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13 results on '"Brain Injuries, Traumatic/complications"'

1. Psychosis Secondary to Traumatic Brain Injury: Critical Literature Review and Illustrative Case Study

Author

Joana Regala, Francisco Moniz-Pereira, and António Bento

Subjects
Brain Injuries, Traumatic/complications, Psychotic Disorders/diagnosis, Psychotic Disorders/drug therapy, Psychotic Disorders/etiology, Psychiatry, RC435-571, Psychology, BF1-990
Abstract

Psychosis secondary to traumatic brain injury (PSTBI) is rare yet a serious sequela of traumatic brain injury (TBI). We provide a critical literature review on PSTBI, outlining clinical features and approach to the diagnosis and treatment. Finally, we illustrate a case description, to discuss its conceptual framework. Conceptualizing PSTBI as a neurobiological syndrome has clinical relevance, insofar as, it facilitates a rational scheme, by which specific diagnostic dilemmas should be tackled in the workup, to provide a tailored treatment. Additionally, it may shed light on the understanding of psychotic disorders by integrating data on primary and secondary psychosis. TBI can contribute to the emergence of psychotic symptoms in various manners. It may precipitate psychosis in susceptible individuals, occur in a direct relationship to post‐traumatic epilepsy, or develop directly due to brain injury. It is this last clinical entity that we focus on in this article. Its neurobiological underpinnings comprise the following mechanisms: damage to frontal and temporal lobes (primary injury); structural and/or functional dysconnectivity in sensory‐ and other information‐ ‐processing networks, such as the Default‐Mode network, which stem from diffuse axonal injury (DAI) (primary injury); neuroinflammation and neurodegeneration (secondary injury). The clinical presentation may take two forms: delusional disorder or schizophrenia‐like psychosis. Both subtypes are often preceded by a prodromal phase superimposed on other sequelae, namely affective instability, social and occupational functional decline. In comparison to primary schizophrenia, PSTBI has a lower genetic load, fewer negative symptoms, more neurocognitive symptoms, which may be intertwined with frontal‐subcortical system dysfunction/ frontal syndromes and are more likely to present findings on neuroimaging and electroencephalographic studies. PSTBI has a bimodal distribution of onset. Latencies of under a year (early‐onset) have been associated with DAI and delusional disorder subtype. Schizophrenia‐like psychosis subtype usually develops after a latency of 1‐5 years (late‐onset), and has been more associated with epilepsy, focal brain lesions and a chronic course. Antipsychotics should be used cautiously considering the increased sensitivity to the sedating, anticholinergic, and seizure threshold‐lowering side effects. Late‐onset PSTBI might benefit from anticonvulsants, by virtue of its anti‐ ‐kindling properties. Additionally, further pharmacological approaches may be used to address cognitive, emotional, and behavioural issues.

Published
2023
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2. Depression and cognitive sequelae after a traumatic brain lesion

Author

Trine Okkerstrøm Ryttersgaard, Jens Østergaard Riis, Søren Paaske Johnsen, Poul Henning Mogensen, and Carsten Reidies Bjarkam

Subjects
Young Adult, Cognition, Adolescent, Depression/epidemiology, Brain Injuries, Traumatic/complications, Brain Injuries/complications, Disease Progression, Humans, Brain, Follow-Up Studies
Abstract

INTRODUCTION: To improve rehabilitation in young people with an acquired brain injury, the Danish Ministry of Health initiated the "National study on young brain injury survivors" in 2012. Using data from this initiative, we examined the changes in depression, cognition, global functional outcome and return to work/school among young traumatic brain injury (TBI) survivors.METHOD: This was an observational one-year follow-up study based on data from "Danish registry for young adults with acquired brain injury". The main measures were Major Depression Inventory, neuropsychological examination, and Glasgow Outcome Scale - extended (GOS-E).RESULTS: A total of 76 young TBI survivors attended two interdisciplinary examinations and had complete data. Sixty-six (86.8%) had rehabilitation between the two visits, and the global functional outcome was vastly higher at the second visit (z = -3.373, p = 0.0007). At the first versus the second visit, the prevalence proportion of depression was 14.5% (95% confidence interval (CI): 7.5-24.4) versus 10.5% (95% CI: 4.7-19.7), and for cognitive sequelae it was 31.6% (95% CI: 21.4-43.3) versus 19.7% (95% CI: 11.5-30.5). Patients with depression and/or cognitive sequelae had a lower GOS-E score (p = 0.0016) than patients without depression/cognitive sequelae and a negative association was found between depression, cognitive sequelae and return to work/school (p = 0.045).CONCLUSION: Emotional and cognitive rehabilitation for young TBI survivors seems essential as depression and cognitive sequelae are associated with a lower global functional outcome and return to work/school.FUNDING: none.TRIAL REGISTRATION: not relevant.

Published
2023

3. Measurement invariance of six language versions of the post-traumatic stress disorder checklist for DSM-5 in civilians after traumatic brain injury

Author

Bockhop, Fabian, Zeldovich, Marina, Cunitz, Katrin, Van Praag, Dominique, van der Vlegel, Marjolein, Beissbarth, Tim, Hagmayer, York, von Steinbuechel, Nicole, Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny Gabriele Wagner, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Barzó, Pál, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-Michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Carbayo Lozano, Guillermo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Véronique, Degos, Vincent, Della Corte, Francesco, den Boogert, Hugo, Depreitere, Bart, Đilvesi, Đula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubovic, Jagoš, Gomez, Pedro A., Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, L. Gruen, Russell, Gupta, Deepak, A. Haagsma, Juanita, Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J., Jacobs, Bram, Jankowski, Stefan, Jarrett, Mike, Jiang, Ji-yao, Johnson, Faye, Jones, Kelly, Karan, Mladen, G. Kolias, Angelos, Kompanje, Erwin, Kondziella, Daniel, Kornaropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lefering, Rolf, Legrand, Valerie, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lingsma, Hester, I.R. Maas, Andrew, Castaño-León, Ana M., Maegele, Marc, Majdan, Marek, Manara, Alex, Manley, Geoffrey, Martino, Costanza, Maréchal, Hugues, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menon, David, Menovsky, Tomas, Mikolic, Ana, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Nieboer, Daan, Nyirádi, József, Olubukola, Otesile, Oresic, Matej, Ortolano, Fabrizio, Palotie, Aarno, Parizel, Paul M., Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Piippo-Karjalainen, Anna, Pirinen, Matti, Pisica, Dana, Ples, Horia, Polinder, Suzanne, Pomposo, Inigo, Posti, Jussi P., Puybasset, Louis, Radoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Helmrich, Isabel Retel, Rhodes, Jonathan, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Rocka, Saulius, Røe, Cecilie, Røise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey V., Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, RueckertMartin Rusnák, Daniel, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Sewalt, Charlie, Singh, Ranjit D., Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stevens, Robert, Stewart, William, Steyerberg, Ewout W., Stocchetti, Nino, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Steven Taylor, Mark, Te Ao, Braden, Tenovuo, Olli, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Timmers, Marjolein, Tolias, Christos, Trapani, Tony, Maria Tudora, Cristina, Unterberg, Andreas, Vajkoczy, Peter, Vallance, Shirley, Valeinis, Egils, Vámos, Zoltán, van der Jagt, Mathieu, Van der Steen, Gregory, Naalt, Joukje van der, T.J.M. van Dijck, Jeroen, van Erp, Inge A. M., van Essen, Thomas A., Hecke, Wim Van, van Heugten, Caroline, van Veen, Ernest, Vande Vyvere, Thijs, van Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Vilcinis, Rimantas, Volovici, Victor, von Steinbüchel, Nicole, Voormolen, Daphne, Vulekovic, Petar, K.W. Wang, Kevin, Whitehouse, Daniel, Wiegers, Eveline, Williams, Guy, Wilson, Lindsay, Winzeck, Stefan, Wolf, Stefan, Yang, Zhihui, Ylén, Peter, Younsi, Alexander, Zeiler, Frederick A., Zelinkova, Veronika, Ziverte, Agate, Zoerle, Tommaso, Apollo - University of Cambridge Repository, Ragauskas, Arminas, Rocka, Saulius, Tamosuitis, Tomas, Vilcinis, Rimantas, „Springer Nature' grupė, Ročka, Saulius, Tamošuitis, Tomas, CTR-TBI Participants Investigators, Molecular Neuroscience and Ageing Research (MOLAR), Public Health, Amrein, Krisztina, Jiang, Ji-yao, Johnson, Faye, Jones, Kelly, Karan, Mladen, Kolias, Angelos G., Kompanje, Erwin, Kondziella, Daniel, Kornaropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Andelic, Nada, Kowark, Ana, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lefering, Rolf, Legrand, Valerie, Lejeune, Aurelie, Levi, Leon, Andreassen, Lasse, Lightfoot, Roger, Lingsma, Hester, Maas, Andrew I. R., Castaño-León, Ana M., Maegele, Marc, Majdan, Marek, Manara, Alex, Manley, Geoffrey, Martino, Costanza, Maréchal, Hugues, Anke, Audny, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menon, David, Menovsky, Tomas, Mikolic, Ana, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Negru, Ancuta, Antoni, Anna, Nelson, David, Newcombe, Virginia, Nieboer, Daan, Nyirádi, József, Olubukola, Otesile, Oresic, Matej, Ortolano, Fabrizio, Palotie, Aarno, Parizel, Paul M., Payen, Jean-François, Audibert, Gérard, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Piippo-Karjalainen, Anna, Pirinen, Matti, Pisica, Dana, Ples, Horia, Polinder, Suzanne, Pomposo, Inigo, Azouvi, Philippe, Posti, Jussi P., Puybasset, Louis, Radoi, Andreea, Raj, Rahul, Rambadagalla, Malinka, Retel Helmrich, Isabel, Rhodes, Jonathan, Richardson, Sylvia, Richter, Sophie, Azzolini, Maria Luisa, Ripatti, Samuli, Roe, Cecilie, Roise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey V., Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Bartels, Ronald, Rueckert, Martin, Rusnák, Daniel, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Schoonman, Guus, Barzó, Pál, Schou, Rico Frederik, Schwendenwein, Elisabeth, Sewalt, Charlie, Singh, Ranjit D., Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stevens, Robert, Beauvais, Romuald, Stewart, William, Steyerberg, Ewout W., Stocchetti, Nino, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Taylor, Mark Steven, Te Ao, Braden, Tenovuo, Olli, Beer, Ronny, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Timmers, Marjolein, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Unterberg, Andreas, Vajkoczy, Peter, Vallance, Shirley, Bellander, Bo-Michael, Valeinis, Egils, Vámos, Zoltán, van der Jagt, Mathieu, Van der Steen, Gregory, van der Naalt, Joukje, van Dijck, Jeroen T. J. M., van Erp, Inge A. M., van Essen, Thomas A., Van Hecke, Wim, van Heugten, Caroline, Belli, Antonio, Van Praag, Dominique, van Veen, Ernest, Vande Vyvere, Thijs, van Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Benali, Habib, Volovici, Victor, von Steinbüchel, Nicole, Voormolen, Daphne, Vulekovic, Petar, Wang, Kevin K. W., Whitehouse, Daniel, Wiegers, Eveline, Williams, Guy, Wilson, Lindsay, Berardino, Maurizio, Winzeck, Stefan, Wolf, Stefan, Yang, Zhihui, Ylén, Peter, Younsi, Alexander, Zeiler, Frederick A., Zelinkova, Veronika, Ziverte, Agate, Zoerle, Tommaso, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Carbayo Lozano, Guillermo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Véronique, Degos, Vincent, Della Corte, Francesco, den Boogert, Hugo, Depreitere, Bart, Đilvesi, Đula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubovic, Jagoš, Gomez, Pedro A., Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Åkerlund, Cecilia, Haagsma, Juanita A., Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J., Jacobs, Bram, Jankowski, Stefan, Jarrett, Mike, Bockhop, F, Zeldovich, M, Cunitz, K, Van Praag, D, van der Vlegel, M, Beissbarth, T, Hagmayer, Y, von Steinbuechel, N, Åkerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini Maria, L, Bartels, R, Barzó, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi Maria, R, Cameron, P, Carbayo Lozano, G, Carbonara, M, Cavallo, S, Chevallard, G, Chieregato, A, Citerio, G, Clusmann, H, Coburn, M, Coles, J, Cooper Jamie, D, Correia, M, Čović, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Đilvesi, Đ, Dixit, A, Donoghue, E, Dreier, J, Dulière, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin Valery, L, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Guoyi Gao, N, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubovic, J, A., G, Gratz, J, Gravesteijn, B, Grossi, F, L., G, Gupta, D, A., H, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, J., H, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, G., K, Kompanje, E, Kondziella, D, Kornaropoulos, E, Koskinen, L, Kovács, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Lecky, F, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lingsma, H, I. R., M, Castaño-León Ana, M, Maegele, M, Majdan, M, Manara, A, Manley, G, Martino, C, Maréchal, H, Mattern, J, Mcmahon, C, Melegh, B, Menon, D, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyirádi, J, Olubukola, O, Oresic, M, Ortolano, F, Palotie, A, Parizel Paul, M, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Polinder, S, Pomposo, I, Posti Jussi, P, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Helmrich Isabel, R, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosand, J, Rosenfeld Jeffrey, V, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, RueckertMartin Rusnák, D, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schäfer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou Rico, F, Schwendenwein, E, Sewalt, C, Singh Ranjit, D, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Stewart, W, Steyerberg Ewout, W, Stocchetti, N, Sundström, N, Takala, R, Tamás, V, Tamosuitis, T, Steven Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Maria Tudora, C, Unterberg, A, Vajkoczy, P, Vallance, S, Valeinis, E, Vámos, Z, van der Jagt, M, Van der Steen, G, Naalt Joukje van, D, T. J. M., V, van Erp Inge, A, van Essen Thomas, A, Hecke Wim, V, van Heugten, C, van Veen, E, Vande Vyvere, T, van Wijk Roel, P, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa Paul, M, Vik, A, Vilcinis, R, Volovici, V, von Steinbüchel, N, Voormolen, D, Vulekovic, P, K. W., W, Whitehouse, D, Wiegers, E, Williams, G, Wilson, L, Winzeck, S, Wolf, S, Yang, Z, Ylén, P, Younsi, A, Zeiler Frederick, A, Zelinkova, V, Ziverte, A, Zoerle, T, Centre of Excellence in Complex Disease Genetics, Aarno Palotie / Principal Investigator, Institute for Molecular Medicine Finland, Genomics of Neurological and Neuropsychiatric Disorders, HUS Neurocenter, Neurokirurgian yksikkö, Statistical and population genetics, Clinicum, Helsinki University Hospital Area, Faculty Common Matters (Faculty of Social Sciences), Department of Public Health, Samuli Olli Ripatti / Principal Investigator, and Complex Disease Genetics

Subjects
Post-Traumatic/psychology, Multidisciplinary, Traumatic/complications, Brain Injuries, Traumatic/complications, 3124 Neurology and psychiatry, Diagnostic and Statistical Manual of Mental Disorder, Stress Disorders, Post-Traumatic/psychology, Checklist, Diagnostic and Statistical Manual of Mental Disorders, Stress Disorders, Post-Traumatic, Brain Injuries, Brain Injuries, Traumatic, Humans, Human medicine, Human, Stress Disorders, Language
Abstract

Scientific reports 12, 16571 (2022). doi:10.1038/s41598-022-20170-2, Published by Macmillan Publishers Limited, part of Springer Nature, [London]

Published
2022

4. Visualization of Intracranial Pressure Insults After Severe Traumatic Brain Injury

Author

Donnelly, Joseph, Zeiler, Frederick A, Güiza, Fabian, Beqiri, Erta, Mitchell, Simon J, Aries, Marcel J, Czosnyka, Marek, Smielewski, Peter, Depreitere, B., Meyfroidt, G., Güiza, F., Intensive Care, MUMC+: MA Medische Staf IC (9), and RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience

Subjects
medicine.medical_specialty, Traumatic/complications, Intracranial Pressure, Traumatic brain injury, Glasgow Outcome Scale, Cerebral autoregulation, Lower limit, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Cerebral perfusion pressure, Reactivity (psychology), Intracranial pressure, Retrospective Studies, business.industry, Brain Injuries, Traumatic/complications, musculoskeletal, neural, and ocular physiology, Lower intensity, medicine.disease, nervous system diseases, nervous system, Brain Injuries, Cerebrovascular Circulation, Cardiology, business, 030217 neurology & neurosurgery, psychological phenomena and processes
Abstract

Cerebral perfusion pressure (CPP) lower limits of reactivity can be determined almost continuously after severe traumatic brain injury (TBI), and deviation below the lower limit carries important prognostic information. In this study, we used a recently derived coloured contour method for visualizing intracranial pressure (ICP) insults to describe the influence of having a CPP above the CPP lower limits of reactivity after severe TBI. In a cohort of 729 patients, we examined the relationship between ICP insults and the 6-month Glasgow Outcome Scale score, using colour-coded plots, as described previously. We then assessed this relationship when ICP insults were above or below the CPP lower limit of reactivity. We found a curvilinear relationship whereby even prolonged durations of low-intensity ICP insults were not associated with poor outcomes but short durations of high-intensity insults were. When only ICP insults with a CPP below the CPP lower limit of reactivity were considered, a much lower intensity of ICP insults could be tolerated. A CPP above the lower limits of reactivity exerts a protective effect, whereas a CPP below the lower reactivity limits renders the patient vulnerable to increased morbidity from intracranial hypertension.

Published
2021

5. Semi-automated Computed Tomography Volumetry as a Proxy for Intracranial Pressure in Patients with Severe Traumatic Brain Injury: Clinical Feasibility Study

Author

van de Wijgert, Ilse H, van de Wijgert, Ilse H, Jansen, Jacobus F A, Tas, Jeanette, Zeiler, Fred A, Voorter, Paulien H M, van Hal, Vera H J, Aries, Marcel J, van de Wijgert, Ilse H, van de Wijgert, Ilse H, Jansen, Jacobus F A, Tas, Jeanette, Zeiler, Fred A, Voorter, Paulien H M, van Hal, Vera H J, and Aries, Marcel J

Abstract

INTRODUCTION: Traumatic brain injury (TBI) is associated with high mortality due to intracranial pressure (ICP). Whether computed tomography (CT) scanning of the brain within the first 24 h is indicative of intracranial hypertension is largely unknown. We assessed the feasibility of semi-automated CT segmentation in comparison with invasive ICP measurements.RELEVANCE: CT volumetry of the brain might provide ICP data when invasive monitoring is not possible or is undesirable.METHODS: We identified 33 patients with TBI who received a CT scan at admission and ICP monitoring within 24 h. Semi-automated segmentation of CT images in Matlab yielded cerebrospinal fluid (CSF) and intracranial volume (ICV) data. The ratio CSF/ICV × 100 (expressed as a percentage) was used as a proxy for ICP. The association between invasive ICP and the CSF/ICV ratio was evaluated using a simple linear regression model and a mono-exponential function derived from previous research in animals.RESULTS: ICP is moderately but significantly associated with the CSF/ICV ratio (r = -0.44, p = 0.01). The mono-exponential function provided a better fit of the relationship between ICP and the CSF/ICV ratio than the linear model.CONCLUSION: Our feasibility TBI data show that cross-sectional volumetric CT measures are associated with ICP. This non-invasive method can be used in future studies to monitor patients who are not candidates for invasive monitoring or to evaluate therapy effects objectively.

Published
2021

6. Quantitative pupillometry for the monitoring of intracranial hypertension in patients with severe traumatic brain injury

Author

Mahmoud Messerer, Fritz-Patrick Jahns, Philippe Eckert, John Paul Miroz, Mauro Oddo, Roy Thomas Daniel, and Fabio Silvio Taccone

Subjects
Adult, Male, Soins intensifs réanimation, Traumatic brain injury, Intracranial pressure, Critical Care and Intensive Care Medicine, Intracranial hypertension, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Brain Injuries, Traumatic, Aged, Analysis of Variance, Brain Injuries, Traumatic/complications, Brain Injuries, Traumatic/physiopathology, Female, Glasgow Coma Scale, Humans, Intracranial Hypertension/physiopathology, Middle Aged, Monitoring, Physiologic/instrumentation, Monitoring, Physiologic/methods, Neurologic Examination/instrumentation, Neurologic Examination/methods, Prospective Studies, Pupil, Weights and Measures/instrumentation, Weights and Measures/standards, Neurological Pupil index, Outcome, Prognosis, Pupillary reactivity, Pupillometry, medicine, Prospective cohort study, Monitoring, Physiologic, Neurologic Examination, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Repeated measures design, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Weights and Measures, medicine.disease, humanities, Concomitant, Anesthesia, Cohort, business, Cohort study
Abstract

Background: Elevated intracranial pressure (ICP) is frequent after traumatic brain injury (TBI) and may cause abnormal pupillary reactivity, which in turn is associated with a worse prognosis. Using automated infrared pupillometry, we examined the relationship between the Neurological Pupil index (NPi) and invasive ICP in patients with severe TBI. Methods: This was an observational cohort of consecutive subjects with severe TBI (Glasgow Coma Scale [GCS] < 9 with abnormal lesions on head CT) who underwent parenchymal ICP monitoring and repeated NPi assessment with the NPi-200® pupillometer. We examined NPi trends over time (four consecutive measurements over intervals of 6 h) prior to sustained elevated ICP > 20 mmHg. We further analyzed the relationship of cumulative abnormal NPi burden (%NPi values < 3 during total ICP monitoring time) with intracranial hypertension (ICHT) - categorized as refractory (ICHT-r; requiring surgical decompression) vs. non-refractory (ICHT-nr; responsive to medical therapy) - and with the 6-month Glasgow Outcome Score (GOS). Results: A total of 54 patients were studied (mean age 54 ± 21 years, 74% with focal injuries on CT), of whom 32 (59%) had ICHT. Among subjects with ICHT, episodes of sustained elevated ICP (n = 43, 172 matched ICP-NPi samples; baseline ICP [T - 6 h ] 14 ± 5 mmHg vs. ICPmax [T 0 h ] 30 ± 9 mmHg) were associated with a concomitant decrease of the NPi (baseline 4.2 ± 0.5 vs. 2.8 ± 1.6, p < 0.0001 ANOVA for repeated measures). Abnormal NPi values were more frequent in patients with ICHT-r (n = 17; 38 [3-96]% of monitored time vs. 1 [0-9]% in patients with ICHT-nr [n = 15] and 0.5 [0-10]% in those without ICHT [n = 22]; p = 0.007) and were associated with an unfavorable 6-month outcome (15 [1-80]% in GOS 1-3 vs. 0 [0-7]% in GOS 4-5 patients; p = 0.002). Conclusions: In a selected cohort of severe TBI patients with abnormal head CT lesions and predominantly focal cerebral injury, elevated ICP episodes correlated with a concomitant decrease of NPi. Sustained abnormal NPi was in turn associated with a more complicated ICP course and worse outcome., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2019

7. Management of arterial partial pressure of carbon dioxide in the frst week after traumatic brain injury: results from the CENTER-TBI study

Author

Citerio, Giuseppe, Robba, Chiara, Rebora, Paola, Petrosino, Matteo, Rossi, elenora, Malgeri, L, Stocchetti, Nino, Galimberti, Stefania, Menon, David K., Andelic, Nada, Andreassen, Lasse, Anke, Audny Gabriele Wagner, Frisvold, Shirin, Helseth, Eirik, Røe, Cecilie, Røise, Olav, Skandsen, Toril, Vik, Anne, Åkerlund, Cecilia, Amrein, Krisztina, Antoni, Anna, Audibert, Gerard, Azouvi, Philippe, Azzolini, Maria luisa, Bartels, Ronald, Barzo, Pal, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brinck, Vibeke, Brazinova, Alexandra, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria rosa, Cameron, Peter, Lozano, Guillermo carbayo, Chevallard, Giorgio, Carbonara, Marco, Chieregato, Arturo, Cnossen, Maryse, Coburn, Mark, Citerio, G, Robba, C, Rebora, P, Petrosino, M, Rossi, E, Malgeri, L, Stocchetti, N, Galimberti, S, Menon, D, Ragauskas, Arminas, Rocka, Saulius, Tamosuitis, Tomas, Vilcinis, Rimantas, „Springer' grupė, Åkerlund, Cecilia, Jankowski, Stefan, Jarrett, Mike, Jiang, Ji-yao, Johnson, Faye, Jones, Kelly, Karan, Mladen, G Kolias, Angelos, Kompanje, Erwin, Kondziella, Daniel, Kornaropoulos, Evgenios, Amrein, Krisztina, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lefering, Rolf, Legrand, Valerie, Andelic, Nada, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lingsma, Hester, Maas, Andrew I. R., Castaño-León, Ana M., Maegele, Marc, Majdan, Marek, Manara, Alex, Manley, Geoffrey, Andreassen, Lasse, Martino, Costanza, Maréchal, Hugues, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menon, David, Menovsky, Tomas, Mikolic, Ana, Misset, Benoit, Muraleedharan, Visakh, Anke, Audny, Murray, Lynnette, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Nieboer, Daan, Nyirádi, József, Olubukola, Otesile, Oresic, Matej, Ortolano, Fabrizio, Palotie, Aarno, Antoni, Anna, Parizel, Paul M., Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Piippo-Karjalainen, Anna, Pirinen, Matti, Pisica, Dana, Ples, Horia, Audibert, Gérard, Polinder, Suzanne, Pomposo, Inigo, Posti, Jussi P., Puybasset, Louis, Radoi, Andreea, Raj, Rahul, Rambadagalla, Malinka, Helmrich, Isabel Retel, Rhodes, Jonathan, Azouvi, Philippe, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Roe, Cecilie, Roise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey V., Rosenlund, Christina, Rosenthal, Guy, Azzolini, Maria Luisa, Rossaint, Rolf, Rossi, Sandra, Martin Rusnák, Daniel Rueckert, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Bartels, Ronald, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Sewalt, Charlie, Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stevens, Robert, Barzó, Pál, Stewart, William, Steyerberg, Ewout W., Stocchetti, Nino, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Taylor, Mark Steven, Te Ao, Braden, Tenovuo, Olli, Beauvais, Romuald, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Timmers, Marjolein, Tolias, Christos, Trapani, Tony, Maria Tudora, Cristina, Unterberg, Andreas, Vajkoczy, Peter, Vallance, Shirley, Beer, Ronny, Valeinis, Egils, Vámos, Zoltán, van der Jagt, Mathieu, Van der Steen, Gregory, Naalt, Joukje van der, van Dijck, Jeroen T. J. M., van Essen, Thomas A., Van Hecke, Wim, van Heugten, Caroline, Van Praag, Dominique, Bellander, Bo-Michael, van Veen, Ernest, Vyvere, Thijs Vande, van Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Belli, Antonio, Volovici, Victor, von Steinbüchel, Nicole, Voormolen, Daphne, Vulekovic, Petar, K W Wang, Kevin K. W., Wiegers, Eveline, Williams, Guy, Wilson, Lindsay, Winzeck, Stefan, Wolf, Stefan, Benali, Habib, Yang, Zhihui, Ylén, Peter, Younsi, Alexander, Zeiler, Frederick A., Zelinkova, Veronika, Ziverte, Agate, Zoerle, Tommaso, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Carbayo Lozano, Guillermo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Covic, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Véronique, Degos, Vincent, Della Corte, Francesco, den Boogert, Hugo, Depreitere, Bart, Ðilvesi, Ðula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubovic, Jagoš, Gomez, Pedro A., Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J., Jacobs, Bram, Ročka, Saulius, Tamošuitis, Tomas, Citerio, G., Robba, C., Rebora, P., Petrosino, M., Rossi, E., Malgeri, L., Stocchetti, N., Galimberti, S., Menon D. K., (Center-TBI participants and investigators), Beretta, L., Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, and Molecular Neuroscience and Ageing Research (MOLAR)

Subjects
medicine.medical_specialty, Intracranial Pressure, Traumatic brain injury, Original, Intracranial pressure, Partial Pressure, Critical Care and Intensive Care Medicine, GUIDELINES, carbon dioxide, hyperventilation, intracranial pressure, outcome, traumatic brain injury, law.invention, Cohort Studies, law, Anesthesiology, Hyperventilation, Brain Injuries, Traumatic, Medicine, Humans, Arterial Pressure, Prospective Studies, Outcome, Hypocapnia, business.industry, Brain Injuries, Traumatic/complications, HEAD-INJURY, Brain, Carbon Dioxide, medicine.disease, Intensive care unit, respiratory tract diseases, Carbon dioxide, Anesthesia, Breathing, Observational study, medicine.symptom, business, Cohort study, circulatory and respiratory physiology
Abstract

Intensive care medicine 47(9), 961-973 (2021). doi:10.1007/s00134-021-06470-7, Published by Springer, Berlin

Published
2021

8. Semi-automated Computed Tomography Volumetry as a Proxy for Intracranial Pressure in Patients with Severe Traumatic Brain Injury: Clinical Feasibility Study

Author

Jacobus F.A. Jansen, Marcel J.H. Aries, Frederick A. Zeiler, Vera H J van Hal, Ilse H van de Wijgert, Jeanette Tas, Paulien H.M. Voorter, and Signal Processing Systems

Subjects
medicine.medical_specialty, Intracranial Hypertension/diagnostic imaging, Traumatic/complications, Intracranial Pressure, Traumatic brain injury, Computed tomography, Brain imaging, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Volumetry, Neuroimaging, Medicine, Humans, In patient, Proxy (statistics), Tomography, Intracranial pressure, medicine.diagnostic_test, integumentary system, business.industry, musculoskeletal, neural, and ocular physiology, Brain Injuries, Traumatic/complications, High mortality, medicine.disease, X-Ray Computed, nervous system diseases, Cross-Sectional Studies, Brain Injuries, Feasibility Studies, Radiology, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Abstract

Introduction: Traumatic brain injury (TBI) is associated with high mortality due to intracranial pressure (ICP). Whether computed tomography (CT) scanning of the brain within the first 24 h is indicative of intracranial hypertension is largely unknown. We assessed the feasibility of semi-automated CT segmentation in comparison with invasive ICP measurements. Relevance: CT volumetry of the brain might provide ICP data when invasive monitoring is not possible or is undesirable. Methods: We identified 33 patients with TBI who received a CT scan at admission and ICP monitoring within 24 h. Semi-automated segmentation of CT images in Matlab yielded cerebrospinal fluid (CSF) and intracranial volume (ICV) data. The ratio CSF/ICV × 100 (expressed as a percentage) was used as a proxy for ICP. The association between invasive ICP and the CSF/ICV ratio was evaluated using a simple linear regression model and a mono-exponential function derived from previous research in animals. Results: ICP is moderately but significantly associated with the CSF/ICV ratio (r = −0.44, p = 0.01). The mono-exponential function provided a better fit of the relationship between ICP and the CSF/ICV ratio than the linear model. Conclusion: Our feasibility TBI data show that cross-sectional volumetric CT measures are associated with ICP. This non-invasive method can be used in future studies to monitor patients who are not candidates for invasive monitoring or to evaluate therapy effects objectively.

Published
2021

9. Polymorphonuclear (PMN) elastase in patients after severe traumatic brain injury

Author

Postl, Lukas Kurt, Bogner, Viktoria, van Griensven, Martijn, Beirer, Marc, Kanz, Karl Georg, Egginger, Christoph, Biberthaler, Peter, and Kirchhoff, Chlodwig

Subjects
Intracranial Hemorrhage, Traumatic/cerebrospinal fluid, Adult, Male, Leukocyte Elastase/blood, lcsh:Medicine, Severity of Illness Index, Young Adult, Traumatic brain injury, Brain Injuries, Traumatic, TBI, Humans, Prospective Studies, Aged, NEUTROPHIL ELASTASE, Aged, 80 and over, Research, Brain Injuries, Traumatic/complications, Polymorphonuclear elastase, lcsh:R, INHIBITOR, Middle Aged, PMN, Intracranial Hemorrhage, Traumatic, Alpha 1-proteinase, Blood-Brain Barrier, Case-Control Studies, Disease Progression, Female, ELISA, Leukocyte Elastase, Biomarkers/blood, SIVELESTAT, Biomarkers
Abstract

Background Data on PNM elastase levels in cerebrospinal fluid following traumatic brain injury (TBI) in humans are not available in the literature. Therefore, the aim of this prospective study was to evaluate the dynamics of PMN elastase in the cerebrospinal fluid (CSF) of patients after TBI. Methods Patients suffering from isolated, closed TBI, presenting with an initial Glasgow coma score ≤ 8 and with intracerebral hemorrhage on the initial cranial computed tomography scan (performed within 90 min after TBI) were enrolled. CSF and blood samples were obtained immediately, 12 h, 24 h, 48 h, and 72 h after admission. ELISA testing was used to quantify the PMN elastase levels in CSF. In addition, the ratio of CSF albumin to serum albumin was calculated to evaluate the role of the blood–cerebrospinal fluid barrier (BCSFB). As controls, CSF samples were taken from patients receiving spinal anesthesia for elective orthopedic surgery of the lower extremity. Results Twenty-three patients meeting the inclusion criteria and ten control patients were enrolled. The PMN elastase showed a significant elevation at 48 and 72 h after TBI. When comparing the PMN elastase levels of patients with intact BCSFB to patients with defective BCSFB, there was no significant difference for the respective observation points. Conclusions This is the first study to demonstrate that the PMN elastase levels in CSF significantly increased in the early posttraumatic phase (48 h and 72 h after TBI) in patients. The function of the BCSFB showed no significant influence on the PMN levels.

Published
2018

10. Brain death and postmortem organ donation: report of a questionnaire from the CENTER-TBI study

Author

Van Veen E., Van Der Jagt M., Cnossen M. C., Maas A. I. R., De Beaufort I. D., Menon D. K., Citerio G., Stocchetti N., Rietdijk W. J. R., Van Dijck J. T. J. M., Kompanje E. J. O., Ackerlund C., Adams H., Agnoletti V., Allanson J., Amrein K., Andaluz N., Andelic N., Andreassen L., Antun A., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Azzolini M. L., Baciu C., Badenes R., Bartels R., Barzo P., Bauerfeind U., Beauvais R., Beer R., Francisco J. B., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Den Boogert H., Bouzat P., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Calappi E., Calvi M. R., Cameron P., Lozano G. C., Carbonara M., Carise E., Carpenter K., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Coburn M., Coles J., Coles-Kemp L., Collett J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., De Ruiter Godard C. W., Dilvesi D., Ding S., Dippel D., Dixit A., Donoghue E., Dreier J., Duliere G. -L., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., Geleijns K., George P., Ghuysen A., Giga L., Giraud B., Glocker B., Golubovic J., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hoedemaekers A., Hoefer S., Horton L., Huijben J., Hutchinson P. J., Haberg A. K., Jacobs B., Jankowski S., Jarrett M., Jelaca B., Jiang J. -Y., Jones K., Kamnitsas K., Karan M., Katila A., Kaukonen M., Kerforne T., Kivisaari R., Kolias A. G., Kolumban B., Kolundzija K., Kondziella D., Koskinen L. -O., Kovacs N., Lagares A., Lanyon L., Laureys S., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., MacDonald S., Maegele M., Majdan M., Major S., Manara A., Manley G., Didier M., Martin L. F., Martino C., Maruenda A., Marechal H., Masala A., Mattern J., McFadyen C., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Muraleedharan V., Murray L., Muhlan H., Nair N., Negru A., Nelson D., Newcombe V., Nieboer D., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Floury S. P., Pirinen M., Ples H., Poca M. A., Polinder S., Pomposo I., Posti J., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Real R., Rehorcikova V., Rhodes J., Ripatti S., Rocka S., Roe C., Roise O., Roks G., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Porras R., Sandor J., Santos E., Sasu L., Savo D., Schaffer N., Schipper I., Schlosser B., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Steinbuchel N., Stevanovic A., Stevens R., Stewart W., Steyerberg E. W., Sundstrom N., Synnot A., Taccone F. S., Takala R., Tamas V., Tanskanen P., Taylor M. S., Te Ao B., Tenovuo O., Telgmann R., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Trapani T., Tudora C. M., Vajkoczy P., Vallance S., Valeinis E., Van Der Steen G., Van Der Naalt J., Van Essen T. A., Van Hecke W., Van Heugten C., Van Praag D., Vyvere T. V., Van Waesberghe J., Vanhaudenhuyse A., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Voormolen D., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wessels L., Wildschut E., Williams G., Wilson L., Winkler M. K. L., Wolf S., Ylen P., Younsi A., Zaaroor M., Zhihui Y., Ziverte A., Zumbo F., Intensive Care, Public Health, van Veen, Ernest, van der Jagt, Mathieu, Cnossen, Maryse C., Maas, Andrew I R, de Beaufort, Inez D., Menon, David K., Citerio, Giuseppe, Stocchetti, Nino, Rietdijk, Wim J R, van Dijck, Jeroen T J M, Kompanje, Erwin J O (CENTER-TBI investigators and participants), Beretta, Luigi, Apollo - University of Cambridge Repository, Ragauskas, Arminas, Rocka, Saulius, Vilcinis, Rimantas, „Springer' grupė, Neurokirurgian yksikkö, Clinicum, Van Veen E., Van Der Jagt M., Cnossen M.C., Maas A.I.R., De Beaufort I.D., Menon D.K., Citerio G., Stocchetti N., Rietdijk W.J.R., Van Dijck J.T.J.M., Kompanje E.J.O., Ackerlund C., Adams H., Agnoletti V., Allanson J., Amrein K., Andaluz N., Andelic N., Andreassen L., Antun A., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Azzolini M.L., Baciu C., Badenes R., Bartels R., Barzo P., Bauerfeind U., Beauvais R., Beer R., Francisco J.B., Bellander B.-M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Den Boogert H., Bouzat P., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Calappi E., Calvi M.R., Cameron P., Lozano G.C., Carbonara M., Carise E., Carpenter K., Castano-Leon A.M., Causin F., Chevallard G., Chieregato A., Coburn M., Coles J., Coles-Kemp L., Collett J., Cooper J.D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., De Ruiter Godard C.W., Dilvesi D., Ding S., Dippel D., Dixit A., Donoghue E., Dreier J., Duliere G.-L., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V.L., Feng J., Foks K., Fossi F., Francony G., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., Geleijns K., George P., Ghuysen A., Giga L., Giraud B., Glocker B., Golubovic J., Gomez P.A., Grossi F., Gruen R.L., Gupta D., Haagsma J.A., Haitsma I., Hartings J.A., Helbok R., Helseth E., Hertle D., Hoedemaekers A., Hoefer S., Horton L., Huijben J., Hutchinson P.J., Haberg A.K., Jacobs B., Jankowski S., Jarrett M., Jelaca B., Jiang J.-Y., Jones K., Kamnitsas K., Karan M., Katila A., Kaukonen M., Kerforne T., Kivisaari R., Kolias A.G., Kolumban B., Kolundzija K., Kondziella D., Koskinen L.-O., Kovacs N., Lagares A., Lanyon L., Laureys S., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., MacDonald S., Maegele M., Majdan M., Major S., Manara A., Manley G., Didier M., Martin L.F., Martino C., Maruenda A., Marechal H., Masala A., Mattern J., McFadyen C., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Muraleedharan V., Murray L., Muhlan H., Nair N., Negru A., Nelson D., Newcombe V., Nieboer D., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P.M., Patruno A., Payen J.-F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Floury S.P., Pirinen M., Ples H., Poca M.A., Polinder S., Pomposo I., Posti J., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Real R., Rehorcikova V., Rhodes J., Ripatti S., Rocka S., Roe C., Roise O., Roks G., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Porras R., Sandor J., Santos E., Sasu L., Savo D., Schaffer N., Schipper I., Schlosser B., Schmidt S., Schoechl H., Schoonman G., Schou R.F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Steinbuchel N., Stevanovic A., Stevens R., Stewart W., Steyerberg E.W., Sundstrom N., Synnot A., Taccone F.S., Takala R., Tamas V., Tanskanen P., Taylor M.S., Te Ao B., Tenovuo O., Telgmann R., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J.-F.L., Trapani T., Tudora C.M., Vajkoczy P., Vallance S., Valeinis E., Van Der Steen G., Van Der Naalt J., Van Essen T.A., Van Hecke W., Van Heugten C., Van Praag D., Vyvere T.V., Van Waesberghe J., Vanhaudenhuyse A., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P.M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Voormolen D., Vulekovic P., Vamos Z., Wade D., Wang K.K.W., Wang L., Wessels L., Wildschut E., Williams G., Wilson L., Winkler M.K.L., Wolf S., Ylen P., Younsi A., Zaaroor M., Zhihui Y., Ziverte A., Zumbo F., Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Psychiatrie & Neuropsychologie, Menon, David [0000-0002-3228-9692], Ročka, Saulius, Molecular Neuroscience and Ageing Research (MOLAR), CENTER-TBI Investigators, van Veen, E, van der Jagt, M, Cnossen, M, Maas, A, de Beaufort, I, Menon, D, Citerio, G, Stocchetti, N, Rietdijk, W, van Dijck, J, and Kompanje, E

Subjects
Neurology, Internationality, Traumatic/complications, brain death, ethics, postmortem organ donation, traumatic brain injury, ventricular drainage, withdrawing life-sustaining measures, GUIDELINES, Critical Care and Intensive Care Medicine, 0302 clinical medicine, Traumatic brain injury, Trauma Centers, WORLDWIDE, Surveys and Questionnaires, Brain Injuries, Traumatic, Response rate (survey), Brain death, VDP::Medical disciplines: 700::Clinical medical disciplines: 750, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Tissue and Organ Procurement/legislation & jurisprudence, POLICIES, Europe, VARIABILITY, Neurosurgery, Clinical evaluation, medicine.medical_specialty, Tissue and Organ Procurement, Withdrawing life-sustaining measure, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, Neurological assessment, medicine, Humans, Organ donation, Ethics, Postmortem organ donation, Ventricular drainage, Withdrawing life-sustaining measures, Ethic, business.industry, Research, Brain Injuries, Traumatic/complications, 3112 Neurosciences, 030208 emergency & critical care medicine, ADULTS, lcsh:RC86-88.9, Traumatic brain injury, Brain death, Ethics, Postmortem organ donation, Withdrawing life-sustaining measures, Ventricular drainage, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Trauma Centers/organization & administration, Brain Injuries, Emergency medicine, Human medicine, business, 030217 neurology & neurosurgery, Regional differences
Abstract

Source at https://doi.org/10.1186/s13054-018-2241-4. Licensed CC BY-NC-ND 4.0. Background: We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation. Methods: Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%). Results: Regarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time. Conclusions: This study showed both agreement and some regional differences regarding practices around brain death and postmortem organ donation. We hope our results help quantify and understand potential differences, and provide impetus for current dialogs toward further harmonization of practices around brain death and postmortem organ donation.

Published
2018

11. Effects of propranolol and clonidine on brain edema, blood-brain barrier permeability, and endothelial glycocalyx disruption after fluid percussion brain injury in the rat

Author

Genét, Gustav Folmer, Bentzer, Peter, Hansen, Morten Bagge, Ostrowski, Sisse Rye, Johansson, Pär Ingemar, Genét, Gustav Folmer, Bentzer, Peter, Hansen, Morten Bagge, Ostrowski, Sisse Rye, and Johansson, Pär Ingemar

Abstract

BACKGROUND: Traumatic brain injury causes a disruption of the vascular endothelial glycocalyx layer that is associated with an overactivation of the sympathoadrenal system. We hypothesized that early and unselective beta-blockade with propranolol alone or in combination with the alfa2-agonist clonidine would decrease brain edema, blood-brain barrier permeability, and glycocalyx disruption at 24 hours after trauma.METHODS: We subjected 53 adult male Sprague-Dawley rats to lateral fluid percussion brain injury and randomized infusion with propranolol (n = 16), propranolol + clonidine (n = 16), vehicle (n = 16), or sham (n = 5) for 24 hours. Primary outcome was brain water content at 24 hours. Secondary outcomes were blood-brain barrier permeability and plasma levels of syndecan-1 (glycocalyx disruption), cell damage (histone-complexed DNA fragments), epinephrine, norepinephrine, and animal motor function.RESULTS: We found no difference in brain water content (mean ± SD) between propranolol (80.8 ± 0.3%; 95% confidence interval [CI], 80.7-81.0) and vehicle (81.1 ± 0.6%; 95% CI, 80.8-81.4) (p = 0.668) or between propranolol/clonidine (80.8 ± 0.3%; 95% CI, 80.7-81.0) and vehicle (p = 0.555). We found no effect of propranolol and propranolol/clonidine on blood-brain barrier permeability and animal motor scores. Unexpectedly, propranolol and propranolol/clonidine caused an increase in epinephrine and syndecan-1 levels.CONCLUSION: This study does not provide any support for unselective beta-blockade with propranolol or the combination of propranolol and the alfa2-agonist clonidine on brain water content. The novel finding of an increase in plasma concentrations of epinephrine and syndecan-1 after propranolol treatment in traumatic brain injury is of unclear significance and should be investigated further.

Published
2018

12. Traumatic brain injury in England and Wales:prospective audit of epidemiology, complications and standardised mortality

Author

Lawrence, T, Helmy, A, Bouamra, O, Woodford, M, Lecky, F, and Hutchinson, P J

Subjects
Adult, Male, Patient Transfer, Adolescent, Bronchopneumonia/complications, Severity of Illness Index, Young Adult, Humans, Glasgow Coma Scale, Prospective Studies, Registries, England/epidemiology, Child, Wales/epidemiology, Aged, Aged, 80 and over, Brain Injuries, Traumatic/complications, Accidents, Traffic, Infant, Newborn, Disease Management, Infant, Length of Stay, Middle Aged, Prognosis, Logistic Models, Child, Preschool, Multivariate Analysis, Accidental Falls, Female, Comprehension, Craniotomy
Abstract

OBJECTIVES: To provide a comprehensive assessment of the management of traumatic brain injury (TBI) relating to epidemiology, complications and standardised mortality across specialist units.DESIGN: The Trauma Audit and Research Network collects data prospectively on patients suffering trauma across England and Wales. We analysed all data collected on patients with TBI between April 2014 and June 2015.SETTING: Data were collected on patients presenting to emergency departments across 187 hospitals including 26 with specialist neurosurgical services, incorporating factors previously identified in the Ps14 multivariate logistic regression (Ps14n) model multivariate TBI outcome prediction model. The frequency and timing of secondary transfer to neurosurgical centres was assessed.RESULTS: We identified 15 820 patients with TBI presenting to neurosurgical centres directly (6258), transferred from a district hospital to a neurosurgical centre (3682) and remaining in a district general hospital (5880). The commonest mechanisms of injury were falls in the elderly and road traffic collisions in the young, which were more likely to present in coma. In severe TBI (Glasgow Coma Score (GCS) ≤8), the median time from admission to imaging with CT scan is 0.5 hours. Median time to craniotomy from admission is 2.6 hours and median time to intracranial pressure monitoring is 3 hours. The most frequently documented complication of severe TBI is bronchopneumonia in 5% of patients. Risk-adjusted W scores derived from the Ps14n model indicate that no neurosurgical unit fell outside the 3 SD limits on a funnel plot.CONCLUSIONS: We provide the first comprehensive report of the management of TBI in England and Wales, including data from all neurosurgical units. These data provide transparency and suggests equity of access to high-quality TBI management provided in England and Wales.

Published
2016

13. Biochemical indications of cerebral ischaemia and mitochondrial dysfunction in severe brain trauma analysed with regard to type of lesion

Author

Peter Reinstrup, Troels Halfeld Nielsen, Carl-Henrik Nordström, Urban Ungerstedt, and Wilhelm Schalén

Subjects
0301 basic medicine, Male, Neurology, Microdialysis, Subdural haematoma, Ischaemia, Brain Ischemia, Pyruvic Acid/metabolism, 0302 clinical medicine, Traumatic brain injury, Brain Injuries, Traumatic, Pyruvic Acid, Glucose/metabolism, Other Basic Medicine, Cytoplasmatic redox, Lactic Acid/metabolism, Neuroradiology, Cerebral Infarction, Middle Aged, Brain Ischemia/etiology, Mitochondria, Traumatic brain injury Microdialysis Ischaemia Mitochondrial dysfunction Lactate Pyruvate Cytoplasmatic redox energy-metabolism perfusion-pressure intracerebral microdialysis subarachnoid hemorrhage glycolytic metabolites intracranial-pressure bedside diagnosis cyclosporine-a amino-acids injury Neurosciences & Neurology Surgery, Anesthesia, Female, Neurosurgery, medicine.symptom, Pyruvate, Adult, medicine.medical_specialty, Ischemia, macromolecular substances, Lesion, 03 medical and health sciences, Mitochondria/metabolism, medicine, Humans, Lactic Acid, Cerebral Infarction/metabolism, business.industry, Brain Injuries, Traumatic/complications, medicine.disease, 030104 developmental biology, Glucose, Lactate, Surgery, Neurology (clinical), business, Mitochondrial dysfunction, Energy Metabolism, 030217 neurology & neurosurgery
Abstract

Background: The study focuses on three questions related to the clinical usefulness of microdialysis in severe brain trauma: (1) How frequently is disturbed cerebral energy metabolism observed in various types of lesions? (2) How often does the biochemical pattern indicate cerebral ischaemia and mitochondrial dysfunction? (3) How do these patterns relate to mortality? Method: The study includes 213 consecutive patients with severe brain trauma (342 intracerebral microdialysis catheters). The patients were classified into four groups according to the type of lesion: extradural haematoma (EDH), acute subdural haematoma (SDH), cerebral haemorrhagic contusion (CHC) and no mass lesion (NML). Altogether about 150,000 biochemical analyses were performed during the initial 96 h after trauma. Results: Compromised aerobic metabolism occurred during 38 % of the study period. The biochemical pattern indicating mitochondrial dysfunction was more common than that of ischaemia. In EDH and NML aerobic metabolism was generally close to normal. In SDH or CHC it was often severely compromised. Mortality was increased in SDH with impaired aerobic metabolism, while CHC did not exhibit a similar relation. Conclusions: Compromised energy metabolism is most frequent in patients with SDH and CHC (32 % and 49 % of the study period, respectively). The biochemical pattern of mitochondrial dysfunction is more common than that of ischaemia (32 % and 6 % of the study period, respectively). A correlation between mortality and biochemical data is obtained provided the microdialysis catheter is placed in an area where energy metabolism reflects tissue outcome in a large part of the brain.

Published
2016

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