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Improving The Virtual Neurosurgery Residency Interview Experience, Ellina Hattar, MD, Omaditya Khanna, MD, Ritam Ghosh, MD, Nikolaos Mouchtouris, MD, Kevin Hines, MD, Daniel Franco, MD, Michelle Hoffman, James S. Harrop, MD, Ashwini D. Sharan, MD 2021 Thomas Jefferson University

Improving The Virtual Neurosurgery Residency Interview Experience, Ellina Hattar, Md, Omaditya Khanna, Md, Ritam Ghosh, Md, Nikolaos Mouchtouris, Md, Kevin Hines, Md, Daniel Franco, Md, Michelle Hoffman, James S. Harrop, Md, Ashwini D. Sharan, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

The residency selection process has proven a challenge in the face of the Covid-19 pandemic. In the neurosurgery match, residents are chosen based on objective metrics as well as their ability to effectively work as part of a team tasked with caring for medically complex patients faced with neurosurgical conditions. As there remain limitations on the number of externships students could participate in and the Step 1 examination is expected to be reported as either pass or fail in years to come, we will have fewer objective metrics to review in the student application. We conducted a study to best ...


Addressing Catheter Associated Uti In The Neuro Icu, Aria Mahtabfar, MD, Giuliana Labella, MSN, Caitlin Harley, MSN, Omar Shah, MD, MBA 2021 Thomas Jefferson University

Addressing Catheter Associated Uti In The Neuro Icu, Aria Mahtabfar, Md, Giuliana Labella, Msn, Caitlin Harley, Msn, Omar Shah, Md, Mba

House Staff Quality Improvement and Patient Safety Conference (2020-)

Increasing systemic pressures have forced clinicians to identify and address a variety of metrics to provide better “quality” care. Catheter associated UTIs (CAUTI) are a common health careassociated infection in the Neuro ICU and are associated with increased LOS and overall mortality.

Aims for Improvement: Improving the incidence of CAUTI at the Gibbon and JHN ICUs on an annual basis after incremental interventions.


Improving Serial Imaging Protocols In Spontaneous Intracerebral Hemorrhage, Kevin Hines, MD, Nikolaos Mouchtouris, MD, Fadi Al-Saiegh, MD, Karim Hafazalla, Jacob Mazza, Giuliana Labella, Muhammad K. Athar, MD, Adam Flanders, MD, M. Reid Gooch, MD, Stavropoula Tjoumakaris, MD, Robert H. Rosenwasswer, MD, Pascal Jabbour, MD 2021 Thomas Jefferson University

Improving Serial Imaging Protocols In Spontaneous Intracerebral Hemorrhage, Kevin Hines, Md, Nikolaos Mouchtouris, Md, Fadi Al-Saiegh, Md, Karim Hafazalla, Jacob Mazza, Giuliana Labella, Muhammad K. Athar, Md, Adam Flanders, Md, M. Reid Gooch, Md, Stavropoula Tjoumakaris, Md, Robert H. Rosenwasswer, Md, Pascal Jabbour, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

There is no universally agreed upon protocol to image patient presenting with intra-parenchymal hemorrhage of non-traumatic etiology (sICH). At our institution, it is common practice for a patient to have 3 CT’s done within 24 hours. They are often at onset of symptoms or presentation, 6 hours post onset of symptoms, and finally 24 hours post bleed onset.

The goal of this project will be to assess the safety and efficacy of obtaining this repeat imaging in our patients in the hopes that limiting unnecessary CT head studies will decrease resource utilization, decrease patient radiation, expedite movement of stable ...


Addressing The Limitations Of Neurosurgical Care Via Telemedicine, Nikolaos Mouchtouris, MD, Robert Sergott, MD, Mark Moster, MD, Michael Karsy, MD, Laura Sweeney, CRNP, Christopher Farrell, MD, James Evans, MD 2021 Thomas Jefferson University

Addressing The Limitations Of Neurosurgical Care Via Telemedicine, Nikolaos Mouchtouris, Md, Robert Sergott, Md, Mark Moster, Md, Michael Karsy, Md, Laura Sweeney, Crnp, Christopher Farrell, Md, James Evans, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Novel telemedicine software successfully automates cranial nerve assessment of patients from the comfort of their home


Intracranial Vcam1 At Time Of Mechanical Thrombectomy Predicts Ischemic Stroke Severity, Benton Maglinger, Madison Sands, Jacqueline A. Frank, Christopher J. McLouth, Amanda L. Trout, Jill M. Roberts, Stephen Grupke, Jadwiga Turchan-Cholewo, Ann M. Stowe, Justin F. Fraser, Keith R. Pennypacker 2021 University of Kentucky

Intracranial Vcam1 At Time Of Mechanical Thrombectomy Predicts Ischemic Stroke Severity, Benton Maglinger, Madison Sands, Jacqueline A. Frank, Christopher J. Mclouth, Amanda L. Trout, Jill M. Roberts, Stephen Grupke, Jadwiga Turchan-Cholewo, Ann M. Stowe, Justin F. Fraser, Keith R. Pennypacker

Behavioral Science Faculty Publications

BACKGROUND: Emergent large vessel occlusion (ELVO) strokes are devastating ischemic vascular events for which novel treatment options are needed. Using vascular cell adhesion molecule 1 (VCAM1) as a prototype, the objective of this study was to identify proteomic biomarkers and network signaling functions that are potential therapeutic targets for adjuvant treatment for mechanical thrombectomy.

METHODS: The blood and clot thrombectomy and collaboration (BACTRAC) study is a continually enrolling tissue bank and registry from stroke patients undergoing mechanical thrombectomy. Plasma proteins from intracranial (distal to clot) and systemic arterial blood (carotid) were analyzed by Olink Proteomics for N=42 subjects. Statistical ...


Outcomes Following Discectomy For Far Lateral Disc Herniation Are Not Predicted By Obstructive Sleep Apnea, John Connolly, Austin J. Borja, Svetlana Kvint, Donald K. E. Detchou, Gregory Glauser, Krista Strouz, Scott D. McClintock, Paul J. Marcotte, Neil R. Malhotra 2021 University of Pennsylvania

Outcomes Following Discectomy For Far Lateral Disc Herniation Are Not Predicted By Obstructive Sleep Apnea, John Connolly, Austin J. Borja, Svetlana Kvint, Donald K. E. Detchou, Gregory Glauser, Krista Strouz, Scott D. Mcclintock, Paul J. Marcotte, Neil R. Malhotra

Mathematics Faculty Publications

Introduction: Previous studies have demonstrated that obstructive sleep apnea (OSA) is associated with adverse postoperative outcomes, but few studies have examined OSA in a purely spine surgery population. This study investigates the association of the STOP-Bang questionnaire, a screening tool for undiagnosed OSA, with adverse events following discectomy for far lateral disc herniation (FLDH). Methods: All adult patients (n = 144) who underwent FLDH surgery at a single, multihospital, academic medical center (2013-2020) were retrospectively enrolled. Univariate logistic regression was performed to evaluate the relationship between risk of OSA (low- or high-risk) according to STOP-Bang score and postsurgical outcomes, including unplanned ...


Exploring The Relationship Between Traumatic Brain Injury And Post-Traumatic Epilepsy: A Review, Alayna Nelson 2021 Philadelphia College of Osteopathic Medicine

Exploring The Relationship Between Traumatic Brain Injury And Post-Traumatic Epilepsy: A Review, Alayna Nelson

PCOM Capstone Projects

According to the Centers for Disease Control and Prevention (2020), traumatic brain injury (TBI) is considered a major public health problem in the United States. Each year, 2.53 million Americans, including 812,000 children, document a TBI-related emergency room visit (CDC, 2020). TBI is a disruption in the brain’s normal function, caused by a bump or blow to the head or by penetrating head injury (CDC, 2020). These injuries range in severity and can cause damage to one or multiple areas of the brain (Oleksii et al., 2019). Mild TBI, often used synonymously with concussion, comprises more than ...


Chiari Formation And Atlantoaxial Instability. Commentary On Minimally Invasive Non-Expansile Tubular Extradural Posterior Fossa Decompression (Minted Technique) For The Management Of Chiari I.5 Malformation: Historical Overview Of Surgical Techniques, Technical Note, Proof Of Concept, Illustrative Case And Case Series. Lesser Is Better, Atul Goel 2021 Department of Neurosurgery, K.E.M., Hospital and Seth G.S. Medical College, Parel, Mumbai

Chiari Formation And Atlantoaxial Instability. Commentary On Minimally Invasive Non-Expansile Tubular Extradural Posterior Fossa Decompression (Minted Technique) For The Management Of Chiari I.5 Malformation: Historical Overview Of Surgical Techniques, Technical Note, Proof Of Concept, Illustrative Case And Case Series. Lesser Is Better, Atul Goel

Archives of Neurosurgery

The authors have reviewed Chiari formation treatment and have put-forth their personal experience with minimally invasive techniques to perform foramen magnum decompression surgery. Based on the historical review of the subject, the authors have discussed the historical validity of only bone decompression, extra-arachnoidal decompression, and tonsillectomy. The article falls in line with the current minimally invasive surgery wave, a slightly larger cousin of the buttonhole surgery trend. It may be pertinent that I review my understanding of the subject based on the ongoing experience of nearly four decades. In the year 1998, we identified that the posterior fossa volume in ...


Neurosurgical Praxis Guidelines During The Covid-19 Outbreak. Consensus-Based On Currently Available Literature., José Antonio Soriano Sánchez, Bárbara Nettel Rueda, José Alberto Israel Romero Rangel, Armando Alpizar Aguirre, Miguel Ángel Andrade-Ramos, Ulises García Dr., Diego Mendez Rosito, Jorge A. Santos, Sara Patricia Pérez Reyes, Julian Eduardo Soto Abraham, Jose E. Valerio Pascua, Marco Antonio Barajas Romero, Eduardo Díaz Juárez, Alma Griselda Ramírez Reyes, Maria Elena Gonzalez, Claudia Katiutska González Valdez, Félix Domínguez Cortinas, Noé Santiago Ramírez, Tenoch Herrada Pineda, Manuel Eduardo Soto García, Edgar Nathal Vera, Gustavo Melo Guzmán 2021 The American British Cowdray Medical Center IAP

Neurosurgical Praxis Guidelines During The Covid-19 Outbreak. Consensus-Based On Currently Available Literature., José Antonio Soriano Sánchez, Bárbara Nettel Rueda, José Alberto Israel Romero Rangel, Armando Alpizar Aguirre, Miguel Ángel Andrade-Ramos, Ulises García Dr., Diego Mendez Rosito, Jorge A. Santos, Sara Patricia Pérez Reyes, Julian Eduardo Soto Abraham, Jose E. Valerio Pascua, Marco Antonio Barajas Romero, Eduardo Díaz Juárez, Alma Griselda Ramírez Reyes, Maria Elena Gonzalez, Claudia Katiutska González Valdez, Félix Domínguez Cortinas, Noé Santiago Ramírez, Tenoch Herrada Pineda, Manuel Eduardo Soto García, Edgar Nathal Vera, Gustavo Melo Guzmán

Archives of Neurosurgery

INTRODUCTION: The World Health Organization recommended several strategies to contain the COVID-19 pandemic, including optimization of care for all patients, especially the seriously ill. Given the strain, the pandemic has posed on healthcare systems around the world, many neurosurgical associations have provided triage recommendations for patients to save resources for the pandemic. We aimed to provide practical recommendations based on specific illnesses requiring surgical procedures commonly performed by neurosurgeons on a life-threatening basis of patient illness. We consider this guideline will help neurosurgeons for the appropriate triage of patients on a daily-situation basis during this pandemic.

METHODS: The Mexican Society ...


The Pipeline Endovascular Device Versus The Flow Re-Direction Endoluminal Device For Cerebral Aneurysm. A One-Year Follow-Up In A Single-Center Experience, Omar Pichardo, Alan Picazo, Omar Castillon, Jonathan Zuniga, Gustavo Alan Juarez Jimenez 2021 Hospital Regional 1o de Octubre, ISSSTE

The Pipeline Endovascular Device Versus The Flow Re-Direction Endoluminal Device For Cerebral Aneurysm. A One-Year Follow-Up In A Single-Center Experience, Omar Pichardo, Alan Picazo, Omar Castillon, Jonathan Zuniga, Gustavo Alan Juarez Jimenez

Archives of Neurosurgery

Background: The Flow Diverters are devices derived from brain stents, made up of a network of microfilaments of various materials that allow the vessel remodeling. The Pipeline Embolization Device and The Flow Re-Direction Endoluminal Device are the two devices with more global clinical experience. Our objective is to compare the 1-year results using these devices in a cohort of patients assessing their occlusion rate and their clinical outcome as by the modified Rankin Score (mRS).

Methods: In this retrospective nested case-control cohort study, we reviewed the medical records of patients undergoing treatment with a Flow Diverter stent for brain aneurysms ...


Suprameatal Tubercle Classification; Its Implementation On Clinical Cases, Humberto Reyna Mendez, Jose Alfredo Espinosa Mora, Laura Ubaldo Reyes, Alberto Angeles Castellanos, Ignacio Mora Magaña, Mauro Alberto Segura Lozano, Rachel Blue, John YK Lee, Diego Mendez Rosito 2021 Centro Medico Nacional 20 de Noviembre, ISSSTE. Mexico City

Suprameatal Tubercle Classification; Its Implementation On Clinical Cases, Humberto Reyna Mendez, Jose Alfredo Espinosa Mora, Laura Ubaldo Reyes, Alberto Angeles Castellanos, Ignacio Mora Magaña, Mauro Alberto Segura Lozano, Rachel Blue, John Yk Lee, Diego Mendez Rosito

Archives of Neurosurgery

Abstract:

Background: The suprameatal tubercle (SMT) is a variable prominence of the petrosal surface of the temporal bone that lies above the internal acoustic meatus. An enlarged SMT may present an obstacle during surgeries of the posterior fossa, including microvascular decompression or by itself cause trigeminal neuralgia.

Methods: Based on our prior study of 200 temporal bones, its data collection and establishing a classification of the SMT this extension study exemplifies its clinical application.

Results: According to the classification of the SMT four selected cases are clinically and anatomically correlated to exemplify the utility of this classification.

Conclusion: The SMT ...


Endoscopic–Assisted Surgery For Cerebello Pontine Angle Pathology: Technical Note And Surgical Results In A Series Of Patients, Jaime Jesus Martinez Anda, Pablo David Guerrero Suarez, Diego Pineda Martínez, Rafael Avendaño Pradel, Ernesto Javier Jurado Delgado, Ricardo Santiago Villlagrana Sánchez, Juan Carlos Cisneros Lesser, Carolina De la Llata Segura, Rogelio Revuelta Gutiérrez 2021 Neurosurgery Department, Toluca Medical Center of Social Security Institute of the State of Mexico and Provinces, State of Mexico, Mexico

Endoscopic–Assisted Surgery For Cerebello Pontine Angle Pathology: Technical Note And Surgical Results In A Series Of Patients, Jaime Jesus Martinez Anda, Pablo David Guerrero Suarez, Diego Pineda Martínez, Rafael Avendaño Pradel, Ernesto Javier Jurado Delgado, Ricardo Santiago Villlagrana Sánchez, Juan Carlos Cisneros Lesser, Carolina De La Llata Segura, Rogelio Revuelta Gutiérrez

Archives of Neurosurgery

Objectives: Endoscopic–assisted surgery combined with the operating microscope has been described for several surgical techniques and pathologies of the cerebellopontine angle (CPA). The use of an endoscope allows for a panoramic view of the CPA cistern and a high degree of maneuverability in narrow cisternal spaces that enable the surgeon to deal with most CPA lesions safely. We performed an observational study to describe the surgical anatomy and technique for endoscopic-assisted CPA surgery, describing our experience in a case series of patients with CPA pathology. Methods: Anatomical and surgical technique description of endoscopic-assisted surgery for CPA pathology, based on ...


Validation Of The Distress Thermometer In A Mexican Population With Brain Tumors: A Diagnostic Accuracy Study, Dan Morgenstern-Kaplan, Sergio Moreno-Jiménez, Fernanda Páez-Plascencia, Angel Ruiz-Chow, Fabiola Flores-Vázquez 2021 1. Radiosurgery Unit, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico

Validation Of The Distress Thermometer In A Mexican Population With Brain Tumors: A Diagnostic Accuracy Study, Dan Morgenstern-Kaplan, Sergio Moreno-Jiménez, Fernanda Páez-Plascencia, Angel Ruiz-Chow, Fabiola Flores-Vázquez

Archives of Neurosurgery

Objective: Mental health in cancer patients must be addressed. This study's main objective was to evaluate the sensitivity and specificity of the DT in a population of patients with brain tumors and determine the optimal cut-off point for the DT. Methods: We performed a cross-sectional study at the National Institute of Neurology and Neurosurgery in Mexico City, in a cohort of 110 patients. Results: Of the 108 participants with brain tumors that were included in the analysis (2 patients excluded by incomplete DT), 40 had gliomas, 31 had pituitary adenomas, 21 had meningiomas, and 16 had other types of ...


Traumatic Injuries Of The Common Peroneal Nerve And Current Surgical Strategies For Improving Foot Drop. A Clinical Series And Literature Review., Carlos Alberto Rodríguez Aceves, María Elena Córdoba Mosqueda, Racob Alberto García Velazco, Humberto González Ugalde, Héctor Antonio Soriano Solís, Fabiola Estela Elizabeth Ortega Ponce, Kartik G. Krishnan 2021 Neurosurgery Department, The American British Cowdray Medical Center, Neurological Center. México City, México

Traumatic Injuries Of The Common Peroneal Nerve And Current Surgical Strategies For Improving Foot Drop. A Clinical Series And Literature Review., Carlos Alberto Rodríguez Aceves, María Elena Córdoba Mosqueda, Racob Alberto García Velazco, Humberto González Ugalde, Héctor Antonio Soriano Solís, Fabiola Estela Elizabeth Ortega Ponce, Kartik G. Krishnan

Archives of Neurosurgery

Background: Common peroneal nerve injuries are the most frequent nerve injuries in the lower extremity. They may produce severe gait deficits because of weakness or absence in ankle dorsiflexion. Functional improvement after injury, despite any intervention, remains unpredictable. There are various surgical strategies aimed to restore foot drop, but no consensus exists regarding the best surgical treatment.

Objective: In this article, we report our experience and reviewing general aspects of common peroneal nerve anatomy and lesions, current surgical strategies to restore functionality, and the overall outcomes previously published in the literature.

Methods: Retrospective review of patients with foot drop secondary ...


Minimally Invasive Non-Expansile Tubular Extradural Posterior Fossa Decompression (Minted Technique) For The Management Of Chiari I.5 Malformation: Historical Overview Of Surgical Techniques, Technical Note, Proof Of Concept, Illustrative Case And Case Series. Lesser Is Better, José Alberto Israel Romero Rangel, Manuel Eduardo Soto García, Sergio Soriano Solís, Carlos Raúl Rangel Morales, Gerson Reyes Rodríguez, José Antonio Soriano Sánchez 2021 The American-British Cowdray Medical Center

Minimally Invasive Non-Expansile Tubular Extradural Posterior Fossa Decompression (Minted Technique) For The Management Of Chiari I.5 Malformation: Historical Overview Of Surgical Techniques, Technical Note, Proof Of Concept, Illustrative Case And Case Series. Lesser Is Better, José Alberto Israel Romero Rangel, Manuel Eduardo Soto García, Sergio Soriano Solís, Carlos Raúl Rangel Morales, Gerson Reyes Rodríguez, José Antonio Soriano Sánchez

Archives of Neurosurgery

BACKGROUND: Chiari's Malformation surgical treatment has significantly changed since the "classical" technique description by Gardner (1950). It is probably the most commonly performed approach, even when multiple techniques are available because no substantial changes nor any clear surgical objectives have been made. OBJECTIVE: To demonstrate a new cutting-edge surgical technique mastering the advantage of each surgical procedure ever described in the history of Chiari's Malformation establishing three critical points in surgical technique: clear patient-specific surgical goals, dynamic posterior fossa reconstruction, and extradural occipitoatlantal dense-adhesions release. METHODS: A comprehensive review of historically described approaches, proof of concept of surgical ...


“Primum Non Nocere”, The Role Of Research In Meeting This Primary Objective In Neurosurgical Praxis., José Antonio Soriano Sánchez, Fiacro Jiménez Ponce, José Alberto Israel Romero Rangel 2021 Founder and Directive Editor of Archives of Neurosurgery

“Primum Non Nocere”, The Role Of Research In Meeting This Primary Objective In Neurosurgical Praxis., José Antonio Soriano Sánchez, Fiacro Jiménez Ponce, José Alberto Israel Romero Rangel

Archives of Neurosurgery

The present editorial object is to make us aware of the role that scientific production has in patient safety. Our goal shall be to provide the best neurosurgical praxis parameters supported by the best scientific evidence, developed in strict alignment to current research and publishing ethics, to warrant patient safety in every process of neurosurgical care. Once this has been said, be the worldwide neurosurgical scientific community welcome to publish in Archives of Neurosurgery, a new journal that will make publishing possible for every neurosurgeon around the world, to become the scientific home of Neurosurgery.


Gait And Balance Changes With Investigational Peripheral Nerve Cell Therapy During Deep Brain Stimulation In People With Parkinson’S Disease, Geetanjali Gera, Zain Guduru, Tritia R. Yamasaki, Julie A. Gurwell, Monica Chau, Anna Krotinger, Frederick A. Schmitt, John T. Slevin, Greg A. Gerhardt, Craig G. van Horne, Jorge E. Quintero 2021 University of Kentucky

Gait And Balance Changes With Investigational Peripheral Nerve Cell Therapy During Deep Brain Stimulation In People With Parkinson’S Disease, Geetanjali Gera, Zain Guduru, Tritia R. Yamasaki, Julie A. Gurwell, Monica Chau, Anna Krotinger, Frederick A. Schmitt, John T. Slevin, Greg A. Gerhardt, Craig G. Van Horne, Jorge E. Quintero

Physical Therapy Faculty Publications

Background: The efficacy of deep brain stimulation (DBS) and dopaminergic therapy is known to decrease over time. Hence, a new investigational approach combines implanting autologous injury-activated peripheral nerve grafts (APNG) at the time of bilateral DBS surgery to the globus pallidus interna. Objectives: In a study where APNG was unilaterally implanted into the substantia nigra, we explored the effects on clinical gait and balance assessments over two years in 14 individuals with Parkinson’s disease. Methods: Computerized gait and balance evaluations were performed without medication, and stimulation was in the off state for at least 12 h to best assess ...


Support For Family Members Who Are Caregivers To Relatives With Acquired Brain Injury, Janet Walker, Lourens Schlebusch, Bernhard Gaede 2021 UNIVERSITY OF KWAZULU-NATAL, DEPARTMENT OF FAMILY MEDICINE, DURBAN, SOUTH AFRICA

Support For Family Members Who Are Caregivers To Relatives With Acquired Brain Injury, Janet Walker, Lourens Schlebusch, Bernhard Gaede

Journal of Mind and Medical Sciences

Objectives. Family members caring for a patient with acquired brain injury (ABI) are coping with inordinate levels of stress partially due to their lack of understanding of the neuropsychological effects of acquired brain injury in the patient. The objective of this research is to show that as the caregivers’ stress levels increase, there is an increase in suicidal ideation. This highlights the causal relationship between unhealthy stress and reduced psychological well-being in these caregivers. In addition, qualitative research evidence regarding the caregivers’ views of their main sources of stress are presented. Methods. The participants were a random sample of 80 ...


Method Of Intra-Arterial Drug Administration In A Rat: Sex Based Optimization Of Infusion Rate, Sarah J. Messmer, Justin F. Fraser, Keith R. Pennypacker, Jill M. Roberts 2021 University of Kentucky

Method Of Intra-Arterial Drug Administration In A Rat: Sex Based Optimization Of Infusion Rate, Sarah J. Messmer, Justin F. Fraser, Keith R. Pennypacker, Jill M. Roberts

Center for Advanced Translational Stroke Science Faculty Publications

BACKGROUND: Endovascular thrombectomy is the process of removing a blood clot and re-establishing blood flow in patients with emergent large vessel occlusion. The technique provides an opportunity to deliver therapeutics directly to the site of injury. The intra-arterial (IA) route of drug administration in the mouse was developed to bridge the gap between animal stroke treatments and clinical stroke therapy. Here, we adapted the IA method for use in rats, by investigating various flow rates to optimize the IA injection through the internal carotid artery (ICA).

METHODS: Male and female Sprague-Dawley rats (∼4 months of age) were subjected to placement ...


Tranexamic Acid To Reduce Head Injury Death In People With Traumatic Brain Injury: The Crash-3 International Rct, Ian Roberts, Haleema Shakur-Still, Amy Aeron-Thoma, Danielle Beaumont, Antonio Belli, Amy Brenner, Madeleine Cargill, Rizwana Chaudhri, Nicolas Douglas, Rashid Jooma 2021 London School of Hygiene & Tropical Medicine, London, UK.

Tranexamic Acid To Reduce Head Injury Death In People With Traumatic Brain Injury: The Crash-3 International Rct, Ian Roberts, Haleema Shakur-Still, Amy Aeron-Thoma, Danielle Beaumont, Antonio Belli, Amy Brenner, Madeleine Cargill, Rizwana Chaudhri, Nicolas Douglas, Rashid Jooma

Section of Neurosurgery

Background: Tranexamic acid safely reduces mortality in traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury and can cause brain herniation and death. We assessed the effects of tranexamic acid in traumatic brain injury patients.
Objective: To assess the effects of tranexamic acid on death, disability and vascular occlusive events in traumatic brain injury patients. We also assessed cost-effectiveness.
Design: Randomised trial and economic evaluation. Patients were assigned by selecting a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients, caregivers and those assessing outcomes were masked to allocation ...


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