Abstract:
:The Glasgow Coma Scale (GCS) was introduced 40 years ago and has received world-wide acceptance. The GCS rates eye, motor, and verbal responses to assess the level of consciousness. Concerns have been expressed with regard to reliability and consistency of assessments. We considered that lack of standardization in application techniques and reporting of the GCS may have contributed to these concerns, and aimed to assess current procedures in its use. Questionnaire-based assessments were conducted by an online survey and during neurosurgical training courses. Overall, 616 participants were recruited, representing 48 countries and including physicians and nurses from different disciplines. Use of the GCS was reported by nearly all participants for assessment of patients with traumatic brain injury, but not for all patients with a reduced level of consciousness from other causes (78%). Major differences were found regarding the type of stimulus applied when patients do not obey commands: Nail bed pressure, supraorbital pressure, trapezius or pectoralis pinch, and sternal rub were all frequently used, whereas 25% of responders reported to never use a peripheral stimulus. Strategies for reporting the GCS varied greatly, and 35% of participants limited the reporting to a summary score. Moreover, different approaches were used when one of the components could not be assessed. Overall, the surveys have identified a general lack of standardization in assessment and reporting of the GCS. The results illustrate the need for continued education to improve reliability of assessments through guidance to a standard approach.
journal_name
J Neurotraumajournal_title
Journal of neurotraumaauthors
Reith FC,Brennan PM,Maas AI,Teasdale GMdoi
10.1089/neu.2014.3843subject
Has Abstractpub_date
2016-01-01 00:00:00pages
89-94issue
1eissn
0897-7151issn
1557-9042journal_volume
33pub_type
杂志文章abstract::To evaluate new pharmacologic agents with potentially beneficial effects on posttraumatic spinal cord function, we used a modified weight drop (WD) technique to induce spinal cord injuries. These contusive spinal cord injuries in the rat closely mimic the human clinicopathologic situation. Especially for drug screenin...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1996.13.741
更新日期:1996-12-01 00:00:00
abstract::In various animal and human studies, early administration of 17β-estradiol, a strong antioxidant, anti-inflammatory, and anti-apoptotic agent, significantly decreases the severity of injury in the brain associated with cell death. Estrone, the predominant estrogen in postmenopausal women, has been shown to be a promis...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2274
更新日期:2012-08-10 00:00:00
abstract::Despite the shift in demographics of spinal cord injury (SCI) due to an aging population, relatively little has been reported regarding the effect of age on outcomes after SCI. This study examines the potential confounding effect of co-morbidities on the age-related differences in the hospital mortality following acut...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2008.0764
更新日期:2009-08-01 00:00:00
abstract::The clinical manifestations that occur after traumatic brain injury (TBI) include a wide range of cognitive, emotional, and behavioral deficits. The loss of excitatory synapses could potentially explain why such diverse symptoms occur after TBI, and a recent preclinical study has demonstrated a loss of dendritic spine...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2013.2960
更新日期:2013-12-01 00:00:00
abstract::Previous studies have resulted in conflicting results regarding the predictive effect of various clinical symptoms, signs, and plain imaging for intracranial pathology in adults with minor head injury. We sought to perform a meta-analysis of the literature to assess the significance of these factors for the prediction...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,meta分析
doi:10.1089/0897715041526122
更新日期:2004-07-01 00:00:00
abstract::End-to-side neurorrhaphy is widely used in the peripheral nervous system for nerve repair; however, the application of this technique has been limited to somatic nerves. The feasibility of nerve regeneration through end-to-side neurorrhaphy between autonomic and somatic nerves with different characteristics in the per...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2255
更新日期:2012-05-20 00:00:00
abstract::The majority of studies do not support the use of the prophylactic anticonvulsants studied thus far for the prevention of late PTS. Routine seizure prophylaxis later than 1 week following head injury is, therefore, not recommended. If late PTS occur, patients should be managed in accordance with standard approaches to...
journal_title:Journal of neurotrauma
pub_type: 指南,杂志文章,实务指引,评审
doi:10.1089/neu.2000.17.549
更新日期:2000-06-01 00:00:00
abstract::Mild traumatic brain injury (mTBI) disrupts hippocampal function and can lead to long-lasting episodic memory impairments. The encoding of episodic memories relies on spatial information processing within the hippocampus. As the primary entry point for spatial information into the hippocampus, the dentate gyrus is tho...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5350
更新日期:2018-06-01 00:00:00
abstract::Paralysis is an indication for trauma patients to be preferentially triaged by emergency services to designated level I or II trauma centers (TC). We sought to describe triage practices for patients with acute traumatic spinal cord injury (TSCI) and its associated emergency department (ED) outcomes. Adults ages ≥ 18 y...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2015.4016
更新日期:2015-12-15 00:00:00
abstract::Intraspinal injections of lysolecithin were used to produce unilateral demyelination in the dorsal columns of the rat spinal cord. The purpose of this study was to evaluate the effects of demyelination on the conductive properties of axons belonging to a spinal pathway of known origin and site of termination. At 5 and...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1992.9.231
更新日期:1992-10-01 00:00:00
abstract::The past 10 years have seen a rapid increase in the use of diffusion tensor imaging to identify biomarkers of traumatic brain injury (TBI). Although the literature generally indicates decreased anisotropic diffusion at more chronic injury periods and in more severe injuries, considerable debate remains regarding the d...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.2014.3337
更新日期:2014-07-15 00:00:00
abstract::Microdialysis sampling was used to characterize the release of norepinephrine and serotonin upon impact injury to the rat spinal cord. Increases in extracellular norepinephrine concentrations in response to injury were small and of short duration. In contrast, serotonin concentrations quickly rose 35-90 times followin...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1990.7.219
更新日期:1990-01-01 00:00:00
abstract::The expression of alternatively spliced mRNAs for amyloid precursor protein (APP) isoforms and their translation products were examined in the rat cerebral cortex 1, 3, 6, and 12 h and 1, 3, and 7 days (n = 4-5 in each group) after fluid-percussion brain injury. In situ hybridization studies demonstrated that the expr...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2000.17.123
更新日期:2000-02-01 00:00:00
abstract::There is an urgent need for both the scientific development and clinical validation of novel therapies for acute spinal cord injury (SCI). The scientific development of novel therapies would be facilitated by a better understanding of the acute pathophysiology of human SCI. Clinical validation of such therapies would ...
journal_title:Journal of neurotrauma
pub_type: 临床试验,杂志文章
doi:10.1089/neu.2009.1080
更新日期:2010-04-01 00:00:00
abstract::This study investigated corticomotor excitability and inhibition, cognitive functioning, and fine motor dexterity in retired elite and amateur Australian football (AF) players who had sustained concussions during their playing careers. Forty male AF players who played at the elite level (n=20; mean age 49.7±5.7 years)...
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
abstract::Traumatic brain injury (TBI) is a leading cause of death and disability in the United States, with children who sustain a TBI having a greater risk of developing long-lasting cognitive, behavioral, and motor function deficits. This has led to increased interest in utilizing large animal models to study pathophysiologi...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2019.6405
更新日期:2019-10-01 00:00:00
abstract::Traumatic brain injury (TBI) is associated with the development of numerous psychiatric diseases. Of particular concern for TBI patients is the impact of chronic impulsivity on daily functioning. Despite the scope of the human problem, little has been done to address impulsivity in animal models of brain injury. In th...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4813
更新日期:2017-10-01 00:00:00
abstract::Depression is associated with poorer recovery after traumatic brain injury (TBI), yet awareness of depression risk post-TBI among providers and patients is low. The aim of this study was to estimate risk of depression post-TBI among adults 18 years of age and older and to identify risk factors associated with developi...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5608
更新日期:2019-01-15 00:00:00
abstract::Information on the nature of deficits and adaptive mechanisms occurring after spinal cord injury is essential to the design of strategies for promoting functional recovery. Motor impairments and compensations were quantified by three-dimensional kinematic analysis in freely walking rats, 6 months after mild cervical (...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2005.22.544
更新日期:2005-05-01 00:00:00
abstract::Diffuse axonal injury is recognized as a progressive and long-term consequence of traumatic brain injury. Axonal injury can have sustained negative consequences on neuronal functions such as anterograde and retrograde transport and cellular processes such as autophagy that depend on cytoarchitecture and axon integrity...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2015.4196
更新日期:2016-08-15 00:00:00
abstract::The Basso, Bresnahan and Beattie (BBB) locomotor scale has not been tested to evaluate functional consequences of peripheral nerve lesions. Alternative methods to evaluate animal functional recovery after sciatic nerve injury are desirable. Male Wistar rats had a right sciatic nerve segment exposed and were divided in...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/089771504774129955
更新日期:2004-05-01 00:00:00
abstract::Spinal cord injury (SCI) launches a complex cascade of events that leads to progressive damage and loss of function. Compromise of plasma membrane integrity due to the mechanical impact is an acute event that may contribute to cellular dysfunction. Therefore, the objective of this study was to better understand the ex...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2008.0523
更新日期:2009-04-01 00:00:00
abstract::The role of Ca2+ in cellular injury has received particular attention in studies of acute spinal cord trauma. In this context, the spatial and temporal distribution of extracellular Ca2+ ([Ca2+]e) may have an important bearing on the development of secondary tissue injury. We therefore studied the spatial-temporal dis...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1994.11.255
更新日期:1994-06-01 00:00:00
abstract::Inflammatory lesions in the brain activate a systemic acute-phase response (APR), which is dependent on the release of extracellular vesicles (EVs) into the circulation. The resulting APR is responsible for regulating leukocyte mobilization and subsequent recruitment to the brain. Factors that either exacerbate or inh...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5049
更新日期:2018-02-15 00:00:00
abstract::Autonomic dysreflexia (AD) is a potentially life-threatening syndrome in individuals with spinal cord injury (SCI) above the T6 spinal level that is characterized by episodic hypertension in response to noxious stimuli below the lesion. Maladaptive intraspinal plasticity is thought to contribute to the temporal develo...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5184
更新日期:2018-03-15 00:00:00
abstract::The aim of this systematic review was to critically evaluate the evidence on interventions for depression following traumatic brain injury (TBI) and provide recommendations for clinical practice and future research. We reviewed pharmacological, other biological, psychotherapeutic, and rehabilitation interventions for ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.2009.1091
更新日期:2009-12-01 00:00:00
abstract::Although atrophic changes have been well described following traumatic brain injury (TBI) in humans, little is known concerning the mechanisms or progression of brain tissue loss. In the present study, we evaluated the temporal profile of histopathological changes following parasagittal fluid-percussion (FP) brain inj...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1997.14.715
更新日期:1997-10-01 00:00:00
abstract::Gap junctions are conductive channels formed by membrane proteins termed connexins (Cx), which permit the intercellular exchange of metabolites, ions, and small molecules. Junctional permeability is regulated by pH, membrane potential, and intracellular secondary messengers. The purpose of this study was to elucidate ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2009.1234
更新日期:2010-07-01 00:00:00
abstract::We investigated the activation of lower limb motor pools by supraspinal and spinal networks after human spinal cord injury (SCI). We compared electromyographic (EMG) activity from six muscles during voluntarily attempted non-weight-bearing single-joint movements, multijoint movements approximating stepping in a supine...
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
abstract::Several behavioral factors such as violence, impulsivity, and alcohol-related problems are associated with traumatic spinal cord injury (TSCI). Such factors have been associated with inherently low neuronal serotonergic capacity that in turn is reflected in low activity of monoamine oxidase (MAO) as measured in platel...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4462
更新日期:2016-11-01 00:00:00