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Special Issue "Evaluation and Management of Traumatic Brain Injury"

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Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran 1416634793, Iran
Interests: neurotrauma; traumatic brain injury

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Dear Colleagues,

Traumatic brain injury (TBI) is one of the principal causes of morbidity, disability, and mortality affecting people of all ages. It is a major global health issue and imposes a heavy burden on the family, healthcare system, and society.

Despite advances in knowledge about the clinical characteristics and underlying pathophysiological mechanisms of TBI and the development of novel and promising therapeutic approaches, there are many challenges to diagnosing, monitoring, and treating TBI to date. We do not have a rapid and accurate diagnosis for successful predicting and triaging yet; several clinical trials for therapeutic purposes have failed over the past few decades, and neurocognitive disorders are significant problems in the long term.

In this Special Issue of Brain Sciences, we highlight current research focusing on these major challenges. We invite the authors to submit their cutting-edge basic and clinical research on developing, improving, and validating point-of-care platforms for early and on-site diagnosis, neuroimaging-based scoring systems, intracranial pressure monitoring approaches, therapeutic interventions, and neurocognitive assessments and rehabilitation in TBI.

Dr. Mahdi Sharif-Alhoseini
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

traumatic brain injury
diagnosis
prediction
point of care
biomarkers
management
treatment
rehabilitation

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Open AccessArticle

The Role of Decompressive Craniectomy on Functional Outcome, Mortality and Seizure Onset after Traumatic Brain Injury

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Brain Sci. 2023, 13(4), 581; https://doi.org/10.3390/brainsci13040581 - 29 Mar 2023

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Abstract

Background: Decompressive craniectomy (DC) to treat increased intracranial pressure after a traumatic brain injury (TBI) is a common but controversial choice in clinical practice. This study aimed to determine the impact of DC on functional outcomes, mortality and the occurrence of seizures in a large cohort of patients with TBI. Methods: This retrospective study included patients with TBI consecutively admitted for a 6-month neurorehabilitation program between 1 January 2009 and 31 December 2018. The radiological characteristics of brain injury were determined with the Marshall computed tomographic classification. The neurological status and rehabilitation outcome were assessed using the Glasgow Coma Scale (GCS) and the Functional Independence Measure (FIM), which were both assessed at baseline and on discharge. Furthermore, the GCS was recorded on arrival at the emergency department. The DC procedure, prophylactic antiepileptic drug (AED) use, the occurrence of early or late seizures (US, unprovoked seizures) and death during hospitalization were also recorded. Results: In our cohort of 309 adults with mild-to-severe TBI, DC was performed in 98 (31.7%) patients. As expected, a craniectomy was more frequently performed in patients with severe TBI (p < 0.0001). However, after adjusting for the confounding variables including GCS scores, age and the radiological characteristics of brain injury, there was no association between DC and poor functional outcomes or mortality during the inpatient rehabilitation period. In our cohort, the independent predictors of an unfavorable outcome at discharge were the occurrence of US (β = −0.14, p = 0.020), older age (β = −0.13, p = 0.030) and the TBI severity on admission (β = −0.25, p = 0.002). Finally, DC (OR 3.431, 95% CI 1.233–9.542, p = 0.018) and early seizures (OR = 3.204, 95% CI 1.176–8.734, p = 0.023) emerged as the major risk factors for US, independently from the severity of the brain injury and the prescription of a primary prophylactic therapy with AEDs. Conclusions: DC after TBI represents an independent risk factor for US, regardless of the prescription of prophylactic AEDs. Meanwhile, there is no significant association between DC and mortality, or a poor functional outcome during the inpatient rehabilitation period. Full article

(This article belongs to the Special Issue Evaluation and Management of Traumatic Brain Injury)

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Special Issue "Evaluation and Management of Traumatic Brain Injury"

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