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Background: Traumatic brain injury (TBI) patients transferred from high-altitude areas present with unique challenges that complicate the treatment of these patients. This study aims to summarize the clinical characteristics and treatment experience of TBI patients transferred to the authors' center from ultra-high-altitude areas.
Observations: The authors conducted a retrospective case series analysis of 10 TBI cases admitted to their center between January 2021 and December 2023. These patients were airlifted from areas > 3500 m above sea level. On admission and at specified intervals up to 30 days postadmission, patients underwent head CT scans, laboratory tests, and posttraumatic stress disorder (PTSD) assessments. Self-care ability scores and psychological assessments were obtained at various time points postdischarge. With a precise and proactive treatment strategy, there was a significant reduction in intracranial hematoma volume, hemoglobin levels, D-dimer, procalcitonin, and serum sodium by the 30th day. The incidence of PTSD was markedly reduced at 6 months postdischarge compared with initial assessments within the 1st week.
Lessons: TBI patients transferred from high-altitude areas exhibited persistent intracerebral hematoma, elevated intracranial pressure, relative anemia, hypercoagulation, etc., and thus a precise and proactive treatment would benefit these patients. https://thejns.org/doi/10.3171/CASE24823.
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http://dx.doi.org/10.3171/CASE24823 | DOI Listing |
Radiol Phys Technol
September 2025
Division of Medical Physics, Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, 110085, India.
This study compares the dosimetric performance of Base Dose Optimization (BDO) and Gradient-Based Optimization (GBO) for extended target volumes in Total Body Irradiation (TBI). The focus is on overlapping regions using the Rando Phantom. The study evaluates dose distribution, conformity, homogeneity, and sensitivity to positional deviations.
View Article and Find Full Text PDFJ Neurol Sci
September 2025
Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America.
Background: A key limitation of the IMPACT model for prognostication after severe traumatic brain injury (TBI) is the use of predictors from hospital admission only. We sought to identify if including daily blood labs (e.g.
View Article and Find Full Text PDFClin Neurol Neurosurg
September 2025
Department of Endocrinology, Mymensingh Medical College, Mymensingh 2200, Bangladesh.
Introduction: India experiences the highest number of road traffic fatalities globally. Acquired hypopituitarism is a common sequela in patients who sustain traumatic brain injury (TBI). This study aimed to investigate the prevalence and imaging characteristics of hypopituitarism in patients with TBI at a tertiary care centre in North India.
View Article and Find Full Text PDFNeurology
September 2025
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA.
Background And Objectives: Moderate-to-severe traumatic brain injury (TBI) can result in disability across physical, social, and cognitive domains. The Glasgow Outcome Scale-Extended (GOSE), which evaluates global function, is the most frequently used TBI outcome measure. However, the GOSE may not capture all domains of recovery.
View Article and Find Full Text PDFCrit Care Explor
September 2025
Surgical Services, Minneapolis VA Medical Center, Minneapolis, MN.
Objective: This post hoc study of the Progesterone for Traumatic Brain Injury, Experimental Clinical Treatment (ProTECT) III trial investigates whether improving traumatic brain injury (TBI) classification, using serum biomarkers (glial fibrillary acidic protein [GFAP] and ubiquitin carboxyl-terminal esterase L1 [UCH-L1]) and algorithmically assessed total lesion volume, could identify a subset of responders to progesterone treatment, beyond broad measures like the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale-Extended (GOS-E), which may fail to capture subtle changes in TBI recovery.
Design: Brain lesion volumes on CT scans were quantified using Brain Lesion Analysis and Segmentation Tool for CT. Patients were classified into true-positive and true-negative groups based on an optimization scheme to determine a threshold that maximizes agreement between radiological assessment and objectively measured lesion volume.