BACKGROUND: Early computerized tomography (CT) abnormalities are important predictors of outcome after traumatic brain injury (TBI). OBJECTIVE: To develop a novel CT scoring system (Helsinki score) and to compare it with the Marshall classification Rotterdam score in predicting long-term patients TBI. METHODS: Eight hundred sixty-nine consecutive TBI were included this open-cohort, retrospective, single-center study. Logistic regression was used Helsinki score. The scores from Marshall,...

Traumatic brain injury (TBI) is a major contributor to morbidity and mortality. Computerized tomography (CT) scanning of the essential for diagnostic screening intracranial injuries in need neurosurgical intervention, but may also provide information concerning patient prognosis enable baseline risk stratification clinical trials. Novel CT scoring systems have been developed improve current prognostic models, including Stockholm Helsinki scores, so far not extensively validated. The primary...

Object. Stress-induced hyperglycemia has been shown to be associated with poor outcome after aneurysmal subarachnoid hemorrhage (SAH). The authors prospectively tested whether hyperglycemia, independent of other factors, affects patient outcomes and the occurrence cerebral infarction SAH. Methods. Previous diseases, health habits, medications, clinical condition, neuroimaging variables were recorded for 175 patients SAH who admitted hospital within 48 hours bleeding. plasma level glucose was...

Object. From the moment an intracranial aneurysm ruptures, cerebral blood flow is impaired, and this impairment mainly determines outcome in patients who survive after initial bleeding. The exact mechanism of unknown, but activation coagulation fibrinolysis correlate with clinical condition aneurysmal subarachnoid hemorrhage (SAH). purpose study was to determine whether enoxaparin, a low-molecular-weight heparin, which well-known anticoagulating agent, has any effect on SAH postoperatively....

Background and Purpose— Brain-derived neurotrophic factor ( BDNF ) plays a role in neuronal survival, plasticity neurogenesis. The gene contains common Val66Met polymorphism; the Met allele is associated with lower depolarization-induced release differences memory functions brain morphology. We hypothesized that poor recovery from subarachnoid hemorrhage. Methods— A sample of 105 survivors was assessed at 3 months after hemorrhage using Glascow Outcome Scale. Poor outcome defined as severe...

Abstract Introduction The relationship between hyperoxemia and outcome in patients with traumatic brain injury (TBI) is controversial. We sought to investigate the independent long-term mortality moderate-to-severe injury. Methods Finnish Intensive Care Consortium database was screened for mechanically ventilated a TBI. Patients were categorized, according highest measured alveolar-arterial O 2 gradient or lowest PaO value during first 24 hours of ICU admission, hypoxemia (<10.0 kPa),...

Abstract Introduction The aim of this study was to evaluate the usefulness APACHE II (Acute Physiology and Chronic Health Evaluation II), SAPS (Simplified Acute Score II) SOFA (Sequential Organ Failure Assessment) scores compared simpler models based on age Glasgow Coma Scale (GCS) in predicting long-term outcome patients with moderate-to-severe traumatic brain injury (TBI) treated intensive care unit (ICU). Methods A national ICU database screened for eligible TBI (age over 15 years, GCS...

Previous epidemiological studies suggest that working-aged persons with a history of moderate-to-severe traumatic brain injury (TBI) may have an increased risk for developing neurodegenerative disease (NDD) while mild TBI do not. In this comprehensive nationwide study in Finland, we assessed the NDD and working-age population.We performed population-based follow-up using Finnish Care Register Health to identify all between ages 18 65 years hospitalized during 1987-2014 due who did not...

Abstract OBJECTIVE: The objective of this study was to determine whether an angiographically proven rate saccular intracranial aneurysm occlusion after surgical clipping suggests that postoperative angiography should continue be used routinely or supplanted by intraoperative angiography. These data also establish a basis for comparing surgery with new endovascular methods treatment. METHODS: During 3.5-year period, consecutive series 622 patients (955 aneurysms, 808 which were surgically...

The effect of blood alcohol concentration (BAC) on outcome after traumatic brain injury (TBI) is controversial. We sought to assess the independent positive BAC long-term in patients with TBI treated intensive care unit (ICU). performed a retrospective analysis 405 TBI, admitted ICU large urban Level 1 trauma center between January 2009 and December 2012. Outcome was six-month mortality unfavorable neurological (defined as Glasgow Scale score [death], 2, [vegetative state], or 3 [severe...

Delayed cerebral ischemia (DCI) is one of the main contributing factors to poor clinical outcome after aneurysmal subarachnoid hemorrhage (SAH). Unsuccessful treatment can cause irreversible brain injury in form DCI-related infarction. We aimed assess association between location, distribution, and size infarction relation outcome.

INTRODUCTION: Intraventricular hemorrhage (IVH) often complicates spontaneous intracerebral (ICH) and subarachnoidal hemorrhages (SAH), leading to increased mortality morbidity. Neuroinflammation resulting from blood organization in cerebrospinal fluid (CSF) contributes poor outcomes. METHODS: Data were collected six centers the EU USA utilizing new active EVD system. Forty patients analyzed, including those with SAH, ICH-related IVH, vascular anomaly-related hemorrhage. Blood removal...

After aneurysmal subarachnoid hemorrhage (SAH), elevated D-dimer levels have been associated with poor clinical condition and outcome. We tested prospectively whether values affect outcome after SAH independently of severity bleeding.Previous diseases, as well radiological variables, were recorded for 136 patients admitted within 48 hours bleeding. Plasma was measured in the morning aneurysm occlusion at discharge 10 to 12 days SAH. Factors predicting according Glasgow Outcome Scale 3 months...

OBJECT Experimental studies have shown numerous neuroprotective properties of alcohol ("ethanol") after TBI, but clinical provided conflicting results. The authors aimed to assess the relationship between positive blood concentration (BAC) on hospital admission and mortality moderate severe traumatic brain injury (TBI). METHODS searched 8 databases for observational reported January 1, 1990, October 7, 2013, investigated effect BAC TBI. Reviews each study were conducted, data extracted...

Delayed admission to appropriate care has been shown increase mortality following traumatic brain injury (TBI). We investigated factors associated with delayed a hospital neurosurgical expertise in cohort of TBI patients the intensive unit (ICU). A retrospective analysis all treated ICUs Helsinki University Central Hospital was carried out from 1.1.2009 31.12.2010. Patients were categorized into two groups: direct and admission. group initially transported local without before inter-transfer...

Background Normobaric hyperoxia is used to alleviate secondary brain ischaemia in patients with traumatic injury ( TBI ), but clinical evidence limited and may cause adverse events. Methods An open label, randomised controlled pilot study comparing blood concentrations of reactive oxygen species ROS interleukin 6 IL ‐6) neuron‐specific enolase NSE ) between two different fractions inspired severe on mechanical ventilation. Results We enrolled 27 the Fi O 2 0.40 group 38 0.70 group; 19 23...

Previous studies suggest that cognitive and psychosocial impairments after subarachnoid hemorrhage (SAH) result from diffuse brain damage caused by the initial bleeding rather than focal lesions. We describe relationship of local infarctions to these explore how well test questionnaire results explain outcome.A total 170 patients, selected a consecutive series patients with aneurysmal SAH, underwent neurological neuroradiological examinations, 138 them were assessed neuropsychological tests...

Object. The aim of this study was to test whether enoxaparin treatment (40 mg subcutaneously once daily) reduces the risk cerebral infarction after subarachnoid hemorrhage (SAH) and investigate predictive factors for permanent ischemic lesions visible on follow-up computerized tomography (CT) scans obtained 3 months SAH. Methods. After undergoing surgery a ruptured aneurysm, 170 patients were randomized in prospective, double-blind, placebo-controlled trial effect occurrence lesions, which...

Prediction models are important tools for heterogeneity adjustment in clinical trials and the evaluation of quality delivered care to patients with traumatic brain injury (TBI). We sought improve predictive performance IMPACT (International Mission Prognosis Analysis Clinical Trials) prognostic model by combining it APACHE II (Acute Physiology Chronic Health Evaluation II) 6-month outcome prediction TBI treated intensive unit. A total 890 admitted a large urban level 1 trauma center...

Abstract Current accepted cerebrovascular reactivity indices suffer from the need of high frequency data capture and export for post-acquisition processing. The role minute-by-minute in monitoring remains uncertain. goal was to explore statistical time-series relationships between intra-cranial pressure (ICP), mean arterial (MAP) index (PRx) using both 10-s minute update TBI. Prospective 31 patients 3 centers with moderate/severe TBI high-frequency archived physiology were reviewed. Both by...

Abstract Background Lumbar disc herniation is often managed conservatively; nevertheless, surgical intervention can be required. Majority of patients experience a drastic relief symptoms after surgery, but previous studies have reported that their health-related quality life remains inferior compared to the general population for several years. There may major cumulative loss young as they long expected ahead them. Methods A total 526 eligible adult under age 40 underwent surgery lumbar from...

Objective: To assess temporal trends in 1-year healthcare costs and outcome of intensive care for traumatic brain injury Finland. Design: Retrospective observational cohort study. Setting: Multicenter study including four tertiary ICUs. Patients: Three thousand fifty-one adult patients (≥ 18 yr) with significant treated a ICU during 2003–2013. Intervention: None. Measurements Main Results : Total included the index hospitalization costs, rehabilitation unit social security reimbursements....

OBJECTIVE: Approximately one-third of all patients with acute nontraumatic subarachnoid hemorrhage (SAH) experience complications owing to delayed ischemic deficit. We reported recently that enoxaparin 40 mg once daily for 10 days seems safe and demonstrates thromboprophylactic efficacy, but it failed improve outcome in a randomized SAH trial. In the present study, we assessed hemostatic variables associated clinical status SAH. also monitored effect on activation coagulation fibrinolysis...