Article
Clinical Neurology
Amir Rezakhah, Andrew J. Kobets, Faezeh Emami Sigaroudi, Ata Mahdkhah, Jalal Barshan, Ali Gharajedaghi, Seyed Ahmad Naseri Alavi
Summary: This study investigated the relationship between clinical and laboratory findings at admission and Glasgow Outcome Scale (GOS) score in children with traumatic brain injury. The results showed that hypotension, hyponatremia, prolonged prothrombin time, prolonged partial thromboplastin time, pupil size, pupil reaction to light, and Glasgow Coma Scale score were significantly correlated with GOS score.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Teodor Svedung Wettervik, Anders Hanell, Timothy Howells, Elisabeth Ronne Engstrom, Anders Lewen, Per Enblad
Summary: The primary aim of this study was to determine the combined effect of insult intensity and duration of intracranial pressure (ICP), cerebral perfusion pressure (CPP), and pressure reactivity index (PRx) on patient outcome in traumatic brain injury (TBI) and aneurysmal subarachnoid hemorrhage (aSAH). The results showed similarities and differences between the two conditions, with aSAH patients requiring higher CPP targets.
JOURNAL OF NEUROSURGERY
(2023)
Article
Critical Care Medicine
Jeanette Tas, Erta Beqiri, Ruud C. van Kaam, Marek Czosnyka, Joseph Donnelly, Roel H. Haeren, Iwan C. C. van der Horst, Peter J. Hutchinson, Sander M. J. van Kuijk, Analisa L. Liberti, David K. Menon, Cornelia W. E. Hoedemaekers, Bart Depreitere, Peter Smielewski, Geert Meyfroidt, Ari Ercole, Marcel J. H. Aries
Summary: This study evaluated the feasibility and safety of CA-guided CPP management in TBI patients requiring intracranial pressure monitoring and therapy. The results demonstrate that targeting an individual and dynamic CA-guided CPP is feasible and safe in TBI patients, encouraging further prospective trials powered for clinical outcomes.
JOURNAL OF NEUROTRAUMA
(2021)
Article
Critical Care Medicine
Jennifer C. Laws, E. Haley Vance, Kristina A. Betters, Jessica J. Anderson, Sydney Fleishman, Christopher M. Bonfield, John C. Wellons III, Meng Xu, James C. Slaughter, Dario A. Giuse, Neal Patel, Lori C. Jordan, Michael S. Wolf
Summary: This retrospective observational study assessed the acute effects of ketamine on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in children with severe traumatic brain injury (TBI). The results showed that ketamine reduced ICP during ICP crises, but had no significant effect when used for sedation. These findings suggest that ketamine may be considered as a treatment for intracranial hypertension in children with severe TBI.
CRITICAL CARE MEDICINE
(2023)
Article
Clinical Neurology
Deepak Lohia, Manish Agrawal, Rohit Babal, Devendra Kumar Purohit
Summary: By evaluating the perfusion abnormalities using computed tomography perfusion (CTP) in pediatric head injury patients, the study found that cerebral blood flow (CBF) and mean transient time (MTT) can serve as prognostic indicators for neurologic outcomes in these patients.
WORLD NEUROSURGERY
(2022)
Article
Critical Care Medicine
Erta Beqiri, Frederick Zeiler, Ari Ercole, Michal Placek, Jeanette Tas, Joseph Donnelly, Marcel J. H. Aries, Peter Hutchinson, David Menon, Nino Stocchetti, Marek Czosnyka, Peter Smielewski
Summary: A previous study suggested that the percentage of time spent with CPP below LLR is associated with mortality in TBI patients. This study aims to validate this finding in a large multicentre cohort.
Article
Neurosciences
Bocheng Yang, Xiaochuan Sun, Quanhong Shi, Wei Dan, Yan Zhan, Dinghao Zheng, Yulong Xia, Yanfeng Xie, Li Jiang
Summary: This study aimed to design a model for predicting the early prognosis of traumatic brain injury (TBI) patients using parameters that can be quickly obtained in emergency conditions. The results showed that age, Glasgow coma scale score, Apolipoprotein E genotype, damage area, serum C-reactive protein and interleukin-8 levels, and Marshall computed tomography score were associated with the early prognosis of TBI patients. The prediction models based on these parameters provided a reliable and rapid method for evaluating and predicting the early prognosis of TBI patients.
CNS NEUROSCIENCE & THERAPEUTICS
(2022)
Article
Clinical Neurology
Joel Frohlich, Micah A. Johnson, David L. McArthur, Evan S. Lutkenhoff, John Dell'Italia, Courtney Real, Vikesh Shrestha, Norman M. Spivak, Jesus E. Ruiz Tejeda, Paul M. Vespa, Martin M. Monti
Summary: The study found that sedation-induced burst-suppression (SIBS) was positively associated with outcomes at 6 months in patients with moderate-to-severe traumatic brain injury (TBI), but did not predict outcomes at discharge. These results suggest that burst suppression may have neuroprotective effects in acute patients with TBI etiologies.
FRONTIERS IN NEUROLOGY
(2021)
Article
Critical Care Medicine
Teodor Svedung Wettervik, Anders Hanell, Timothy Howells, Anders Lewen, Per Enblad
Summary: The aim of this study was to investigate the association between absolute pressure reactivity index (PRx) values and cerebral perfusion pressure (CPP) with outcome in traumatic brain injury (TBI). The study found that a higher percentage of monitoring time with deviation from optimal CPP (CPPopt) and within the reactivity-thresholds of PRx were independently associated with favorable outcome.
JOURNAL OF NEUROTRAUMA
(2023)
Article
Neuroimaging
Efrosini Papadaki, Eleftherios Kavroulakis, Katina Manolitsi, Dimitrios Makrakis, Emmanouil Papastefanakis, Pelagia Tsagaraki, Styliani Papadopoulou, Alexandros Zampetakis, Margarita Malliou, Antonios Vakis, Panagiotis Simos
Summary: This study investigated the relationship between hemodynamic changes and psychoemotional status in patients with chronic mild traumatic brain injury (mTBI) compared to healthy volunteers. Results revealed that mTBI patients scored lower in cognitive domains and had higher rates of anxiety and depression symptoms, while also exhibiting significantly reduced cerebral blood flow values in specific brain regions. Depressive symptomatology was associated with lower perfusion in the left anterior cingulate gyrus and higher perfusion in the putamen, bilaterally, within the mTBI group, highlighting specific associations between regional perfusion and mental health symptoms.
BRAIN IMAGING AND BEHAVIOR
(2021)
Article
Behavioral Sciences
Jai Carmichael, Amelia J. Hicks, Gershon Spitz, Kate Rachel Gould, Jennie Ponsford
Summary: Genomics plays a key role in the development of precision medicine, particularly in the context of conditions like traumatic brain injury (TBI). However, understanding the complex interplay between genes and outcomes, especially with moderating variables, is challenging. This discussion focuses on the moderation of gene-outcome associations in TBI, highlighting specific genes and demographic variables, and providing recommendations for future research in this area.
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
(2021)
Review
Anesthesiology
Abhijit V. Lele, Monica S. Vavilala
Summary: This review addresses the measurement, natural history, and potential clinical implications of cerebral autoregulation (CA) after traumatic brain injury (TBI). Understanding the status of CA is of great importance for managing and improving the outcomes of patients with TBI.
JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
(2023)
Article
Clinical Neurology
Teodor Svedung Wettervik, Anders Hanell, Per Enblad, Anders Lewen
Summary: This study aimed to determine the association between intracranial hemorrhage lesion characteristics and the clinical course and long-term outcome for traumatic brain injury (TBI) patients. A total of 385 TBI patients were included in this observational, retrospective study. The results showed that intracranial lesion characteristics were associated with clinical progression, cerebral pathophysiology, and outcome following TBI.
ACTA NEUROCHIRURGICA
(2023)
Article
Clinical Neurology
Teodor Svedung Wettervik, Fartein Velle, Anders Hanell, Timothy Howells, Pelle Nilsson, Anders Lewen, Per Enblad
Summary: The aim of this study was to investigate the combined effect of insult intensity and duration on clinical outcome in pediatric traumatic brain injury. The results showed that high intracranial pressure (ICP) and low cerebral perfusion pressure (CPP), as well as prolonged periods of high pressure reactivity index (PRx) and deviation from optimal CPP (CPPopt), were associated with unfavorable outcome. These findings suggest the importance of managing ICP and CPP levels in the treatment of pediatric TBI.
CHILDS NERVOUS SYSTEM
(2023)
Review
Clinical Neurology
Coulter Small, Brandon Lucke-Wold, Chhaya Patel, Hussam Abou-Al-Shaar, Rachel Moor, Yusuf Mehkri, Megan Still, Matthew Goldman, Patricia Miller, Steven Robicsek
Summary: Cerebral perfusion pressure (CPP) is a concept widely used in caring for critically ill patients, but its application in moderate and severe traumatic brain injury (TBI) is limited by dysfunction in cerebral autoregulation. Current clinical management also has inherent limitations that require further research for improvement.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2022)
Article
Clinical Neurology
Tom Altmann, Megan Torvell, Stephen Owens, Dipayan Mitra, Neil S. Sheerin, B. Paul Morgan, David Kavanagh, Rob Forsyth
NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION
(2020)
Article
Clinical Neurology
Bin Jiang, Nancy K. Hills, Rob Forsyth, Lori C. Jordan, Mahmoud Slim, Steven G. Pavlakis, Neil Freidman, Nomazulu Dlamini, Osman Farooq, Ying Li, Guangming Zhu, Heather Fullerton, Max Wintermark, Warren D. Lo
Summary: In childhood arterial ischemic stroke patients, larger infarct volume and younger age at stroke onset are associated with poorer outcomes, but the strength of these relationships is weak. Specific infarct locations are significantly associated with poorer outcomes, but lose significance when adjusted for infarct volume.
Editorial Material
Pediatrics
Rob J. Forsyth
ARCHIVES OF DISEASE IN CHILDHOOD
(2021)
Article
Multidisciplinary Sciences
S. Ramaraju, S. Reichert, Y. Wang, R. Forsyth, P. N. Taylor
Summary: The study aimed to quantify the effect of inhaled 5% carbon dioxide/95% oxygen on EEG recordings from NCSE patients. Results showed inconsistent effects of carbogen on EEG band-power and network metrics across the five patients, suggesting a potentially non-homogeneous impact. Tuning carbogen parameters on a personalized basis may improve seizure suppression in the future.
Article
Pediatrics
Rajib Lodh, Sam Amin, Amr Ammar, Lucy Bellis, Phillip Brink, Amedeo Calisto, Darach Crimmins, Paul Eunson, Rob J. Forsyth, John Goodden, Margaret Kaminska, Joanne Kehoe, Martin Kirkpatrick, Ram Kumar, Jane Leonard, Alice Lording, Katherine Martin, Russell Miller, Santosh R. Mordekar, Benedetta Pettorini, Martin Smith, Rachel Smith, Christine Sneade, Andrea Whitney, Michael Vloeberghs, Hesham Zaki, Daniel E. Lumsden
Summary: A survey was conducted on children and young people receiving intrathecal baclofen therapy in the UK and Ireland, finding that most patients were non-ambulant, had cerebral palsy, and had significant spasticity and/or dystonia. The most commonly used ITB dosing modes were continuous and flexible. There is a significant need for nationally accepted pediatric referral criteria and clinical standards for ITB use in the UK and Ireland.
ARCHIVES OF DISEASE IN CHILDHOOD
(2021)
Editorial Material
Clinical Neurology
Rob Forsyth
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY
(2022)
Article
Clinical Neurology
Rob Forsyth, Colin Hamilton, Matthew Ingram, Gemma Kelly, Tim Grove, Lorna Wales, Mark S. Gilthorpe
Summary: The study found a complex relationship between rehabilitation dose and outcomes after pediatric acquired brain injury. Content-aware measures of rehabilitation dose showed a significant positive correlation with rehabilitation treatment outcomes. These findings contribute to advancing comparative effectiveness research in pediatric neurorehabilitation.
DEVELOPMENTAL NEUROREHABILITATION
(2022)
Article
Clinical Neurology
Omar A. Abdel-mannan, Celeste Manchoon, Thomas Rossor, Justine-Clair Southin, Carmen Tur, Wallace Brownlee, Susan Byrne, Manali Chitre, Alasdair Coles, Rob Forsyth, Rachel Kneen, Kshitij Mankad, Dipak Ram, Siobhan West, Sukhvir Wright, Evangeline Wassmer, Ming Lim, Olga Ciccarelli, Cheryl Hemingway, Yael Hacohen
Summary: The study found that newer disease-modifying therapies (DMTs) were associated with lower risk of clinical and radiologic relapses in children with relapsing-remitting multiple sclerosis (RRMS) compared to injectables. Multivariable analysis showed injectables were linked to increased risk of clinical relapse and new radiologic activity, supporting the argument for a shift towards more efficacious DMTs.
NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION
(2021)
Article
Rehabilitation
Adrian M. Svingos, Stacy J. Suskauer, Beth S. Slomine, Hsuan Wei Chen, Michael E. Ellis-Stockley, Rob J. Forsyth
Summary: This study aimed to determine the distribution of items on the Cognitive and Linguistic Scale (CALS) and explore the relationship between Rasch-derived Cognitive Ability Estimates and outcome trajectory parameters. The study concluded that the Cognitive Ability Estimates derived from the CALS may serve as an ideal outcome measure for evaluating interventions in pediatric rehabilitation settings for acquired brain injury.
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
(2022)
Article
Clinical Neurology
Christopher Hatton, Simona S. Ghanem, David J. Koss, Ilham Y. Abdi, Elizabeth Gibbons, Rita Guerreiro, Jose Bras, Lauren Walker, Ellen Gelpi, Wendy Heywood, Tiago F. Outeiro, Johannes Attems, Robert McFarland, Rob Forsyth, Omar M. El-Agnaf, Daniel Erskine
Summary: This study identified prion-like alpha-synuclein in the brain tissue of infants with Krabbe disease, challenging the assumption that alpha-synuclein pathology is solely age-associated and suggesting a link to biological pathways such as sphingolipid metabolism.
Article
Clinical Neurology
Rob J. Forsyth, Liz Roberts, Rob Henderson, Lorna Wales
Summary: This study aims to describe the variation in neurorehabilitation content provided to young people after severe paediatric acquired brain injury (pABI) and relate it to observed functional recovery. The study found significant correlations between aspects of delivered therapy and recovery, suggesting that rehabilitation plays a role in the recovery process. However, further research is needed to understand the causal relationship between rehabilitation and recovery after pABI.
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY
(2022)
Article
Clinical Neurology
Thomas B. Atkinson, Rob J. Forsyth
Summary: The effect of age at injury on outcomes after brain injury is debated. Some argue that the immature brain has greater plasticity for recovery, while others argue that early injury impairs future learning abilities. This study found that it is easier to maintain or recover previously established functions than to learn them for the first time in an injured brain, supporting the latter viewpoint.
EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY
(2023)
Meeting Abstract
Clinical Neurology
Lorna Wales, Rob Forsyth, Gemma Kelly
JOURNAL OF HEAD TRAUMA REHABILITATION
(2022)
Article
Pediatrics
Jacqueline Y. Thompson, Julie C. Menzies, Joseph C. Manning, Jennifer McAnuff, Emily Clare Brush, Francesca Ryde, Tim Rapley, Nazima Pathan, Stephen Brett, David J. Moore, Michelle Geary, Gillian A. Colville, Kevin P. Morris, Roger Charles Parslow, Richard G. Feltbower, Sophie Lockley, Fenella J. Kirkham, Rob J. Forsyth, Barnaby R. Scholefield
Summary: The survey found that key components of ERM as defined by participants included tailored, multidisciplinary rehabilitation packages focused on promoting recovery. Multidisciplinary involvement in initiating ERM was commonly reported. Over half of respondents favored delivering ERM after achieving physiological stability.
BMJ PAEDIATRICS OPEN
(2022)
Meeting Abstract
Neurosciences
Lorna Wales, Rob Forsyth, Gemma Kelly
