with traumatic brain injury (TBI) is considered to be expensive, especially in patients with severe TBI (s-TBI). To improve future treatment decision-making, resource allocation and research initiatives, this study reviewed the in-hospital costs for patients with s-TBI and the quality of study methodology.A systematic search was performed using the following

2019 PLoS ONE PubMed abstract

136. Comparison of Effects of Manual and Mechanical Airway Clearance Techniques on Intracranial Pressure in Patients With Severe Traumatic Brain Injury on a Ventilator: Randomized, Crossover Trial (Abstract)

Comparison of Effects of Manual and Mechanical Airway Clearance Techniques on Intracranial Pressure in Patients With Severe Traumatic Brain Injury on a Ventilator: Randomized, Crossover Trial Physical therapist intervention can play a significant role in the prevention of mechanical and infectious complications in patients with traumatic brain injury (TBI) who are mechanically ventilated.The objective of this study was to observe and compare the effects of manual and mechanical airway clearance (...) techniques on intracranial pressure (ICP) and hemodynamics in patients with severe TBI.The design was a prospective, randomized, crossover trial.The setting was a neurointensive care unit at a level 1 trauma center.Forty-six adult patients aged 18 to 75 years, of either sex, with severe TBI, receiving mechanical ventilatory support with continuous ICP monitoring, and undergoing regular airway clearance techniques participated in this study.Two techniques were performed by a single trained physical

2019 EvidenceUpdates

137. Can the important brain injury criteria predict neurosurgical intervention in mild traumatic brain injury? A validation study. (Abstract)

Can the important brain injury criteria predict neurosurgical intervention in mild traumatic brain injury? A validation study. There is variability in the management of patients presenting to the emergency department (ED) with mild traumatic brain injury (MTBI) and abnormal findings on their initial head computed tomography (CT). The main objective of this study was to validate the value of the Important Brain Injury (IBI) criteria, introduced by the Canadian CT-Head Rule, in predicting

2019 EvidenceUpdates

138. Acupuncture for hearing loss after traumatic brain injury: A protocol for systematic review of randomized controlled trial. (Full text)

Acupuncture for hearing loss after traumatic brain injury: A protocol for systematic review of randomized controlled trial. This study aims to systematically assess the effectiveness and safety of acupuncture on hearing loss (HL) after traumatic brain injury (TBI).In this study, the following databases will be retrieved from inception up to the May 1, 2019: PUBMED, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database

2019 Medicine PubMed abstract

139. Prophylaxis Pharmacotherapy to Prevent the Onset of Post-Traumatic Brain Injury Depression: A Systematic Review. (Full text)

Prophylaxis Pharmacotherapy to Prevent the Onset of Post-Traumatic Brain Injury Depression: A Systematic Review. Depression is a common psychiatric problem following traumatic brain injury (TBI) with reported prevalence rates of 30-77% in the first year post-TBI. Given the negative influence of post-TBI depression on cognition and interpersonal, social, physical, and occupational functioning, early initiation of pharmacotherapy to prevent post-TBI depression has been considered. This systematic (...) controlled trials (RCTs), two retrospective cohorts, and one case-control. Prophylactic pharmacotherapy included antidepressants, beta-blockers and statins. In one RCT, the number needed to treat with sertraline to prevent one case of depression post-TBI at 24 weeks was 5.9 (95% confidence interval [CI]: 3.1-71.1). In a second RCT affected by significant attrition, sertraline had no effect. Prescribing beta-blockers prior to TBI reduced the depression risk regardless of the specific brain trauma. TBI

2019 Journal of neurotrauma PubMed abstract

140. Can S100B Serum Biomarker Testing Reduce Head Computed Tomography Scanning in Children With Mild Traumatic Brain Injury? (Full text)

Message S100B serum biomarker has high sensitivity and negative predictive value for detecting traumatic intracranial lesions in children with mild traumatic brain injury. However, how to incorporate this into existing risk-stratification tools is unclear, and reduced availability of the test currently limits its practical application in the emergency department (ED). Methods Data Sources The authors searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, Scopus (...) . The 8 included studies comprised 601 children with mild traumatic brain injury who underwent serum S100B biomarker testing compared with head CT or clinical follow-up as the references standard. S100B levels for detecting traumatic intracranial lesions in children with mild traumatic brain injury had a pooled sensitivity of 100% (95% CI 98% to 100%) and negative predictive value of 100% (95% CI 99% to 100%), whereas the pooled specificity was 41% (95% CI 26% to 57%), with significant heterogeneity

2019 Annals of Emergency Medicine Systematic Review Snapshots PubMed abstract