scholarly journals Effect of Right Median Nerve Stimulation on Level of Consciousness in Traumatic Brain Injury Subjects

2016 ◽  
Vol 8 (3) ◽  
pp. 67
Author(s):  
Sirisha Nekkanti ◽  
Rahul Shaik ◽  
Srinivas Mondem ◽  
Nandini Meruva ◽  
Gunathevan Elumalai
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Median Nerve ◽  
Nerve Stimulation ◽  
Control Group ◽  
Coma Scale ◽  
Median Nerve Stimulation ◽  
Significant Difference ◽  
Level Of Consciousness ◽  
Experimental Group

<p class="Default"><strong>Background</strong>: The median nerve serves a peripheral gateway to the central nervous system. Median nerve stimulation is positively associated with regaining the level of consciousness in patients with traumatic brain injury, but the level of evidence is still a research question. So the purpose of the study is to find out the effectiveness of right median nerve stimulation on the level of consciousness and the relation between them in subjects with traumatic brain injury.<strong> Methodology: </strong>Twenty subjects with traumatic brain injury of axonal type were selected for study and randomized into two groups. Experimental group received right median nerve stimulation along with medications where as control group received medications only one month, 30 minutes a day. Glasgow coma scale is used to assess the changes in conscious levels<strong>. Result: </strong>The results have revealed that there is significance improvement noted in experimental group when compared to control group. Comparison  of Glassgow coma scale scores between experimental and control groups after one month showed significant difference with a P value 0.0261.<strong> Conclusion: </strong>Right median nerve stimulation is strongly associated with improvement of consciousness in patients with traumatic brain injury.</p><p><strong> </strong></p><p><strong> </strong></p>

scholarly journals The Influence of Different Footwear on Balance and Gait Recovery of Persons with Traumatic Brain Injury during the Second Phase of Rehabilitation

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Rasa Šakalienė ◽  
Vaida Diliūnaitė
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Balance Training ◽  
Gait Training ◽  
Control Group ◽  
Second Phase ◽  
Training Methods ◽  
Balance Test ◽  
Significant Difference ◽  
Experimental Group

The individuals with traumatic brain injury (TBI) have impairments of cognitive, social and motor functions. Gait impairment is a very important factor for individuals with TBI, since it directly affects the patients’ activities of daily living and their social integration in society. Impaired gait also increases the risk of falls. Gait and balance training is an important factor for the achievement of independence, quality of life and sense of security in moving for persons with TBI, but there is no common approach to these patients’ rehabilitation and gait training methods. It is not clear whether during physiotherapy the patients who wore MBT (Masai Barefoot Technology) shoes couldundergo gait and balance recovery more efficiently than those, who wore usual shoes. The aim of the research was to evaluate the influence of different footwear on balance and gait recovery in persons with traumatic brain injury during the second phase of rehabilitation. Research sample consisted of 30 individuals (19–43 yr) who suffered mild to moderate TBI. Targeted persons were randomily divided into two groups of 15 patients: the control group consisted of 15 patients – 10 men and 5 women (age 31.6 ± 8.3 yr), who received the gait and balance training program with normal shoes in the physiotherapy room. The experimental group also consisted of 15 patients – 12 men and 3 women (age 30.6 ± 6.2 yr). The patients of the experimental group did the same exercises, but during physiotherapy they wore MBT shoes. The changes of gait indices for both groups were assessed by Emory gait scale, the changes of balance – by Fullerton balance test. The control of balance and gait significantly improved in both groups (p < 0.001) after rehabilitation. However, the balance and gait improvement in the patients with mild and moderate TBI, who were wearing MBT shoes during the physiotherapy, was exactly the same as in persons, who were wearing usual shoes during the physiotherapy. So, the significant difference between the groups (p > 0.05) was not found. The wearing of MBT shoes during the physiotherapy procedures did not affect the balance and gait recovery in persons with mild and moderate TBI.Keywords: traumatic brain injury, physiotherapy, MBT shoes, gait.

scholarly journals Sleep Disorders Following Mild and Moderate Traumatic Brain Injury

2019 ◽  
Vol 9 (1) ◽  
pp. 10 ◽  
Author(s):  
Laith Al-Ameri ◽  
Talib Mohsin ◽  
Ali Abdul Wahid
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Control Group ◽  
P Value ◽  
Sleeping Disorders ◽  
Moderate Traumatic Brain Injury ◽  
Significant Difference

(1) Background: Sleeping disorders are frequently reported following traumatic brain injury (TBI). Different forms of sleeping disorders have been reported, such as sleepiness, insomnia, changes in sleeping latency, and others. (2) Methods: A case-control study with 62 patients who were victims of mild or moderate TBI with previous admissions to Iraqi tertiary neurosurgical centers were enrolled as the first group, and 158 patients with no history of trauma were considered as the control. All were 18 years of age or older, and the severity of the trauma and sleep disorders was assessed. The Pittsburgh sleep quality index was used to assess sleep disorders with average need for sleep per day and average sleep latency were assessed in both groups. Chi-square and t-test calculations were used to compare different variables. (3) Results: 39 patients (24.7%) of the controlled group experienced sleeping disorders compared to TBI group with 45 patients (72.6%), P-value < 0.00001. A total of 42 patients were diagnosed on admission as having a mild degree of TBI (mean GCS 13.22 ± 1.76) and 20 patients were diagnosed with moderate TBI (mean GCS11.05 ± 1.14. 27). A total of 27 (46.28%) patients with mild severity TBI and 18 patients (90%) of moderate severity were considered to experience sleeping disorders, P-value 0.0339. Each of the mild and moderate TBI subgroups show a P-value < 0.00001 compared to the control group. Average sleep hours needed per day for TBI and the control were 8.02 ± 1.04 h and 7.26 ± 0.58 h, respectively, P-value < 0.00001. Average sleep latency for the TBI and the control groups were 13.32 ± 3.16 min and 13.93 ± 3.07 min respectively, P-value 0.065. (4) Conclusion: Sleep disturbances are more common following mild and moderate TBI three months after the injury with more hours needed for sleep per day and no significant difference in sleep latency. Sleep disturbances increase in frequency with the increase in the severity of TBI.

scholarly journals Hyperbaric oxygen for severe traumatic brain injury: a randomized trial

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052093982
Author(s):  
Xianliang Zhong ◽  
Aijun Shan ◽  
Jianzhong Xu ◽  
Jian Liang ◽  
Ying Long ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hyperbaric Oxygen ◽  
Severe Traumatic Brain Injury ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Vital Signs ◽  
Neurological Function ◽  
Control Group ◽  
Experimental Group

Objective The present study aimed to explore the effects of hyperbaric oxygen therapy on the prognosis and neurological function of patients with severe traumatic brain injury. Methods A prospective study was carried out in 88 patients diagnosed with severe brain injury at our hospital and they were enrolled as research participants and randomly assigned to control and experimental groups (n = 44 per group) using a random number table method. Both groups underwent routine treatment. Patients in the experimental group were administered hyperbaric oxygen therapy approximately 1 week after admission when their vital signs had stabilized. Results No significant intergroup differences were observed in the Glasgow Coma Scale (GCS) and U.S. National Institutes of Health Stroke Scale (NIHSS) scores before treatment. However, after oxygen treatment, compared with the control group, the experimental group showed higher GCS and lower NIHSS scores. The GCS score at admission, tracheotomy status, and first hyperbaric oxygen therapy duration were independent prognostic factors in patients with severe traumatic brain injury. Conclusion Hyperbaric oxygen therapy may promote recovery of neurological function and improve the cognitive function and prognosis of patients with severe traumatic brain injury.

scholarly journals Metabolic Correction of Primary Hemostasis in the Acute Phase of Traumatic Brain Injury

2021 ◽  
Vol 17 (1) ◽  
pp. 57-68
Author(s):  
G. A. Boyarinov ◽  
O. D. Solovyova ◽  
E. I. Yakovleva ◽  
L V. Boyarinova ◽  
A. V. Deryugina
Keyword(s):  
Traumatic Brain Injury ◽  
Endothelial Cells ◽  
Platelet Count ◽  
Brain Injury ◽  
Acute Phase ◽  
Intraperitoneal Administration ◽  
Control Group ◽  
Liver Sinusoid ◽  
Primary Hemostasis ◽  
Experimental Group

The aim of the study was to investigate the effect of ethylmethylhydroxypyridine on the ultrastructural alterations in endothelial cells of liver sinusoidal capillaries (SC) and primary hemostasis in the acute phase of traumatic brain injury (TBI).Materials and methods. Ultrastructural endothelial cell changes were studied in 36 female outbred rats in the acute phase of TBI using electron microscopy, and the platelet count was determined using a blood analyzer. The experimental group (n=18) animals received intraperitoneal injections of ethylmethylhydroxypyridine at the dose of 8.0 mg/kg per day for 12 days, and the control group (n=18) rats were administered with normal saline solution at the same dose.Results. Administration of ethylmethylhydroxypyridine in the early post TBI period reduced microvilli damage in endothelial, hepatic and stellate cells in the Disse space, whereas in the control group a significant decrease of these cells counts was detected. In contrast to the control group, the experimental group animals did not demonstrate thrombocytopenia on the days 1, 3, and 7 after injury. There was a significant increase in the platelet count compared with the baseline values, which was highest on day 12 after injury.Conclusion. Intraperitoneal administration of ethylmethylhydroxypyridine in rats in early post TBI period inhibited the TBI-associated damaging effect of secondary factors on liver sinusoid endothelial cells and platelet consumption.

scholarly journals Effect of preoperative antiplatelet or anticoagulation therapy on hemorrhagic complications in patients with traumatic brain injury undergoing craniotomy or craniectomy

2019 ◽  
Vol 47 (5) ◽  
pp. E3 ◽  
Author(s):  
Ladina Greuter ◽  
Muriel Ullmann ◽  
Luigi Mariani ◽  
Raphael Guzman ◽  
Jehuda Soleman
Keyword(s):  
Traumatic Brain Injury ◽  
Regression Analysis ◽  
Brain Injury ◽  
Univariate Analysis ◽  
Postoperative Bleeding ◽  
Acute Subdural Hematoma ◽  
Control Group ◽  
Bleeding Events ◽  
Cox Regression Analysis ◽  
Significant Difference

OBJECTIVETraumatic brain injury (TBI) is common among the elderly, often treated with antiplatelet (AP) or anticoagulation (AC) therapy, creating new challenges in neurosurgery. In contrast to elective craniotomy, in which AP/AC therapy is mostly discontinued, in TBI usually no delay in treatment can be afforded. The aim of this study was to analyze the effect of AP/AC therapy on postoperative bleeding after craniotomy/craniectomy in TBI.METHODSPostoperative bleeding rates in patients treated with AP/AC therapy (blood thinner group) and in those without AP/AC therapy (control group) were retrospectively compared. Furthermore, univariate and multivariate analyses were conducted to identify risk factors for postoperative bleeding. Lastly, a proportional Cox regression analysis comparing postoperative bleeding events within 14 days in both groups was performed.RESULTSOf 143 consecutive patients undergoing craniotomy/craniectomy for TBI between 2012 and 2017, 47 (32.9%) were under AP/AC treatment. No significant difference for bleeding events was observed in univariate (40.4% blood thinner group vs 36.5% control group; p = 0.71) or Cox proportional regression analysis (log rank χ2 = 0.29, p = 0.59). Patients with postoperative bleeding showed a significantly higher mortality rate (p = 0.035). In the univariate analysis, hemispheric lesion, acute subdural hematoma, hematological disease, greater extent of midline shift, and pupillary difference were significantly associated with a higher risk of postoperative bleeding. However, in the multivariate regression analysis none of these factors showed a significant association with postoperative bleeding.CONCLUSIONSPatients treated with AP/AC therapy undergoing craniotomy/craniectomy due to TBI do not appear to have increased rates of postoperative bleeding. Once postoperative bleeding occurs, mortality rates rise significantly.

scholarly journals Effects of Hyperbaric Oxygen Therapy on Serum Adhesion Molecules, and Serum Oxidative Stress in Patients with Acute Traumatic Brain Injury

2021 ◽  
Vol 11 (10) ◽  
pp. 985
Author(s):  
Hung-Chen Wang ◽  
Pei-Ming Wang ◽  
Yu-Tsai Lin ◽  
Nai-Wen Tsai ◽  
Yun-Ru Lai ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Adhesion Molecules ◽  
Cell Adhesion Molecule ◽  
Control Group ◽  
Significant Difference ◽  
Acute Traumatic Brain Injury ◽  
And Control ◽  
Cell Adhesion Molecule 1

Background: Serum concentrations of adhesion molecules and oxidative stress is thought to participate in the pathobiology of secondary brain injury after acute traumatic brain injury (TBI). We aimed to study the hypothesis that hyperbaric oxygen therapy (HBOT) both improves the adhesion molecules levels and antioxidant capacity. Methods: Thirty blood samples from ten patients after acute TBI were obtained after injury and before and after HBOT. Four patients received early HBOT started two weeks after injury, four patients received late HBOT started ten weeks after injury and two patients did not receive HBOT and served as control in this study. The HBOT patients received total 30 times HBOT in six weeks period. Results: Those serum biomarkers in patients with TBI had not significantly difference in glutathione (GSH), thiobarbituric acid reactive substances (TBARS), soluble intercellular cell adhesion-molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) concentrations on admission between early HBOT, late HBOT, and control group (p = 0.916, p = 0.98, p = 0.306, and p = 0.548, respectively). Serum GSH levels were higher at 10 weeks after injury in the early HBOT group than in the late HBOT group and control group (mean, 1.40 μmol/L, 1.16 μmol/L, and 1.05 μmol/L, respectively). Then the serum GSH level was increased at 18 weeks after injury in the late HBOT group (mean, 1.49 μmol/L). However, there was only statistically significant difference at Weeks 18 (p = 0.916, p = 0.463, and p = 0.006, at Week 2, Week 10, and Week 18, respectively). Serum TBARS levels were decreased at 10 weeks after injury in the early HBOT group than in the late HBOT group and control group (mean, 11.21 μmol/L, 17.23 μmol/L, and 17.14 μmol/L, respectively). Then the serum TBARS level was decreased at 18 weeks after injury in the late HBOT group (mean, 12.06 μmol/L). There was statistically significant difference after HBOT (p = 0.98, p = 0.007, and p = 0.018, at Week 2, Week 10, and Week 18, respectively). There was no statistically significant difference between the three groups on sICAM-1 and sVCAM-1 levels from Week 2 to Week 18. Conclusions: HBOT can improve serum oxidative stress in patients after TBI. These molecules may be added as evaluation markers in clinical practice. Perhaps in the future it may also become part of the treatment of patients after acute traumatic brain injury. Further large-scale study may be warrant.

The factors of the outcome of neurosurgical treatment in traumatic brain injury

2021 ◽  
pp. 511-517
Author(s):  
Keneshbek Bakirbaevich Yrysov ◽  
Doolos Muratovich Muratov ◽  
Gulzar Zhakypovna Alibaeva ◽  
Talant Suyorkulovich Kalykov
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Deep Coma ◽  
Brain Contusion ◽  
Coma Scale ◽  
Patients Âgés ◽  
Significant Difference ◽  
Neurosurgical Treatment ◽  
Age Over 60

The purpose of the research: to improve the results of neurosurgical treatment in patients with traumatic brain injury by detecting an optimal way of craniotomy. Material and methods. The study includes the analysis of 127 patients operated on in the Department of Neurosurgery. The examination sample consisted of 109 (85.8%) male and 18 (14.2%) female patients. Patients’ ages varied from 16 to 85 years. The average age of the patients was 43.8 ± 4.2 years. Results. Not depending on craniotomy method, there was not a statistically significant difference in outcome in patients with traumatic brain injury. Using of trephination, craniectomy and osteoplastic craniotomy revealed no significant differences in outcomes in patients with traumatic brain injury. Patients’ age over 60 years, consciousness degree 4-6 scores according to Glasgow Coma Scale, and dislocation syndrome are unfavorable prognostic factors. Resection craniotomy in traumatic brain injury may be effective even in deep coma consciousness level and dislocation syndrome, but in absence of intraoperative brain edema. Conclusion. During the planning of craniotomy method in traumatic brain injury, 4-9 score consciousness degree according to Glasgow Coma Scale, brain contusion foci, acute subdural and intracerebral hematomas, brain compression volume of 30-150 cm³, patient’ age and dislocation syndrome should be considered, which, in total, predicts an outcome.

scholarly journals The Role of Dietitian in Improving Energy and Protein Intake in Traumatic Brain Injury Patients Admitted to the Neurosurgical Intensive Care Unit

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 109-116
Author(s):  
Fatemeh Ramezani Kapourchali ◽  
◽  
Ali Malekshahi Moghadam ◽  
Anoush Dehnadi Moghadam ◽  
Shahrokh Yousefzadeh-Chabok ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Mechanical Ventilation ◽  
Brain Injury ◽  
Protein Intake ◽  
Brain Injuries ◽  
Average Energy ◽  
Nutritional Intervention ◽  
Traumatic Brain Injuries ◽  
Control Group ◽  
Significant Difference

Introduction:Early and sufficient nutritional support is vital to improve outcomes in patients with traumatic brain injury. This study aims to determine the effects of dietitian involvementin the nutritional and clinical outcomes inpatients with traumatic brain injuries admitted tothe neurosurgical ICU. Materials &Methods: Forty-eight male patients with traumatic brain injuries admitted to Poursina Hospital neurosurgical ICU were studied, retrospectively. Patients were divided to either receive dietitian intervention or without any nutritional recommendation(control). Demographic information, Glasgow Coma Scale and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, the timing of initial enteral feeding, the amount of energy and protein intakeon day 4, the duration of mechanical ventilation and ICU length of stay were recorded. Results:Patients under the dietitian recommendation had significantly lower timing of initial enteral nutrition compared to the other cases (P=0.02). The average energy or protein intake and the percentage of target energy or protein intake on day4 appeared to be significantly lower in the subjects in the control group than in those with nutritional intervention(P≤0.001). There was no statistically significant difference in the duration of mechanical ventilation and ICU length of staybetween different groups of patients. Conclusions:Instead of occasional consultations for exclusive cases, the daily attendance of dietitians during multidisciplinary rounds of ICU is required to assess the nutritional needs of patients.

scholarly journals An ultrasound-guided percutaneous nerve stimulation regimen based on finite element modeling for median nerve rupture

2021 ◽  
Author(s):  
xiaolei chu ◽  
Xizi Song ◽  
Yuru Li ◽  
Ziren Wu ◽  
Qi Li ◽  
...  
Keyword(s):  
Finite Element ◽  
Finite Element Modeling ◽  
Grip Strength ◽  
Median Nerve ◽  
Nerve Stimulation ◽  
Functional Score ◽  
Control Group ◽  
Element Modeling ◽  
Experimental Group ◽  
Stimulation Regimen

Abstract Object: In order to promote the functional recovery of median nerve rupture patients, this paper proposes an ultrasound-guided percutaneous nerve stimulation regimen based on finite element modeling. Method: First, according to anatomy feature, a multi-layer human forearm model is constructed. What’s more, taking current density and activate function as optimization indicators, the percutaneous nerve stimulation regimen is designed with finite element modeling, including electrical needle angel, distance and position. Finally, to test the performance of designed regimen, a total of 22 patients with median nerve rupture participate in the clinical randomized controlled trial. And the clinical treatment effect is evaluated with BMRC, grip strength, functional score of median nerve and DASH scores. Results: The designed percutaneous nerve stimulation regimen is that, parallel to each other, electrical needles are located at both ends of the injury nerve with a distance of 3 cm. Besides, clinical trial results show that, after treatment the difference in sensory function was statistically significant. In terms of motor function, the BMRC of motor and grip strength are improved in both groups after treatment and there are significant differences between groups. Besides the grip strength improvement of experimental group is 4 times higher than that of control group. On global function, the DASH scores are reduced by 29% with experimental group but only 8% with control group; functional score of median nerve improved by 24% in the experimental group and by 22% in the control group, but the difference between groups is statistically significant after treatment. Conclusion: Clinical trial results demonstrate that the designed percutaneous nerve stimulation regimen can significantly improve the sensory, motor and global function of median nerve rupture, which is a potential clinical treatment regimen. Trial registration: ChiCTR, ChiCTR2000030790. Registered14 march 2020, http://www.chictr.org.cn/ChiCTR2000030790

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