Abstract:
:Penetrating brain injury (PBI) is the most devastating type of traumatic brain injury. Development of coagulopathy in the acute setting of PBI, though common, remains of unclear significance as does its reversal. The aim of this study is to investigate the relationship between coagulopathy and clinical presentation, radiographical features, and outcome in civilian patients with PBI. Eighty-nine adult patients with PBI at a Level I trauma center in Chicago, Illinois who survived acute resuscitation and with available coagulation profile were analyzed. Coagulopathy was defined as international normalized ratio [INR] >1.3, platelet count <100,000 /μL, or partial thromboplastin time >37 sec. Median age (interquartile range; IQR) of our cohort was 27 (21-35) years, and 74 (83%) were male. The intent was assault in 74 cases (83%). The mechanism of PBI was gunshot wound in all patients. Forty patients (45%) were coagulopathic at presentation. In a multiple regression model, coagulopathy was associated with lower Glasgow Coma Scale (GCS)-Motor score (odds ratio [OR], 0.67; confidence interval [CI], 0.48-0.94; p = 0.02) and transfusion of blood products (OR, 3.91; CI, 1.2-12.5; p = 0.02). Effacement of basal cisterns was the only significant radiographical features associated with coagulopathy (OR, 3.34; CI, 1.08-10.37; p = 0.04). Mortality was found to be significantly more common in coagulopathic patients (73% vs. 25%; p < 0.001). However, in our limited sample, reversal of coagulopathy at 24 h was not associated with a statistically significant improvement in outcome. The triad of coagulopathy, low post-resuscitation GCS, and radiographical effacement of basal cisterns identify a particularly ominous phenotype of PBI. The role, and potential reversal of, coagulopathy in this group warrants further investigation.
journal_name
J Neurotraumajournal_title
Journal of neurotraumaauthors
Mansour A,Loggini A,Goldenberg FD,Kramer C,Naidech AM,Ammar FE,Vasenina V,Castro B,Das P,Horowitz PM,Karrison T,Zakrison T,Hampton D,Rogers SO,Lazaridis Cdoi
10.1089/neu.2020.7422subject
Has Abstractpub_date
2021-01-20 00:00:00eissn
0897-7151issn
1557-9042pub_type
杂志文章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::To examine the mechanism of the increase in cerebral blood flow induced by L-arginine administration after traumatic brain injury, the cerebral hemodynamic effects of L-arginine, D-arginine, and the free radical scavengers superoxide dismutase (SOD) and catalase were compared in the controlled cortical impact injury m...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/08977150360517209
更新日期:2003-01-01 00:00:00
abstract::Headache attributed to traumatic injury to the head (HAIH) is claimed to be the most common sequela following mild traumatic brain injury (MTBI), but epidemiological evidence is scarce. We explored whether patients with MTBI had an increase in headache suffering following injury compared with controls. We also studied...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.6328
更新日期:2019-12-01 00:00:00
abstract::Acute changes in cerebral perfusion and metabolism after subarachnoid hemorrhage (SAH) have been shown to contribute significantly to acute brain injury. The purpose of this study was to examine the effects of moderate hypothermia on the acute changes after massive experimental SAH as evaluated by diffusion-weighted i...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2007.0443
更新日期:2008-07-01 00:00:00
abstract::The purpose of this study was to investigate the potential neuroprotective efficacy of the mitochondrial uncoupler 2,4-dinitrophenol (DNP) in rats following a mild to moderate spinal cord contusion injury. Animals received intraperitoneal injections of vehicle (DMSO) or 5 mg/mL of DNP prior to injury. Twenty-four hour...
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
abstract::Traumatic brain injury (TBI) has been identified as a risk factor for Alzheimer's disease (AD). However, how such neural damage contributes to AD pathology remains unclear; specifically, the relationship between the timing of a TBI relative to aging and the onset of AD pathology is not known. In this study, we have ex...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.5982
更新日期:2019-06-01 00:00:00
abstract::For patients surviving serious traumatic brain injury (TBI), families and other stakeholders often desire information on long-term functional prognosis, but accurate and easy-to-use clinical tools are lacking. We aimed to build utilitarian decision trees from commonly collected clinical variables to predict Glasgow Ou...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5359
更新日期:2018-07-15 00:00:00
abstract::Head contact-induced loads can result in skull fractures and/or brain injuries. While skull fractures have been produced from post-mortem human cadaver surrogates (PMHS), injury probability curves describing their structural responses have not been developed. The objectives of this study were to develop skull fracture...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2017.5356
更新日期:2018-06-01 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::Moderate to severe traumatic brain injury (TBI) in humans and rats induces measurable metabolic changes, including a sustained depression in cerebral glucose uptake. However, the effect of a mild TBI on brain glucose uptake is unclear, particularly in rodent models. This study aimed to determine the glucose uptake pat...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2013.2928
更新日期:2013-12-01 00:00:00
abstract::Experimental traumatic brain injury (TBI) initiates massive disturbances in Ca2+ concentrations in the brain that may contribute to neuronal damage. Intracellular Ca2+ may be elevated via influx through voltage-operated cation channels, ligand-gated ionotropic channels, and store-operated cation channels (SOCs). In th...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2000.17.83
更新日期:2000-01-01 00:00:00
abstract::Mild traumatic brain injury (mTBI) patients frequently experience emotion dysregulation symptoms, including post-traumatic stress. Although mTBI likely affects cortical activation and structure, resulting in cognitive symptoms after mTBI, early effects of mTBI on cortical emotion processing circuits have rarely been e...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2015.4392
更新日期:2017-01-15 00:00:00
abstract::Acute subdural hematoma (ASDH) is associated with high morbidity and mortality. Whether the volume effect of the hematoma and increase of intracranial pressure (ICP) or the local effect of blood are responsible for this severe pathophysiology is unclear. Therefore, we compared subdural infusion of autologous blood and...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4464
更新日期:2017-02-15 00:00:00
abstract::Striatal-enriched tyrosine phosphatase (STEP) has been identified as a component of physiological and pathophysiological signaling pathways mediated by N-methyl-d-aspartate (NMDA) receptor/calcineurin/calpain activation. Activation of these pathways produces a subsequent change in STEP isoform expression or activation...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2253
更新日期:2012-07-01 00:00:00
abstract::This paper encompasses the prediction of early and late recovery from traumatic brain injury (TBI). Predictors of the duration of coma and the utilization of posttraumatic amnesia duration to predict residual memory function are discussed. The issues surrounding prediction of long-term neurobehavioral recovery from TB...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.1995.12.913
更新日期:1995-10-01 00:00:00
abstract::Prognostic biomarkers for post-injury outcome are necessary for the development of neuroprotective and antiepileptogenic treatments for traumatic brain injury (TBI). We hypothesized that T2 relaxation magnetic resonance imaging (MRI) predicts the progression of perilesional cortical pathology and epileptogenesis. The ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2019.6796
更新日期:2020-12-01 00:00:00
abstract::Assessment of acute mild traumatic brain injury (mTBI) symptoms after a combat blast could aid diagnosis and guide follow-up care. Our objective was to document acute mTBI symptoms following a combat blast and to examine associations between acute symptoms and mental health and service discharge outcomes. A retrospect...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2012.2537
更新日期:2013-08-15 00:00:00
abstract::Traumatic injury to the central nervous system (CNS) is accompanied by the spreading damage of secondary degeneration, resulting in further loss of neurons and function. Partial transection of the optic nerve (ON) has been used as a model of secondary degeneration, in which axons of retinal ganglion cells in the ventr...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2010.1426
更新日期:2010-11-01 00:00:00
abstract::Closed head injury often has a devastating outcome, partly because the insult, like other injuries to the central nervous system (CNS), triggers self-destructive processes. During studies of the response to other CNS insults, it was unexpectedly discovered that the immune system, if well controlled, provides protectio...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/089771503767168483
更新日期:2003-06-01 00:00:00
abstract::A therapeutic strategy for acute spinal cord injury would be to reduce the progressive degeneration and disconnection of axons from their targets. Here, we describe a model to evaluate degeneration of the ascending sensory projections to the nuclei in the medulla following graded spinal cord contusions in adult female...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2005.22.415
更新日期:2005-04-01 00:00:00
abstract::Central nervous system (CNS) destruction in spinal cord injury (SCI) is caused by a complex series of cellular and molecular events. Recent studies have concentrated on signaling by receptors in the tumor necrosis factor receptor (TNFR) superfamily that mediate diverse biological outcomes ranging from inflammation to ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.2006.23.335
更新日期:2006-03-01 00:00:00
abstract::Closed-head concussive injury is one of the most common causes of traumatic brain injury (TBI). While single concussions result in short-term neurologic dysfunction, multiple concussions can result in cumulative damage and increased risk for neurodegenerative disease. Despite the prevalence of concussion, knowledge ab...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2057
更新日期:2012-01-20 00:00:00
abstract::Spinal cord injury (SCI) is a devastating condition that affects patients on both a personal and societal level. The objective of the study is to improve the prediction of long-term functional outcome following SCI based on the acute clinical findings. A total of 76 patients with acute traumatic SCI were prospectively...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4955
更新日期:2017-06-15 00:00:00
abstract::Abstract Although several functional magnetic resonance imaging (fMRI) studies have been conducted in human models of mild traumatic brain injury (mTBI), to date no studies have explicitly examined how injury may differentially affect both the positive phase of the hemodynamic response function (HRF) as well as the po...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,随机对照试验
doi:10.1089/neu.2013.3069
更新日期:2014-01-15 00:00:00
abstract::The effects of ethanol intoxication on brain injury and cerebral blood flow (CBF) were investigated in a porcine fluid-percussion model of traumatic brain injury (TBI). Immature swine, under halothane anesthesia (1%), had a TBI delivered with a fluid-percussion device. The experimental group (n = 10) received ethanol ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1993.10.275
更新日期:1993-10-01 00:00:00
abstract::There are no established biomarkers for mild traumatic brain injury (mTBI), in part because post-concussive symptoms (PCS) are subjective and conventional imaging is typically unremarkable. To test whether diffuse axonal abnormalities quantified with three-dimensional (3D) proton magnetic resonance spectroscopic imagi...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2012.2696
更新日期:2013-07-01 00:00:00
abstract::Traumatic spinal cord injury (SCI) elicits a complex cascade of cellular and molecular inflammatory events. Although certain aspects of the inflammatory response are essential to wound healing and repair, post-SCI inflammation is, on balance, thought to be detrimental to recovery by causing "bystander damage" and the ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2019.6952
更新日期:2020-08-26 00:00:00
abstract::Traumatic brain injury (TBI) is one of the most acute degenerative pathologies in the central nervous system, and in vivo indices enabling an assessment of TBI on a mechanistic basis have yet to be established. The aim of this work was to pursue neuroinflammatory changes and their link to functional disruptions of tra...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2009.1196
更新日期:2010-08-01 00:00:00
abstract::Chronic verbal retrieval deficits have been noted in traumatic brain injury (TBI), but no U.S. Food and Drug Administration-approved interventions are available. The present study investigated whether 10 sessions of 20 min of 1 mA anodal high-definition transcranial direct current stimulation (HD-tDCS) targeting pre-s...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.6331
更新日期:2020-01-01 00:00:00
abstract::Predicting outcome after pediatric traumatic brain injury (TBI) is important for providing information to families and prescribing rehabilitation services. The study objective was to assess whether biomarkers concentrations obtained at the time of injury are associated with outcome. Serial serum concentrations of neur...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2007.0316
更新日期:2007-12-01 00:00:00