Traumatic Brain Injury


Author: Christy L Collins Background: Data limited to emergency department and inpatient visits undoubtedly underestimate the medical charges associated with traumatic brain injury. The objective of this study was to estimate the direct medical charges of pediatric traumatic brain injuries across all clinical settings in one large, pediatric hospital in […]

Direct medical charges of pediatric traumatic brain injury in multiple ...


Author: Yasuko Kitagishi Traumatic encephalopathy has emerged as a significant public health problem. It is believed that traumatic encephalopathy is caused by exposure to repetitive brain trauma prior to the initial symptoms of neurodegenerative disease. Therefore, prevention is important for the disease. The PI3K/AKT/PTEN (phosphoinositide-3 kinase/AKT/phosphatase and tensin homologue deleted […]

Diets involved in PPAR and PI3K/AKT/PTEN pathway may contribute to ...



Author: Alan A Garner Background: The utility of advanced prehospital interventions for severe blunt traumatic brain injury (BTI) remains controversial. Of all trauma patient subgroups it has been anticipated that this patient group would most benefit from advanced prehospital interventions as hypoxia and hypotension have been demonstrated to be associated […]

The study protocol for the Head Injury Retrieval Trial (HIRT): ...


Author: Paolo Pelosi The occurrence of moderate to severe acute respiratory distress syndrome due to traumatic brain injury is not uncommon and is associated with an extremely high incidence of morbidity and mortality. Owing to the complex interaction between the lung and brain, protective ventilation for the lung with lower […]

High-frequency oscillatory ventilation with tracheal gas insufflation: the rescue strategy ...



Author: Brittney NV Scott Background: Infection occurs commonly among patients hospitalized after traumatic brain injury (TBI) and has been associated with increased intensive care unit and hospital lengths of stay and an elevated risk of poor neurological outcome and mortality. However, as many relevant published studies to date have varied […]

Incidence, prevalence, and occurrence rate of infection among adults hospitalized ...


Author: Christian von Rüden Background: Aim of this study was to evaluate prognosis of severely injured patients. Methods: All severely injured patients with an Injury Severity Score (ISS) >= 50 were identified in a 6-year-period between 2000 and 2005 in German Level 1 Trauma Center Murnau. Data was evaluated from […]

Outcome after severe multiple trauma: a retrospective analysis



Author: Marta Sidoryk-Wegrzynowicz Astrocytes are responsible for numerous aspects of metabolic support, nutrition, control of the ion and neurotransmitter environment in central nervous system (CNS). Failure by astrocytes to support essential neuronal metabolic requirements plays a fundamental role in the pathogenesis of brain injury and the ensuing neuronal death. Astrocyte-neuron […]

Role of astrocytes in manganese mediated neurotoxicity


Author: Kan-Hsun Chang Background: The synthetic glucocorticoid dexamethasone (DEX) is commonly used to prevent chronic lung disease in prematurely born infants. Treatment regimens usually consist of high doses of DEX for several weeks, notably during a critical period of brain development. Therefore, there is some concern about adverse effects of […]

Neonatal dexamethasone treatment exacerbates hypoxic-ischemic brain injury



Author: Huang Fuang Intracerebral hemorrhage (ICH) is a common type of fatal stroke, accounting for about 15% to 20% of all strokes. Hemorrhagic strokes are associated with high mortality and morbidity, and increasing evidence shows that innate immune responses and inflammatory injury play a critical role in ICH-induced neurological deficits. […]

Toll-like receptor 4 signaling in intracerebral hemorrhage-induced inflammation and injury


Author: Sandy R Shultz Background: Concussions account for the majority of traumatic brain injuries (TBI) and can result in cumulative damage, neurodegeneration, and chronic neurological abnormalities. The underlying mechanisms of these detrimental effects remain poorly understood and there are presently no specific treatments for concussions. Neuroinflammation is a major contributor […]

Treatment with an anti-CD11d integrin antibody reduces neuroinflammation and improves ...



Author: Stephanie L Go You are the attending intensivist in a neurointensive care unit caring for a woman five days post-rupture of a cerebral aneurysm (World Federation of Neurological Surgeons Grade 4 and Fisher Grade 3). She is intubated for airway protection and mild hypoxemia related to an aspiration event […]

Pro/con debate: Should PaCO2 be tightly controlled in all patients ...


Author: Chih-Chung Lin Background: Endothelin-1 (ET-1) is a proinflammatory mediator and elevated in the regions of several brain injury and inflammatory diseases. The deleterious effects of ET-1 on endothelial cells may aggravate brain inflammation mediated through the regulation of cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2) system in various cell types. However, the […]

Up-regulation of COX-2/PGE2 by endothelin-1 via MAPK-dependent NF-kappaB pathway in ...



Author: Kieran Donnelly I read with interest the paper by Sekhon et al, ‘Association of hemoglobin concentration in critically ill patients with severe traumatic brain injury’ (July edition of Critical Care) [1]. Whilst the conclusion (‘mean 7-day hemoglobin concentration < 90g/L associated with increased hospital mortality in patients with severe […]

An expected association between low haemoglobin and poor outcome in ...


Author: Donald EG Griesdale The observational literature suggests that hypernatremia is associated with worse outcomes in patients with traumatic brain injury. In a previous issue of Critical Care, Wells and colleagues add to this literature by failing to show an association between hypernatremia and reduced intracranial pressure. However, we must […]

Hypernatremia and intracranial pressure: more questions than answers