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Traumatic Brain Injury


Understanding the neuroprotective effect of tranexamic acid: an exploratory analysis of the CRASH-3 randomised trial.
Brenner A, Belli A, Chaudhri R, Coats T, Frimley L, Jamaluddin SF, Jooma R, Mansukhani R, Sandercock P, Shakur-Still H, Shokunbi T, Roberts I; CRASH-3 trial collaborators.
Crit Care. 2020 Nov 11;24(1):560.

Rationale for inclusion: Analysis of CRASH-2 / CRASH-3 data demonstrating TXA reduces early deaths in non-moribund TBI patients.

CAVEAT: Subset analysis of larger randomized trial.

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Incidence, Risk Factors, and Effects on Outcome of Ventilator-Associated Pneumonia in Patients With Traumatic Brain Injury: Analysis of a Large, Multicenter, Prospective, Observational Longitudinal Study.
Robba C, Rebora P, Banzato E, Wiegers EJA, Stocchetti N, Menon DK, Citerio G; Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury Participants and Investigators.
Chest. 2020 Dec;158(6):2292-2303.

Rationale for Inclusion: Prospective, multicenter observation trial showing longer ICU length of stay but no effect on mortality and neurologic outcomes in patients with VAPs.

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Beta blockers in critically ill patients with traumatic brain injury: Results from a multicenter, prospective, observational American Association for the Surgery of Trauma study.
Ley EJ, Leonard SD, Barmparas G, Dhillon NK, Inaba K, Salim A, O'Bosky KR, Tatum D, Azmi H, Ball CG, Engels PT, Dunn JA, Carrick MM, Meizoso JP, Lombardo S, Cotton BA, Schroeppel TJ, Rizoli S, Chang DSJ, de León LA, Rezende-Neto J, Jacome T, Xiao J, Mallory G, Rao K, Widdel L, Godin S, Coates A, Benedict LA, Nirula R, Kaul S, Li T; Beta Blockers TBI Study Group Collaborators.
J Trauma Acute Care Surg. 2018 Feb;84(2):234-244.

Rationale for inclusion: Prospective, observational multicenter study showed improved survival in TBI patients when beta blockers were administered after injury

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Hypothermia for hypertension after traumatic brain injury.
Andrews PJ, Sinclair HL, Rodriguez A, Harris BA, Battison CG, Rhodes JK, Murray GD; Eurotherm3235 Trial Collaborators.
N Engl J Med. 2015 Dec 17;373(25):2403-12.

Rationale for inclusion: 387 patients with intracranial hypertension randomized to standard care or hypothermia + standard care.  The addition of hypothermia did not improve functional outcomes at 6 months from injury.

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A trial of intracranial-pressure monitoring in traumatic brain injury.
Chesnut RM, Temkin N, Carney N, Dikmen S, Rondina C, Videtta W, Petroni G, Lujan S, Pridgeon J, Barber J, Machamer J, Chaddock K, Celix JM, Cherner M, Hendrix T; Global Neurotrauma Research Group.
N Engl J Med. 2012 Dec 27;367(26):2471-81.

Rationale for inclusion: 324 patients with severe TBI were randomized to either pressure monitoring or clinical examination/imaging to find no difference in measured outcomes.

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Placebo-controlled trial of amantadine for severe traumatic brain injury.
Giacino JT, Whyte J, Bagiella E, Kalmar K, Childs N, Khademi A, Eifert B, Long D, Katz DI, Cho S, Yablon SA, Luther M, Hammond FM, Nordenbo A, Novak P, Mercer W, Maurer-Karattup P, Sherer M.
N Engl J Med. 2012 Mar 1;366(9):819-26.

Rationale for inclusion: Patients 1-4 months after TBI were randomized to amantadine or placebo.  Patients randomized to amantadine experienced a more rapid rate of functional recovery.

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Decompressive craniectomy in diffuse traumatic brain injury.
Cooper DJ, Rosenfeld JV, Murray L, Arabi YM, Davies AR, D'Urso P, Kossmann T, Ponsford J, Seppelt I, Reilly P, Wolfe R; DECRA Trial Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group.
N Engl J Med. 2011 Apr 21;364(16):1493-502.

Rationale for inclusion: RCT determined that patients with severe diffuse traumatic brain injury fared no better when randomized to early bifrontotemporoparietal decompressive craniectomy than standard care.

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Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study.
Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R, Nadel FM, Monroe D, Stanley RM, Borgialli DA, Badawy MK, Schunk JE, Quayle KS, Mahajan P, Lichenstein R, Lillis KA, Tunik MG, Jacobs ES, Callahan JM, Gorelick MH, Glass TF, Lee LK, Bachman MC, Cooper A, Powell EC, Gerardi MJ, Melville KA, Muizelaar JP, Wisner DH, Zuspan SJ, Dean JM, Wootton-Gorges SL; Pediatric Emergency Care Applied Research Network (PECARN).
Lancet. 2009 Oct 3;374(9696):1160-70.

Rationale for inclusion: This prospective, multi-center, observational study of 42,412 pediatric trauma patients with head injury and GCS of 14-15 validated a clinical prediction rule that identified children at low risk of clinically-important traumatic brain injury for which head CT could be safely avoided.

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Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics.
Steyerberg EW, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh GS, Murray GD, Marmarou A, Roberts I, Habbema JD, Maas AI.
PLoS Med. 2008 Aug 5;5(8):e165; discussion e165.

Rationale for inclusion: 11 studies were analyzed and individual patient data prospectively collected to find that age, motor score, pupillary reactivity, CT findings, secondary injury, and laboratories were predictive of outcomes at 6 months.

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Guidelines for prehospital management of traumatic brain injury 2nd edition.
Badjatia N, Carney N, Crocco TJ, Fallat ME, Hennes HM, Jagoda AS, Jernigan S, Letarte PB, Lerner EB, Moriarty TM, Pons PT, Sasser S, Scalea T, Schleien CL, Wright DW; Brain Trauma Foundation; BTF Center for Guidelines Management.
Prehosp Emerg Care. 2008;12 Suppl 1:S1-52.

Rationale for inclusion: This supplement of Prehospital Emergency Care presents comprehensive, evidence guidelines for the prehospital management of children with traumatic brain injury.

CAVEAT: Guidelines

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The epidemiology and impact of traumatic brain injury: a brief overview.
Langlois JA, Rutland-Brown W, Wald MM.
J Head Trauma Rehabil. 2006 Sep-Oct;21(5):375-8.

Rationale for inclusion: An epidemiological view of TBI and its staggering long-term impact and costs.

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Hyperglycemia and outcomes from pediatric traumatic brain injury.
Cochran A, Scaife ER, Hansen KW, Downey EC.
J Trauma. 2003 Dec;55(6):1035-8.

Rationale for inclusion: This retrospective, single center review of pediatric patients with severe TBI showed that hyperglycemia is associated with poor neurologic outcome.

CAVEAT: Single center, retrospective 

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A population-based study of inflicted traumatic brain injury in young children.
Keenan HT, Runyan DK, Marshall SW, Nocera MA, Merten DF, Sinal SH.
JAMA. 2003 Aug 6;290(5):621-6.

Rationale for inclusion: This study of 230,000 children aged 2 years and younger showed a higher risk of inflicted traumatic brain injury in males, children of young mothers, non-European Americans, products of multiple births, and younger infants. This paper helped to define risk factors for inflicted traumatic brain injury.

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A prospective study of short- and long-term outcomes after traumatic brain injury in children: behavior and achievement.
Taylor HG, Yeates KO, Wade SL, Drotar D, Stancin T, Minich N.
Neuropsychology. 2002 Jan;16(1):15-27.

Rationale for inclusion: This longitudinal study across four years of behavior and achievement in children with severe traumatic brain injury (N=53), moderate traumatic brain injury (N=56), and controls (N=80, orthopedic injuries) showed persistent sequelae of traumatic brain injury. The study also showed that postinjury improvement can be influenced but he family environment.

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The Canadian CT Head Rule for patients with minor head injury.
Stiell IG, Wells GA, Vandemheen K, Clement C, Lesiuk H, Laupacis A, McKnight RD, Verbeek R, Brison R, Cass D, Eisenhauer ME, Greenberg G, Worthington J.
Lancet. 2001 May 5;357(9266):1391-6.

Rationale for inclusion: Prospective study that established a clinical decision tool for the use of CT after minor head injury.

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A randomized trial of very early decompressive craniectomy in children with traumatic brain injury and sustained intracranial hypertension.
Taylor A, Butt W, Rosenfeld J, Shann F, Ditchfield M, Lewis E, Klug G, Wallace D, Henning R, Tibballs J.
Childs Nerv Syst. 2001 Feb;17(3):154-62.

Rationale for inclusion: This single center, prospective, randomized  trial of 27 children sustaining severe TBI compared medical management plus decompressive craniectomy to medical management alone. They found that early decompressive craniectomy  improves intracranial pressure and episodes of intracranial hypertension with improved long term neurologic outcome.

CAVEAT: Single center

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Indications for computed tomography in patients with minor head injury.
Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, DeBlieux PM.
N Engl J Med. 2000 Jul 13;343(2):100-5.

Rationale for inclusion: Among patients with GCS of 15, all with CT findings had one of the following:  headache, vomiting, age >60, intoxication, memory deficits, physical evidence of head/neck trauma, or seizures.

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A population-based study of seizures after traumatic brain injuries.
Annegers JF, Hauser WA, Coan SP, Rocca WA.
N Engl J Med. 1998 Jan 1;338(1):20-4.

Rationale for inclusion: Study that definitively established the link between TBI and rates of post-traumatic seizures which varied with respect to injury severity and time after injury.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Treatment of traumatic brain injury with moderate hypothermia.
Marion DW, Penrod LE, Kelsey SF, Obrist WD, Kochanek PM, Palmer AM, Wisniewski SR, DeKosky ST.
N Engl J Med. 1997 Feb 20;336(8):540-6.

Rationale for inclusion: RCT compared moderate hypothermia (33C) to normothermia treatment for TBI to find that hypothermia may improve outcomes.

CAVEAT: Treatment effect was not preserved among all GCS subgroups and all followup intervals.

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The role of secondary brain injury in determining outcome from severe head injury.
Chesnut RM, Marshall LF, Klauber MR, Blunt BA, Baldwin N, Eisenberg HM, Jane JA, Marmarou A, Foulkes MA.
J Trauma. 1993 Feb;34(2):216-22.

Rationale for inclusion: Prospective investigation of severe TBI patients that determined hypoxia and hypotension to have detrimental impact on outcomes.

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The diagnosis of head injury requires a classification based on computed axial tomography.
Marshall LF, Marshall SB, Klauber MR, Van Berkum Clark M, Eisenberg H, Jane JA, Luerssen TG, Marmarou A, Foulkes MA.
J Neurotrauma. 1992 Mar;9 Suppl 1:S287-92.

Rationale for inclusion: A description of the "Marshall" head injury classification system based on CT findings.

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Hypertonic saline lowers raised intracranial pressure in children after head trauma.
Fisher B, Thomas D, Peterson B.
J Neurosurg Anesthesiol. 1992 Jan;4(1):4-10.

Rationale for inclusion: This prospective, double-blind, crossover study evaluated the impact of 3% saline compared to 0.9% saline. 3% saline infusion significantly reduced ICP after traumatic brain injury in children. This study help define the role of hypertonic saline in the management of pediatric TBI.

CAVEAT: Single center

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Late outcome of very severe blunt head trauma: a 10-15 year second follow-up.
Thomsen IV.
J Neurol Neurosurg Psychiatry. 1984 Mar;47(3):260-8.

Rationale for inclusion: 40 patients were followed for 10-15 years  to find permanent disability common after severe TBI.

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Seizures after head trauma: a population study.
Annegers JF, Grabow JD, Groover RV, Laws ER Jr, Elveback LR, Kurland LT.
Neurology. 1980 Jul;30(7 Pt 1):683-9.

Rationale for inclusion: Defined the rate of post-traumatic seizures after severe, moderate, and mild head injury.

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