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Nam D. Tran, Stefan Kim, Heather K. Vincent, Anthony Rodriguez, David R. Hinton, M. Ross Bullock, and Harold F. Young

between salineand dexamethasone-treated animals at 24 hours (79.85 ± 0.14 [TBI-saline/24 hours] vs 79.60 ± 0.27 [TBI-Dex/24 hours], p = 0.98). Thus, dexamethasone was effective in reducing cerebral edema following TBI at 4 hours, but not at 24 hours. F ig . 5. Bar graph. Brain water content in TBI animals following acidosis and dexamethasone administration. Traumatic brain injury induced increasing cerebral edema at 4 hours (*p < 0.05, compared with uninjured controls) and 24 hours (**p < 0.03, compared with injured animals at 4 hours). This cerebral edema was

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Shahid Shafi, Sunni A. Barnes, D Millar, Justin Sobrino, Rustam Kudyakov, Candice Berryman, Nadine Rayan, Rosemary Dubiel, Raul Coimbra, Louis J. Magnotti, Gary Vercruysse, Lynette A. Scherer, Gregory J. Jurkovich, and Raminder Nirula

developed to improve clinical practices ( http://www.east.org/resources/treatment-guidelines ). 4 In fact, the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission for Accreditation of Health Care Organizations now require compliance with several EBM protocols as quality measures, such as congestive heart failure and surgical care ( http://www.medicare.gov/hospitalcompare/search.html ). Despite these efforts, compliance with several evidence-based processes of care (POCs) remains just over 50%. 7 , 8 , 11 Traumatic brain injury (TBI) is the leading

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Muhammad Shahzad Shamim, Mohsin Qadeer, Ghulam Murtaza, S. Ather Enam, and Najiha B. Farooqi

: 991 – 996 , 2006 8 Grände PO : The “Lund Concept” for the treatment of severe head trauma—physiological principles and clinical application . Intensive Care Med 32 : 1475 – 1484 , 2006 9 Gurkin SA , Parikshak M , Kralovich KA , Horst HM , Agarwal V , Payne N : Indicators for tracheostomy in patients with traumatic brain injury . Am Surg 68 : 324 – 329 , 2002 10 Holevar M , Dunham JC , Brautigan R , Clancy TV , Como JJ , Ebert JB , : Practice management guidelines for timing of tracheostomy: the EAST Practice

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Hon-Yi Shi, Shiuh-Lin Hwang, King-Teh Lee, and Chih-Lung Lin

: The epidemiological trends of head injury in the largest Canadian adult trauma center from 1986 to 2007. Clinical article . J Neurosurg 114 : 1502 – 1509 , 2011 3 Chiu WT , Huang SJ , Tsai SH , Lin JW , Tsai MD , Lin TJ , : The impact of time, legislation, and geography on the epidemiology of traumatic brain injury . J Clin Neurosci 14 : 930 – 935 , 2007 4 Deyo RA , Cherkin DC , Ciol MA : Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases . J Clin Epidemiol 45 : 613 – 619 , 1992 5 Funk

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Sherman C. Stein, Xiao-Han Chen, Grant P. Sinson, and Douglas H. Smith

Bostrom K, Helander CG: Aspects on pathology and neuropathology in head injury. Acta Neurochir Suppl 36: 51–55, 1986 5. Bouma GJ , Muizelaar JP , Choi SC , et al : Cerebral circulation and metabolism after severe traumatic brain injury: the elusive role of ischemia. J Neurosurg 75 : 685 – 693 , 1991 Bouma GJ, Muizelaar JP, Choi SC, et al: Cerebral circulation and metabolism after severe traumatic brain injury: the elusive role of ischemia. J Neurosurg 75: 685–693, 1991 6. Bredbacka S , Blomback M

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Rebekah Marsh, Daniel D. Matlock, Julie A. Maertens, Alleluiah Rutebemberwa, Megan A. Morris, Todd C. Hankinson, and Tellen D. Bennett

RS , Mainprize TG , Moulton R , : Intracranial pressure monitoring among children with severe traumatic brain injury . J Neurosurg Pediatr 16 : 523 – 532 , 2015 2 Alkhoury F , Kyriakides TC : Intracranial pressure monitoring in children with severe traumatic brain injury: National Trauma Data Bank–based review of outcomes . JAMA Surg 149 : 544 – 548 , 2014 3 Arora NK , McHorney CA : Patient preferences for medical decision making: who really wants to participate? Med Care 38 : 335 – 341 , 2000 4 Barry MJ , Edgman-Levitan S

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Christos Lazaridis, Stacia M. DeSantis, Peter Smielewski, David K. Menon, Peter Hutchinson, John D. Pickard, and Marek Czosnyka

I ntracranial hypertension has been closely linked to adverse outcomes after traumatic brain injury (TBI); nevertheless there have been no large randomized trials that directly compare intracranial pressure (ICP) treatment thresholds. Data from observational studies and noncontrolled series have suggested thresholds ranging from 15 to 25 mm Hg. 2 , 11 , 20 , 25 , 28 The Brain Trauma Foundation's (BTF's) latest guideline 5 has identified a lack of Level I evidence and offered, as a Level II, the treatment threshold of 20 mm Hg, mainly based on the largest

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Christopher M. Bonfield, Sandi Lam, Yimo Lin, and Stephanie Greene

T raumatic brain injury in children and adolescents is a significant public health concern, with an estimated incidence of 250 per 100,000 per year. Traumatic brain injury results in more than 7000 deaths, 60,000 hospitalizations, and 600,000 emergency room visits annually among American children. 13 , 14 In the US, TBI is the leading cause of childhood death and long-term disability, and is one of the most frequent causes of interruption to normal child development. 9 , 14 Attention deficit hyperactivity disorder is a neurobehavioral disorder

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Pasquale Scotti, Chantal Séguin, Benjamin W. Y. Lo, Elaine de Guise, Jean-Marc Troquet, and Judith Marcoux

A s a result of increasing life expectancy, the proportion of elderly adults (≥ 65 years old) in the population is rapidly growing. The elderly constituted 8% of the global population in 2015, and that figure is projected to reach 14% by 2040. 28 Furthermore, as the mean age is increasing within this subpopulation, so too is the frequency of fall-related injuries (54% increase between 2005 and 2013), and those falls are more likely to cause a traumatic brain injury (TBI). 7 , 16 The average hospitalization rate for TBI among the elderly is nearly 4 times

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Jade-Marie Corbett, Kwok M. Ho, and Stephen Honeybul

A bnormal hematological parameters are common after severe traumatic brain injury (TBI). A systematic review of 34 studies over a 40-year period reported an overall incidence of coagulopathy in as many as 60% of patients with severe TBI. 10 More importantly, the presence of coagulopathy after TBI was reported to be associated with a dramatic increase in mortality compared to those without coagulopathy (46% vs 7%). 6 , 7 In addition to coagulopathy, a reduced hemoglobin concentration and hyperglycemia are also common after TBI, and associated with an increased