Neurotrauma reports最新文献

{"title":"The Effect of Non-Invasive, Non-Pharmacological Interventions on Autonomic Regulation of Cardiovascular Function in Adults with Spinal Cord Injury: A Systematic Review with Meta-Analysis.","authors":"Jacob Schoffl, Ashley Craig, Candice McBain, Ilaria Pozzato, James W Middleton, Mohit Arora","doi":"10.1089/neur.2024.0110","DOIUrl":"10.1089/neur.2024.0110","url":null,"abstract":"<p><p>Autonomic regulation of cardiovascular function is often disrupted following a spinal cord injury (SCI). A systematic review was undertaken to evaluate the effect of non-invasive, non-pharmacological (NINP) interventions on cardiovascular autonomic biomarkers in adults with SCI. AMED, CENTRAL, CINAHL EMBASE, and MEDLINE were searched from inception to May 17, 2024. Randomized controlled trials (RCTs) of NINP interventions for cardiovascular autonomic biomarkers (heart rate variability [HRV], systolic blood pressure variability [SBPV], or baroreflex gain) in adults (≥18 years of age) with SCI (>3 months) were included. Primary outcomes included HRV (low-frequency power [HRV-LF], high-frequency power [HRV-HF], root mean square of successive differences [RMSSD]), SBPV (low-frequency power [SBPV-LF]), and baroreflex sensitivity. The quality and certainty of the evidence were assessed using version 2 of the Cochrane risk of bias tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis tool, respectively. Of 2651 records identified, six RCTs were included (participants, <i>n</i> = 123). HRV-LF (four studies; participants, <i>n</i> = 69) and HRV-HF (five studies; participants, <i>n</i> = 93) showed no to small changes in favor of NINP interventions ([g = 0.25; 95% confidence interval [CI] = -0.23, 0.73; <i>p</i> = 0.31; I² = 0%], [g = 0.00; 95% CI = -0.41, 0.42; <i>p</i> = 0.98; I² = 0%], respectively). Limited evidence was available for RMSSD, SBPV-LF, and baroreflex gain. This review found that the evidence is inconclusive regarding the effect of NINP interventions on the included HRV, BPV, and BRS parameters in adults with SCI. Further research with strong methodological rigor is needed to provide greater insights in this area.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"5 1","pages":"1151-1172"},"PeriodicalIF":1.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506552","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":"Gut Microbial Composition Is Associated with Symptom Self-Report in Trauma-Exposed Iraq and Afghanistan Veterans.","authors":"Y Irina Li, Kathleen Pagulayan, Holly Rau, Rebecca Hendrickson, Abigail G Schindler","doi":"10.1089/neur.2024.0011","DOIUrl":"10.1089/neur.2024.0011","url":null,"abstract":"<p><p>Iraq and Afghanistan War-era Veterans are at elevated risk for physical injuries and psychiatric illnesses, in particular the polytrauma triad of mild traumatic brain injury (mTBI), post-traumatic stress disorder (PTSD), and chronic pain. The gut microbiome has been implicated in modulation of critical processes beyond digestion, including immune system functioning and stress responsivity, and may be an important factor in understanding physical and mental health outcomes following deployment and trauma exposure. However, minimal research to date has sought to characterize gut microbiome composition in this population. Male Veterans of the conflicts in Iraq and Afghanistan who previously completed a Veterans Affairs' comprehensive TBI evaluation were enrolled in the current study. Participants completed self-report measures of PTSD symptom severity, pain intensity and interference, fatigue, cognitive symptoms, substance use, and sleep quality. They also submitted fecal samples, and metagenomic sequencing was used to calculate alpha and beta diversity and taxonomic microbial composition. Associations between microbiome data and clinical variables were then examined. Alpha and beta diversity measures were not significantly correlated with clinical outcomes. Fatigue, post-concussive symptoms, executive function symptoms, and cannabis use were associated with differences in gut microbial composition, specifically Verrucomicrobiota. Together, results suggest that altered gut microbiome composition is associated with psychiatric and cognitive symptoms in Veterans and highlight a potential new therapeutic target of interest. Future research is needed to examine whether probiotic treatment is effective for reducing symptoms common in this clinical population.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517291","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":"Long-Term Functional Recovery after Severe Traumatic Brain Injury with Type II Diffuse Injury.","authors":"Marcia Harumy Yoshikawa, Sérgio Brasil, Davi Jorge Fontoura Solla, Robson Luís Amorim, Daniel Augustin Godoy, Angelos Kolias, Wellingson Silva Paiva","doi":"10.1089/neur.2024.0052","DOIUrl":"10.1089/neur.2024.0052","url":null,"abstract":"<p><p>This study aims to describe the late clinical outcomes of patients with severe traumatic brain injury (sTBI) and the risk factors associated with it. Patients were enrolled between April 2012 and January 2015 and followed until January 2022. The inclusion criteria were age 16-65 years, Glasgow Coma Scale ≤8 on admission, diagnosis of blunt TBI with Marshall diffuse injury type II on initial computerized tomography (CT), and alive at discharge. Clinical, laboratory, and radiological data from admission were collected. Glasgow Outcome Scale Extended (GOSE), Functional Independence Measure, and Zarit Burden Interview (ZBI) were assessed in the follow-up. Sixty-five patients were included, with a median follow-up time of 8 years. Nineteen (29.2%) patients had good recovery (GOSE 7-8), and 10 (15.3%) had moderate-to-severe sequelae (GOSE 4-6). Thirty-six (55.4%) patients died after discharge, and most of them in the first 3 months after discharge (<i>n</i> = 26; 72.2%). Despite the early mortality rate being the highest, the 6-month score is explained in the text (CRASH-CT) score on admission was not associated with death in the follow-up (<i>p</i> = 0.25). In the multivariate statistical analysis, only prothrombin time was associated with GOSE (<i>p =</i> 0.01). Twelve (41.3%) patients were independent for basic activities of daily living, and the most common cause of dependence was memory impairment (<i>n</i> = 12; 41.3%). The median ZBI score reported by caregivers was 23.5 (range 5-48), indicating mild overload. In this study, patients with sTBI sustaining Marshall II lesions had a significant mortality rate after discharge, and we found coagulation impairment as a potential predictor of poor outcomes. Around 30% experienced functional dependence and inability to return to social and work activities. Current instruments used to predict outcomes of TBI patients had poor predictive performance in this low- and middle-income country population, suggesting the need for new models to properly guide clinical decision-making and counseling family members.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"13-19"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506570","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":"Neuroinflammation at the Gray-White Matter Interface in Active-Duty U.S. Special Operations Forces.","authors":"Brian L Edlow, Chieh-En J Tseng, Natalie Gilmore, Isabella R McKinney, Samantha L Tromly, Katryna B Deary, Collin G Hu, Brian C Healy, David S Priemer, Christine L Mac Donald, Kristen Dams-O'Connor, Douglas N Greve, Yelena G Bodien, Daniel P Perl, Jacob M Hooker, Nicole R Zürcher","doi":"10.1089/neur.2024.0116","DOIUrl":"10.1089/neur.2024.0116","url":null,"abstract":"<p><p>Emerging evidence from autopsy studies indicates that interface astroglial scarring (IAS) at the gray-white matter junction is a pathological signature of repeated blast brain injury in military personnel. However, there is currently no <i>in vivo</i> neuroimaging test that detects IAS, which is a major barrier to diagnosis, prevention, and treatment. In 27 active-duty U.S. Special Operations Forces personnel with high levels of cumulative blast exposure, we performed translocator protein (TSPO) positron emission tomography (PET) using [¹¹C]PBR28 to detect neuroinflammation at the cortical gray-white matter interface, a neuroanatomic location where IAS has been reported in autopsy studies. TSPO signal in individual Operators was compared with the mean TSPO signal in a control group of nine healthy civilian volunteers. We identified five Operators (18.5%) with TSPO signal at the cortical gray-white matter interface that was more than 2 standard deviations above the control mean. Cumulative blast exposure, as measured by the generalized blast exposure value, did not differ between the five Operators with elevated TSPO signal and the 22 Operators without elevated TSPO signal. While the pathophysiologic link between neuroinflammation and IAS remains uncertain, these preliminary observations provide the basis for further investigation into TSPO PET as a potential biomarker of repeated blast brain injury.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"5 1","pages":"1205-1211"},"PeriodicalIF":1.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916178","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":"Low-Intensity Blast Exposure Induces Multifaceted Long-Lasting Anxiety-Related Behaviors in Mice.","authors":"Heather R Siedhoff, Shanyan Chen, Ashley Balderrama, Dejun Jackson, Runting Li, Grace Y Sun, Ralph G DePalma, Jiankun Cui, Zezong Gu","doi":"10.1089/neur.2024.0134","DOIUrl":"10.1089/neur.2024.0134","url":null,"abstract":"<p><p>Primary blast exposure is a predominant cause of mild traumatic brain injury (mTBI) among veterans and active-duty military personnel, and affected individuals may develop long-lasting behavioral disturbances that interfere with quality of life. Our prior research with the \"Missouri Blast\" model demonstrated behavioral changes relevant to deficits in cognitive and affective domains after exposure to low-intensity blast (LIB). In this study, behavioral evaluations were extended to 3 months post-LIB injury using multifaceted conventional and advanced behavioral paradigms. C57BL/6J male mice, aged 2 months old, were subjected to a non-inertial primary LIB-induced mTBI by detonating 350 g of C-4 at a 3-m distance on 1-m-tall platforms. Three months after injury, mice were evaluated using the open-field test (OFT), social interaction test, and advanced Erasmus Ladder paradigm. With OFT, no apparent anxiety-like changes were detected with the LIB-exposed mice and sham controls, and both groups displayed similar center-zone activities. Although no social interaction parameters reached significance, a majority of LIB-exposed mice <i>initiated</i> less than 50% of interactions compared with their interaction partners, suggesting decreased sociability. With the Erasmus Ladder test to assess motor functions, associative learning, and stimulus response, LIB-exposed mice appeared to display increased instances of leaving before the cue, reminiscent of \"escape behavior,\" indicative of anxiety-related activity different from that OFT detected. Overall, these results revealed subtle multifaceted long-lasting anxiety-relevant effects following LIB exposure. The \"Missouri Blast\" platform offers a basis for future research to investigate the underlying biological mechanism(s) leading to domain-specific behavioral changes.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"5 1","pages":"1195-1204"},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916081","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":"Brain Network Alterations in Chronic Spinal Cord Injury: Multilayer Community Detection Approach.","authors":"Farzad V Farahani, Lukman E Ismaila, Cristina L Sadowsky, Haris I Sair, Li Min Chen, Visar Belegu, James J Pekar, Martin A Lindquist, Ann S Choe","doi":"10.1089/neur.2024.0098","DOIUrl":"10.1089/neur.2024.0098","url":null,"abstract":"<p><p>Neurological recovery in individuals with spinal cord injury (SCI) is multifaceted, involving mechanisms such as remyelination and perilesional spinal neuroplasticity, with cortical reorganization being one contributing factor. Cortical reorganization, in particular, can be evaluated through network (graph) analysis of interregional functional connectivity. This study aimed to investigate cortical reorganization patterns in persons with chronic SCI using a multilayer community detection approach on resting-state functional MRI data. Thirty-eight participants with chronic cervical or thoracic SCI and 32 matched healthy controls were examined. Significant alterations in brain community structures were observed in the SCI cohort, particularly within the sensorimotor network (SMN). Importantly, this revealed a pattern of segregation within the SMN, aligning with borders of representations of the upper and lower body and orofacial regions. The SCI cohort showed reduced recruitment and integration coefficients across multiple brain networks, indicating impaired internetwork communication that may underlie sensory and motor deficits in persons with SCI. These findings highlight the impact of SCI on brain connectivity and suggest potential compensatory mechanisms.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"5 1","pages":"1048-1059"},"PeriodicalIF":1.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916077","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":"Small Molecule Drug C381 Attenuates Brain Vascular Damage Following Repetitive Mild Traumatic Injury.","authors":"Lulin Li, Andy Nguyen, Brian Zhao, Ryan Vest, Lakshmi Yerra, Bryan Sun, Jian Luo","doi":"10.1089/neur.2024.0060","DOIUrl":"10.1089/neur.2024.0060","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) remains a significant public health concern, with no effective therapeutic interventions to ameliorate the enduring consequences. The prevailing understanding of TBI pathophysiology indicates a central role for vascular dysfunction. Transforming growth factor-β (TGF-β) is a multifunctional cytokine crucial for vascular development. Aberrant TGF-β signaling is implicated in vascular pathologies associated with various neurological conditions. We recently developed a novel small molecule drug, C381, a TGF-β activator with the ability to restore lysosomal function. Here we used a mouse model of repetitive mild TBI (mTBI) to examine whether C381 would attenuate vascular injury. We first employed RNA-seq analysis to investigate the gene expression patterns associated with mTBI and evaluated the therapeutic potential of C381 in mitigating these changes. Our results demonstrate distinct mTBI-related gene expression signatures, prominently implicating pathways related to vascular integrity and endothelial function. Notably, treatment with C381 reversed these mTBI-induced gene expression changes. Immunohistochemical analysis further corroborated these findings, revealing that C381 treatment attenuated vascular damage in mTBI-affected brain tissue. These findings strongly support the potential clinical usefulness of C381 as a novel therapeutic intervention for mTBI.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"5 1","pages":"1016-1026"},"PeriodicalIF":1.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514223","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":"Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT Scans.","authors":"David Bark, Julia Basu, Dimitrios Toumpanakis, Johan Burwick Nyberg, Tomas Bjerner, Elham Rostami, David Fällmar","doi":"10.1089/neur.2024.0017","DOIUrl":"10.1089/neur.2024.0017","url":null,"abstract":"<p><p>This study aimed to evaluate the predictive value and clinical impact of a clinically implemented artificial neural network software model. The software detects intracranial hemorrhage (ICH) from head computed tomography (CT) scans and artificial intelligence (AI)-identified positive cases are then annotated in the work list for early radiologist evaluation. The index test was AI detection by the program Zebra Medical Vision-HealthICH+. Radiologist-confirmed ICH was the reference standard. The study compared whether time benefits from using the AI model led to faster escalation of patient care or surgery within the first 24 h. A total of 2,306 patients were evaluated by the software, and 288 AI-positive cases were included. The AI tool had a positive predictive value of 0.823. There was, however, no significant time reduction when comparing the patients who required escalation of care and those who did not. There was also no significant time reduction in those who required acute surgery compared with those who did not. Among the individual patients with reduced time delay, no cases with evident clinical benefit were identified. Although the clinically implemented AI-based decision support system showed adequate predictive value in identifying ICH, there was no significant clinical benefit for the patients in our setting. While AI-assisted detection of ICH shows great promise from a technical perspective, there remains a need to evaluate the clinical impact and perform external validation across different settings.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"5 1","pages":"1009-1015"},"PeriodicalIF":1.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514208","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":"Metacognitive Therapy for People Experiencing Persistent Post-Concussion Symptoms Following Mild Traumatic Brain Injury: A Preliminary Multiple Case-Series Study.","authors":"Johanne C C Rauwenhoff, Roger Hagen, Migle Karaliute, Odin Hjemdal, Leif Edward Ottesen Kennair, Stian Solem, Robert F Asarnow, Cathrine Einarsen, Joar Øveraas Halvorsen, Stephanie Paoli, Simen Berg Saksvik, Hanne Smevik, Gøril Storvig, Adrian Wells, Toril Skandsen, Alexander Olsen","doi":"10.1089/neur.2024.0076","DOIUrl":"10.1089/neur.2024.0076","url":null,"abstract":"<p><p>After mild traumatic brain injury (mTBI), a subgroup of individuals experience persistent post-concussion symptoms (PPCS) that include headaches, cognitive difficulties, and fatigue. The aim of this preliminary study was to investigate possible effects associated with metacognitive therapy (MCT) on PPCS, maladaptive coping strategies, and positive and negative metacognitive beliefs following mTBI. A pre-post design supplemented with single-case A-B replication series to assess potential MCT mechanisms was used. Of the nine participants who received MCT, all experienced a decrease in PPCS, which constituted a reliable improvement for eight participants. For eight participants (we could calculate effect sizes for eight out of nine participants), moderate to very large decreases in maladaptive coping styles and positive and negative metacognitive beliefs were observed. However, based on visual analyses, participants 6, 8, and 9 show a downward baseline trend regarding MCT mechanisms that may have persisted into the intervention phase. No adverse events were reported. In conclusion, MCT was associated with improvements in PPCS and unhelpful psychological mechanisms, but caution is required in interpreting this association. Future research using formal single-case replication on symptom measures and randomized controlled trials appears to be justified.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"5 1","pages":"890-902"},"PeriodicalIF":1.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514211","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":"Multicenter Study Examining Temporal Trends in Traumatic Intracranial Hemorrhage Over Six Years Using Joinpoint Regression.","authors":"Timbre Backen, Kristin Salottolo, David Acuna, Carlos H Palacio, Gina Berg, Andrea Tsoris, Robert Madayag, Kaysie Banton, David Bar-Or","doi":"10.1089/neur.2024.0097","DOIUrl":"10.1089/neur.2024.0097","url":null,"abstract":"<p><p>The aging US population has altered the epidemiology of traumatic injury, but there are few studies examining changing patterns of traumatic intracranial hemorrhage (tICH). We examined temporal changes in incidence, demographics, severity, management, and outcomes of tICH among trauma admissions at six US Level I trauma centers over 6 years (July 1, 2016-June 30, 2022). Patients with tICH (subdural, epidural, subarachnoid, and intracerebral hemorrhage) were identified by 10th revision of the International Statistical Classification of Diseases diagnosis codes. Temporal trends were examined over 12 six-month intervals using joinpoint regression and reported as biannual percent change (BPC); models without joinpoints are described as linear trends over time. There were 67,514 trauma admissions over 6 years and 11,935 (17.7%) patients had a tICH. The proportion of tICH injuries significantly increased 2.6% biannually from July 2016 to July 2019 (BPC = 2.6, <i>p</i> = 0.04), then leveled off through June 2022 (BPC = -0.9, <i>p</i> = 0.19). Similarly, the proportion of geriatric patients (≥65 years old) increased 2.4% biannually from July 2016 to July 2019 (BPC = 2.4, <i>p</i> = 0.001) as did injuries due to falls (BPC = 2.2, <i>p</i> = 0.01). Three of the four most prevalent comorbidities significantly increased: hypertension linearly increased 2.1% biannually, functional dependence increased 25.5% biannually through June 2019, and chronic anticoagulant use increased 19.0% biannually through June 2019 and then 3.1% thereafter. There were no trends in the rates of neurosurgical intervention (BPC = -0.89, <i>p</i> = 0.40), ED Glasgow coma score 3-8 (BPC = -0.4, <i>p</i> = 0.77), or presence of severe extracranial injuries (BPC = -0.7, <i>p</i> = 0.45). In-hospital mortality linearly declined 2.6% biannually (BPC = 2.6, <i>p</i> = 0.05); however, there was a 10.3% biannual linear increase in discharge to hospice care (BPC = 10.3, <i>p</i> < 0.001). These results demonstrate the incidence of tICH admissions is temporally increasing, and the population is growing older with more comorbidities and injuries from falls. Yet, traumatic brain injury severity and neurosurgical management are unchanged. The shift from in-patient death to hospice care suggests an increased need for palliative care services.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"5 1","pages":"999-1008"},"PeriodicalIF":1.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514212","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}