Outcome of Traumatic bilateral basal ganglia Hemorrhage: Rarest entity: Prospective study of five cases: Single institutional Experience

Traumatic Basal ganglia hemorrhage is rare entity but bilateral basal ganglia hematoma after trauma is extremely rare and is limited to case reports. We describe five cases of traumatic bilateral basal ganglia hemorrhage, and its outcome and management. All Cases were managed conservatively. The general incidence of TBGH is reported between 2.4-3% of closed head injury. However, the incidence is higher in post mortem studies (9.8%). Five consecutive patients of TBGH, shown in initial Noncontrast CT (NCCT) head, admitted in our institute from August 2013 to August 2016, during this period total patient admitted of head injury is 1061 so incidence of Traumatic bilateral basal ganglia Hemorrhage in our series is 0.47% which is very less compare to previous literature formed the prospective study group. There were 3 males and 2 females; age ranging from 20 to 45 years (average 30 years).Hypertensive patients, drugs abuse history, history of coagulopathy with doubtful history of trauma or unknown mode of injury was excluded from the study. All patients had sustained road traffic accidents. NCCT head done of all patients after initial resuscitation. GCS at admission were 9 to 12 (mean 10.4), Outcome assessed by Glasgow outcome Score. All patients outcome was good. Average follow up 8.54 months

Bilateral traumatic basal ganglia haemorrhage, a rare entity: Experience at single institute with review of literature

Aims. Traumatic basal ganglia haemorrhage is rare entity but post traumatic bilateral basal ganglia hematoma is even extremely rare and was earlier presented as case reports. Its incidence is about 3% after a closed head injury however, the incidence is higher in post mortem studies. Material & Methods. Out of 1485 head injury patients admitted to our institute from January 2012 to January 2019, there were 9 cases of traumatic bilateral basal ganglia haemorrhage. The incidence of traumatic bilateral basal ganglia Haemorrhage in our series is 0.61% which is very less compared to previous literature. Results. There were 6 males and 3 females; age ranging from 19 to 50 years (average 32 years). Patients with hypertension, history of drugs abuse, history of coagulopathy, with doubtful history of trauma or unknown mode of injury were excluded from the study. The mode of injury in all the patients was road traffic accidents. Average follow up was 9.54 months. Outcome was assessed by Glasgow outcome Score. In 8 out of 9 patients, outcome was good. One patient died. All the nine cases were managed conservatively. Conclusion. We report nine cases from a single institute which to the best of our knowledge is the largest series in world literature. Prognosis is variable and dependent on many factors. The prognosis of TBGH is favourable if not associated with other disorders like hypertension, diabetes mellitus, and coagulation disorders or diffuse axonal injury

Health Care Implications of the COVID-19 Pandemic for Patients with Severe Traumatic Brain Injury-A Nationwide, Observational Cohort Study

Background Containment measures during the coronavirus disease of 2019 (COVID-19) pandemic have resulted in a substantial reduction in treatment of injury. The effect of the COVID-19 pandemic on the epidemiology and mortality of severe traumatic brain injury on a national, population-based level is unknown. Methods Data on all patients with severe traumatic brain injury between 2017 and 2020 were retrieved from the National Trauma Registry of Norway. The study cohort was derived from the pandemic period (March 12 to December 31, 2020) and the control cohort from the prepandemic years 2017 to 2019. The outcome measures were 30-day mortality, in-hospital mortality, and discharge destination. Results This study included 522 trauma patients with severe traumatic brain injury, 387 (74.1%) in the prepandemic and 135 (25.9%) in the pandemic period. Length of stay increased significantly during the pandemic period (4 vs. 3 days; P = 0.014). The 30-day mortality rate was 39% (n = 149) in the prepandemic versus 38% (n = 52) pandemic period (P = 0.998). In-hospital mortality was 33% (n = 128) in the prepandemic versus 33% (n = 44) in the pandemic period (P = 0.920). There were no statistically significant differences in discharge destination besides the number of patients discharged to home in the pandemic period (P = 0.003). When adjusted for clinical relevant factors such as age, gender, and head injury severity, the mortality outcomes did not change during the pandemic period. Conclusions The containment and lockdown measures during the COVID-19 pandemic in Norway did not affect the number of patients or mortality of patients with severe traumatic brain injury.publishedVersio

Duration of Posttraumatic Amnesia Predicts Neuropsychological and Global Outcome in Complicated Mild Traumatic Brain Injury.

OBJECTIVES: Examine the effects of posttraumatic amnesia (PTA) duration on neuropsychological and global recovery from 1 to 6 months after complicated mild traumatic brain injury (cmTBI). PARTICIPANTS: A total of 330 persons with cmTBI defined as Glasgow Coma Scale score of 13 to 15 in emergency department, with well-defined abnormalities on neuroimaging. METHODS: Enrollment within 24 hours of injury with follow-up at 1, 3, and 6 months. MEASURES: Glasgow Outcome Scale-Extended, California Verbal Learning Test II, and Controlled Oral Word Association Test. Duration of PTA was retrospectively measured with structured interview at 30 days postinjury. RESULTS: Despite all having a Glasgow Coma Scale Score of 13 to 15, a quarter of the sample had a PTA duration of greater than 7 days; half had PTA duration of 1 of 7 days. Both cognitive performance and Extended Glasgow Outcome Scale outcomes were strongly associated with time since injury and PTA duration, with those with PTA duration of greater than 1 week showing residual moderate disability at 6-month assessment. CONCLUSIONS: Findings reinforce importance of careful measurement of duration of PTA to refine outcome prediction and allocation of resources to those with cmTBI. Future research would benefit from standardization in computed tomographic criteria and use of severity indices beyond Glasgow Coma Scale to characterize cmTBI

Display Enhanced Testing For Concussions And Mild Traumatic Brain Injury

Cognitive assessment systems and methods that provide an integrated solution for evaluating the presence or absence of cognitive impairment. The present invention is used to test cognitive functions of an individual including information processing speed, working memory, work list learning and recall, along with variations of these tasks. Immersive and non-immersive systems and methods are disclosed. Testing and results feedback using the present invention may be completed in real time, typically in less than 15 minutes.Emory UniversityGeorgia Tech Research Corporatio

Surgical trial in traumatic intracerebral haemorrhage (STITCH) : A randomised controlled trial of early surgery compared with Initial conservative treatment

Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme.Peer reviewedPublisher PD

Early surgery versus initial conservative treatment in patients with traumatic intracerebral haemorrhage [STITCH(Trauma)] : the first randomized trial

Acknowledgements This project was funded by the NIHR Health Technology Assessment programme (project number 07/37/16). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.Peer reviewedPublisher PD

Prognostic value of early magnetic resonance imaging in dogs after traumatic brain injury: 50 cases

Retrospective study of dogs with TBI that underwent 1.5T MRI within 14 days after head trauma. MRI evaluators were blinded to the clinical presentation, and all images were scored based on an MRI grading system (Grade I [normal brain parenchyma] to Grade VI [bilateral lesions affecting the brainstem with or without any lesions of lesser grade]). Skull fractures, percentage of intraparenchymal lesions, degree of midline shift, and type of brain herniation were evaluated. MGCS was assessed at presentation. The presence of seizures was recorded. Outcome was assessed at 48 h (alive or dead) and at 3, 6, 12, and 24 months after TBI