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Evaluation of the Scandinavian guidelines for head injuries based on a consecutive series with computed tomography from a Norwegian university hospital.

https://arctichealth.org/en/permalink/ahliterature121019
Source
Scand J Trauma Resusc Emerg Med. 2012;20:62
Publication Type
Article
Date
2012
Author
Ingrid Haavde Strand
Ole Solheim
Kent Gøran Moen
Anne Vik
Author Affiliation
Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.
Source
Scand J Trauma Resusc Emerg Med. 2012;20:62
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Algorithms
Child
Child, Preschool
Comorbidity
Craniocerebral Trauma - epidemiology - radiography - therapy
Female
Guideline Adherence
Hospitals, University
Humans
Infant
Male
Middle Aged
Norway
Practice Guidelines as Topic
Prospective Studies
Scandinavia
Tomography, X-Ray Computed
Young Adult
Abstract
This study prospectively assesses clinical characteristics and management of consecutive minimal, mild and moderate head injury patients referred for CT scans. Compliance with the Scandinavian head injury guidelines and possible reasons for non-compliance is explored.
From January 16th 2006 to January 15th 2007, 1325 computed tomography (CT) examinations due to minimal, mild or moderate head injury according to the Head Injury Severity Scale (HISS) were carried out at our University Hospital. When ordering a CT scan due to head trauma, physicians were asked to fill out a questionnaire.
Guideline compliance was impossible to assess in 49.5% of all cases. This was due to non-assessable or missing key variables necessary in the decision making algorithm. One or more key variables for HISS classification were not assessable in 34.4% as it was unknown whether there had been loss of consciousness (LOC), duration of LOC was unknown or it was impossible to assess amnesia or focal neurologic deficits. Definite compliance with both CT and admittance recommendations in guidelines was seen in only 31.2%. In 54.2% of patients with minimal head injuries who underwent CT scans, imaging was not necessary according to guidelines. 59.1% of all patients were admitted to hospital, however only 23.7% of these were admitted because of the head-injury alone. Age?
Notes
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PubMed ID
22947500 View in PubMed
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Incidence and mortality of moderate and severe traumatic brain injury in children: A ten year population-based cohort study in Norway.

https://arctichealth.org/en/permalink/ahliterature301924
Source
Eur J Paediatr Neurol. 2019 May; 23(3):500-506
Publication Type
Journal Article
Date
May-2019
Author
Mari Olsen
Anne Vik
Tom Ivar Lund Nilsen
Oddvar Uleberg
Kent Gøran Moen
Oddrun Fredriksli
Espen Lien
Torun Gangaune Finnanger
Toril Skandsen
Author Affiliation
Clinic of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway. Electronic address: mari.olsen@ntnu.no.
Source
Eur J Paediatr Neurol. 2019 May; 23(3):500-506
Date
May-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Brain Injuries, Traumatic - epidemiology
Child
Child, Preschool
Cohort Studies
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Norway - epidemiology
Retrospective Studies
Abstract
In this study we wanted to estimate population-based rates of incidence and mortality of moderate and severe traumatic brain injury (TBI) in children in one specific region in Norway.
In the region there are seven acute care hospitals (ACHs) in addition to a Level 1 trauma centre. Of 702 869 inhabitants (2014), 145 395 were children aged 0-16 years. Data were collected during ten years (2004-2014). All children aged 0-16 years with moderate (Glasgow Coma Scale [GCS] score 9-13) or severe (GCS score = 8) TBI admitted to the Level 1 trauma centre were prospectively included. Children treated outside the Level 1 trauma centre were retrospectively included from the ACHs. Children who died from TBI prehospitally were included from the National Cause of Death Registry. Poisson regression was used to estimate incidence rate ratios (with a 95% confidence interval) comparing age, sex, and time periods.
A total of 71 children with moderate or severe TBI were identified. Crude incidence rates were 2·4 (95% CI 1·7-3·3) for moderate and 2·5 (95% CI 1·8-3·4) for severe TBI per 100 000 person-years (py). Mortality rate from TBI was 1·2 (95% CI 0·7-1·9) per 100 000 py, and 88% were prehospital deaths.
The incidence rates and mortality of moderate and severe TBI were low compared to international reports. Most likely explained by successful national prevention of TBI.
PubMed ID
30879962 View in PubMed
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The Influence of Traumatic Axonal Injury in Thalamus and Brainstem on Level of Consciousness at Scene or Admission: A Clinical Magnetic Resonance Imaging Study.

https://arctichealth.org/en/permalink/ahliterature288239
Source
J Neurotrauma. 2018 Feb 09;
Publication Type
Article
Date
Feb-09-2018
Author
Hans Kristian Moe
Kent Gøran Moen
Toril Skandsen
Kjell Arne Kvistad
Steven Laureys
Asta Håberg
Anne Vik
Source
J Neurotrauma. 2018 Feb 09;
Date
Feb-09-2018
Language
English
Publication Type
Article
Abstract
The aim of this study was to investigate how traumatic axonal injury (TAI) lesions in the thalamus, basal ganglia, and brainstem on clinical brain magnetic resonance imaging (MRI) are associated with level of consciousness in the acute phase in patients with moderate to severe traumatic brain injury (TBI). There were 158 patients with moderate to severe TBI (7-70 years) with early 1.5T MRI (median 7 days, range 0-35) without mass lesion included prospectively. Glasgow Coma Scale (GCS) scores were registered before intubation or at admission. The TAI lesions were identified in T2*gradient echo, fluid attenuated inversion recovery, and diffusion weighted imaging scans. In addition to registering TAI lesions in hemispheric white matter and the corpus callosum, TAI lesions in the thalamus, basal ganglia, and brainstem were classified as uni- or bilateral. Twenty percent of patients had TAI lesions in the thalamus (7% bilateral), 18% in basal ganglia (2% bilateral), and 29% in the brainstem (9% bilateral). One of 26 bilateral lesions in the thalamus or brainstem was found on computed tomography. The GCS scores were lower in patients with bilateral lesions in the thalamus (median four) and brainstem (median five) than in those with corresponding unilateral lesions (median six and eight, p?=?0.002 and 0.022). The TAI locations most associated with low GCS scores in univariable ordinal regression analyses were bilateral TAI lesions in the thalamus (odds ratio [OR] 35.8; confidence interval [CI: 10.5-121.8], p?
PubMed ID
29334825 View in PubMed
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Patients with Mild Traumatic Brain Injury Recruited from Both Hospital and Primary Care Settings: A Controlled Longitudinal Magnetic Resonance Imaging Study.

https://arctichealth.org/en/permalink/ahliterature301719
Source
J Neurotrauma. 2019 Jul 31; :
Publication Type
Journal Article
Date
Jul-31-2019
Author
Cathrine Elisabeth Einarsen
Kent Gøran Moen
Asta Kristine Håberg
Live Eikenes
Kjell Arne Kvistad
Jian Xu
Hans Kristian Moe
Marie Hexeberg Tollefsen
Anne Vik
Toril Skandsen
Author Affiliation
1Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
Source
J Neurotrauma. 2019 Jul 31; :
Date
Jul-31-2019
Language
English
Publication Type
Journal Article
Abstract
With an emphasis on traumatic axonal injury (TAI), frequency and evolution of traumatic intracranial lesions on 3T clinical magnetic resonance imaging (MRI) were assessed in a combined hospital and community-based study of patients with mild traumatic brain injury (mTBI). The findings were related to post-concussion symptoms (PCS) at 3 and 12 months. Prospectively, 194 patients (16-60 years of age) were recruited from the emergency departments at a level 1 trauma center and a municipal outpatient clinic into the Trondheim mTBI follow-up study. MRI was acquired within 72?h (n?=?194) and at 3 (n?=?165) and 12 months (n?=?152) in patients and community controls (n?=?78). The protocol included T2, diffusion weighted imaging, fluid attenuated inversion recovery (FLAIR), and susceptibility weighted imaging (SWI). PCS was assessed with British Columbia Post Concussion Symptom Inventory in patients and controls. Traumatic lesions were present in 12% on very early MRI, and in 5% when computed tomography (CT) was negative. TAI was found in 6% and persisted for 12 months on SWI, whereas TAI lesions on FLAIR disappeared or became less conspicuous on follow-up. PCS occurred in 33% of patients with lesions on MRI and in 19% in patients without lesions at 3 months (p?=?0.12) and in 21% with lesions and 14% without lesions at 12 months (p?=?0.49). Very early MRI depicted cases of TAI in patients with mTBI with microbleeds persisting for 12 months. Patients with traumatic lesions may have a more protracted recovery, but the study was underpowered to detect significant differences for PCS because of the low frequency of trauma-related MRI lesions.
PubMed ID
31280698 View in PubMed
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Time of injury and relation to alcohol intoxication in moderate to severe traumatic brain injury: A decade-long prospective study.

https://arctichealth.org/en/permalink/ahliterature295807
Source
World Neurosurg. 2018 Oct 29; :
Publication Type
Journal Article
Date
Oct-29-2018
Author
Vera Vik Bjarkø
Toril Skandsen
Kent Gøran Moen
Sasha Gulati
Eirik Helseth
Tom Il Nilsen
Anne Vik
Author Affiliation
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: vbjarko@gmail.com.
Source
World Neurosurg. 2018 Oct 29; :
Date
Oct-29-2018
Language
English
Publication Type
Journal Article
Abstract
Knowledge about the causes and time of injury for traumatic brain injury (TBI) is important for the development of efficient prevention policies.
We aimed to study time of injury and relation to alcohol intoxication for moderate to severe TBI in a level 1 trauma center in Norway.
From October 2004 to September 2014, 493 consecutive moderate (Glasgow Coma Scale score [GCS] 9-13) and severe TBI (GCS score 3-8) patients (=16 years) were prospectively included in the Trondheim TBI Study (222 moderate and 270 severe TBI patients).
Mean age was 47 years (SD 21). Positive blood alcohol concentration (BAC) was found in 29% and median BAC was 41.5 mmol/l (IQR 28.7 to 54.3), equal to 1.91‰. Admissions were more frequent on Saturdays (RR 2.67, 95% CI 1.87 to 3.80) and Sundays (RR 2.10, 95% CI 1.45 to 3.03) compared to Mondays, and positive BAC was more common on weekends than weekdays (43% versus 16%). Furthermore, admissions were more frequent in June (RR 2.26, 95% CI 1.44 to 3.55), July (RR 2.07, 95% CI 1.31 to 3.28) and December (RR 2.07, 95% CI 1.31 to 3.28) compared to January. The number of patients with positive BAC was highest in December (RR 5.75, 95% CI 1.99 to 16.63) and 70% of these were caused by falls.
Our findings demonstrate that moderate to severe TBI admissions display a clear weekly and seasonal variation, and that alcohol is an important modifiable risk factor for moderate to severe TBI.; Abbreviations: BAC = Blood alcohol concentration, GCS = Glasgow coma scale, TBI = Traumatic brain injury.
PubMed ID
30385362 View in PubMed
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Time of Injury and Relation to Alcohol Intoxication in Moderate-to-Severe Traumatic Brain Injury: A Decade-Long Prospective Study.

https://arctichealth.org/en/permalink/ahliterature298352
Source
World Neurosurg. 2019 Feb; 122:e684-e689
Publication Type
Journal Article
Date
Feb-2019
Author
Vera Vik Bjarkø
Toril Skandsen
Kent Gøran Moen
Sasha Gulati
Eirik Helseth
Tom I L Nilsen
Anne Vik
Author Affiliation
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: vbjarko@gmail.com.
Source
World Neurosurg. 2019 Feb; 122:e684-e689
Date
Feb-2019
Language
English
Publication Type
Journal Article
Keywords
Accidents - trends
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Alcoholic Intoxication - diagnostic imaging - epidemiology
Brain Injuries, Traumatic - diagnostic imaging - epidemiology
Cohort Studies
Female
Humans
Male
Middle Aged
Norway - epidemiology
Prospective Studies
Risk factors
Seasons
Severity of Illness Index
Time Factors
Young Adult
Abstract
Knowledge about the causes and time of injury for traumatic brain injury (TBI) is important for the development of efficient prevention policies. We aimed to study time of injury and relation to alcohol intoxication for moderate-to-severe TBI in a level 1 trauma center in Norway.
From October 2004 to September 2014, 493 consecutive patients (=16 years) with moderate (Glasgow Coma Scale [GCS] score 9-13) and severe TBI (GCS score 3-8) were prospectively included in the Trondheim TBI Study (222 patients with moderate and 270 patients with severe TBI).
Mean age was 47 years (standard deviation 21 years). Positive blood alcohol concentration (BAC) was found in 29%, and median BAC was 41.5 mmol/L (interquartile range 28.7-54.3), equal to 1.91‰. Admissions were more frequent on Saturdays (relative risk [RR] 2.67, 95% confidence interval [CI] 1.87-3.80) and Sundays (RR 2.10, 95% CI 1.45-3.03) compared with Mondays, and positive BAC was more common on weekends than weekdays (43% vs. 16%). Furthermore, admissions were more frequent in June (RR 2.26, 95% CI 1.44-3.55), July (RR 2.07, 95% CI 1.31-3.28), and December (RR 2.07, 95% CI 1.31-3.28) compared with January. The number of patients with positive BAC was greatest in December (RR 5.75, 95% CI 1.99-16.63), and 70% of these were caused by falls.
Our findings demonstrate that moderate-to-severe TBI admissions display a clear weekly and seasonal variation and that alcohol is an important modifiable risk factor for moderate-to-severe TBI.
PubMed ID
30385362 View in PubMed
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6 records – page 1 of 1.