Posts Tagged ‘traumatic brain injury’
Background: In a variety of surgical specialties, simulation-based technologies play an important role in resident training. The Congress of Neurological Surgeons (CNS) established an initiative to enhance neurosurgical training by developing a simulation-based curriculum to complement standard didactic and clinical learning.
Objective: To enhance resident education in the management of traumatic brain injury by the use of simulation-based training.
Methods: A course-based neurosurgical simulation curriculum was developed and offered at the 2012 CNS annual meeting. Within this curriculum, a trauma module was developed to teach skills necessary in the management of traumatic brain injury, including the performance of craniotomy for trauma. Didactic and simulator-based instruction were incorporated into the course. Written and practical pre- and posttests, as well as questionnaires, were used to assess the improvement in skill level and to validate the simulator as a teaching tool.
Background: The Centers for Disease Control and Prevention have called for studies detailing the prevalence and burden of mild traumatic brain injury (mTBI) in the outpatient clinical setting.
Objective: The aim of this study was to describe the prevalence of outpatient visits for minor head injury and compare the number of outpatient visits for minor head injury with the number of emergency department (ED) visits.
Methods: This was a cross-sectional study of outpatient visits for minor head injuries from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS). We examined outpatient visits for minor head injury between 2005 and 2009 and compared them with visits in the ED for the same diagnoses using simple survey-weighted descriptive statistics.
Background and Importance: Dabigatran is a direct thrombin inhibitor gaining popularity as a stroke prevention agent in atrial fibrillation patients. Compared to warfarin, dabigatran showed superiority in stroke prevention, but lower rates of major hemorrhage and intracerebral hemorrhage. While warfarin has a well-established reversal strategy, there is far less experience reversing dabigatran.
Clinical Presentation: We present our experience with three patients who suffered intracranial hemorrhage either spontaneously or after low energy cranial trauma and review the available literature describing dabigatran use in traumatic brain injury patients.
Background: Cerebrovascular pressure reactivity is the principal mechanism of autoregulation of cerebral blood flow. Assessment of cerebral autoregulation can be performed using the mean flow index (Mx) based on transcranial Doppler (TCD) ultrasonography. Pressure reactivity can be monitored using the pressure reactivity index (PRx), which is based on intracranial pressure (ICP) monitoring. From a practical point of view, PRx can be monitored continuously, while Mx can only in short periods when TCD probes can be applied.
Objective: To assess to what degree impairment in pressure reactivity (PRx) is associated with impairment in cerebral autoregulation (Mx).
Methods: A database of 345 traumatic brain injury (TBI) patients was screened for data availability including simultaneous Mx and PRx monitoring. Absolute differences, temporal changes, and association with outcome of the two indices were analyzed.
Background: Monitoring brain tissue PO2 (PbtO2) is part of multimodality monitoring of patients with traumatic brain injury (TBI). However, PbtO2 measurement is a sampling of only a small area of tissue surrounding the sensor tip.
Objective: To examine the effect of catheter location on the relationship between PbtO2and neurological outcome.
Methods: A total of 405 patients who had PbtO2 monitoring as part of standard management of severe traumatic brain injury were studied. The relationships between probe location and resulting PbtO2 and outcome were examined.