scholarly journals A Retrospective Evaluation of Pediatric Major Trauma Related to Sport and Recreational Activities in Nova Scotia

CJEM ◽  
2015 ◽  
Vol 18 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Robert S. Green ◽  
Michael B. Butler ◽  
Nelofar Kureshi ◽  
Mete Erdogan
Keyword(s):  
Traumatic Brain Injury ◽  
Nova Scotia ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Major Trauma ◽  
Pediatric Trauma ◽  
Case Series ◽  
Hospital Length Of Stay ◽  
Series Data ◽  
Recreational Activities

AbstractObjectivesA small proportion of pediatric sport- and recreation-related injuries are serious enough to be considered “major trauma.” However, the immediate and long-term consequences in cases of pediatric major trauma are significant and potentially life-threatening. The objective of this study was to describe the incidence and outcomes of pediatric major traumas related to sport and recreational activities in Nova Scotia.MethodsThis study was a retrospective case series. Data on major pediatric traumas related to sport and recreational activities on a provincial scope were extracted from the Nova Scotia Trauma Program Registry between 2000 and 2013. We evaluated frequency, type, severity, and outcomes of major traumas. Outcomes assessed included length of hospital stay, admission to a special care unit (SCU), and mortality.ResultsOverall, 107 children aged three to 18 years sustained a major trauma (mean age 12.5 [SD 3.8]; 84% male). Most injuries were blunt traumas (97%). The greatest proportion were from cycling (59, 53%), followed by hockey (8, 7%), skateboarding (7, 7%) and skiing (7, 7%). The Nova Scotia Pediatric Trauma Team was activated in 27% of cases. Mean in-hospital length of stay was five days (SD 5.6), and nearly half (49%) of patients required SCU admission. Severe traumatic brain injury occurred in 52% of cases, and mortality in five cases.ConclusionsOver a 13-year period, the highest incidence of pediatric major trauma related to sport and recreational activities was from cycling, followed by hockey. Severe traumatic brain injury occurred in over half of pediatric major trauma patients.

scholarly journals P053: Characteristics and patterns of major traumatic brain injury in Nova Scotia: a 12-year retrospective analysis

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S96-S96
Author(s):  
R. Green ◽  
N. Kureshi ◽  
L. Fenerty ◽  
G. Thibault-Halman ◽  
M. Erdogan ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Nova Scotia ◽  
Brain Injury ◽  
Motor Vehicle ◽  
Case Series ◽  
Penetrating Trauma ◽  
Motor Vehicle Crashes ◽  
Series Data ◽  
Vehicle Crashes ◽  
Injury Rates

Introduction: Traumatic brain injury (TBI) is a leading cause of death and disability in Nova Scotia. TBI occurs in approximately 50% of major trauma seen annually in the province. The purpose of this study was to describe the characteristics and patterns of major TBI seen in Nova Scotia over a 12-year period. Methods: This was a retrospective case series. Data were obtained from the Nova Scotia Trauma Registry for all patients presenting with major TBI (abbreviated injury score [AIS] head ≥3) between 2002 and 2013. Injury rates were calculated on the basis of 100,000 population (all ages) using population estimates from Statistics Canada. Results: Overall, 4152 major TBI patients were seen in Nova Scotia hospitals during the study period. Mean age of TBI patients was 51±25 years; 73% were male. The majority of injuries were the result of blunt trauma (93%), with relatively few major TBIs resulting from penetrating trauma (7%). The most common mechanisms of injury were falls (44%) and motor vehicle crashes (27%). Analysis of census-based subpopulations of the province showed that injury rates varied significantly among counties (from 25 to 63 per 100,000 population). We observed an increase in the number of major TBI patients over twelve years. Conclusion: Our findings suggest significant regional variation in major TBI rates in Nova Scotia. There are ongoing needs for prevention and intervention efforts that focus on unintentional falls and motor vehicle crashes, especially in older adults. These results also suggest that geographically targeted efforts may be warranted.

Keep the Brain Cool—Endovascular Cooling in Patients With Severe Traumatic Brain Injury: A Case Series Study

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. 867-873 ◽  
Author(s):  
Marlene Fischer ◽  
Peter Lackner ◽  
Ronny Beer ◽  
Raimund Helbok ◽  
Stephanie Klien ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Case Series ◽  
Brain Cool ◽  
Case Series Study ◽  
Endovascular Cooling ◽  
Series Study ◽  
The Brain

Do long-term results justify decompressive craniectomy after severe traumatic brain injury?

2008 ◽  
Vol 109 (4) ◽  
pp. 685-690 ◽  
Author(s):  
Matthias H. Morgalla ◽  
Bernd E. Will ◽  
Florian Roser ◽  
Marcos Tatagiba
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Decompressive Craniectomy ◽  
Severe Traumatic Brain Injury ◽  
Barthel Index ◽  
Case Series ◽  
Clinical Results ◽  
Long Term Results

Object A decompressive craniectomy can be a life-saving procedure to relieve critically increased intracranial pressure. The survival of a patient is important as well as the subsequent and long-term quality of life. In this paper the authors' goal was to investigate whether long-term clinical results justify the use of a decompressive craniectomy. Methods Thirty-three patients (20 males and 13 females) with a mean age of 36.3 years (range 13–60 years) with severe traumatic brain injury (Grades III and IV) and subsequent massive brain swelling were examined. For postoperative assessment the Barthel Index was used. A surgical intervention was based on the following criteria: 1) The intracranial pressure could not be controlled by conservative treatment and constantly exceeded 30 mm Hg (cerebral perfusion pressure < 50 mm Hg). 2) Transcranial Doppler ultrasonography revealed only a systolic flow pattern or systolic peaks. 3) There were no other major injuries. 4) The patient was not older than 60 years. Results One-fifth of all patients died and one-fifth remained in a vegetative state. Mild deficits were seen in 6 of 33 patients. A full rehabilitation (Barthel Index 90–100) was achieved in 13 patients (39.4%). Five patients could resume their former occupation, and another 4 had to change jobs. Conclusions Age remains to be one of the most important exclusion factors. Decompressive craniectomy provided good clinical results in nearly 40% of patients who were otherwise most likely to die. Therefore, long-term results justify the use of decompressive craniectomy in this case series.

scholarly journals Prehospital Intubation in Patients with Isolated Severe Traumatic Brain Injury: A 4-Year Observational Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mazin Tuma ◽  
Ayman El-Menyar ◽  
Husham Abdelrahman ◽  
Hassan Al-Thani ◽  
Ahmad Zarour ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Length Of Stay ◽  
Severe Traumatic Brain Injury ◽  
Multivariate Regression Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Trauma Resuscitation ◽  
Initial Blood ◽  
Initial Blood Pressure

Objectives. To study the effect of prehospital intubation (PHI) on survival of patients with isolated severe traumatic brain injury (ISTBI).Method. Retrospective analyses of all intubated patients with ISTBI between 2008 and 2011 were studied. Comparison was made between those who were intubated in the PHI versus in the trauma resuscitation unit (TRU).Results. Among 1665 TBI patients, 160 met the inclusion criteria (105 underwent PHI, and 55 patients were intubated in TRU). PHI group was younger in age and had lower median scene motor GCS (P=0.001). Ventilator days and hospital length of stay (P=0.01and 0.006, resp.) were higher in TRUI group. Mean ISS, length of stay, initial blood pressure, pneumonia, and ARDS were comparable among the two groups. Mortality rate was higher in the PHI group (54% versus 31%,P=0.005). On multivariate regression analysis, scene motor GCS (OR 0.55; 95% CI 0.41–0.73) was an independent predictor for mortality.Conclusion. PHI did not offer survival benefit in our group of patients with ISTBI based on the head AIS and the scene motor GCS. However, more studies are warranted to prove this finding and identify patients who may benefit from this intervention.

scholarly journals Gabapentin in the management of dysautonomia following severe traumatic brain injury: a case series

2006 ◽  
Vol 78 (5) ◽  
pp. 539-541 ◽  
Author(s):  
I. J Baguley ◽  
R. E Heriseanu ◽  
J. A Gurka ◽  
A. Nordenbo ◽  
I. D Cameron
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Case Series

Change in cerebral autoregulation as a function of time in children after severe traumatic brain injury: a case series

2007 ◽  
Vol 23 (10) ◽  
pp. 1163-1169 ◽  
Author(s):  
Nuj Tontisirin ◽  
William Armstead ◽  
Pichaya Waitayawinyu ◽  
Anne Moore ◽  
Yuthana Udomphorn ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Cerebral Autoregulation ◽  
Case Series

Relationship of aggressive monitoring and treatment to improved outcomes in severe traumatic brain injury

2010 ◽  
Vol 112 (5) ◽  
pp. 1105-1112 ◽  
Author(s):  
Sherman C. Stein ◽  
Patrick Georgoff ◽  
Sudha Meghan ◽  
Kasim L. Mirza ◽  
Omar M. El Falaky
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Meta Analysis ◽  
Intensive Therapy ◽  
Case Series ◽  
Convincing Evidence ◽  
Icp Monitoring ◽  
National Guidelines ◽  
Severe Tbi

Object Despite being common practice for decades and being recommended by national guidelines, aggressive monitoring and treatment of patients with severe traumatic brain injury (TBI) have not been supported by convincing evidence. Methods The authors reviewed trials and case series reported after 1970 in which patients were treated for severe closed TBI, and mortality rates and favorable outcomes at 6 months after injury were analyzed. The patient groups were divided into those with and without intracranial pressure (ICP) monitoring and intensive therapy, and the authors performed a meta-analysis to assess the effects of treatment intensity on outcome. Results Although the mortality rate fell during the years reviewed, it was consistently ~ 12% lower among patients in the intense treatment group (p < 0.001). Favorable outcomes did not change significantly over time, and were 6% higher among the aggressively treated patients (p = 0.0105). Conclusions Aggressive ICP monitoring and treatment of patients with severe TBI is associated with a statistically significant improvement in outcome. This improvement occurs independently of temporal effects.

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