Search results for "Brain injury"
showing 10 items of 143 documents
Cisternostomy for Traumatic Brain Injury: A New Era Begins
2016
Traumatic brain injury (TBI) is a major cause of death and disability especially in the young generations. In the United States TBI affects about 1.7 million people annually [1] and this number is higher in the developing countries. It is well known that TBI is associated to a primary and secondary brain injury. The first is without solution and depends on the impact. In surviving patients, what plays a critical role is the subsequent secondary injury since, without effective treatments, complex cascades will promote additional brain damage.
Does granulocyte-colony stimulating factor stimulate peripheral nerve regeneration? An experimental study on traumatic lesion of the sciatic nerve in…
2021
Aim of the study. To analyse the therapeutic potential of granulocyte-colony stimulating factor (G-CSF) treatment using a rat model of traumatic sciatic nerve lesion. Clinical rationale for the study. G-CSF has proven strong neurotrophic properties in various models of ischaemic and traumatic brain injury. Fewer studies exist regarding the influence of G-CSF on posttraumatic peripheral nerve regeneration. Currently, the possibilities of pharmacological prevention or treatment of mechanical nerve injury are limited, and there is an urgent need to find new treatment strategies applicable in clinical situations. Material and methods . A controlled traumatic right sciatic nerve lesion was set u…
Hyperventilation in Adult TBI Patients: How to Approach It?
2021
Hyperventilation is a commonly used therapy to treat intracranial hypertension (ICTH) in traumatic brain injury patients (TBI). Hyperventilation promotes hypocapnia, which causes vasoconstriction in the cerebral arterioles and thus reduces cerebral blood flow and, to a lesser extent, cerebral blood volume effectively, decreasing temporarily intracranial pressure. However, hyperventilation can have serious systemic and cerebral deleterious effects, such as ventilator-induced lung injury or cerebral ischemia. The routine use of this therapy is therefore not recommended. Conversely, in specific conditions, such as refractory ICHT and imminent brain herniation, it can be an effective life-savin…
Neuro-ICU patient disposition
2018
This article revises the recent evidence on ICU admission criteria for acute neurological patients [traumatic brain injury (TBI) patients, postoperative neurosurgical procedures and stroke].The appropriate utilization of ICU beds is essential, but it is complex and a challenge to attain. To date there are no widely accepted international guidelines for managing these acute brain-injured patients (stroke, TBI, postneurosurgery) in the ICU. The criteria for ICU admission after neurological acute injury, high-dependency unit or a specialized neurosurgical ward vary from institution to institution depending on local structures and characteristics of the available resources. Better evidence to s…
European evidence-based recommendations for clinical assessment of upper limb in neurorehabilitation (CAULIN): data synthesis from systematic reviews…
2021
Abstract Background Technology-supported rehabilitation can help alleviate the increasing need for cost-effective rehabilitation of neurological conditions, but use in clinical practice remains limited. Agreement on a core set of reliable, valid and accessible outcome measures to assess rehabilitation outcomes is needed to generate strong evidence about effectiveness of rehabilitation approaches, including technologies. This paper collates and synthesizes a core set from multiple sources; combining existing evidence, clinical practice guidelines and expert consensus into European recommendations for Clinical Assessment of Upper Limb In Neurorehabilitation (CAULIN). Methods Data from systema…
Ventilation, oxidative stress and risk of brain injury in preterm newborn
2020
AbstractPreterm infants have an increased risk of cognitive and behavioral deficits and cerebral palsy compared to term born babies. Especially before 32 weeks of gestation, infants may require respiratory support, but at the same time, ventilation is known to induce oxidative stress, increasing the risk of brain injury. Ventilation may cause brain damage through two pathways: localized cerebral inflammatory response and hemodynamic instability. During ventilation, the most important causes of pro-inflammatory cytokine release are oxygen toxicity, barotrauma and volutrauma. The purpose of this review was to analyze the mechanism of ventilation-induced lung injury (VILI) and the relationship…
Surgical Treatment for Traumatic Brain Injury: Is It Time for Reappraisal?
2015
Traumatic brain injury (TBI) is a major cause of morbidity and mortality in the United States. It is estimated that each year, on average, TBIs associated with 1.1 million visits to the emergency department, 235,000 hospitalizations, and 50,000 deaths.
Tissue Oxygenation in Normal and Edematous Brain Cortex During Arterial Hypocapnia
1984
Since arterial hypocapnia causes a cerebral blood flow decrease, hypocapnic conditions are induced in patients with severe traumatic brain injury by controlled hyperventilation in order to reduce the intracranial pressure (Gordon, 1971). Beneficial effects on the clinical course of patients, however, can be observed only under conditions of moderate hypocapnia. As shown by animal experiments severe arterial hypocapnia results in insufficient oxygen supply conditions in brain tissue (Grote et al., 1981), which subsequently influences the brain metabolism (Granholm et al., 1969, 1971) and counteracts the influence of hypocapnia on cerebral blood flow regulation (Grote et al., 1981). The prese…
Hipertensión endocraneal asociada a la sedación con sevoflurano mediante el dispositivo AnaConDa®en un paciente con traumatismo craneoencefálico seve…
2013
Sedation in neurocritical patients remains a challenge as there is no drug that meets all the requirements. Since the appearance of the AnaConDa® device, and according to the latest recommendations, sevoflurane has become an alternative for patients with brain injury. The use of AnaConDa® produces an increase in the anatomical dead space that leads to a decrease in alveolar ventilation. If the decrease in the alveolar ventilation is not offset by an increase in minute volume, there will be an increase in PaCO2. We report the case of a patient with severe traumatic brain injury who suffered an increase in intracranial pressure as a result of increased PaCO2 after starting sedation with the A…
Exercise as therapy for neurodevelopmental and cognitive dysfunction in people with a Fontan circulation: A narrative review
2023
People with a Fontan circulation are at risk of neurodevelopmental delay and disability, and cognitive dysfunction, that has significant implications for academic and occupational attainment, psychosocial functioning, and overall quality of life. Interventions for improving these outcomes are lacking. This review article discusses current intervention practices and explores the evidence supporting exercise as a potential intervention for improving cognitive functioning in people living with a Fontan circulation. Proposed pathophysiological mechanisms underpinning these associations are discussed in the context of Fontan physiology and avenues for future research are recommended.