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Samuel S. Shin, C. Edward Dixon, David O. Okonkwo, and R. Mark Richardson

T here are multiple therapy modalities for attenuating neurological disabilities in traumatic brain injury (TBI) patients, including occupational, physical, and cognitive rehabilitation, but there is a critical need for more effective therapies, especially pharmacological or surgical treatments. The pathophysiology of TBI is complex and includes inflammation, oxidative stress, apoptosis, excitotoxicity, and mitochondrial dysfunction. After almost a century of translational science, there has yet to be a successful Phase III clinical trial investigating a

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Adam Ross Befeler, William Gordon, Nickalus Khan, Julius Fernandez, Michael Scott Muhlbauer, and Jeffrey Marius Sorenson

management of traumatic brain injury? A prospective evaluation . J Trauma 57 : 939 – 943 , 2004 5 Brown CV , Zada G , Salim A , Inaba K , Kasotakis G , Hadjizacharia P , : Indications for routine repeat head computed tomography (CT) stratified by severity of traumatic brain injury . J Trauma 62 : 1339 – 1345 , 2007 6 Chao A , Pearl J , Perdue P , Wang D , Bridgeman A , Kennedy S , : Utility of routine serial computed tomography for blunt intracranial injury . J Trauma 51 : 870 – 876 , 2001 7 Fazel R , Krumholz HM

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Ryan S. Kitagawa, Robert M. Van Haren, Shoji Yokobori, David Cohen, Samuel R. Beckerman, Faiz Ahmad, and M. Ross Bullock

LE : Traumatic aortic injury: computerized tomographic findings at presentation and after conservative therapy . J Comput Assist Tomogr 34 : 388 – 394 , 2010 2 Andrews PJ , Sleeman DH , Statham PF , McQuatt A , Corruble V , Jones PA , : Predicting recovery in patients suffering from traumatic brain injury by using admission variables and physiological data: a comparison between decision tree analysis and logistic regression . J Neurosurg 97 : 326 – 336 , 2002 3 Arthurs ZM , Starnes BW , Sohn VY , Singh N , Martin MJ

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Kadhaya David Muballe, Constance R. Sewani-Rusike, Benjamin Longo-Mbenza, and Jehu Iputo

Traumatic Brain Injury (IMPACT) and Corticosteroid Randomisation After Significant Head Injury (CRASH-1). 29 , 47 Indeed, these two characteristics have not been previously studied to determine any relationship with clinical outcomes in TBI. Following neurosurgical intervention and management, some patients did not recover and were observed to have had an unchanged (“maintained”) neurological functional status (GOS ≤ 3) by day 90. Univariate correlates of recovery by ROC curve analysis defined thresholds for serum IL-1β, serum MDA (by TBARS assay), and serum and CSF SOD

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Bon H. Verweij, J. Paul Muizelaar, Federico C. Vinas, Patti L. Peterson, Ye Xiong, and Chuan P. Lee

–497, 1982 2. Bergsneider M , Hovda DA , Shalmon E , et al : Cerebral hyperglycolysis following severe traumatic brain injury in humans: a positron emission tomography study. J Neurosurg 86 : 241 – 251 , 1997 Bergsneider M, Hovda DA, Shalmon E, et al: Cerebral hyperglycolysis following severe traumatic brain injury in humans: a positron emission tomography study. J Neurosurg 86: 241–251, 1997 3. Berman RF , Verweij BH , Muizelaar JP : Neurobehavioral protection by the neuronal calcium channel blocker Ziconotide in a model of traumatic diffuse brain

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Brian J. Zink and Paul J. Feustel

E thanol (EtOH) consumption leads to an increased risk of accidents and trauma; 13, 25 studies in emergency department patients have shown that up to 50% of brain-injured adults have consumed EtOH prior to suffering traumatic brain injury (TBI). 4, 8, 17, 31, 32 A number of animal studies, each using a different model and species, has found that EtOH worsens brain injury and neurological outcome and increases mortality following brain injury. 1, 11, 12, 22 These investigations have focused primarily on neuropathological lesions and mortality and have not

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Je Yeong Sone, Douglas Kondziolka, Jason H. Huang, and Uzma Samadani

T he most prevalent method of preventing or minimizing traumatic brain injury (TBI) is helmet use. Helmets are one of the earliest and most enduring methods of personal protection in the history of human civilization. They provide protection from head trauma by absorbing the impact energy and diffusing and displacing peak impact and pressure gradient to a greater surface area of the head, rather than to a localized region. 76 History of Pre-20th–Century Helmets Since the helmet's inception, the vast majority have been designed for ceremonial uses and

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Michael F. Stiefel, Joshua D. Udoetuk, Alejandro M. Spiotta, Vicente H. Gracias, Aaron Goldberg, Eileen Maloney-Wilensky, Stephanie Bloom, and Peter D. Le Roux

: Monitoring of brain tissue PO2 in traumatic brain injury: effect of cerebral hypoxia on outcome . Acta Neurochir Suppl 71 : 153 – 156 , 1998 6 Bishop MH , Shoemaker WC , Appel PL , Meade P , Ordog GJ , Wasserberger J , : Prospective, randomized trial of survivor values of cardiac index, oxygen delivery, and oxygen consumption as resuscitation endpoints in severe trauma . J Trauma 38 : 780 – 787 , 1995 7 Bouma GJ , Muizelaar JP , Choi SC , Newlon PG , Young HF : Cerebral circulation and metabolism after severe traumatic brain

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Robert G. Whitmore, Jayesh P. Thawani, M. Sean Grady, Joshua M. Levine, Matthew R. Sanborn, and Sherman C. Stein

. 6 However, we have corrected the estimates of Faul et al., 6 which were based on average costs for all hospitalized traumatic brain injury (TBI) patients, not just for those with severe TBI. We used a formula that relied on the relative cost of a day in the ICU being approximately 3 times as much as care on a medical-surgical floor. 9 Hence, in contrast to the calculations of Faul et al., in our calculations, hospitalization for the aggressive-treatment group costs considerably more than that for the routine-care group. Average ICU and hospital stays for the

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Ronald L. Hayes, Bruce G. Lyeth, Larry W. Jenkins, Richard Zimmerman, Tracy K. McIntosh, Guy L. Clifton, and Harold F. Young

P revious research has indicated that traumatic brain injury (TBI) increases levels of endogenous opioids. Naloxone, a nonspecific opioid antagonist, significantly reverses the hypotension and reduction in pulse pressure following fluid-percussion injury in cats. 26 There are also recent clinical reports of increased µ -endorphin levels in the cerebrospinal fluid of head-injured patients. 80 Other laboratory studies have indicated that dynorphin A-immunoreactivity (but not leucine-enkephalin or µ -endorphin immunoreactivity) increased in the brain regions