Featured Research

from universities, journals, and other organizations

Hospitals vary in monitoring, treatment of children with brain injury

Date:
November 11, 2013
Source:
Wolters Kluwer Health: Lippincott Williams & Wilkins
Summary:
Hospitals vary in management of children with traumatic brain injury, particularly in monitoring and preventing the harmful effects of increased intracranial pressure (ICP), according to a study.

Hospitals vary in management of children with traumatic brain injury -- particularly in monitoring and preventing the harmful effects of increased intracranial pressure (ICP), according to a study in the November issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The November Neurosurgery also reports on unusual language side effects in patients undergoing electrical brain stimulation for obsessive-compulsive disorder (OCD), and presents plans for a pilot study of a new vaccine therapy for patients with aggressive brain cancers called gliomas.

Variations in Management of Child Brain Injury

Dr. William Van Cleve of University of Washington, Seattle, and colleagues analyzed data on more than 7,000 children with moderate to severe brain injury treated at 156 US hospitals over seven years. The study focused on two evidence- based interventions for brain injury: ICP monitoring, done to measure pressure within the skull; and craniectomy, a surgical procedure to prevent or relieve excessive pressure.

Overall, about 27 percent of children had ICP monitoring, while 12 percent underwent craniectomy. Rates of both interventions varied significantly between hospitals. Children treated at combined pediatric adult/trauma centers were one-fifth less likely to undergo ICP monitoring, compared to those at adult-only centers.

The variation remained significant after adjustment for other factors. The researchers call for further studies to understand "the institutional and regional factors associated with variability in the use of these invasive but potentially outcome-modifying technologies."

Brain Stimulation for OCD Leads to 'Foreign Accent Syndrome'

A. Rosaura Polak, MSc, of University of Amsterdam, Academic Medical Center and colleagues report on an unusual effect of deep brain stimulation in two Dutch patients with OCD. Now commonly used for Parkinson's disease, brain electrical stimulation has also emerged as a new treatment for treatment-refractory OCD that doesn't improve with medications. In both patients, OCD symptoms improved with brain stimulation.

However, there were also some unexpected language-related side effects. Both patients began speaking in a different accent, either in an accent that was common in their native region or with a more distinguished pronunciation. The changes were similar to a rare "foreign accent syndrome" reported in stroke patients.

Other changes included a more "aggressive vocabulary," such as swearing; and "hypomanic" behaviors, such as hyperactivity and excitability. In both patients, the language changes persisted after adjustment to the brain stimulation patterns. The results suggest that deep brain stimulation for OCD "influences not only mood and behavior but also linguistically related circuitry," the researchers write.

Plans for Trial of New Vaccine for Recurrent Gliomas

John Goldberg and colleagues of University of Miami Miller School of Medicine outline plans for a clinical pilot study to assess a "dendritic cell vaccine" for patients with gliomas that recur after surgery. The vaccine consists of the patients' own immune cells, mixed with fragments of destroyed tumor cells.

The goal of the vaccine is to stimulate the patients' own immune system to attack the tumor cells. Similar dendritic cell vaccines have shown promising results in previous studies -- in one small study, one-third of patients were alive and free of brain cancer at five years' follow-up.

Before vaccination, patients will receive an approved topical medication (imiquimod) that appears to promote immune activity of dendritic cells. The authors plan to enroll 20 patients over two years. If the results show promising effects on patient survival with acceptable side effects, it will pave the way for larger studies of approaches using dendritic cell vaccines to reduce the risk of recurrence after surgery for glioma.


Story Source:

The above story is based on materials provided by Wolters Kluwer Health: Lippincott Williams & Wilkins. Note: Materials may be edited for content and length.


Journal Reference:

  1. William Van Cleve, Mary A. Kernic, Richard G. Ellenbogen, Jin Wang, Douglas F. Zatzick, Michael J. Bell, Mark S. Wainwright, Jonathan I. Groner, Richard B. Mink, Christopher C. Giza, Linda Ng Boyle, Pamela H. Mitchell, Frederick P. Rivara, Monica S. Vavilala. National Variability in Intracranial Pressure Monitoring and Craniotomy for Children With Moderate to Severe Traumatic Brain Injury. Neurosurgery, 2013; 73 (5): 746 DOI: 10.1227/NEU.0000000000000097

Cite This Page:

Wolters Kluwer Health: Lippincott Williams & Wilkins. "Hospitals vary in monitoring, treatment of children with brain injury." ScienceDaily. ScienceDaily, 11 November 2013. <www.sciencedaily.com/releases/2013/11/131111112521.htm>.
Wolters Kluwer Health: Lippincott Williams & Wilkins. (2013, November 11). Hospitals vary in monitoring, treatment of children with brain injury. ScienceDaily. Retrieved October 1, 2014 from www.sciencedaily.com/releases/2013/11/131111112521.htm
Wolters Kluwer Health: Lippincott Williams & Wilkins. "Hospitals vary in monitoring, treatment of children with brain injury." ScienceDaily. www.sciencedaily.com/releases/2013/11/131111112521.htm (accessed October 1, 2014).

Share This



More Health & Medicine News

Wednesday, October 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Cases Keep Coming for Monrovia's Island Hospital

Ebola Cases Keep Coming for Monrovia's Island Hospital

AFP (Oct. 1, 2014) A look inside Monrovia's Island Hospital, a key treatment centre in the fight against Ebola in Liberia's capital city. Duration: 00:34 Video provided by AFP
Powered by NewsLook.com
Ebola Puts Stress on Liberian Health Workers

Ebola Puts Stress on Liberian Health Workers

AP (Oct. 1, 2014) The Ebola outbreak is putting stress on first responders in Liberia. Ambulance drivers say they are struggling with chronic shortages of safety equipment and patients who don't want to go to the hospital. (Oct. 1) Video provided by AP
Powered by NewsLook.com
Doctors Reassure Public Ebola Patient Won't Cause Outbreak

Doctors Reassure Public Ebola Patient Won't Cause Outbreak

Newsy (Sep. 30, 2014) After the announcement that the first U.S. patient had been diagnosed with Ebola, doctors were quick to say a U.S. outbreak is highly unlikely. Video provided by Newsy
Powered by NewsLook.com
TX Hospital Confirms Patient Admitted With Ebola

TX Hospital Confirms Patient Admitted With Ebola

AP (Sep. 30, 2014) Medical officials from Texas Health Presbyterian Hospital confirm they are treating a patient with the Ebola virus, the first case found in the US. (Sept. 30 Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins