Dynamics of brain tissue changes induced by traumatic brain injury assessed with the Marshall, Morris–Marshall, and the Rotterdam classifications and its impact on outcome in a prostacyclin placebo-controlled study

Bobinski, Lukas; Olivecrona, Magnus; Koskinen, Lars-Owe D.

doi:10.1007/s00701-012-1345-x

Cited by 23 publications

(15 citation statements)

References 41 publications

(112 reference statements)

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“…The demographic characteristics of our patients with TBI having cardiac dysfunction are similar to those reported in studies of patients with stroke, aneurysmal SAH, and SDH, 2,5,6,9,19,20,22 –24 with an older age more prevalent in all-cause cardiac dysfunction and a male predominance. Age was the only clinical or demographic characteristic that was both associated and predictive of the development of all-cause cardiac dysfunction, but age was not associated or predictive of systolic cardiac dysfunction.…”

Section: Discussionsupporting

confidence: 78%

“…After TBI, specific patterns of injury on CT correlate with outcome and mortality and include the Marshall and Rotterdam scores. [9][10][11][12][13][14] The radiographic predictors of TBI-related cardiac dysfunction have not been reported previously. This study aimed to determine whether the presence or location of injury in isolated TBI is associated with cardiac dysfunction.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Radiographic and Clinical Predictors of Cardiac Dysfunction Following Isolated Traumatic Brain Injury

Urdaneta

Fink

Krishnamoorthy

et al. 2016

J Intensive Care Med

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Radiographic and Clinical Predictors of Cardiac Dysfunction Following Isolated Traumatic Brain Injury

Urdaneta

Fink

Krishnamoorthy

et al. 2016

J Intensive Care Med

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“…Currently, the research and the clinical usage of cranial CT images in TBI patients mainly focus on CT scores, including the Marshall and Rotterdam CT score [ 11 , 12 ]. TBI patients are comprehensively classified on the basis of the radiological findings on CT images.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Intracranial Hypertension in Traumatic Brain Injury Patient: A Noninvasive Approach Based on Cranial Computed Tomography Features

Shan

et al. 2021

JCM

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Background: Our purpose was to establish a noninvasive quantitative method for assessing intracranial pressure (ICP) levels in patients with traumatic brain injury (TBI) through investigating the Hounsfield unit (HU) features of computed tomography (CT) images. Methods: In this retrospective study, 47 patients with a closed TBI were recruited. Hounsfield unit features from the last cranial CT and the initial ICP value were collected. Three models were established to predict intracranial hypertension with Hounsfield unit (HU model), midline shift (MLS model), and clinical expertise (CE model) features. Results: The HU model had the highest ability to predict intracranial hypertension. In 34 patients with unilateral injury, the HU model displayed the highest performance. In three classifications of intracranial hypertension (ICP ≤ 22, 23–29, and ≥30 mmHg), the HU model achieved the highest F1 score. Conclusions: This radiological feature-based noninvasive quantitative approach showed better performance compared with conventional methods, such as the degree of midline shift and clinical expertise. The results show its potential in clinical practice and further research.

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“…In our study, the high levels of glycerol and lactate/pyruvate ratio probably mirror the fact that the microdialysis probes were close to the injury. Another pitfall is the highly dynamic evolution of the tissue damage [40] which may result in interpretation difficulties in relation to the microdialysis samples. In the present study, there was no difference in Rotterdam score, thus indicating balanced groups.…”

Section: Discussionmentioning

confidence: 99%

Prostacyclin Affects the Relation Between Brain Interstitial Glycerol and Cerebrovascular Pressure Reactivity in Severe Traumatic Brain Injury

et al. 2019

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BackgroundCerebral injury may alter the autoregulation of cerebral blood flow. One index for describing cerebrovascular state is the pressure reactivity (PR). Little is known of whether PR is associated with measures of brain metabolism and indicators of ischemia and cell damage. The aim of this investigation was to explore whether increased interstitial levels of glycerol, a marker of cell membrane damage, are associated with PR, and if prostacyclin, a membrane stabilizer and regulator of the microcirculation, may affect this association in a beneficial way.Materials and MethodsPatients suffering severe traumatic brain injury (sTBI) were treated according to an intracranial pressure (ICP)-targeted therapy based on the Lund concept and randomized to an add-on treatment with prostacyclin or placebo. Inclusion criteria were verified blunt head trauma, Glasgow Coma Score ≤ 8, age 15–70 years, and a first measured cerebral perfusion pressure of ≥ 10 mmHg. Multimodal monitoring was applied. A brain microdialysis catheter was placed on the worst affected side, close to the penumbra zone. Mean (glycerolmean) and maximal glycerol (glycerolmax) during the 96-h sampling period were calculated. The mean PR was calculated as the ICP/mean arterial pressure (MAP) regression coefficient based on hourly mean ICP and MAP during the first 96 h.ResultsOf the 48 included patients, 45 had valid glycerol and PR measurements available. PR was higher in the placebo group as compared to the prostacyclin group (p = 0.0164). There was a positive correlation between PR and the glycerolmean (ρ = 0.503, p = 0.01) and glycerolmax (ρ = 0.490, p = 0.015) levels in the placebo group only.ConclusionsPR is correlated to the glycerol level in patients suffering from sTBI, a relationship that is not seen in the group treated with prostacyclin. Glycerol has been associated with membrane degradation and may support glycerol as a biomarker for vascular endothelial breakdown. Such a breakdown may impair the regulation of cerebrovascular PR.

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Dynamics of brain tissue changes induced by traumatic brain injury assessed with the Marshall, Morris–Marshall, and the Rotterdam classifications and its impact on outcome in a prostacyclin placebo-controlled study

Cited by 23 publications

References 41 publications

Radiographic and Clinical Predictors of Cardiac Dysfunction Following Isolated Traumatic Brain Injury

Radiographic and Clinical Predictors of Cardiac Dysfunction Following Isolated Traumatic Brain Injury

Evaluation of Intracranial Hypertension in Traumatic Brain Injury Patient: A Noninvasive Approach Based on Cranial Computed Tomography Features

Prostacyclin Affects the Relation Between Brain Interstitial Glycerol and Cerebrovascular Pressure Reactivity in Severe Traumatic Brain Injury

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