Traumatic Brain Injury

@article{Parikh2007TraumaticBI,
  title={Traumatic Brain Injury},
  author={Samira N. Parikh and Marcella Koch and Raj K. Narayan},
  journal={International Anesthesiology Clinics},
  year={2007},
  volume={45},
  pages={119-135}
}
Traumatic brain injury (TBI) is physical injury to brain tissue that temporarily or permanently impairs brain function. Diagnosis is suspected clinically and confirmed by imaging [primarily computed tomography (CT), although magnetic resonance imaging (MRI) can be helpful later when it is logistically possible to obtain]. Initial treatment consists of ensuring a reliable airway and maintenance of adequate ventilation and blood pressure. Surgery is often needed in more severe cases to remove… 
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TBI is the best known established epigenetic risk factor for later development of neurodegenerative diseases and dementia and genetic background of ß-amyloid precursor protein (APP), Apolipoprotein E (ApoE), presenilin (PS) and neprilysin (NEP) genes is associated with exacerbation of neuro decline after TBI.
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TLDR
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Given the completion of recent combat operations and the transition of TBI patients into long-term care within the US Department of Veterans Affairs system, a review of the literature concerning TBI is timely.
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This trial has been designed to determine whether functional imaging indexes and tau level in the cerebrospinal fluid can predict recovery of cognitive function in patients with traumatic brain injury and provide objective evidence for the clinical prevention and treatment of cognitive dysfunction following traumatic head injury.
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References

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TLDR
This chapter will provide an overview of the essential principles involved in optimizing outcome after traumatic brain injury, including aspects of prehospital and emergency room care, operative and perioperative strategies, and intensive care monitoring and intervention.
Mechanism-based MRI classification of traumatic brainstem injury and its relationship to outcome.
TLDR
Understanding the anatomy and extent of brainstem injury, as well as its relationship to supratentorial abnormalities, will facilitate a more accurate use of early MRI as a prognostic tool and assist in the counseling of families.
Traumatic cerebral vascular injury: the effects of concussive brain injury on the cerebral vasculature.
TLDR
A more thorough understanding of the direct and indirect effects of trauma on the cerebral vasculature will lead to improvements in current treatments of brain trauma as well as to the development of novel and, hopefully, more effective therapeutic strategies.
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TLDR
No evidence is found that barbiturate therapy in patients with acute severe head injury improves outcome, and barbiturates also reduce blood pressure and therefore may adversely effect cerebral perfusion pressure.
Comparison of MRI and electrophysiological studies for detecting brainstem lesions in traumatic brain injury
TLDR
Both techniques are effective in disclosing traumatic brainstem injury, with diagnostic overlap in about 50% of cases, and MRI is recommended in each case having normal electrophysiological findings when brain stem injury is suspected.
Magnetic resonance imaging of traumatic brain injury: relationship of T2 SE and T2*GE to clinical severity and outcome
TLDR
This study demonstrates the enhanced sensitivity of T2* GE for detecting haemorrhagic lesions associated with TBI and supports a complimentary role for both T2 SE and T2 GE weighted imaging in characterizing injury severity and predicting longer-term outcomes.
MR imaging of head trauma: review of the distribution and radiopathologic features of traumatic lesions.
TLDR
MR was found to be superior to CT and to be very effective in the detection of traumatic head lesions and some secondary forms of injury, and T1-weighted images proved to be most useful for anatomic localization and classification.
Traumatic brain injury: physiology, mechanisms, and outcome
TLDR
There is a gathering body of work that highlights the outcome impact of subtle neurocognitive changes, which may not be quantified adequately by outcome measures used in previous trials.
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TLDR
The possibility that a patient who has recently sustained a head injury might develop an acute intracranial hematoma can never be completely discounted, even when there are no abnormal clinical signs, and a skull x-ray retains a useful place in the investigation of selected patients with a minor head injury.
Head-injured patients who talk and deteriorate into coma. Analysis of 211 cases studied with computerized tomography.
TLDR
Of 838 patients with severe head injuries admitted since the introduction of computerized tomography, 211 talked at some time between trauma and subsequent deterioration into coma, four of every five patients who deteriorated into coma had a mass lesion potentially requiring surgery.
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