Resting energy expenditure in non-ventilated, non-sedated patients recovering from serious traumatic brain injury: comparison of prediction equations with indirect calorimetry values.

Background & Aims: Little is known about energy requirements in brain injured (TBI) patients, despite evidence suggesting adequate nutritional support can improve clinical outcomes. The study aim was to compare predicted energy requirements with measured resting energy expenditure (REE) values, in patients recovering from TBI.

Methods: Indirect calorimetry (IC) was used to measure REE in 45 patients with TBI.

A reduced abbreviated indirect calorimetry protocol is clinically acceptable for use in spontaneously breathing patients with traumatic brain injury.

A steady state should be established when using indirect calorimetry to assess resting energy expenditure, reduce error, and improve the validity of the measurement. Steady-state criteria are often rigorous and difficult to achieve in hospitalized patients, particularly in patients recovering from traumatic brain injury. This study aimed to assess whether reducing the timeframe for steady-state conditions to 2, 3, or 4 minutes when using indirect calorimetry was significantly different from the widely accepted 5-minute steady-state protocol in patients recovering from traumatic brain injury.

Primary malignant melanoma of the cerebellopontine angle: a diagnostic dilemma: case report.

Objective: To present a rare case of a primary malignant melanoma of the central nervous system presenting as a cerebellopontine angle (CPA) tumor and to delineate aspects of the clinical presentation and magnetic resonance imaging scan characteristics that may suggest this unusual condition.

Clinical Presentation: The clinical presentation consisted of a short duration of right-sided sensorineural hearing loss, facial weakness, and ataxia in a previously healthy man. Brain magnetic resonance imaging scans showed a right-sided CPA tumor exhibiting shortening of T1 and T2 relaxation times, but overall neuroradiological features were not consistent with any commonly occurring CPA tumors.