Indian Journal of Neurotrauma最新文献

{"title":"Adrenergic Suppression Modalities in Acute Traumatic Brain Injury","authors":"Scott Meyer, Fotis G. Souslian, Eric Nussbaum, L. Moscote-Salazar, Tariq Janjua","doi":"10.1055/s-0044-1787114","DOIUrl":"https://doi.org/10.1055/s-0044-1787114","url":null,"abstract":"","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"2 8","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive Craniocerebral Wound Reconstruction Using Fascia Lata Graft: A Case Report and Technical Note","authors":"Charles Champeaux Depond, A. Bernat, Philippe Metellus","doi":"10.1055/s-0044-1778734","DOIUrl":"https://doi.org/10.1055/s-0044-1778734","url":null,"abstract":"Penetrating head injury is rare and, their management is nonstandard with persistent cerebrospinal fluid (CSF) leakage being possibly challenging to treat. A 34-year-old man with no past medical history was referred in emergency room for an impressive accidental penetrating craniocerebral wound through which the brain was extruding due to the raised intracranial pressure. Computed tomography scan showed a comminuted frontal fracture extended to the anterior skull base and a severe bifrontal lobe concussion with a diffuse intracranial hemorrhage. A debridement and washout of the craniocerebral wound were achieved with careful hemostasis followed by a decompressive craniectomy. Fortunately, the patient survived but, the CSF continued to leak through the anterior skull base fracture with no endoscopic treatment possibility. Fifteen days after the initial trauma, a surgical sealing was decided using a large fascia lata sheath harvested on the right thigh by a “S”-shaped incision. A significant piece of fascia lata was cut off and meticulously sutured to the remaining dura mater rims in double-layered watertight fashion. Both cranial and right thigh wounds healed uneventfully and the CSF leak never reoccurred. Twenty-two weeks after the initial trauma, a custom-made titanium cranioplasty was inserted without any dissection difficulty. In case of persistent CSF leakage not amenable to endonasal endoscopic treatment, the use of a large piece of facia lata harvested on the thigh using an “S”-shaped incision is a simple, reliable way to efficiently repair a large dura mater defect. It requires neither special skills nor sophisticated instruments.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"164 ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140476048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neglected Cervical Facet Dislocation without Neurological Deficit: A Simple Solution to a Complex Problem—A Case Series and Review","authors":"Vishal Kumar, Ankit Rai, S. Dhatt","doi":"10.1055/s-0043-1777680","DOIUrl":"https://doi.org/10.1055/s-0043-1777680","url":null,"abstract":"Cervical facet dislocation is a disastrous injury. Delayed presentation is not uncommon owing to various reasons in developing countries. Autofusion and a halt in progression are seen in spondylolysis and spondylolisthesis. Conservative treatment with close observation can be offered to the carefully selected patients with neglected cervical facet dislocations with intact neurology, as the injury is stable after autofusion. We registered eight male patients with cervical facet dislocation with delayed presentation for various reasons. Dynamic radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI) were done to rule out any instability, cord compression, or bony fusion. Patients were followed up for 6 months clinically and radiologically. A total of eight patients presented with cervical facet dislocation, with a mean delay in presentation of 33 weeks (range: 14–54 weeks). Postinjury, all the patients were neurologically intact, with the only complaint of cervical pain at presentation. Dynamic radiographs did not show any instability. No cord compression or changes were noted on the MRI. Conservative management was advised for all eight patients. A subsequent follow-up CT scan demonstrated bony fusion at the dislocated facets in three of these patients. All the patients remained neurologically intact, with no further progression of the deformity. Surgical management is the mainstay of treatment for neglected facet dislocations. A combined approach has been advocated in most of the studies for proper reduction and alignment in these cases, which is quite extensive and has its own morbidity. A trial of conservative treatment can be offered to selected patients with intact neurology.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"103 ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140475592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Midline Shift Detection and Quantification in Traumatic Brain Injury: A Comprehensive Review","authors":"Deepak Agrawal, Sharwari Joshi, Latha Poonamallee","doi":"10.1055/s-0043-1777676","DOIUrl":"https://doi.org/10.1055/s-0043-1777676","url":null,"abstract":"Traumatic brain injury (TBI) often results in midline shift (MLS) that is a critical indicator of the severity and prognosis of head injuries. Automated analysis of MLS from head computed tomography (CT) scans using artificial intelligence (AI) techniques has gained much attention in the past decade and has shown promise in improving diagnostic efficiency and accuracy. This review aims to summarize the current state of research on AI-based approaches for MLS analysis in TBI cases, identify the methodologies employed, evaluate the performance of the algorithms, and draw conclusions regarding their potential clinical applicability. A comprehensive literature search was conducted, identifying 15 distinctive publications. The identified articles were analyzed for their focus on MLS detection and quantification using AI techniques, including their choice of AI algorithms, dataset characteristics, and methodology. The reviewed articles covered various aspects related to MLS detection and quantification, employing deep neural networks trained on two-dimensional or three-dimensional CT imaging datasets. The dataset sizes ranged from 11 patients' CT scans to 25,000 CT images. The performance of the AI algorithms exhibited variations in accuracy, sensitivity, and specificity, with sensitivity ranging from 70 to 100%, and specificity ranging from 73 to 97.4%. AI-based approaches utilizing deep neural networks have demonstrated potential in the automated detection and quantification of MLS in TBI cases. However, different researchers have used different techniques; hence, critical comparison is difficult. Further research and standardization of evaluation protocols are needed to establish the reliability and generalizability of these AI algorithms for MLS detection and quantification in clinical practice. The findings highlight the importance of AI techniques in improving MLS diagnosis and guiding clinical decision-making in TBI management.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"490 ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140471692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurotrauma Care and Essential Neurological Examination: Opportunities and Challenges","authors":"O. Atallah, M. M. Rahman, Amit Agrawal","doi":"10.1055/s-0043-1777681","DOIUrl":"https://doi.org/10.1055/s-0043-1777681","url":null,"abstract":"","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"334 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140476730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship between Patient Load and Nursing Staffing Strength in Various Shifts of the Day in Emergency Department of a Major Tertiary Care Hospital in India","authors":"Manisha Mehra, Metilda Robin, Deepak Agrawal","doi":"10.1055/s-0043-1761938","DOIUrl":"https://doi.org/10.1055/s-0043-1761938","url":null,"abstract":"\u0000 Introduction A hospital has to function 24 hours a day, which makes shift duties almost inescapable for the nurses. However, shift wise staffing of nursing in emergency departments (EDs) of most hospitals continues to parallel that of other clinical departments.\u0000 Objective The aim of this study was to see the adequacy of staffing in reference to patient load in the different shifts of the day in the ED of a major tertiary care hospital in India.\u0000 Methods This is a prospective cross-sectional study. The number of patients entering the ED in each shift as well as the number of nurses assigned in each shift were taken from the rotation over a period of 1 week. A single point questionnaire was also administered to all five nurses in each shift over the study period to assess staff perception of patient load in the shift. Ethics approval was taken from institutional ethics committee.\u0000 Results For calculating the differential patient load in different shifts. We have calculated the average number of registered patients entering the emergency in over 1 week was 24 in the morning shift, 24 in the evening shift, and 81 in the night shift. The average nursing strength was 11 in morning shift, 11 in the evening shift, and 10 in the night shift. The average response from 15 nurses after interviewing them was 1 (overstaffed) in the morning, 2 (properly staffed) in the evening shift (properly staffed), and 4 in the night shift.\u0000 Conclusion The ratio of registered patients entering the emergency and the number of nurses deployed in each shift does not match, which gives an important view to revise roster in such a way that will not compromise the patient care.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"167 2","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140475502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Dexamethasone Affects Necessity for Surgical Intervention for Chronic Subdural Hematoma: Systematic Review and Meta-Analysis","authors":"Amit Agrawal, Amit Gupta, Rakesh Mishra, O. Atallah, M. M. Rahman, Saikat Das, L. Moscote-Salazar, Prasad Krishnan, V. Maurya","doi":"10.1055/s-0044-1779288","DOIUrl":"https://doi.org/10.1055/s-0044-1779288","url":null,"abstract":"The effectiveness of dexamethasone in managing chronic subdural hematoma (cSDH) patients remains uncertain although the drug is widely used in this condition. The present systematic review aims to understand the role of dexamethasone in reducing the need for surgery in cSDH patients. This study was conducted as per the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the electronic databases of PubMed, SCOPUS, Cochrane Central Register of Controlled Trials (the Cochrane Library), and ScienceDirect with a predefined search strategy. The population consisted of cSDH patients older than 18 years and treated primarily with dexamethasone. The primary outcome was the need for surgery after dexamethasone therapy in cSDH patients. The meta-analysis of a group of patients was done with the invariance method to estimate the pooled odds of the requirement for surgery after dexamethasone therapy. In the studies with a one-to-one comparison of dexamethasone with placebo/observation, the Mantel–Haenszel statistics were used to determine the odds of surgery. The quality of the studies was assessed with the Newcastle–Ottawa scale (NOS) and the Cochrane risk of bias tool was used to assess the risk of bias in randomized studies. In total, 598 studies were obtained from the database search and after applying the inclusion and exclusion criteria, 10 studies were finally selected for the qualitative and quantitative synthesis. One of the 10 studies was a randomized controlled trial (RCT), while the rest were observational studies. There were 653 patients who received the primary dexamethasone therapy. Of these, 388 patients did not require surgery, while 256 needed surgeries after the therapy. The pooled estimate of requirement for surgery after dexamethasone therapy was 0.41, with a 95% confidence interval of 0.37 to 0.45. A meta-analysis of the one-to-one comparison from three included studies showed a higher need of surgery in the (comparator) placebo/observation group than in the dexamethasone group with odds ratio of 7.16 (95% confidence interval: 2.21–23.13, with p = 0.0001). In addition, we identified the gaps in literature, and the complications and mortality reported in the studies. Dexamethasone is effective in reducing the requirement for surgery in some selected cSDH cases, although many patients still require surgical intervention.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"114 ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140475447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Venous Sinus Thrombosis in Pediatrics with Closed Head Injury: A Systematic Review and Meta-analysis","authors":"Saad R. Alghamdi, Juhina AlMayahi, Abdulrahman Bagais, Lamyaa AlOraimi, Qais Al-Rashidi, T. Al-Saadi","doi":"10.1055/s-0044-1778730","DOIUrl":"https://doi.org/10.1055/s-0044-1778730","url":null,"abstract":"This study aims to systematically review the current literature on pediatric cerebral venous sinus thrombosis (CVST) following closed head injury and to evaluate the clinical management of these patients. Systemic review of the literature was conducted using the following databases: PubMed, Google Scholar, Microsoft Academic, Clinical Trials, Cochrane Library, and Web of Science. All databases were searched from their date of inception to June 2022. Inclusion criteria were applied to identify articles reporting on pediatric patients with CVST following closed head injury. Out of the articles screened, 23 met the inclusion criteria, reporting on 23 pediatric patients with CVST. Falls were the most common cause of traumatic CVST (52.2%), followed by motor vehicle accidents (30.4%). Nausea and vomiting were the most common presenting symptoms (71.4%), and magnetic resonance venogram was the most common diagnostic method (43.5%). Multisinus involvement was noted in 52.2% of cases. Patients with falls from height were more likely to receive conservative management than those with nonfall mechanisms of injury (p < 0.05). Pediatric CVST following closed head injury is a rare condition, with only case reports available in the literature. Prompt diagnosis and early treatment can lead to good survival and neurological outcomes. In severe cases, neurosurgical intervention may be necessary to prevent mortality and severe morbidity. This review highlights the need for further research to establish evidence-based management guidelines for this rare but potentially serious condition in the pediatric population.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"221 ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140472091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Profiles of Mild Traumatic Brain Injury and mild Vascular Cognitive Impairment: A Comparative Study","authors":"R. Menon, S. Ramachandran, Parvathy P. Karunakaran","doi":"10.1055/s-0043-1777678","DOIUrl":"https://doi.org/10.1055/s-0043-1777678","url":null,"abstract":"\u0000 Objective The cognitive profile of any neurological disorder is very important throughout the duration of a person's treatment. It has a role in diagnosis, prognosis, and even after remission of active symptoms. It is a common trend among clinicians to monitor and compare the cognitive profiles of different disease conditions to locate the area of maximum dysfunction, with respect to a particular diagnosis. This study correlates the cognitive profiles of mild traumatic brain injury (mTBI) and mild vascular cognitive impairment (mVCI).\u0000 Methods The study population comprised 30 mTBI and 30 mVCI patients medically diagnosed by a neurologist. The patients were been selected from the neuromedical outpatient department (OPD) and neurosurgery OPD of the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum. Simple random sampling had been used to select the sample. The patients diagnosed with the stated disease conditions were referred for neuropsychological assessment. Testable and cooperative patients were recruited for the study. To stabilize the data and for a transparent comparison, 30 healthy controls with no medically diagnosed illnesses were also added to the study. The results were analyzed using R.\u0000 Result and Conclusion The study concluded that cognitive profiles of mTBI and mVCI patients were significantly different from the cognitive profiles of healthy controls, but there was no statistically significant difference between the cognitive profiles of mVCI and mTBI patients except in confrontation naming and recognition memory.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"99 ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140479043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Individualized Educational Package for Improving Knowledge and Practices of Caregivers of Patients with Spinal Cord Injury: A Quasiexperimental Study","authors":"Indu Punia, Manju A. K. Rajora, D. Khakha, Deepak Agarwal","doi":"10.1055/s-0044-1778732","DOIUrl":"https://doi.org/10.1055/s-0044-1778732","url":null,"abstract":"\u0000 Introduction Globally, traumatic spinal cord injury occurs at a rate of 13 to 53 cases per million populations. These patients tend to get dependent on hospital staff as well as caregivers for their activities of daily living. There are insufficient data available on whether the caregivers have adequate knowledge and required skills to perform the same.\u0000 Aim Our aim was to evaluate the impact of an individualized educational package on the knowledge and practices of caregivers of patients with spinal cord injury.\u0000 Methods The caregivers (n = 30) were recruited in the quasi-experimental study by using a nonequivalent, control group design using the TREND checklist. Study subjects were divided into two groups, that is, control and experimental. The intervention was delivered through an educational package in the experimental group, and no intervention was given to the control group. The educational package was delivered by dedicated registered nurse. Ethical approval was taken from the ethical committee, and informed consent was obtained from the study participants. Data were analyzed using STATA version 16 and SPSS version 20.\u0000 Result The mean age of patients was 34.6 + 2.7 years, and majority (90%) were males. The most common cause of spinal cord injury was fall from height in 53.3% patients followed by road traffic accidents in 36.6% patients. The mean posttest knowledge score (30.7 + 8.6) of subjects in the experimental group was significantly higher than the control group (18.4 + 5.3). Also, the mean posttest practice score (54.3 + 9) of subjects in the experimental group was significantly higher than the control group (35.9 + 6.8).\u0000 Conclusion Educating caregivers (relatives) can dramatically improve the quality of life of patients as well as prevent complications and rehospitalizations. A dedicated nurse educator should be posted in spinal cord injury wards to deliver such educational packages.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"420 3","pages":""},"PeriodicalIF":0.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140472813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}