Objectives: Decompressive craniectomy (DC) is a last-tier therapy in the treatment of raised intracranial pressure after traumatic brain injury (TBI). We report the association of comparative radiographic factors in predicting functional outcomes after DC in patients with severe TBI.
Methods: A retrospective analysis of a prospectively maintained database of cases between 2015 and 2018 at an academic tertiary care hospital was carried out. Univariate and multivariable regression analyses were performed for an array of comparative radiographic variables (pre- and post-DC) in relationship to functional outcome according to Glasgow Outcome Scale Extended (GOSE) at 180 days. GOSE was further dichotomized into favorable (GOSE:5-8) and unfavorable (GOSE:0-4) functional outcomes. All associations were reported as odds ratio (OR) with 95% confidence interval (CI).
Results: Statistical analysis included a cohort of 43 patients with a median age of 30.5 years (range: 18-62 years). The median GOSE at 180 days was 7. Multivariable regression analysis after adjusting for confounding variables (age, sex, comorbidities, site of surgery and size of decompression) showed that comparative radiographic findings of midline shift (MLS) > 10 mm (OR 3.2 (95% CI 1.25-8.04); P = 0.01); external cerebral herniation (ECH) > 2.5 cm (OR 2.5 [95% CI 1.18-5.2]; P = 0.02); and effacement of basal cisterns (OR 3.9 [95%CI 1.1-13.9]; P = 0.03), were significant independent predictors of poor functional outcome at 180 days after DC for severe TBI. However, the presence of infarction (OR 2.7 [95%CI 0.43-17.2]; P = 0.28) and absence of gray-white matter differentiation (OR 0.18 [95%CI 0.03-1.2]; P = 0.07) did not reach statistical significance.
Conclusions: The comparative radiographic findings that include MLS > 10mm, ECH > 2.5cm, and effacement of basal cisterns are predictive of poor functional outcome in severe TBI.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wneu.2020.03.118 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Efficacy of small-diameter core decompression with platelet-rich plasma in early osteonecrosis of the femoral head: a retrospective study.
BMC Musculoskelet Disord
January 2025
Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
Background: Osteonecrosis of the femoral head (ONFH) is a challenging condition, primarily affecting young and middle-aged individuals, which results in hip dysfunction and, ultimately, femoral head collapse. However, the comparative effectiveness of joint-preserving procedures, particularly in the early stages of ONFH (ARCO stage I or II), remains inconclusive. This study aims to evaluate the efficacy of a novel technique called small-diameter core decompression (CD) combined with platelet-rich plasma (PRP), for the treatment of early-stage ONFH.
View Article and Find Full Text PDFHistological and radiographic assessment of the regenerative potential of sodium hexametaphosphate (SHMP) as a novel direct pulp capping material in an animal model.
BMC Oral Health
January 2025
Paediatric and Community Dentistry, Faculty of Dentistry, Minia University, Ard Shalaby, El Minia, 61519, Egypt.
Background: This study aimed to assess the histological and radiographic effects of sodium hexametaphosphate (SHMP) as a direct pulp capping (DPC) agent in immature permanent dog premolars.
Methods: A split-mouth design was employed with three healthy 4-month-old Mongrel dogs, each having 36 premolars. The premolars were randomly assigned to either SHMP or MTA.
Enhancing Radiographic Diagnosis: CycleGAN-Based Methods for Reducing Cast Shadow Artifacts in Wrist Radiographs.
J Imaging Inform Med
January 2025
Monash Imaging, Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
We extend existing techniques by using generative adversarial network (GAN) models to reduce the appearance of cast shadows in radiographs across various age groups. We retrospectively collected 11,500 adult and paediatric wrist radiographs, evenly divided between those with and without casts. The test subset consisted of 750 radiographs with cast and 750 without cast.
View Article and Find Full Text PDFEfficacy and safety of jaktinib hydrochloride tablets in active axial spondyloarthritis: a multicentre, randomised, double-blind, placebo-controlled phase II clinical trial.
RMD Open
January 2025
Department of Rheumatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Objective: The objective of this study is to evaluate the efficacy and safety of jaktinib hydrochloride tablets (jaktinib), a Janus kinase inhibitor, in patients with active radiographic axial spondyloarthritis (r-axSpA).
Methods: Adults with active r-axSpA who met modified New York criteria and had an inadequate response to non-steroidal anti-inflammatory drugs were randomised 1:1:1 to receive jaktinib 75 mg two times per day, 100 mg two times per day, or placebo. The primary and key secondary endpoints were Assessment of SpondyloArthritis international Society 20 (ASAS 20) and ASAS 40 responses, respectively, at week 16.
A non-metallic PEEK topology optimization reconstruction implant for large mandibular continuity defects, validated using the MANDYBILATOR apparatus.
Sci Rep
January 2025
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
In cases of large mandibular continuity defects resulting from malignancy resection, the current standard of care involves using patient-specific/custom titanium reconstruction plates along with autogenous grafts (fibula, scapula, or iliac crest segments). However, when grafts are not feasible or desired, only the reconstruction plate is used to bridge the gap. Unfortunately, metal osteosynthesis and reconstruction plates, including titanium, exhibit adverse effects such as stress-shielding and limitations in accurate postoperative irradiation (especially with proton-beam therapy).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!