Biomarkers in acute brain trauma: A narrative review

Quinones-Ossa, GA; Padilla-Zambrano, Huber; Pal, Ranabir; Ghosh, Amrita; Moscote-Salazar, LR; Kumar, VA Kiran; Agrawal, Amit

doi:10.4103/2221-6189.250370

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…Detection of mTBI and monitoring of recovery of subtle impairments is not always possible with conventional means, such as neuroimaging (Eierud et al, 2014) or clinical assessments (McCrea et al, 2015). A lack of accurate and robust diagnostics, biomarkers and outcome measures leads to mTBI going undetected (Jeter et al, 2013;Kim et al, 2018;Quinones-Ossa et al, 2019). Undetected mTBI can lead to impaired functional activities, self-medication and return to sport/work/play before recovery is complete, which may lead to increased future injury risk and other health burden (McPherson et al, 2019;Reneker et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

The Measurement of Eye Movements in Mild Traumatic Brain Injury: A Structured Review of an Emerging Area

Stuart

Parrington

Martini

et al. 2020

Front. Sports Act. Living

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Mild traumatic brain injury (mTBI), or concussion, occurs following a direct or indirect force to the head that causes a change in brain function. Many neurological signs and symptoms of mTBI can be subtle and transient, and some can persist beyond the usual recovery timeframe, such as balance, cognitive or sensory disturbance that may pre-dispose to further injury in the future. There is currently no accepted definition or diagnostic criteria for mTBI and therefore no single assessment has been developed or accepted as being able to identify those with an mTBI. Eye-movement assessment may be useful, as specific eye-movements and their metrics can be attributed to specific brain regions or functions, and eye-movement involves a multitude of brain regions. Recently, research has focused on quantitative eye-movement assessments using eye-tracking technology for diagnosis and monitoring symptoms of an mTBI. However, the approaches taken to objectively measure eye-movements varies with respect to instrumentation, protocols and recognition of factors that may influence results, such as cognitive function or basic visual function. This review aimed to examine previous work that has measured eye-movements within those with mTBI to inform the development of robust or standardized testing protocols. Medline/PubMed, CINAHL, PsychInfo and Scopus databases were searched. Twenty-two articles met inclusion/exclusion criteria and were reviewed, which examined saccades, smooth pursuits, fixations and nystagmus in mTBI compared to controls. Current methodologies for data collection, analysis and interpretation from eye-tracking technology in individuals following an mTBI are discussed. In brief, a wide range of eye-movement instruments and outcome measures were reported, but validity and reliability of devices and metrics were insufficiently reported across studies. Interpretation of outcomes was complicated by poor study reporting of demographics, mTBI-related features (e.g., time since injury), and few studies considered the influence that cognitive or visual functions may have on eye-movements. The reviewed evidence suggests that eye-movements are impaired in mTBI, but future research is required to accurately Stuart et al. Measurement of Eye-Movements in mTBI and robustly establish findings. Standardization and reporting of eye-movement instruments, data collection procedures, processing algorithms and analysis methods are required. Recommendations also include comprehensive reporting of demographics, mTBI-related features, and confounding variables.

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Section: Introductionmentioning

confidence: 99%

The Measurement of Eye Movements in Mild Traumatic Brain Injury: A Structured Review of an Emerging Area

Stuart

Parrington

Martini

et al. 2020

Front. Sports Act. Living

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“…Anticoagulant medications increased due to higher atherosclerosis prevalence among the elderly 2, 9 8, 9 who are also at higher risk of Traumatic Brain Injuries (TBI) and Intracranial Hemorrhage (ICH) from falls or violence 10 causing huge burden of mortality, morbidity, and disability. Devastating consequences and fatal sequel have been reported after these traumas, especially when they are under anticoagulant therapy 8,11 . So, before neurosurgical interventions, it is important to reverse or counteract the effect depending on the type of anticoagulant 1 , if the patient is under anticoagulation therapy.…”

Section: Overviewmentioning

confidence: 99%

“…Lumbar Puncture (LP) is useful for therapeutic and diagnostic use in daily medical practice to help analyze Cerebrospinal Fluid (CSF) especially for suspected neuroinfection 24,25 , biomarkers for TBI prognosis 11,[26][27][28] , to diagnose elevated Intracranial Pressure (ICP) (syn. Intracranial Hypertension) 24,29 .…”

Section: A Lumbar Puncturementioning

confidence: 99%

Planning neurosurgical interventions in patients with anticoagulant therapy

G.A.,

S.L.,

et al. 2022

roneuro

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Clinical practice guideline on anticoagulation is intended to manage patients undergoing neurosurgical procedures for the best possible short and long-term outcomes. In the clinical office practice, anticoagulation is offered to prevent thromboembolism with Warfarin, Heparin, Novel Oral Anticoagulants. The management approach starts with the mitigation plans from a reversal of pre-procedural anticoagulants for impending neurosurgical procedures by estimating procedural bleeding risk on the patients. The haemorrhage criteria and the timing of procedures are best assessed by the proceduralist during and after the intervention, standing on ground situations. Yet, intra- and post-procedure anticoagulant therapy should induct a multidisciplinary consultation paradigm for the best outcome in any emergent scenario. Further, each anticoagulation event should be monitored closely with competence in the optimum reversal process. Different neurosurgical procedures also should be weighed for their inherent hazards along with the probabilities of the bleeding and thromboembolism. The treating team should also concur to suggest a resumption of the pre-procedure anticoagulant therapy which may have been in place for altogether different morbidities. Regarding the anticoagulant agent, there are special conditions and recommendations to bear in mind in the daily medical practice for patient management. In the clinical practice guidelines for neurosurgical procedures, decisions about initiation and continuation of anticoagulants require experience and thorough internalization of the planned procedure, to avoid the risks of inherent risks of bleeding and thromboembolism.

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“…2 Biomarkers are used for diagnosis, risk stratification, and predicting outcomes in TBI patients. 3 The TBI results in neurologic, neuropsychological, or behavioral changes caused by mechanical trauma. 4 The entire spectrum of sequelae of TBI cannot be predicted by GCS and CT scan alone; hence, there is need of addition of serum biomarkers for the evaluation of TBI.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers in Traumatic Brain Injuries: Narrative Review

Pandey

Shukla

Nirmal

et al. 2022

Indian Journal of Neurotrauma

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Traumatic brain injury (TBI) is a multistep interaction of brain antigens, cytokine-mediated humeral, and cellular immune reactions. Because of the limitations of clinical and radiological evaluation in TBI, there has been a considerable advancement toward the need for developing biomarkers that can predict the severity of TBI. Blood-based brain biomarkers hold the potential to predict the absence of intracranial injury and thus decrease unnecessary brain computed tomographic scanning. Various biomarkers have been studied that detects neuronal, axonal, and blood–brain barrier integrity. Biomarkers are still under investigation and hold promise in the future evaluation of TBI patients. They can be used for grading as well as a prognostication of head injury.

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Biomarkers in acute brain trauma: A narrative review

Cited by 7 publications

References 4 publications

The Measurement of Eye Movements in Mild Traumatic Brain Injury: A Structured Review of an Emerging Area

The Measurement of Eye Movements in Mild Traumatic Brain Injury: A Structured Review of an Emerging Area

Planning neurosurgical interventions in patients with anticoagulant therapy

Biomarkers in Traumatic Brain Injuries: Narrative Review

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