Abstract:
:We measured quantitative cortical mantle cerebral blood flow (CBF) by stable xenon computed tomography (CT) within the first 12 h after severe traumatic brain injury (TBI) to determine whether neurologic outcome can be predicted by CBF stratification early after injury. Stable xenon CT was used for quantitative measurement of CBF (mL/100 g/min) in 22 cortical mantle regions stratified as follows: low (0-8), intermediate (9-30), normal (31-70), and hyperemic (>70) in 120 patients suffering severe (Glasgow Coma Scale [GCS] score ≤8) TBI. For each of these CBF strata, percentages of total cortical mantle volume were calculated. Outcomes were assessed by Glasgow Outcome Scale (GOS) score at discharge (DC), and 1, 3, and 6 months after discharge. Quantitative cortical mantle CBF differentiated GOS 1 and GOS 2 (dead or vegetative state) from GOS 3-5 (severely disabled to good recovery; p<0.001). Receiver operating characteristic (ROC) curve analysis for percent total normal plus hyperemic flow volume (TNHV) predicting GOS 3-5 outcome at 6 months for CBF measured <6 and <12 h after injury showed ROC area under the curve (AUC) cut-scores of 0.92 and 0.77, respectively. In multivariate analysis, percent TNHV is an independent predictor of GOS 3-5, with an odds ratio of 1.460 per 10 percentage point increase, as is initial GCS score (OR=1.090). The binary version of the Marshall CT score was an independent predictor of 6-month outcome, whereas age was not. These results suggest that quantitative cerebral cortical CBF measured within the first 6 and 12 h after TBI predicts 6-month outcome, which may be useful in guiding patient care and identifying patients for randomized clinical trials. A larger multicenter randomized clinical trial is indicated.
journal_name
J Neurotraumajournal_title
Journal of neurotraumaauthors
Kaloostian P,Robertson C,Gopinath SP,Stippler M,King CC,Qualls C,Yonas H,Nemoto EMdoi
10.1089/neu.2011.2147subject
Has Abstractpub_date
2012-03-20 00:00:00pages
727-34issue
5eissn
0897-7151issn
1557-9042journal_volume
29pub_type
杂志文章abstract::Sports-related concussion is a major public health problem in the United States and yet its biomechanical mechanisms remain unclear. In vitro studies demonstrate axonal elongation as a potential injury mechanism; however, current response-based injury predictors (e.g., maximum principal strain, ε(ep)) typically do not...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
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journal_title:Journal of neurotrauma
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pub_type: 杂志文章
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journal_title:Journal of neurotrauma
pub_type: 杂志文章,随机对照试验
doi:10.1089/neu.2013.3197
更新日期:2015-04-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/0897715041651060
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/089771502762300256
更新日期:2002-12-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章,meta分析,评审
doi:10.1089/neu.2015.4192
更新日期:2016-03-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2014.3505
更新日期:2015-07-15 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2008.0814
更新日期:2014-02-15 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5577
更新日期:2018-09-06 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/08977150260338010
更新日期:2002-10-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2013.3219
更新日期:2014-07-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2004.21.1396
更新日期:2004-10-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2014.3667
更新日期:2015-07-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2015.4098
更新日期:2016-07-15 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2005.22.772
更新日期:2005-07-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.1911
更新日期:2011-09-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2010.1708
更新日期:2011-12-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4514
更新日期:2017-04-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2004.21.1204
更新日期:2004-09-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2014.3387
更新日期:2015-01-15 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5360
更新日期:2018-04-15 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2020.7422
更新日期:2021-01-20 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2007.0488
更新日期:2008-09-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2009.1163
更新日期:2010-03-01 00:00:00
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journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1991.8.27
更新日期:1991-04-01 00:00:00
abstract::Traumatic brain injury (TBI) is an established risk factor for neurodegenerative disorders and dementias. Epigenetic modifications, such as DNA methylation, may alter the expression of genes without altering the DNA sequence in response to environmental factors. We hypothesized that DNA methylation changes may occur i...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
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更新日期:2021-01-08 00:00:00
abstract::We sought to determine sensitivity of the cortical impact injury model of traumatic brain injury (TBI) to severity of injury and to treatment. We examined the pattern of motor and cognitive deficits and recovery following TBI over a range of injury severities, and examined the efficacy of surface-induced moderate hypo...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/08977150150502604
更新日期:2001-02-01 00:00:00