Neurotrauma reportsPub Date : 2023-11-23eCollection Date: 2023-01-01DOI: 10.1089/neur.2023.0069
Samantha R Neuman, Cordelia Mannix, Rebekah Mannix
{"title":"Firearms Are Now the Leading Cause of Traumatic Brain Injury-Related Mortality in Children.","authors":"Samantha R Neuman, Cordelia Mannix, Rebekah Mannix","doi":"10.1089/neur.2023.0069","DOIUrl":"10.1089/neur.2023.0069","url":null,"abstract":"<p><p>Recent studies have demonstrated a significant change in the epidemiology of injury fatalities in children, most notably a marked increase in firearm-related deaths. Few studies have specifically addressed pediatric TBI-related mortality trends. Studying these trends is important for both clinical preparedness and public health interventions. The purpose of this study therefore is to examine recent trends in mechanisms, intents, and rates of pediatric TBI fatalities. Data regarding fatalities from TBI for children <18 years of age from 2011 to 2021 were extracted from the Centers for Disease Control and Prevention, National Center for Health Statistics' web-based injury statistics query and reporting system. We found that firearms became the leading cause of TBI fatalities in children by 2021, most frequently attributable to self-harm. Taken together, the findings from this study underscore the importance in monitoring the changing epidemiology of pediatric TBI fatalities.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neurotrauma reportsPub Date : 2023-11-22eCollection Date: 2023-01-01DOI: 10.1089/neur.2023.0064
Wivi Taalas, Rahul Raj, Juha Öhman, Jari Siironen
{"title":"Long-Term Functional Outcome and Quality of Life in Long-Term Traumatic Brain Injury Survivors.","authors":"Wivi Taalas, Rahul Raj, Juha Öhman, Jari Siironen","doi":"10.1089/neur.2023.0064","DOIUrl":"https://doi.org/10.1089/neur.2023.0064","url":null,"abstract":"<p><p>Early functional outcome assessments of traumatic brain injury (TBI) survivors may underestimate the long-term consequences of TBI. We assessed long-term temporal changes in functional outcome and quality of life in intensive care unit-managed long-term TBI survivors. This prospective, longitudinal study included 180 patients admitted to a single university hospital during 2000-2002 alive at 15 years post-TBI. Baseline characteristics, including imaging information, were collected. Functional outcome was assessed early (6-24 months) and late (15 years) using the Glasgow Outcome Scale (GOS) and the extended GOS (GOSE). Quality of life was measured at 15 years using the EuroQol Five Dimensions Five Levels (EQ-5D-5L) questionnaire. GOS and GOSE were dichotomized into favorable and unfavorable outcome. An index score was computed for EQ-5D-5L results at 15 years by a standardized valuation protocol. Of 180 patients, 118 replied to 15-year questionnaires. Median age at time of injury was 34 years (interquartile range, 19-45). Using the GCS to assess TBI severity, 67% had a moderate-to-severe TBI. Ninety-seven percent had favorable early functional outcome, and 72% had late favorable functional outcome. Logistic regression found higher age, lower GCS, and Marshall CT III to significantly predict late unfavorable functional outcome. Higher age and Marshall CT III were significant predictors of functional outcome deterioration. Median EQ-5D-5L index score for all patients was 0.88 (0.66-1.00) and correlated positively with GOSE. Most long-term TBI survivors with early favorable outcome also have late favorable functional outcome. Higher age and diffuse brain injury are associated with neurological deterioration. Quality of life was strongly linked to functional outcome.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neurotrauma reportsPub Date : 2023-11-21eCollection Date: 2023-01-01DOI: 10.1089/neur.2023.0080
Youhei Nakamura, Tadahiko Shiozaki, Hiroshi Ito, Shunichiro Nakao, Hiroshi Ogura, Jun Oda
{"title":"Long-Term Outcomes Over 20 Years in Persons With Persistent Disorders of Consciousness After Traumatic Brain Injury.","authors":"Youhei Nakamura, Tadahiko Shiozaki, Hiroshi Ito, Shunichiro Nakao, Hiroshi Ogura, Jun Oda","doi":"10.1089/neur.2023.0080","DOIUrl":"https://doi.org/10.1089/neur.2023.0080","url":null,"abstract":"<p><p>The long-term outcomes of patients with disorders of consciousness after traumatic brain injury (TBI) is unclear. We investigated the long-term outcomes over 20 years in patients who were in a persistent vegetative state (VS). We conducted a retrospective cohort study using a review of medical records and collected data by telephone and written interviews with patients and their families. We included patients who were treated for TBI at our hospital, between October 1996 and January 2003 and who were in a persistent VS, defined as a Disability Rating Scale (DRS) score of ≥22 at 1 month after TBI. The DRS was administered at 1 month, 6 months, 1 year, and then annually out to 20 years. We evaluated their clinical course until July 2021 with the DRS. We analyzed 35 patients in a persistent VS attributable to TBI. We were able to confirm the 20-year outcomes for 26 of the 35 patients (74%); at 20 years post-TBI, 19 (54%) patients were found to be deceased and 7 (20%) were alive. Over the 20-year study period, 23 of the 35 patients (65.7%) emerged from a persistent VS. Among the 35 patients in a persistent VS at 1 month post-TBI, 20 (57%) emerged from a persistent VS within 1 year, and 3 patients (8.6%) emerged from a persistent VS after more than a year after injury. DRS scores improved up to 9 years post-injury, whereas the change in DRS scores from 10 to 20 years post-injury was within ±1 point in all patients. We found that patients with persistent VS attributable to TBI may show improvement in functional disability up to 10 years post-injury. On the other hand, no substantial improvement in functional disability was observed after the 10th year.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neurotrauma reportsPub Date : 2023-11-16eCollection Date: 2023-01-01DOI: 10.1089/neur.2023.0071
Carla Richetta, Yevgeny Karepov
{"title":"E-Bikes (Electrical Bicycles and Scooters) Related Neurosurgical Injuries in the Adult Population: A Single-Center Experience.","authors":"Carla Richetta, Yevgeny Karepov","doi":"10.1089/neur.2023.0071","DOIUrl":"https://doi.org/10.1089/neur.2023.0071","url":null,"abstract":"<p><p>E-bikes (electrical bicycles and scooters) have been increasingly used as a means of transportation, especially among young adults. E-bikers have more accidents, at higher velocities and more severe kinematics, increasing the rate of neurosurgical injuries. Severe neurosurgical injury patterns result in significant morbidity and mortality. We collected data regarding adult patients (>18 years old), who suffered e-bike-related neurosurgical injuries, in a single tertiary medical center in Israel, between July 2019 and June 2020. Fifty-eight consecutive patients were included in this study. The average age was 34.9, and the average Glasgow Coma Scale (GCS) score upon admission was 13.2 and was significantly lower in operated patients (10.75). Fifty-four patients were riders; 51 (94.5%!) were not wearing a helmet. Fifty percent of patients had multiple types of trauma. Six patients suffered a spinal injury. Sixteen patients required either cranial or spinal surgery. Three patients died, and 1 remained in a vegetative state. Median Glasgow Outcome Scale-Extended (GOS-E) score at follow-up was 7.1. Operated patients stayed significantly longer in the intensive care unit (ICU) and in the hospital, and their GOS-E scores at discharge and follow-up were significantly lower. Most spinal injuries underwent surgery. Patients who wore helmets had significantly higher GCS scores and a shorter stay in the ICU and hospital. The unacceptable reality of the careless use of this transportation and the unique kinematics lead to severe neurosurgical injuries, comorbidities, and even mortality. Our results reflect the risks of e-bikes in the adult population. Most of our patients were in the mid-age group, and almost none had used a helmet. The results of this study highlight the potential need for neurosurgical treatment, and the need for long-term rehabilitation and follow-up, reflecting the emotional and financial toll of these injuries. Once again, this study showed that helmets save lives and emphasized the importance of protecting our heads.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10659014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neurotrauma reportsPub Date : 2023-11-06eCollection Date: 2023-01-01DOI: 10.1089/neur.2023.0036
William M Muter, Linda Mansson, Christopher Tuthill, Shreya Aalla, Stella Barth, Emily Evans, Kelly McKenzie, Sara Prokup, Chen Yang, Milap Sandhu, W Zev Rymer, Victor R Edgerton, Parag Gad, Gordon S Mitchell, Samuel S Wu, Guogen Shan, Arun Jayaraman, Randy D Trumbower
{"title":"A Research Protocol to Study the Priming Effects of Breathing Low Oxygen on Enhancing Training-Related Gains in Walking Function for Persons With Spinal Cord Injury: The BO<sub>2</sub>ST Trial.","authors":"William M Muter, Linda Mansson, Christopher Tuthill, Shreya Aalla, Stella Barth, Emily Evans, Kelly McKenzie, Sara Prokup, Chen Yang, Milap Sandhu, W Zev Rymer, Victor R Edgerton, Parag Gad, Gordon S Mitchell, Samuel S Wu, Guogen Shan, Arun Jayaraman, Randy D Trumbower","doi":"10.1089/neur.2023.0036","DOIUrl":"https://doi.org/10.1089/neur.2023.0036","url":null,"abstract":"<p><p>Brief episodes of low oxygen breathing (therapeutic acute intermittent hypoxia; tAIH) may serve as an effective plasticity-promoting primer to enhance the effects of transcutaneous spinal stimulation-enhanced walking therapy (WALK<sub>tSTIM</sub>) in persons with chronic (>1 year) spinal cord injury (SCI). Pre-clinical studies in rodents with SCI show that tAIH and WALK<sub>tSTIM</sub> therapies harness complementary mechanisms of plasticity to maximize walking recovery. Here, we present a multi-site clinical trial protocol designed to examine the influence of tAIH + WALK<sub>tSTIM</sub> on walking recovery in persons with chronic SCI. We hypothesize that daily (eight sessions, 2 weeks) tAIH + WALK<sub>tSTIM</sub> will elicit faster, more persistent improvements in walking recovery than either treatment alone. To test our hypothesis, we are conducting a placebo-controlled clinical trial on 60 SCI participants who randomly receive one of three interventions: tAIH + WALK<sub>tSTIM</sub>; Placebo + WALK<sub>tSTIM</sub>; and tAIH + WALK<sub>tSHAM</sub>. Participants receive daily tAIH (fifteen 90-sec episodes at 10% O<sub>2</sub> with 60-sec intervals at 21% O<sub>2</sub>) or daily placebo (fifteen 90-sec episodes at 21% O<sub>2</sub> with 60-sec intervals at 21% O<sub>2</sub>) before a 45-min session of WALK<sub>tSTIM</sub> or WALK<sub>tSHAM</sub>. Our primary outcome measures assess walking speed (10-Meter Walk Test), endurance (6-Minute Walk Test), and balance (Timed Up and Go Test). For safety, we also measure pain levels, spasticity, sleep behavior, cognition, and rates of systemic hypertension and autonomic dysreflexia. Assessments occur before, during, and after sessions, as well as at 1, 4, and 8 weeks post-intervention. Results from this study extend our understanding of the functional benefits of tAIH priming by investigating its capacity to boost the neuromodulatory effects of transcutaneous spinal stimulation on restoring walking after SCI. Given that there is no known cure for SCI and no single treatment is sufficient to overcome walking deficits, there is a critical need for combinatorial treatments that accelerate and anchor walking gains in persons with lifelong SCI.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT05563103.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10659019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correlation of Insulin-Like Growth Factor 1 With Cognitive Functions in Mild Traumatic Brain Injury Patients","authors":"Ju-Chi Ou, Yin-Hsun Feng, Kai-Yun Chen, Yung-Hsiao Chiang, Tsung-I Hsu, Chung-Che Wu","doi":"10.1089/neur.2023.0085","DOIUrl":"https://doi.org/10.1089/neur.2023.0085","url":null,"abstract":"Mild traumatic brain injury (mTBI) is a prevalent health concern with variable recovery trajectories, necessitating reliable prognostic markers. Insulin-like growth factor 1 (IGF-1) emerges as a potential candidate because of its role in cellular growth, repair, and neuroprotection. However, limited studies investigate IGF-1 as a prognostic marker in mTBI patients. This study aimed to explore the correlation of IGF-1 with cognitive functions assessed using the Wisconsin Card Sorting Test (WCST) in mTBI patients. We analyzed data from 295 mTBI and 200 healthy control participants, assessing demographic characteristics, injury causes, and IGF-1 levels. Cognitive functions were evaluated using the WCST. Correlation analyses and regression models were used to investigate the associations between IGF-1 levels, demographic factors, and WCST scores. Significant differences were observed between mTBI and control groups in the proportion of females and average education years. Falls and traffic accidents were identified as the primary causes of mTBI. The mTBI group demonstrated worse cognitive outcomes on the WCST, except for the “Learning to Learn” index. Correlation analyses revealed significant relationships between IGF-1 levels, demographic factors, and specific WCST scores. Regression models demonstrated that IGF-1, age, and education years significantly influenced various WCST scores, suggesting their roles as potential prognostic markers for cognitive outcomes in mTBI patients. We provide valuable insights into the potential correlation of IGF-1 with cognitive functions in mTBI patients, particularly in tasks requiring cognitive flexibility and problem solving.","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135564265","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}
Justin L. Krieg, Anna V. Leonard, Renee J. Tuner, Frances Corrigan
{"title":"Characterization of Traumatic Brain Injury in a Gyrencephalic Ferret Model Using the Novel Closed Head Injury Model of Engineered Rotational Acceleration (CHIMERA)","authors":"Justin L. Krieg, Anna V. Leonard, Renee J. Tuner, Frances Corrigan","doi":"10.1089/neur.2023.0047","DOIUrl":"https://doi.org/10.1089/neur.2023.0047","url":null,"abstract":"Traumatic brain injury (TBI) results from mechanical force to the brain and leads to a series of biochemical responses that further damage neurons and supporting cells. Clinically, most TBIs result from an impact to the intact skull, making closed head TBI pre-clinical models highly relevant. However, most of these closed head TBI models use lissencephalic rodents, which may not transduce biomechanical load in the same manner as gyrencephalic humans. To address this translational gap, this study aimed to characterize acute axonal injury and microglial responses in ferrets—the smallest gyrencephalic mammal. Injury was induced in male ferrets (Mustela furo; 1.20–1.51 kg; 6–9 months old) with the novel Closed Head Injury Model of Engineered Rotational Acceleration (CHIMERA) model. Animals were randomly allocated to either sham (n = 4), a 22J (joules) impact (n = 4), or a 27J impact (n = 4). Axonal injury was examined histologically with amyloid precursor protein (APP), neurofilament M (RMO 14.9) (RMO-14), and phosphorylated tau (AT180) and the microglial response with ionized calcium-binding adaptor molecule 1 at 24 h post-injury in gray and white matter regions. Graded axonal injury was observed with modest increases in APP and RMO-14 immunoreactivity in the 22J TBI group, mostly within the corpus callosum and fornix and more extensive diffuse axonal injury encompassing gray matter structures like the thalamus and hypothalamus in the 27J group. Accompanying microglial activation was only observed in the 27J group, most prominently within the white matter tracts in response to the larger amounts of axonal injury. The 27J, but not the 22J, group showed an increase in AT180 within the base of the sulci post-injury. This could suggest that the strain may be highest in this region, demonstrating the different responses in gyrencephalic compared to lissencephalic brains. The CHIMERA model in ferrets mimic many of the histopathological features of human closed head TBI acutely and provides a promising model to investigate the pathophysiology of TBI.","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135566382","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}
Freda M. Warner, Bobo Tong, Jessie McDougall, Kathleen A. Martin Ginis, Alexander G. Rabchevsky, Jacquelyn J. Cragg, John L.K. Kramer
{"title":"Perspectives on Data Sharing in Persons With Spinal Cord Injury","authors":"Freda M. Warner, Bobo Tong, Jessie McDougall, Kathleen A. Martin Ginis, Alexander G. Rabchevsky, Jacquelyn J. Cragg, John L.K. Kramer","doi":"10.1089/neur.2023.0035","DOIUrl":"https://doi.org/10.1089/neur.2023.0035","url":null,"abstract":"Open data sharing of clinical research aims to improve transparency and support novel scientific discoveries. There are also risks, including participant identification and the potential for stigmatization. The perspectives of persons participating in research are needed to inform open data-sharing policies. The aim of the current study was to determine perspectives on data sharing in persons with spinal cord injury (SCI), including risks and benefits, and types of data people are most willing to share. A secondary aim was to examine predictors of willingness to share data. Persons with SCIs in the United States and Canada completed a survey developed and disseminated through various channels, including our community partner, the North American Spinal Cord Injury Consortium. The study collected data from 232 participants, with 52.2% from Canada and 42.2% from the United States, and the majority completed the survey in English. Most participants had previously participated in research and had been living with an SCI for ≥5 years. Overall, most participants reported that the potential benefits of data sharing outweighed the negatives, with persons with SCI seen as the most trustworthy partners for data sharing. The highest levels of concern were that information could be stolen and companies might use the information for marketing purposes. Persons with SCI were generally supportive of data sharing for research purposes. Clinical trials should consider including a statement on open data sharing in informed consents to better acknowledge the contribution of research participants in future studies.","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135564724","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":"Retrospective Observational Study of Patients With Subdural Hematoma Treated With Idarucizumab","authors":"Eiichi Suehiro, Hideyuki Ishihara, Yohei Kogeichi, Tsunenori Ozawa, Koichi Haraguchi, Masaru Honda, Yumie Honda, Makoto Inaba, Ryusuke Kabeya, Naoaki Kanda, Kenta Koketsu, Nobukuni Murakami, Hidetoshi Nakamoto, Kotaro Oshio, Kuniyasu Saigusa, Takashi Shuto, Shuichi Sugiyama, Kenji Suzuyama, Tsuguaki Terashima, Mitsuharu Tsuura, Mitsutoshi Nakada, Hitoshi Kobata, Toshio Higashi, Nobuyuki Sakai, Michiyasu Suzuki","doi":"10.1089/neur.2023.0065","DOIUrl":"https://doi.org/10.1089/neur.2023.0065","url":null,"abstract":"Use of anticoagulants is increasing with the aging of societies. The safe first-line drug is likely to be a direct oral anticoagulant (DOAC), but outcomes of treatment of traumatic brain injury (TBI) with anticoagulants are uncertain. Therefore, we examined the clinical effect of idarucizumab as reversal therapy in elderly patients with TBI who were treated with dabigatran. A retrospective multi-center observational study was performed in patients ≥65 years of age who developed acute traumatic subdural hematoma during treatment with dabigatran and underwent reversal therapy with idarucizumab. The items examined included patient background, neurological and imaging findings at arrival, course after admission, complications, and outcomes. A total of 23 patients were enrolled in the study. The patients had a mean age of 78.9 years. Cause of TBI was fall in 60.9% of the subjects. Mean Glasgow Coma Scale score at arrival was 8.7; anisocoria was present in 31.8% of cases. Exacerbation of consciousness was found in 30.4%, but only in 13.3% of subjects treated with idarucizumab before consciousness and imaging findings worsened. Dabigatran was discontinued in 81.8% of cases after hematoma development, with a mean withdrawal period of 12.1 days. The favorable outcome rate was 21.7%, and mortality was 39.1%. In multi-variate analysis, timing of idarucizumab administration was associated with a favorable outcome. There were ischemic complications in 3 cases (13.1%), and all three events occurred ≥7 days after administration of idarucizumab. These findings suggest that in cases that develop hematoma during treatment with dabigatran, it is important to administer idarucizumab early and restart dabigatran after conditions stabilize.","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135566163","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}
Neurotrauma reportsPub Date : 2023-10-31eCollection Date: 2023-01-01DOI: 10.1089/neur.2023.0082
Nicholas S Race, Eleni H Moschonas, Jeffrey P Cheng, Corina O Bondi, Anthony E Kline
{"title":"Antipsychotic Drugs: The Antithesis to Neurorehabilitation in Models of Pre-Clinical Traumatic Brain Injury.","authors":"Nicholas S Race, Eleni H Moschonas, Jeffrey P Cheng, Corina O Bondi, Anthony E Kline","doi":"10.1089/neur.2023.0082","DOIUrl":"10.1089/neur.2023.0082","url":null,"abstract":"<p><p>Sixty-nine million traumatic brain injuries (TBIs) are reported worldwide each year, and, of those, close to 3 million occur in the United States. In addition to neurobehavioral and cognitive deficits, TBI induces other maladaptive behaviors, such as agitation and aggression, which must be managed for safe, accurate assessment and effective treatment of the patient. The use of antipsychotic drugs (APDs) in TBI is supported by some expert guidelines, which suggests that they are an important part of the pharmacological armamentarium to be used in the management of agitation. Despite the advantages of APDs after TBI, there are significant disadvantages that may not be fully appreciated clinically during decision making because of the lack of a readily available updated compendium. Hence, the aim of this review is to integrate the existing findings and present the current state of APD use in pre-clinical models of TBI. The studies discussed were identified through PubMed and the University of Pittsburgh Library System search strategies and reveal that APDs, particularly those with dopamine<sub>2</sub> (D<sub>2</sub>) receptor antagonism, generally impair the recovery process in rodents of both sexes and, in some instances, attenuate the potential benefits of neurorehabilitation. We believe that the compilation of findings represented by this exhaustive review of pre-clinical TBI + APD models can serve as a convenient source for guiding informed decisions by critical care clinicians and physiatrists contemplating APD use for patients exhibiting agitation.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}