Validation of a New Clinico-Radiological Grading for Compound Head Injury: Implications on the Prognosis and the Need for Surgical Intervention

Dhandapani, Sivashanmugam; Sarda, Alok C.; Kapoor, Ankur; Salunke, Pravin; Mathuriya, S. N.; Mukherjee, Kanchan Kumar

doi:10.1016/j.wneu.2015.05.058

Cited by 19 publications

(16 citation statements)

References 22 publications

(36 reference statements)

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“…Even though guidelines are available to manage these symptoms, they are often not suitable for the patients with intracranial lesions, and they need to be more evi-dence-based and tuned to the local milieu of patients [17,35] . Irregular follow-up visits of the patients due to socioeconomic barriers also become a major concern in identifying and managing the outcome [36].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Trends in the Neuropsychological Burden of Patients having Intracranial Tumors with Respect to Neurosurgical Intervention

et al. 2017

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Background: The burden of neuropsychological symptoms evidenced by behavioral changes among patients with intracranial tumors has not been studied in detail. Purpose: This study was conducted to prospectively assess the neuropsychological symptoms in patients with intracranial tumors undergoing treatment. Methods: A longitudinal study was conducted using purposive sampling to assess the neuropsychological symptoms in conscious and consenting patients with intracranial tumors who were availing treatment from a tertiary care center. Neuropsychiatric Inventory Questionnaire (NPI-Q), which identifies 12 behavioral disturbances, was assessed at baseline, and later at 1 month and 6 months after treatment, and scored as symptom severity as well as symptom scores. Results: Among the 34 patients studied, all had experienced at least one neuropsychological symptom. The commonest neuropsychological symptoms at baseline were anxiety (82%), agitation (75%), irritability (74%), depression (74%), and sleep disturbances (70%). The neuropsychiatric symptom and severity scores were 5.84 (SD ±2.7) and 11.8 (±7.1) at baseline, which reduced significantly to 4.3 (±3.1) and 5.6 (±3.2) at 1 month, and further to 2.3 (±2.9) and 3.6 (±3.2) at 6 months, respectively. The neuropsychological symptoms persistent at 6 months were anxiety (33%), depression (33%), sleep disturbances (33%), agitation (25%), irritability (25%), and disinhibition (25%). Conclusion: There is substantial neuropsychological burden among patients with intracranial tumors. The severity score improved immediately after surgery, while the symptom score improved gradually. The variable spectrum of improvement in neuropsychological symptoms at 6 months after surgical treatment needs further consideration. Addressing these symptoms should be one of the long-term goals of the neuro-oncology teams.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Trends in the Neuropsychological Burden of Patients having Intracranial Tumors with Respect to Neurosurgical Intervention

et al. 2017

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“…Head injury is a major cause of disability and death among the productive years of life. [5][6][7] The WHO recognized that the major causes of traffic collisions are driving over the speed limit, driving under the influence, and not using helmets and seat belts. Helmets are known to protect from Because of which present study was conducted where only 19% of the subjects were using helmet while riding two-wheeler which was similar to the study of Kalantharakath and Iyer 8 with 30% use and 16.2% in Fong et al 9 and was contradictory to the study of Bao et al where 64% respondents were using helmet while riding.…”

Section: Discussionmentioning

confidence: 99%

Helmet Use among Two Wheeler Female Riders

Khan

Krishnan

Dhandapani

et al. 2019

IJNS

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Introduction The frequency of traffic collisions in India is among the highest in the world with more than 135,000 traffic collision-related deaths occurring every year. The “Global Status Report on Road Safety” listed by the World Health Organization identified the major causes of injury as driving over the speed limit, driving under the influence, and not using helmets and seat belts. Women face unique challenges after traumatic brain injury, due to differential laws and their enforcement. Objectives To assess the use of helmet among female hospital workers (nurses, hospital attendants, sanitary attendants, and security guards) and their attitude toward helmet wearing. Methods Purposive sampling was done among female two-wheeler-riding hospital workers. A questionnaire was developed to study the use of helmet and an attitude Likert scale for assessing attitude toward wearing helmet. Data were collected, coded, and analyzed using SPSS software version 21. Results Of the total 89 women enrolled, 46.4% were mostly pillion riders, and 33% were mostly drivers. Only 19% were using helmet consistently, despite 93% owning it. Eighty-eight percent of the regular users were younger than 25 years, while 80% of the non-users were above 25 years. Even among regular drivers, 40% never wore helmet. Eighty-two percent of the non-users were merely casual despite knowing about its advantages. Conclusion Helmet use is very poor among women (both drivers and pillion riders), despite working in hospital environment and owning helmet. Stricter enforcement of helmet law is needed, as education and knowledge per-se may not instil helmet use.

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“…Severe head injury continues to be a nightmare due to the associated high mortality and morbidity, and contributes immensely to socioeconomic losses in India and other developing countries. [10][11][12] SHI increases the body's metabolic responses, and therefore nutritional demands, similar to subarachnoid hemorrhage. [13][14][15] Fasting along with hypermetabolism increases the rate of gluconeogenesis resulting in mobilization of amino acids initially from skeletal muscles and later from other visceral organs, which in turn leads to severe wasting of the lean body mass, impairment of vital organ function, and diminution in reparative and immune process.…”

Section: Discussionmentioning

confidence: 99%

Role of Anthropometric Nutritional Assessment in Severe Head Injury

Dhandapani

Agarwal

et al. 2019

IJNT

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Aim Nutritional demand after traumatic brain injury is increased due to hypermetabolic response. The present study was undertaken to assess nutritional status with anthropometric indices, factors associated, and their prognostic role following severe head injury (SHI). Method A total of 114 patients in age group 20 to 60 years, admitted within 24 hours of SHI, with Glasgow Coma Scale of 4 to 8, and with no serious systemic disorder were enrolled for the study. Of these, 67 were prospectively assessed weekly till 21 days for changes in mid arm circumference (MAC), mid arm muscle circumference (MAMC), and triceps skin fold thickness (TSF). They were studied in relation to other factors and outcome was assessed at 3 months. Results The percentage fall at 3 weeks for MAC, MAMC, and TSF were 14, 10, and 37%, respectively. The percentage of fall in MAMC was the earliest, and was significantly greater in patients with surgical intervention, tracheostomy, prolonged fever, delayed enteral feeding, and greater caloric deficit. Admission MAMC < 90% of standard was significantly associated with unfavorable outcome (odds ratio 5.9 [95% confidence interval 1.3–27.8], p = 0.01). Unfavorable outcome was significantly more frequent in patients who had at least 15% fall in MAC (85.7 vs. 41.9%, p = 0.03), or 10% fall in MAMC (68.8 vs. 38.2%, p = 0.04) at 2 weeks, compared with others. Fall in TSF had no significant association with outcome at 3 months. In multivariate analysis, MAMC fall had significant independent association with unfavorable outcome. Conclusion Bedside anthropometry (especially MAMC) is efficient in identifying patients with nutrition depletion with significant influence on outcome at 3 months.

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Validation of a New Clinico-Radiological Grading for Compound Head Injury: Implications on the Prognosis and the Need for Surgical Intervention

Cited by 19 publications

References 22 publications

Prevalence and Trends in the Neuropsychological Burden of Patients having Intracranial Tumors with Respect to Neurosurgical Intervention

Prevalence and Trends in the Neuropsychological Burden of Patients having Intracranial Tumors with Respect to Neurosurgical Intervention

Helmet Use among Two Wheeler Female Riders

Role of Anthropometric Nutritional Assessment in Severe Head Injury

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