Displaying publications 1 - 20 of 41 in total

Abstract:
Sort:
  1. Hutchinson PJ, Kolias AG, Tajsic T, Adeleye A, Aklilu AT, Apriawan T, et al.
    Acta Neurochir (Wien), 2019 Jul;161(7):1261-1274.
    PMID: 31134383 DOI: 10.1007/s00701-019-03936-y
    BACKGROUND: Two randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in 2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach.

    METHODS: The International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries.

    RESULTS: The invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval.

    CONCLUSIONS: In this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction.

    Matched MeSH terms: Brain Injuries, Traumatic/complications; Brain Injuries, Traumatic/surgery*
  2. Mohamed Ludin S, Abdul Rashid N
    Clin Nurs Res, 2020 09;29(7):433-439.
    PMID: 30079766 DOI: 10.1177/1054773818792459
    Throughout recovery, patients with severe traumatic brain injury (TBI) show physical and functional improvement, but continue to have cognitive and psychosocial problems. The aim of this article was to review the literature regarding the functional and health-related quality of life (HRQOL) outcomes in severe TBI. There were 15 articles reviewed, 13 of them were quantitative studies and two were narrative review. Most of the articles showed an improvement occurs rapidly at 6 months post-injury. There were several factors that influence the outcome after TBI, most of it was the Glasgow Coma Scale (GCS) on admission, age, educational level, duration of posttraumatic amnesia (PTA), and length of stay (LOS) in the Intensive Care Unit (ICU). Thus, health care workers should help the survivors of severe TBI in the recovery process to ensure the latter can attain maximum function and quality of life.
    Matched MeSH terms: Brain Injuries, Traumatic*
  3. Cheah CF, Kofler M, Schiefecker AJ, Beer R, Klug G, Pfausler B, et al.
    Neurocrit Care, 2017 04;26(2):284-291.
    PMID: 28000134 DOI: 10.1007/s12028-016-0334-y
    BACKGROUND: Takotsubo cardiomyopathy (TC) is a well-known complication after aneurysmal subarachnoid hemorrhage and has been rarely described in patients with traumatic brain injury (TBI).

    METHODS: Case report and review of literature.

    RESULTS: Here, we report a 73-year-old woman with mild traumatic brain injury (TBI) presenting in cardiogenic shock. Takotsubo cardiomyopathy (TC) was diagnosed by repeated echocardiography. Cardiovascular support by inotropic agents led to hemodynamic stabilization after initiation of levosimendan. Cardiac function fully recovered within 21 days. We performed an in-depth literature review and identified 16 reported patients with TBI and TC. Clinical course and characteristics are discussed in the context of our patient.

    CONCLUSION: Takotsubo cardiomyopathy is under-recognized after TBI and may negatively impact outcome if left untreated.

    Matched MeSH terms: Brain Injuries, Traumatic/complications*
  4. Song J, Shin SD, Jamaluddin SF, Chiang WC, Tanaka H, Song KJ, et al.
    J Neurotrauma, 2023 Jul;40(13-14):1376-1387.
    PMID: 36656672 DOI: 10.1089/neu.2022.0280
    Abstract Traumatic brain injury (TBI) is a significant healthcare concern in several countries, accounting for a major burden of morbidity, mortality, disability, and socioeconomic losses. Although conventional prognostic models for patients with TBI have been validated, their performance has been limited. Therefore, we aimed to construct machine learning (ML) models to predict the clinical outcomes in adult patients with isolated TBI in Asian countries. The Pan-Asian Trauma Outcome Study registry was used in this study, and the data were prospectively collected from January 1, 2015, to December 31, 2020. Among a total of 6540 patients (≥ 15 years) with isolated moderate and severe TBI, 3276 (50.1%) patients were randomly included with stratification by outcomes and subgrouping variables for model evaluation, and 3264 (49.9%) patients were included for model training and validation. Logistic regression was considered as a baseline, and ML models were constructed and evaluated using the area under the precision-recall curve (AUPRC) as the primary outcome metric, area under the receiver operating characteristic curve (AUROC), and precision at fixed levels of recall. The contribution of the variables to the model prediction was measured using the SHapley Additive exPlanations (SHAP) method. The ML models outperformed logistic regression in predicting the in-hospital mortality. Among the tested models, the gradient-boosted decision tree showed the best performance (AUPRC, 0.746 [0.700-0.789]; AUROC, 0.940 [0.929-0.952]). The most powerful contributors to model prediction were the Glasgow Coma Scale, O2 saturation, transfusion, systolic and diastolic blood pressure, body temperature, and age. Our study suggests that ML techniques might perform better than conventional multi-variate models in predicting the outcomes among adult patients with isolated moderate and severe TBI.
    Matched MeSH terms: Brain Injuries, Traumatic*
  5. Lai CD, Marret MJ, Jayanath S, Azanan MS
    Child Abuse Negl, 2023 Nov;145:106434.
    PMID: 37657172 DOI: 10.1016/j.chiabu.2023.106434
    BACKGROUND: Abusive head trauma (AHT) is a major cause of traumatic brain injury in infancy. This exploratory study compared standardized developmental assessment versus functional outcome assessment between 18 months and 5 years of age following AHT in infancy.

    METHODS: Observational cross-sectional study after surviving AHT in infancy. Seventeen children between 18 months and 5 years of age underwent clinical examination, developmental assessment using the Schedule of Growing Skills II (SGS II) and functional assessment using the Glasgow Outcome Scale-Extended Pediatric Revision (GOS-E Peds). Additional clinical information was extracted from medical records.

    RESULTS: Age at assessment ranged from 19 to 53 months (median 26 months). Most (n = 14) were delayed in at least 1 domain, even without neurological or visual impairment or visible cortical injury on neuroimaging, including 8 children with favourable GOS-E Peds scores. The most affected domain was hearing and language. Delay in the manipulative domain (n = 6) was associated with visual and/or neurological impairment and greater severity of delay across multiple domains. Eleven (64.7 %) had GOS-E Peds scores indicating good recovery, with positive correlation between GOS-Peds scores and number of domains delayed (r = 0.805, p 

    Matched MeSH terms: Brain Injuries, Traumatic*
  6. Harun Haron R, Imran MK, Haspani MS
    Malays J Med Sci, 2011 Oct;18(4):69-77.
    PMID: 22589675 MyJurnal
    Traumatic brain injury (TBI) has been associated with an acute stress response mediated by the sympathoadrenomedullary axis, which can be assessed by measuring blood glucose level.
    Matched MeSH terms: Brain Injuries, Traumatic
  7. Ahmad Helmy AK, Salmah Jalaluddin WM, Ab Rahman IG
    Malays J Med Sci, 2010 Oct;17(4):51-6.
    PMID: 22135561 MyJurnal
    Brain ischaemia and infarction are the leading factors in morbidity and mortality of traumatic brain injury. This study aimed to determine the perfusion status of pericontusional hypodense areas in traumatic cerebral contusion
    Matched MeSH terms: Brain Injuries, Traumatic
  8. Abdul Rahman RA, Hanapiah FA, Nikmat AW, Ismail NA, Manaf H
    Neurosciences (Riyadh), 2019 01;24(1):29-35.
    PMID: 30842397 DOI: 10.17712/nsj.2019.1.20180195
    OBJECTIVE: To investigate the effects of concurrent tasks (motor and cognitive) on postural control performance in children with traumatic brain injury (TBI) compared to typically developing (TD) control subjects.

    METHODS: Sixteen children with TBI (aged 11.63+/-1.89 years) and 22 TD controls (aged 11.41+/-2.24 years) participated in this case-control study. This study was conducted between May 2016 and March 2017. Each child performed static standing under 3 different conditions: single, concurrent motor, and concurrent cognitive task. Postural control performance measure includes sway area, anterior-posterior (AP) sway velocity, medio-lateral (ML) sway velocity, AP sway distance and ML sway distance as measured using the APDM Mobility Lab (Oregon, Portland). A repeated-measure analysis of variance was used to analyse the data.

    RESULTS: We found that children with TBI showed significantly more deterioration in postural control performance than TD children (p<0.05). Both concurrent tasks (motor and cognitive) significantly decreased postural control performance in both groups with more pronounced changes in children with TBI than that of the TD controls.

    CONCLUSION: The results demonstrated that, performing concurrent tasks (motor and cognitive) during upright standing resulted in deterioration of postural control performance. The existence of cognitive and balance impairment in children with TBI will possibly cause concurrent tasks to be more complex and demands greater attention compared to single task.

    Matched MeSH terms: Brain Injuries, Traumatic/physiopathology*
  9. Radhiana Hassan, Muniruddin Mohamad, Muhamad Zaim Azami, Husin Ali, Hafizah Pasi
    MyJurnal
    Traumatic brain injury following road traffic accidents is a common cause
    of morbidity and mortality in Malaysia. We aim to determine the differences of traumatic
    brain injury patterns based on CT findings among motorcyclist versus passenger vehicle
    patients involved in road traffic accidents. (Copied from article).
    Matched MeSH terms: Brain Injuries, Traumatic
  10. Chan KH, Tharakan J, Pal HK, Khan N, Tan YC
    Malays J Med Sci, 2010 Oct;17(4):36-43.
    PMID: 22135559
    Post-traumatic seizure is a well-known and serious complication of traumatic brain injury (TBI). The incidence and risk factors vary among study populations. Very little data have been published concerning this in the Malaysian population. The aim of this study was to ascertain the risk factors for the development of early post-traumatic seizures among patients with TBI.
    Matched MeSH terms: Brain Injuries, Traumatic
  11. Zulazmi NA, Arulsamy A, Ali I, Zainal Abidin SA, Othman I, Shaikh MF
    CNS Neurosci Ther, 2021 04;27(4):381-402.
    PMID: 33539662 DOI: 10.1111/cns.13590
    Traumatic brain injury (TBI) is the leading cause of death and disability worldwide and has complicated underlying pathophysiology. Numerous TBI animal models have been developed over the past decade to effectively mimic the human TBI pathophysiology. These models are of mostly mammalian origin including rodents and non-human primates. However, the mammalian models demanded higher costs and have lower throughput often limiting the progress in TBI research. Thus, this systematic review aims to discuss the potential benefits of non-mammalian TBI models in terms of their face validity in resembling human TBI. Three databases were searched as follows: PubMed, Scopus, and Embase, for original articles relating to non-mammalian TBI models, published between January 2010 and December 2019. A total of 29 articles were selected based on PRISMA model for critical appraisal. Zebrafish, both larvae and adult, was found to be the most utilized non-mammalian TBI model in the current literature, followed by the fruit fly and roundworm. In conclusion, non-mammalian TBI models have advantages over mammalian models especially for rapid, cost-effective, and reproducible screening of effective treatment strategies and provide an opportunity to expedite the advancement of TBI research.
    Matched MeSH terms: Brain Injuries, Traumatic/pathology*; Brain Injuries, Traumatic/physiopathology*
  12. Anada RP, Wong KT, Jayapalan JJ, Hashim OH, Ganesan D
    Electrophoresis, 2018 09;39(18):2308-2315.
    PMID: 29570807 DOI: 10.1002/elps.201700407
    The Glasgow Coma Scale (GCS), which classifies patients into mild, moderate or severe traumatic brain injury (TBI), is a system used to prioritize treatment and prognosticate the severity of head injury. In this study, sera of patients with various stages of TBI, as well as control subjects, were analyzed to screen for proteins that may be used to complement the GCS system. By subjecting pooled serum samples to iTRAQ analysis for quantitative comparison of protein abundance, and attesting their altered levels using ELISA, we have detected increased levels of serum amyloid A, C-reactive protein, leucine-rich alpha-2-glycoprotein, lipopolysaccharide-binding protein, fibronectin, vitronectin and alpha-1-antichymotrypsin in patients across all strata of TBI relative to the controls. However, kininogen was decreased only in moderate and severe TBI, whereas apolipoprotein E and zinc-alpha-2-glycoprotein were only increased in severe TBI. Hence, we propose a panel of serum biomarkers, which if analyzed within 24 h of the injury, can be used to diagnose patients with TBI into mild, moderate or severe stratification objectively, thus complementing the traditional GCS.
    Matched MeSH terms: Brain Injuries, Traumatic/blood; Brain Injuries, Traumatic/diagnosis*
  13. Schnakers C, Hirsch M, Noé E, Llorens R, Lejeune N, Veeramuthu V, et al.
    Brain Sci, 2020 Dec 02;10(12).
    PMID: 33276451 DOI: 10.3390/brainsci10120930
    Covert cognition in patients with disorders of consciousness represents a real diagnostic conundrum for clinicians. In this meta-analysis, our main objective was to identify clinical and demographic variables that are more likely to be associated with responding to an active paradigm. Among 2018 citations found on PubMed, 60 observational studies were found relevant. Based on the QUADAS-2, 49 studies were considered. Data from 25 publications were extracted and included in the meta-analysis. Most of these studies used electrophysiology as well as counting tasks or mental imagery. According to our statistical analysis, patients clinically diagnosed as being in a vegetative state and in a minimally conscious state minus (MCS-) show similar likelihood in responding to active paradigm and responders are most likely suffering from a traumatic brain injury. In the future, multi-centric studies should be performed in order to increase sample size, with similar methodologies and include structural and functional neuroimaging in order to identify cerebral markers related to such a challenging diagnosis.
    Matched MeSH terms: Brain Injuries, Traumatic
  14. Othman H, Ludin SM, Saidi S, Awang MS
    J Public Health Res, 2021 Apr 14;10(2).
    PMID: 33855403 DOI: 10.4081/jphr.2021.2205
    BACKGROUND: Traumatic brain injury (TBI) survivors require attention and dependence from their primary caregiver. This is because TBI is a defect that affects both the psychological and physical functions of the victim. Caregivers play an essential role in providing the adequate care victims need to adjust to the new problems they may experience due to their condition, as family members alone may not be able to provide for their needs. In particular, TBI caregivers may face specific challenges when assisting their patients in handling unexpected changes to their daily routines. Therefore, this quantitative study aims to explore the needs of caregivers, their coping mechanisms towards stressful and traumatic circumstances, and how they provide care to their loved ones during the COVID-19 pandemic.

    DESIGN AND METHODS: It was conducted with ten caregivers of individuals suffering from traumatic brain injury, that were selected using a theoretical sampling method. Data were obtained using a semi-structured interview guide, which helped the caregivers provide their responses. Meanwhile, data analysis was performed using the NVIVO analysis software.

    RESULTS: The results showed that there were, three significant themes namely, (a) Support needed, (b) the information need for care, and (c) developing self-resilience. The results also showed that caregivers really need support from the various parties, and the participants lack information on specific care techniques for the severe traumatic brain injury (TBI) survivors.

    CONCLUSION: In conclusion, caregivers require approval and seek more useful information to provide excellent care to their loved ones. Being aware of the caregiver's needs would enable them to offer improved customized care.

    Matched MeSH terms: Brain Injuries, Traumatic
  15. Norain Abdul Rashid
    MyJurnal
    Traumatic brain injury (TBI) is a major medical and socioeconomic
    problem. Patients with severe TBI shows physical and functional improvement but
    remain with cognitive and psycho-social problem throughout recovery. Despite all the
    issues, the impact of TBI on long-term survivors in Malaysia is unknown. The aim of this
    study is to measure the functional level of ICU survivors with severe TBI within 6 months
    post injury. (Copied from article).
    Matched MeSH terms: Brain Injuries, Traumatic
  16. Ali R, Wahab S, Abdul Rahman AH
    Sains Malaysiana, 2013;42(3):403-408.
    This study looked into the rate and pattern of neuropsychological impairment in patients with traumatic brain injury patients at three months post injury. Forty patients attending the neurosurgery outpatient clinic were included in the study. Benton visual retention test (BVRT), rey auditory verbal learning test (RAVLT), digit span test, trail making test (TMT) and mini mental state examination (MMSE) were used for assessment. Forty five percent (n=18) sustained moderate to severe head injury. Twenty five percent (n=10) have abnormal MMSE result. Forty two and a half percent (n=17) have abnormal BVRT result. Seventy five percent (n=30) have abnormal RAVLT result while 35% (n=14) have abnormal digit span test result. Seventy seven and a half percent (n=31) have at least one neurological deficit. There was significant association between severity of head injury (GCS score) and neuropsychological deficit. This study highlights the point that in post head injury patients, there are high occurrences of cognitive dysfunction. MMSE and GCS play a significant and important role in assessing cognitive dysfunction. Severity of head injury as determined by GCS scores also influence the outcome in patients with head injury
    Matched MeSH terms: Brain Injuries, Traumatic
  17. Idris Z, Zenian MS, Muzaimi M, Hamid WZ
    Asian J Neurosurg, 2014 Jul-Sep;9(3):115-23.
    PMID: 25685201 DOI: 10.4103/1793-5482.142690
    Induced hypothermia for treatment of traumatic brain injury is controversial. Since many pathways involved in the pathophysiology of secondary brain injury are temperature dependent, regional brain hypothermia is thought capable to mitigate those processes. The objectives of this study are to assess the therapeutic effects and complications of regional brain cooling in severe head injury with Glasgow coma scale (GCS) 6-7.
    Matched MeSH terms: Brain Injuries, Traumatic
  18. Iaccarino C, Kolias A, Adelson PD, Rubiano AM, Viaroli E, Buki A, et al.
    Acta Neurochir (Wien), 2021 02;163(2):423-440.
    PMID: 33354733 DOI: 10.1007/s00701-020-04663-5
    BACKGROUND: Due to the lack of high-quality evidence which has hindered the development of evidence-based guidelines, there is a need to provide general guidance on cranioplasty (CP) following traumatic brain injury (TBI), as well as identify areas of ongoing uncertainty via a consensus-based approach.

    METHODS: The international consensus meeting on post-traumatic CP was held during the International Conference on Recent Advances in Neurotraumatology (ICRAN), in Naples, Italy, in June 2018. This meeting was endorsed by the Neurotrauma Committee of the World Federation of Neurosurgical Societies (WFNS), the NIHR Global Health Research Group on Neurotrauma, and several other neurotrauma organizations. Discussions and voting were organized around 5 pre-specified themes: (1) indications and technique, (2) materials, (3) timing, (4) hydrocephalus, and (5) paediatric CP.

    RESULTS: The participants discussed published evidence on each topic and proposed consensus statements, which were subject to ratification using anonymous real-time voting. Statements required an agreement threshold of more than 70% for inclusion in the final recommendations.

    CONCLUSIONS: This document is the first set of practical consensus-based clinical recommendations on post-traumatic CP, focusing on timing, materials, complications, and surgical procedures. Future research directions are also presented.

    Matched MeSH terms: Brain Injuries, Traumatic/surgery*
  19. Teah MK, Chan GK, Wong MTF, Yeap TB
    BMJ Case Rep, 2021 Jan 08;14(1).
    PMID: 33419751 DOI: 10.1136/bcr-2020-238318
    Prolonged exposure to benzodiazepines (BDZ) may contribute towards physical dependence, which is manifested by iatrogenic Benzodiazepine Withdrawal Syndrome (BWS), a condition often underdiagnosed. Current evidence recommends precluding BDZ infusion as sedation in the intensive care unit to avoid possible withdrawal and delirium issues. Administration of dexmedetomidine should be considered to facilitate weaning in patients with BWS.
    Matched MeSH terms: Brain Injuries, Traumatic/therapy*
  20. Leong Bin Abdullah MFI, Ng YP, Sidi HB
    Asian J Psychiatr, 2018 Oct;37:67-70.
    PMID: 30144779 DOI: 10.1016/j.ajp.2018.08.017
    BACKGROUND: Depression and anxiety are common psychiatric sequelae of traumatic brain injury (TBI). However, there is lack of data on comorbid depression and anxiety, and depression and anxiety in TBI patients were often evaluated using non-validated diagnostic tools. This study aims to determine the rates, their comorbidity, and factors associated with depressive and anxiety disorders in TBI patients.

    METHODS: In this cross-sectional study, 101 TBI patients were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders to assess the rates of depressive and anxiety disorders after TBI. The association of socio-demographic and clinical factors with depressive and anxiety disorders were determined using Pearson's Chi-Square test.

    RESULTS: A total of 25% of TBI patients (n = 25/101) were diagnosed with depressive disorders, of which 15% had major depressive disorder (n = 15/101) and 10% had minor depression (n = 10/101). Fourteen percent of TBI patients had anxiety disorders (n = 14/101), of which post-traumatic stress disorder (PTSD) was the commonest anxiety disorder (9%, n = 9/101). Seven percent of TBI patients (n = 7/101) had comorbid depressive and anxiety disorders. The only factor associated with depressive disorder was the duration of TBI (≥ 1 year) while the only factor associated with anxiety disorder was the mechanism of trauma (assault).

    CONCLUSION: Major depressive disorder, minor depression and PTSD are common psychiatric complications of TBI. Clinicians should screen for depressive and anxiety disorders in TBI patients, particularly those with ≥1 year of injury and had sustained TBI from assault.

    Matched MeSH terms: Brain Injuries, Traumatic/complications; Brain Injuries, Traumatic/epidemiology*
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links