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Showing 3 results for Traumatic Brain Injury
Acute respiratory distress syndrome assessment after traumatic brain injury
Shahrooz Kazemi , Mozhgan Shakeri Hosseinabad , Maryam Ameri , Batol Ghorbani Yekta ,
Volume 73, Issue 10 (1-2016)
Abstract

Background: Acute respiratory distress syndrome (ARDS) is one of the most important complications associated with traumatic brain injury (TBI). ARDS is caused by inflammation of the lungs and hypoxic damage with lung physiology abnormalities associated with acute respiratory distress syndrome. Aim of this study is to determine the epidemiology of ARDS and the prevalence of risk factors.

Methods: This prospective study performed on patients with acute traumatic head injury hospitalization in the intensive care unit of the Shohaday-e Haftom-e-Tir Hospital (September 2012 to September 2013) done. About 12 months, the data were evaluated. Information including age, sex, education, employment, drug and alcohol addiction, were collected and analyzed. The inclusion criteria were head traumatic patients and exclusion was the patients with chest trauma. Questionnaire was designed with doctors supervision of neurosurgery. Then the collected data were analysis.

Results: In this study, the incidence of ARDS was 23.8% and prevalence of metabolic acidosis was 31.4%. Most injury with metabolic acidosis was Subarachnoid hemorrhage (SAH) 48 (60%) and Subdural hemorrhage (SDH) was Next Level with 39 (48%) Correlation between Glasgow Coma Scale (GCS) and Respiratory Distress Syndrome (ARDS) were significantly decreased (P< 0.0001). The level of consciousness in patients with skull fractures significantly lower than those without fractures (P= 0.009) [(2.3±4.6) vs (4.02±7.07)]. Prevalence of metabolic acidosis during hospitalization was 80 patients (31.4%).

Conclusion: Acute respiratory distress syndrome is a common complication of traumatic brain injury. Management and treatment is essential to reduce the mortality. In this study it was found the age of patients with ARDS was higher than patients without complications. ARDS risk factor for high blood pressure was higher in men. Most victims were pedestrians. The most common injury associated with ARDS was SDH. Our analysis demonstrates that Acute respiratory distress syndrome is common after traumatic brain injury. Management of traumatic brain injury is necessary to manage and reduce the mortality.


Numerical modeling of the brain hypothermia by cooling the cerebrospinal fluid
Aisa Rassoli , Malikeh Nabaei , Nasser Fatouraee , Ghaemeh Nabaei ,
Volume 75, Issue 1 (4-2017)
Abstract

Background: Brain hypothermia by reducing the temperature of the cerebrospinal fluid is done by a cooling pad in the thoracic region and protect brain from the ischemic injuries. Along with the spinal cord, the brain is an essential partner in the central nervous system, and similarly, it is surrounded and protected from the bony skull and from shock by cerebrospinal fluid. The brain analyzes information that is both internal and external to the body, transforms the information into sensations, and stores them as memories. So in this study we investigated the brain hypothermia by finite element modeling.

Methods: To investigate this phenomenon, in this study a numerical model of the head with respect to the structure of brain tissue and its contribution to heat transfer is presented in the fluid lab of the Amirkabir University of Tehran in January of 2016. In this model, Pennes's bioheat equation and finite element analysis has been used to predict temperature distribution in the brain tissue. The model geometry is designed in two state without considering the ventricles of the brain that are involved in the production of cerebrospinal fluid and with considering cerebrospinal fluid. So, in the second case, the cerebrospinal flow is considered as a heat transfer factor.

Results: We concluded that with cooling about 5 °C, in the first model without considering the ventricles, the gray matter temperature is reduced by about 4 °C and there is no change in white matter temperature. In the second model temperature distribution became more asymmetric. The temperature reduced about 3 °C in the corners. However, the temperature reduction at the edge of brain tissue and near cerebrospinal fluid were about 0.5 °C.

Conclusion: It was observed that in the case of ischemia, the temperature drop was higher than normal. So, during brain injuries to prevent serious damage, the brain metabolism can be reduced by cooling the spinal fluid.


Evaluation of frequency and factors associated to cerebrospinal fluid circulation disorder after decompressive craniectomy
Majid Jahanshahi , Morteza Taheri , Seyyed Abdollahadi Daneshi , Mostafa Haji Rezaei ,
Volume 82, Issue 6 (9-2024)
Abstract
Background: Decompressive craniectomy (DC) is a therapeutic approach for patients with raised intracranial pressure and cerebral edema. Although DC is not a complicated procedure, it is associated with significant complications and morbidities that significantly affect clinical outcomes. This study investigates the frequency of cerebrospinal fluid (CSF) circulation disorders after DC and evaluates related factors.
Methods: This cross-sectional analytical study was conducted on 79 patients who underwent DC at Shohadaye Haftome Tir Hospital, one of the main trauma centers in Tehran. The patients' files and the Picture Archiving and Communication System (PACS) were reviewed to collect demographic, clinical, and radiologic data. After identifying patients with post-operative (after DC) CSF circulation disorders, the relevant factors were determined using multivariate logistic regression.
Results: Overall, seventy-nine patients were studied. The mean age of patients was 40.56±12.64 years and 82.3% were male. Forty-seven patients (59.5%) underwent DC due to traumatic causes and thirty-two patients (40.5%) due to vascular pathologies. In total, 36.7% (nineteen) of patients were affected by some degree of subdural hygromas of which 13 patients (44.8%) progressed to clinical and radiologic hydrocephalus. 19% (fifteen patients) developed hydrocephalus within the first six months after surgery. Considering the clinical variables, the GCS of patients was the only one that showed a significant relationship with CSF circulation disorders. Regarding radiological variables, the presence of intraventricular hemorrhage (IVH) was the only relevant factor. In addition, from the surgical perspective, performing duraplasty (autograft or allograft) and reoperation demonstrated significant relationships with CSF circulation disorders. The results of multivariate logistic regression showed that having intraventricular hemorrhage (OR, 6.15-6.9414: CI95%, P=0.003) and reoperation (75.91: OR, 3.88-3.6, 1485/43: CI95%, P=0.004) were two independent factors associated with hydrocephalus in DC patients.
Conclusion: In patients who have undergone decompressive craniectomy, intraventricular hemorrhage (IVH) and reoperation can be independent risk factors for CSF circulation disorders. Although the incidence and presence of IVH cannot be controlled, careful and meticulous surgical technique and skill can significantly improve the outcome of decompressive craniectomy by reducing the need for reoperation

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