Indian Journal of Neurotrauma最新文献_第5页

Work–Life Balance for the Modern Neurosurgeon: Her/His Perspective 现代神经外科医生的工作与生活平衡:她/他的观点

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Indian Journal of Neurotrauma Pub Date : 2023-05-22 DOI: 10.1055/s-0043-57250

A. Prabhune, Harsh Deora, M. Tripathi

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Expansion of Contralateral Extradural Hematoma following Mannitol Therapy 甘露醇治疗后对侧硬膜外血肿的扩大

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Indian Journal of Neurotrauma Pub Date : 2023-05-18 DOI: 10.1055/s-0043-1768172

A. Agrawal, G. Rao

{"title":"Expansion of Contralateral Extradural Hematoma following Mannitol Therapy","authors":"A. Agrawal, G. Rao","doi":"10.1055/s-0043-1768172","DOIUrl":"https://doi.org/10.1055/s-0043-1768172","url":null,"abstract":", Traumatic brain injury can be complicated by edema and mass effect resulting in elevation of the intracranial pressure (ICP), reduction in cerebral perfusion pressure, and global ischemia. 1 The use of osmotic agents (mannitol and hypertonic saline) is recommended to lower the ICP and to improve cerebral blood ﬂ ow to hypoperfused brain regions in patients with traumatic brain injury. 2 Mannitol has traditionally been used as nonsurgical treatment options to control intracranial hypertension, tissue shifts, and ultimately herniation in these patients. 1,3 – 5 A 16-year-old girl sustained traumatic brain injury after being hit by a two-wheeler. She presented to the emergency department (cid:1) 6hours after the incident. She had a history of loss of consciousness for 20minutes, multiple episodes of vomiting, and left ear bleed. There was no history of seizures. On neurological examination, she was opening eyes to call, disoriented, and localizing to pain (E3V4M5). Pupils were bilaterally equal and reacting to light. There were no focal neurological de ﬁ cits. General and systemic examination was unremarkable. A computed tomography (CT) scan of the brain showed thin right fronto-temporo-parietal acute subdural hematoma with mass effect andminimal midlineshift; in addition, therewas a thin temporal extradural hematoma (EDH) of theleft side also ( ► Fig. 1A ). The patient was started on antiedema measures and prophylactic antiepileptics. She regained consciousness thenextdayafteradmissionbutwascomplainingofpersistent","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"21 1","pages":"159 - 160"},"PeriodicalIF":0.2,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79587505","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}

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Pin Site Epidural Hematoma Masquerading as Intractable Brain Swelling: A Diagnostic Dilemma 针位硬膜外血肿伪装成顽固性脑肿胀:诊断困境

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Indian Journal of Neurotrauma Pub Date : 2023-05-18 DOI: 10.1055/s-0043-1768173

A. Reddy, N. Panda, Rajeev Chauhan, Shalvi Mahajan, S. Mohindra

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Mobilization of Patients with External Ventriculostomy Drains: Pro and Cons 外脑室造瘘引流病人的活动:利弊

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Indian Journal of Neurotrauma Pub Date : 2023-04-25 DOI: 10.1055/s-0043-1768055

Tariq Janjua, Fotis G. Souslian, L. Moscote-Salazar

{"title":"Mobilization of Patients with External Ventriculostomy Drains: Pro and Cons","authors":"Tariq Janjua, Fotis G. Souslian, L. Moscote-Salazar","doi":"10.1055/s-0043-1768055","DOIUrl":"https://doi.org/10.1055/s-0043-1768055","url":null,"abstract":"The effects of prolonged immobilization in the critical patient have been well described. Patients on mechanical ventilation and patients receiving extracorporeal membrane oxygenation therapy have been presented as evidence of the feasibility of implementation of early mobilization protocols. Prolonged immobilization of critically ill patients has been associated with intensive care unit-acquired weakness syndrome, increased mortality, at the cognitive level, impact on quality, and cost increase among other considerations. Early mobilization emphasizes strategies to stimulate motor, sensory, and proprioceptive levels in the context of critically ill patients. Early mobility intervention in critically ill patients begins in the ﬁ rst days of stay in the unit and requires a scheduled combination of passive and active activities. The presence of an external ventriculostomy device is not a contraindication for mobilization. 1,2 It helps as above with the progression and improvement in the outcome. The dislodgement and risk of fracture of external ventricular drainage (EVD) are major concerns. Here, we brie ﬂ y go over the technical aspect of EVD placement and how to safely mobilize the patient.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"740 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76825309","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}

引用次数: 0

Revisiting the Classification of Moderate and Mild Traumatic Brain Injury Based on the Admission Glasgow Coma Scale Score 基于入院格拉斯哥昏迷评分的中、轻度颅脑损伤分类的再探讨

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Indian Journal of Neurotrauma Pub Date : 2023-04-25 DOI: 10.1055/s-0043-1768170

Ganesh Swaminathan, A. Abraham, T. Mani, M. Joseph

{"title":"Revisiting the Classification of Moderate and Mild Traumatic Brain Injury Based on the Admission Glasgow Coma Scale Score","authors":"Ganesh Swaminathan, A. Abraham, T. Mani, M. Joseph","doi":"10.1055/s-0043-1768170","DOIUrl":"https://doi.org/10.1055/s-0043-1768170","url":null,"abstract":"Abstract Objective We study the clinical relevance of classifying traumatic brain injury (TBI) into moderate and mild categories based on the Glasgow Coma Scale (GCS) score at admission with respect to the treatment intensity and 6-month mortality and morbidity rates. Methods Analysis of patients from a prospectively maintained database admitted at a level I trauma center from 2013 to 2019 with an admission GCS score between 9 and 15 and a minimum follow-up of 6 months post-TBI was done to study the treatment intensity and 6-month morbidity and mortality rates for each GCS score from 9 to 15. Results In all, 2,060 patients met the study criteria, of which 1,684 were males (81.7%). Road traffic accident was the most common cause of TBI (83.7%). There was a significant linear increase in the proportion of patients who had good outcomes with increasing GCS scores from 9 to 15 ( p ≤ 0.001). When the variables in each GCS score were compared with a GCS score of 15, there was an increase in the odds ratio of mortality and poor outcome with decreasing GCS scores ( p ≤ 0.001). Patients with a lower admission GCS score required more intense treatment in the form of surgery and ventilation ( p ≤ 0.00001). There was a higher incidence of pupillary asymmetry in patients with lower GCS scores ( p ≤ 0.00001). Conclusions The classification of TBI patients into moderate and mild based on the GCS score at admission is not of any practical value, and TBI patients may be more usefully classified based on the admission GCS score into severe and not severe groups.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"30 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78386346","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}

引用次数: 0

Neurological Wake-Up Test for Severe Neurotrauma Patients 重型神经外伤患者的神经唤醒试验

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Indian Journal of Neurotrauma Pub Date : 2023-04-25 DOI: 10.1055/s-0043-1768054

Tariq Janjua, L. Moscote-Salazar

引用次数: 0

Uncertainty in Neurocritical Care: Recognizing Its Relevance for Clinical Decision Making 神经危重症护理的不确定性:认识到其与临床决策的相关性

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Indian Journal of Neurotrauma Pub Date : 2023-04-25 DOI: 10.1055/s-0043-1768056

L. Moscote-Salazar, W. Florez-Perdomo, Tariq Janjua

{"title":"Uncertainty in Neurocritical Care: Recognizing Its Relevance for Clinical Decision Making","authors":"L. Moscote-Salazar, W. Florez-Perdomo, Tariq Janjua","doi":"10.1055/s-0043-1768056","DOIUrl":"https://doi.org/10.1055/s-0043-1768056","url":null,"abstract":"Uncertainty inprinciple entails thepresence ofdoubt. This can lead to the inabilityofdelayeddecisionmaking. Toanobserver, thiswill lead to skepticismandunwillingness toworkwith the process. Ultimately if the process continues, it will lead to mistrust and a dysfunctional working environment. William Osler was one of thefirst to recognizehow uncertainty plays a role in our medical practice. His statement “One special advantage of the skeptical attitude of mind is that a man is never vexed to find that after all, he has been in the wrong”1 helps with the concept he proposed in the practice of medicine. But despite the uncertainty that surrounds medicine, the history of the disease creates challenges around the individuality of each patient. This challenge is present in the practice of neurocritical care. Acute neurological criseswere considered to be part of the black box of complex brain derangements. Over time, with extensive advancement of neurological sciences with tools like neuroimaging, neuromonitoring, surgical procedures, and protocols, the black box is more open now. The practice still has uncertainties, especially with new and complex diseases like coronavirus disease 2019 and the introduction of complex therapies including extensive use of different monoclonal antibodies. Patients with the acute neurological crisis have a multisystem presentation.2 The uncertainty of when an acute pulmonary injury happens with an acute brain crisis is always there.3 Which one is the primary and which one is the key aspect at the time of examination? The neurological examination of these patients can be unreliable due to multiple factors including sedation requirement for ventilator stability to surgical stability to avoid hemorrhagic conversion. The recognition of the presence of this uncertainty is important in neurocritical care. The goal should be to work on facts and change the management based on the response of the therapeutics that are used under the umbrella of the best clinical practice.","PeriodicalId":43198,"journal":{"name":"Indian Journal of Neurotrauma","volume":"16 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78804328","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}

引用次数: 0

Management of Eight Hand Drill Nails Induced Penetrating Brain Injury 8例手钻钉致穿透性脑损伤的处理

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Indian Journal of Neurotrauma Pub Date : 2023-03-01 DOI: 10.1055/s-0043-1762598

Sandeep Kumar, Shailesh Thanvi, H. Beniwal, Sharad Thanvi, Shelly Singh

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Sedation Vacation in Neurocritical Care: A Proposal Algorithm 神经危重症护理中的镇静假期:一种建议算法

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Indian Journal of Neurotrauma Pub Date : 2023-03-01 DOI: 10.1055/s-0043-1762599

L. Moscote-Salazar, W. Florez-Perdomo, Tariq Janjua

引用次数: 0

Penetrating Iron Rod Wound of the Lumbar Spine Causing Cauda Equina Syndrome in a Child: Case Report and Review of the Literature 腰椎铁棒穿透伤致儿童马尾综合征1例报告及文献复习

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Indian Journal of Neurotrauma Pub Date : 2023-03-01 DOI: 10.1055/s-0042-1760450

Roger Mulumba Ilunga, L. Barry, Mouhamadou Moustapha Ndongo, Yakhya Cisse, Hugues Ghislain Atakla, D. Wague, M. Faye, M. Ba

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