Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Journal of Neurology
Published in: Journal of Neurology 11/2019

Open Access 01-11-2019 | Central Nervous System Trauma | Neurological Update

Recent advances in traumatic brain injury

Authors: Abdelhakim Khellaf, Danyal Zaman Khan, Adel Helmy

Published in: Journal of Neurology | Issue 11/2019

Login to get access

Abstract

Traumatic brain injury (TBI) is the most common cause of death and disability in those aged under 40 years in the UK. Higher rates of morbidity and mortality are seen in low-income and middle-income countries making it a global health challenge. There has been a secular trend towards reduced incidence of severe TBI in the first world, driven by public health interventions such as seatbelt legislation, helmet use, and workplace health and safety regulations. This has paralleled improved outcomes following TBI delivered in a large part by the widespread establishment of specialised neurointensive care. This update will focus on three key areas of advances in TBI management and research in moderate and severe TBI: refining neurointensive care protocolized therapies, the recent evidence base for decompressive craniectomy and novel pharmacological therapies. In each section, we review the developing evidence base as well as exploring future trajectories of TBI research.
Literature
1.
Timofeev I, Santarius T, Kolias AG, Hutchinson PJA (2012) Decompressive craniectomy—operative technique and perioperative care. Advances and technical standards in neurosurgery. Springer, New York, pp 115–136
2.
Faul M, Wald MM, Xu L, Coronado VG (2010) Traumatic brain injury in the United States; emergency department visits, hospitalizations, and deaths, 2002–2006
3.
Maas AIR, Menon DK, Adelson PD, Andelic N, Bell MJ, Belli A et al (2017) Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 16(12):987–1048PubMed
4.
5.
Huber A, Dorn A, Witzmann A, Cervós-Navarro J (1993) Microthrombi formation after severe head trauma. Int J Leg Med 106(3):152–155
6.
Hartings JA, Bullock MR, Okonkwo DO, Murray LS, Murray GD, Fabricius M et al (2011) Spreading depolarisations and outcome after traumatic brain injury: a prospective observational study. Lancet Neurol 10(12):1058–1064PubMed
7.
Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness: a practical scale. Lancet 304(7872):81–84
8.
Mena JH, Sanchez AI, Rubiano AM, Peitzman AB, Sperry JL, Gutierrez MI et al (2011) Effect of the modified Glasgow Coma Scale score criteria for mild traumatic brain injury on mortality prediction: comparing classic and modified Glasgow Coma Scale score model scores of 13. J Trauma 71(5):1185–1192 (discussion 93) PubMedPubMedCentral
9.
Dikmen SS, Machamer JE, Powell JM, Temkin NR (2003) Outcome 3–5 years after moderate to severe traumatic brain injury. Arch Phys Med Rehabil 84(10):1449–1457PubMed
10.
Rosenfeld JV, Maas AI, Bragge P, Morganti-Kossmann MC, Manley GT, Gruen RL (2012) Early management of severe traumatic brain injury. Lancet 380(9847):1088–1098PubMed
11.
Patel HC, Bouamra O, Woodford M, King AT, Yates DW, Lecky FE (2005) Trends in head injury outcome from 1989 to 2003 and the effect of neurosurgical care: an observational study. Lancet (London, England) 366(9496):1538–1544
12.
Chesnut RM, Marshall LF, Klauber MR, Blunt BA, Baldwin N, Eisenberg HM et al (1993) The role of secondary brain injury in determining outcome from severe head injury. J Trauma 34(2):216–222PubMed
13.
Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GWJ, Bell MJ et al (2017) Guidelines for the management of severe traumatic brain injury. Neurosurgery 80(1):6–15PubMed
14.
Chesnut RM, Temkin N, Carney N, Dikmen S, Rondina C, Videtta W et al (2012) A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 367(26):2471–2481PubMedPubMedCentral
15.
Smielewski P, Lavinio A, Timofeev I, Radolovich D, Perkes I, Pickard JD et al (2008) ICM+, a flexible platform for investigations of cerebrospinal dynamics in clinical practice. Acta Neurochir Suppl 102:145–151PubMed
16.
17.
18.
Okonkwo DO, Shutter LA, Moore C, Temkin NR, Puccio AM, Madden CJ et al (2017) Brain oxygen optimization in severe traumatic brain injury phase-II: a phase II randomized trial. Crit Care Med 45(11):1907–1914PubMedPubMedCentral
19.
20.
21.
Hutchinson PJ, Jalloh I, Helmy A, Carpenter KL, Rostami E, Bellander BM et al (2015) Consensus statement from the 2014 International Microdialysis Forum. Intensive Care Med 41(9):1517–1528PubMedPubMedCentral
22.
Oddo M, Schmidt JM, Carrera E, Badjatia N, Connolly ES, Presciutti M et al (2008) Impact of tight glycemic control on cerebral glucose metabolism after severe brain injury: a microdialysis study. Crit Care Med 36(12):3233–3238PubMed
23.
Stein NR, McArthur DL, Etchepare M, Vespa PM (2012) Early cerebral metabolic crisis after TBI influences outcome despite adequate hemodynamic resuscitation. Neurocrit Care 17(1):49–57PubMed
24.
Dizdarevic K, Hamdan A, Omerhodzic I, Kominlija-Smajic E (2012) Modified Lund concept versus cerebral perfusion pressure-targeted therapy: a randomised controlled study in patients with secondary brain ischaemia. Clin Neurol Neurosurg 114(2):142–148PubMed
25.
Timofeev I, Carpenter KL, Nortje J, Al-Rawi PG, O’Connell MT, Czosnyka M et al (2011) Cerebral extracellular chemistry and outcome following traumatic brain injury: a microdialysis study of 223 patients. Brain J Neurol 134(Pt 2):484–494
26.
Vespa PM, McArthur D, O’Phelan K, Glenn T, Etchepare M, Kelly D et al (2003) Persistently low extracellular glucose correlates with poor outcome 6 months after human traumatic brain injury despite a lack of increased lactate: a microdialysis study. J Cereb Blood Flow Metab 23(7):865–877PubMed
27.
Menon DK, Coles JP, Gupta AK, Fryer TD, Smielewski P, Chatfield DA et al (2004) Diffusion limited oxygen delivery following head injury. Crit Care Med 32(6):1384–1390PubMed
28.
Zeiler FA, Thelin EP, Helmy A, Czosnyka M, Hutchinson PJA, Menon DK (2017) A systematic review of cerebral microdialysis and outcomes in TBI: relationships to patient functional outcome, neurophysiologic measures, and tissue outcome. Acta Neurochir 159(12):2245–2273PubMed
29.
Brain Trauma Foundation (2016) Guidelines for the management of severe traumatic brain injury. Mary Ann Liebert Inc Publications, New York
30.
Zafar SN, Khan AA, Ghauri AA, Shamim MS (2012) Phenytoin versus leviteracetam for seizure prophylaxis after brain injury—a meta analysis. BMC Neurol 12:30PubMedPubMedCentral
31.
Inaba K, Menaker J, Branco BC, Gooch J, Okoye OT, Herrold J et al (2013) A prospective multicenter comparison of levetiracetam versus phenytoin for early posttraumatic seizure prophylaxis. J Trauma Acute Care Surg 74(3):766–771PubMed
32.
Bhullar IS, Johnson D, Paul JP, Kerwin AJ, Tepas JJ 3rd, Frykberg ER (2014) More harm than good: antiseizure prophylaxis after traumatic brain injury does not decrease seizure rates but may inhibit functional recovery. J Trauma Acute Care Surg 76(1):54–60PubMed
33.
Depreitere B, Guiza F, Van den Berghe G, Schuhmann MU, Maier G, Piper I et al (2014) Pressure autoregulation monitoring and cerebral perfusion pressure target recommendation in patients with severe traumatic brain injury based on minute-by-minute monitoring data. J Neurosurg 120(6):1451–1457PubMed
34.
Donnelly J, Budohoski KP, Smielewski P, Czosnyka M (2016) Regulation of the cerebral circulation: bedside assessment and clinical implications. Crit Care (London, England) 20(1):129
35.
Steiner LA, Czosnyka M, Piechnik SK, Smielewski P, Chatfield D, Menon DK et al (2002) Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury. Crit Care Med 30(4):733–738PubMed
36.
Sorrentino E, Diedler J, Kasprowicz M, Budohoski KP, Haubrich C, Smielewski P et al (2012) Critical thresholds for cerebrovascular reactivity after traumatic brain injury. Neurocrit Care 16(2):258–266PubMed
37.
Undén L, Calcagnile O, Undén J, Reinstrup P, Bazarian J (2015) Validation of the Scandinavian guidelines for initial management of minimal, mild and moderate traumatic brain injury in adults. BMC Med 13:292PubMedPubMedCentral
38.
Thelin EP, Zeiler FA, Ercole A, Mondello S, Buki A, Bellander BM et al (2017) Serial sampling of serum protein biomarkers for monitoring human traumatic brain injury dynamics: a systematic review. Front Neurol 8:300PubMedPubMedCentral
39.
Choi HA, Badjatia N, Mayer SA (2012) Hypothermia for acute brain injury—mechanisms and practical aspects. Nat Rev Neurol 8:214
40.
Andrews PJ, Sinclair HL, Rodriguez A, Harris B, Rhodes J, Watson H et al (2018) Therapeutic hypothermia to reduce intracranial pressure after traumatic brain injury: the Eurotherm3235 RCT. Health Technol Assess (Winchester, England) 22(45):1–134
41.
Andrews PJ, Sinclair HL, Rodriguez A, Harris BA, Battison CG, Rhodes JK et al (2015) Hypothermia for intracranial hypertension after traumatic brain injury. N Engl J Med 373(25):2403–2412PubMed
42.
Lewis SR, Evans DJ, Butler AR, Schofield-Robinson OJ, Alderson P (2017) Hypothermia for traumatic brain injury. Cochrane Database Syst Rev 9:CD001048
43.
Cooper DJ, Nichol AD, Bailey M, Bernard S, Cameron PA, Pili-Floury S et al (2018) Effect of early sustained prophylactic hypothermia on neurologic outcomes among patients with severe traumatic brain injury: the POLAR randomized clinical trial. JAMA 320(21):2211–2220PubMedPubMedCentral
44.
Jiang J-Y, Xu W, Li W-P, Xu W-H, Zhang J, Bao Y-H et al (2005) Efficacy of standard trauma craniectomy for refractory intracranial hypertension with severe traumatic brain injury: a multicenter, prospective, randomized controlled study. J Neurotrauma 22(6):623–628PubMed
45.
Kolias AG, Kirkpatrick PJ, Hutchinson PJ (2013) Decompressive craniectomy: past, present and future. Nat Rev Neurol 9(7):405PubMed
46.
Cooper DJ, Rosenfeld JV, Murray L, Arabi YM, Davies AR, D’Urso P et al (2011) Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med 364(16):1493–1502PubMed
47.
Hutchinson PJ, Kolias AG, Timofeev IS, Corteen EA, Czosnyka M, Timothy J et al (2016) Trial of decompressive craniectomy for traumatic intracranial hypertension. N Engl J Med 375(12):1119–1130PubMed
48.
Jennett B, Snoek J, Bond MR, Brooks N (1981) Disability after severe head injury: observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry 44(4):285–293PubMedPubMedCentral
49.
Kolias AG, Viaroli E, Rubiano AM, Adams H, Khan T, Gupta D et al (2018) The current status of decompressive craniectomy in traumatic brain injury. Curr Trauma Rep 4(4):326–332PubMedPubMedCentral
50.
Kramer AH, Deis N, Ruddell S, Couillard P, Zygun DA, Doig CJ et al (2016) Decompressive craniectomy in patients with traumatic brain injury: are the usual indications congruent with those evaluated in clinical trials? Neurocrit Care 25(1):10–19PubMed
51.
52.
Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW et al (2006) Surgical management of traumatic brain injury. Neurosurgery 58(3):16–24
53.
54.
55.
Roberts I, Yates D, Sandercock P, Farrell B, Wasserberg J, Lomas G et al (2004) Effect of intravenous corticosteroids on death within 14 days in 10,008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial. Lancet (London, England) 364(9442):1321–1328
56.
Wright DW, Kellermann AL, Hertzberg VS, Clark PL, Frankel M, Goldstein FC et al (2007) ProTECT: a randomized clinical trial of progesterone for acute traumatic brain injury. Ann Emerg Med 49(4):391–402PubMed
57.
Xiao G, Wei J, Yan W, Wang W, Lu Z (2008) Improved outcomes from the administration of progesterone for patients with acute severe traumatic brain injury: a randomized controlled trial. Crit Care (London, England) 12(2):R61
58.
Skolnick BE, Maas AI, Narayan RK, van der Hoop RG, MacAllister T, Ward JD et al (2014) A clinical trial of progesterone for severe traumatic brain injury. N Engl J Med 371(26):2467–2476PubMed
59.
Wright DW, Yeatts SD, Silbergleit R, Palesch YY, Hertzberg VS, Frankel M et al (2014) Very early administration of progesterone for acute traumatic brain injury. N Engl J Med 371(26):2457–2466PubMedPubMedCentral
60.
Coleman T, Brines M (2004) Science review: recombinant human erythropoietin in critical illness: a role beyond anemia? Crit Care (London, England) 8(5):337–341
61.
Aloizos S, Evodia E, Gourgiotis S, Isaia EC, Seretis C, Baltopoulos GJ (2015) Neuroprotective effects of erythropoietin in patients with severe closed brain injury. Turk Neurosurg 25(4):552–558PubMed
62.
Li ZM, Xiao YL, Zhu JX, Geng FY, Guo CJ, Chong ZL et al (2016) Recombinant human erythropoietin improves functional recovery in patients with severe traumatic brain injury: a randomized, double blind and controlled clinical trial. Clin Neurol Neurosurg 150:80–83PubMed
63.
Lee J, Cho Y, Choi KS, Kim W, Jang BH, Shin H et al (2018) Efficacy and safety of erythropoietin in patients with traumatic brain injury: a systematic review and meta-analysis. Am J Emerg Med 37:1101PubMed
64.
Mizoguchi K, Yokoo H, Yoshida M, Tanaka T, Tanaka M (1994) Amantadine increases the extracellular dopamine levels in the striatum by re-uptake inhibition and by N-methyl-d-aspartate antagonism. Brain Res 662(1–2):255–258PubMed
65.
Giacino JT, Whyte J, Bagiella E, Kalmar K, Childs N, Khademi A et al (2012) Placebo-controlled trial of amantadine for severe traumatic brain injury. N Engl J Med 366(9):819–826PubMed
66.
Ghalaenovi H, Fattahi A, Koohpayehzadeh J, Khodadost M, Fatahi N, Taheri M et al (2018) The effects of amantadine on traumatic brain injury outcome: a double-blind, randomized, controlled, clinical trial. Brain Inj 32(8):1050–1055PubMed
67.
Hammond FM, Sherer M, Malec JF, Zafonte RD, Dikmen S, Bogner J et al (2018) Amantadine did not positively impact cognition in chronic traumatic brain injury: a multi-site, randomized, controlled trial. J Neurotrauma 35(19):2298–2305PubMedPubMedCentral
68.
Dewan Y, Komolafe EO, Mejía-Mantilla JH, Perel P, Roberts I, Shakur H (2012) CRASH-3-tranexamic acid for the treatment of significant traumatic brain injury: study protocol for an international randomized, double-blind, placebo-controlled trial. Trials 13(1):87PubMedPubMedCentral
69.
Dunn CJ, Goa KL (1999) Tranexamic acid: a review of its use in surgery and other indications. Drugs 57(6):1005–1032PubMed
70.
Harhangi BS, Kompanje EJO, Leebeek FWG, Maas AIR (2008) Coagulation disorders after traumatic brain injury. Acta Neurochir 150(2):165–175PubMed
71.
Gebel JM Jr, Jauch EC, Brott TG, Khoury J, Sauerbeck L, Salisbury S et al (2002) Relative edema volume is a predictor of outcome in patients with hyperacute spontaneous intracerebral hemorrhage. Stroke 33(11):2636–2641PubMed
72.
Williams-Johnson JA, McDonald AH, Strachan GG, Williams EW (2010) Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. West Indian Med J 59(6):612–624PubMed
73.
CRASH-2 Collaborators (Intracranial Bleeding Study) (2011) Effect of tranexamic acid in traumatic brain injury: a nested randomised, placebo controlled trial (CRASH-2 Intracranial Bleeding Study). BMJ 343:d3795
74.
Tan HB, Wasiak J, Rosenfeld JV, O’Donohoe TJ, Gruen RL (2014) Citicoline (CDP-choline) for traumatic brain injury. Cochrane Database Syst Rev 8:CD011217
75.
Zafonte RD, Bagiella E, Ansel BM, Novack TA, Friedewald WT, Hesdorffer DC et al (2012) Effect of citicoline on functional and cognitive status among patients with traumatic brain injury: citicoline Brain Injury Treatment Trial (COBRIT). JAMA 308(19):1993–2000PubMed
76.
Pradillo JM, Denes A, Greenhalgh AD, Boutin H, Drake C, McColl BW et al (2012) Delayed administration of interleukin-1 receptor antagonist reduces ischemic brain damage and inflammation in comorbid rats. J Cereb Blood Flow Metab 32(9):1810–1819PubMedPubMedCentral
77.
Allan SM, Tyrrell PJ, Rothwell NJ (2005) Interleukin-1 and neuronal injury. Nat Rev Immunol 5(8):629PubMed
78.
Helmy A, Guilfoyle MR, Carpenter KL, Pickard JD, Menon DK, Hutchinson PJ (2014) Recombinant human interleukin-1 receptor antagonist in severe traumatic brain injury: a phase II randomized control trial. J Cereb Blood Flow Metab 34(5):845–851PubMedPubMedCentral
79.
Metadata
Title
Recent advances in traumatic brain injury
Authors
Abdelhakim Khellaf
Danyal Zaman Khan
Adel Helmy
Publication date
01-11-2019
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 11/2019
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-019-09541-4

Other articles of this Issue 11/2019

Journal of Neurology 11/2019 Go to the issue

Letter to the Editors

Aperiodic alternating nystagmus in isolated vestibular nucleus infarction

Original Communication

Motor and non-motor symptoms in blepharospasm: clinical and pathophysiological implications

Original Communication

Deep brain stimulation for Meige syndrome: a meta-analysis with individual patient data

Original Communication

The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS)

Review

Biological and imaging predictors of cognitive impairment after stroke: a systematic review

Original Communication

Circulating neurofilament light in ischemic stroke: temporal profile and outcome prediction