Development of an Active Cerebrovascular Autoregulation Model Using Representation Learning: A Proof of Concept Study With Experimental Data.

Background And Objectives: It remains a challenge to monitor cerebrovascular autoregulation (CA) reliably and dynamically in an intensive care unit. The objective was to build a proof-of-concept active CA model exploiting advances in representation learning and the full complexity of the arterial blood pressure (ABP) and intracranial pressure (ICP) signal and outperform the pressure reactivity index (PRx).

Methods: A porcine cranial window CA data set (n = 20) was used.

The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction?

Introduction: In 1960, Lazorthes and Campman introduced the concept of a which gained prominence in the field of traumatic brain injury (TBI), where it relates to neurological deterioration on the third day after injury. However, evidence regarding this phenomenon remains scarce.

Research Question: This study aimed to analyze posttraumatic intracranial pressure (ICP) patterns in a large European cohort to investigate the existence of a third-day crisis and its impact on 12-month functional outcomes.

Cerebral contusions - Pathomechanism, predictive factors for progression and historical and current management.

Introduction: Cerebral contusions (CCs) are common traumatic brain injuries known for their propensity to progress. Understanding their mechanical pathogenesis and predictive factors for progression is crucial for optimal management.

Research Question: To provide an overview of current knowledge on CCs, including pathomechanisms, predictive factors of contusion progression, and management strategies.

Surgical versus conservative treatment for odontoid fractures in older people: an international prospective comparative study.

Background: The optimal treatment for odontoid fractures in older people remains debated. Odontoid fractures are increasingly relevant to clinical practice due to ageing of the population.

Methods: An international prospective comparative study was conducted in fifteen European centres, involving patients aged ≥55 years with type II/III odontoid fractures.

The death of a neurotrauma trial lessons learned from the prematurely halted randomized evaluation of surgery in elderly with traumatic acute subdural hematoma (RESET-ASDH) trial.

Introduction: Acute subdural hematoma (ASDH) due to traumatic brain injury (TBI) constitutes an increasing global health problem, especially in the elderly population. Treatment decisions on surgical versus conservative management pose a neurosurgical dilemma. Large practice variation exists between countries, hospitals, and individual neurosurgeons, illustrating the presence of 'clinical equipoise'.

The Pressure Reactivity Index as a Measure for Cerebrovascular Autoregulation: Validation in a Porcine Cranial Window Model.

Background And Objectives: Pressure reactivity index (PRx) has been proposed as a metric associated with cerebrovascular autoregulatory (CA) function and has been thoroughly investigated in clinical research. In this study, PRx is validated in a porcine cranial window model, developed to visualize pial arteriolar autoregulation and its limits.

Methods: We measured arterial blood pressure, intracranial pressure, pial arteriolar diameter, and red blood cell (RBC) velocity in a closed cranial window piglet model during gradual balloon catheter-induced arterial hypotension (n = 10) or hypertension (n = 10).

Qualitative study exploring the views of patients and healthcare providers on current rehabilitation practices after lumbar fusion surgery.

Objectives: To explore the views of patients and healthcare providers on current rehabilitation after lumbar fusion surgery (LFS) to fuel the development of a novel rehabilitation care pathway.

Design: A cross-sectional, qualitative study with an interpretive descriptive design.

Setting: Academic and non-academic hospital setting in Belgium.

Is age or cardiovascular comorbidity the main predictor of reduced cerebrovascular pressure reactivity in older patients with traumatic brain injury?

Introduction: The Pressure Reactivity index (PRx) has been proposed as a surrogate measure for cerebrovascular autoregulation (CA) and it has been described that older age is associated with worse PRx. The etiology for this reduced capacity remains unknown.

Research Question: To investigate the relation between age and PRx in a cohort of patients with traumatic brain injury (TBI) while correcting for cardiovascular comorbidities.

Refining outcome prediction after traumatic brain injury with machine learning algorithms.

Outcome after traumatic brain injury (TBI) is typically assessed using the Glasgow outcome scale extended (GOSE) with levels from 1 (death) to 8 (upper good recovery). Outcome prediction has classically been dichotomized into either dead/alive or favorable/unfavorable outcome. Binary outcome prediction models limit the possibility of detecting subtle yet significant improvements.

Consensus-based recommendations for diagnosis and surgical management of cranioplasty and post-traumatic hydrocephalus from a European panel.

Introduction: Planning cranioplasty (CPL) in patients with suspected or proven post-traumatic hydrocephalus (PTH) poses a significant management challenge due to a lack of clear guidance.

Research Question: This project aims to create a European document to improve adherence and adapt to local protocols based on available resources and national health systems.

Methods: After a thorough non-systematic review, a steering committee (SC) formed a European expert panel (EP) for a two-round questionnaire using the Delphi method.

Developing a porcine model of severe traumatic brain injury induced by high amplitude rotational acceleration.

Introduction: It is unclear which pathophysiological processes initiate and drive dynamic cerebrovascular autoregulation (CA) impairment as seen in traumatic brain injury (TBI). This is not solely attributable to raised intracranial pressure (ICP), but also results from local tissue damage.

Research Question: In order to investigate CA disturbing processes, a porcine model is needed that mimics severe TBI as seen in humans.

Visualization of the Intracranial Pressure and Time Burden in Childhood Brain Trauma: What We Have Learned One Decade on With KidsBrainIT.

To validate the intracranial pressure (ICP) dose-response visualization plot for the first time in a novel prospectively collected pediatric traumatic brain injury (pTBI) data set from the multi-center, multi-national KidsBrainIT consortium. Prospectively collected minute-by-minute ICP and mean arterial blood pressure time series of 104 pTBI patients were categorized in ICP intensity-duration episodes. These episodes were correlated with the 6-month Glasgow Outcome Score (GOS) and displayed in a color-coded ICP dose-response plot.

Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS).

Background: The early management of polytrauma patients with traumatic spinal cord injury (tSCI) is a major challenge. Sparse data is available to provide optimal care in this scenario and worldwide variability in clinical practice has been documented in recent studies.

Methods: A multidisciplinary consensus panel of physicians selected for their established clinical and scientific expertise in the acute management of tSCI polytrauma patients with different specializations was established.

Tau Imaging in Late Traumatic Brain Injury: A [F]MK-6240 Positron Emission Tomography Study.

Epidemiological studies have identified prior traumatic brain injury (TBI) as a risk factor for developing Alzheimer's disease (AD). Neurofibrillary tangles (NFTs) are common to AD and chronic traumatic encephalopathy following repetitive mild TBI. However, it is unclear if a single TBI is sufficient to cause accumulation of NFTs.

An international, prospective observational study on traumatic brain injury epidemiology study protocol: .

Background: The epidemiology of traumatic brain injury (TBI) is unclear - it is estimated to affect 27-69 million individuals yearly with the bulk of the TBI burden in low-to-middle income countries (LMICs). Research has highlighted significant between-hospital variability in TBI outcomes following emergency surgery, but the overall incidence and epidemiology of TBI remains unclear. To address this need, we established the Global Epidemiology and Outcomes following Traumatic Brain Injury (GEO-TBI) registry, enabling recording of all TBI cases requiring admission irrespective of surgical treatment.

Consensus-Based Development of a Global Registry for Traumatic Brain Injury: Establishment, Protocol, and Implementation.

Background And Objectives: Global disparity exists in the demographics, pathology, management, and outcomes of surgically treated traumatic brain injury (TBI). However, the factors underlying these differences, including intervention effectiveness, remain unclear. Establishing a more accurate global picture of the burden of TBI represents a challenging task requiring systematic and ongoing data collection of patients with TBI across all management modalities.

Predicting return to work after traumatic brain injury using machine learning and administrative data.

Background: Accurate patient-specific predictions on return-to-work after traumatic brain injury (TBI) can support both clinical practice and policymaking. The use of machine learning on large administrative data provides interesting opportunities to create such prognostic models.

Aim: The current study assesses whether return-to-work one year after TBI can be predicted accurately from administrative data.

In-depth assessment of quality of life and real life impact of mild traumatic brain injury in elderly by means of a focus group study.

Traumatic Brain Injury (TBI) in the elderly population leads to more severe consequences than in young patients. However, the impact that TBI has on elderly patients' Quality of Life (QoL) has not been thoroughly investigated and is still unclear. Therefore, the main objective of this study is to qualitatively investigate changes in QoL after mild TBI in elderly patients.