Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

traumatic brain injury

 

Causas de Traumatismo Intracraneal en Pacientes Atendidos en el Servicio de Emergencias del Hospital de Especialidades Teodoro Maldonado Carbo de Guayaquil. Causes Of Traumatic Brain Injury In Patients Admitted To The Emergency Department Of A Specialty Hospital In Guayaquil

Introduction: Traumatic brain injury (TBI) is defined as an alteration in brain function caused by an external force. The most common causes of TBI are falls and traffic accidents, the latter being the most c ommon in low-income countries.

Methodology: A cross-sectional study was conducted in patients with a diagnosis of intracranial trauma in the emergency department of the Teodoro Maldonado Carbo Hospital from January 2017 to December 2020 with the aim of analyzing its causes, clinical and radiological characteristics.

Results: 324 patients were analyzed within the study, evidencing that the most common cause of TBI was traffic accident followed by falls. TBI is more common in men with a mean age of 40 years. Using Pearson’s chi-square and Kruskal-Wallis tests, a statistically significant association was found between cause with age and length of hospital stay (p<0.001). However, there were no significant associations between the specific cause of TBI with patient clinical variables or mortality (p>0.05).

Conclusion: The most prevalent cause of intracranial trauma was traffic accident. There is an association between the cause of TBI and length of hospital stay.

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Correlación entre variables clínicas sugestivas de hipertensión intracraneal y alteraciones en la neuroimagen en trauma craneoencefálico. Correlation between clinical variables suggestive of intracranial hypertension and alterations in neuroimaging in traumatic brain injury

Methods: Retrospective observational cohort study where patients admitted for TBI to the ICU area of the HLV were included. 

Results: We included a total of 297 subjects. The most common neuroimaging lesion was multiple lesions (35.4%). We found that there is a significant correlation between the presence of lesion in neuroimaging and the presence of fixed pupils at admission (p = <0.001), score ≤ 8 on the Glasgow scale (p = <0.001) and need for orotracheal intubation (p = <0.001). Similarly, the same 3 variables were significant when related to the score ≥ III on the Marshall scale. In the logistic regression model, pupil fixation was the only one that was shown to increase the risk of a score ≥ III on the Marshall scale (OR: 3.50, 95% CI 1.53-7.99). 

Conclusion: The clinical variables: pupil fixation, need for endotracheal intubation and Glasgow ≤ 8 are related to the development and severity of lesion on neuroimaging in patients with TBI.

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Análisis neurofutbolístico de Loris Karius: de la gloria al infierno. Loris Karius neurofutbolistic analysis: from glory to hell.

In the soccer context there have been huge errors that have cost the teams dearly. Sometimes they occur due to nerves or deconcentration, however, according to our clinical eye, sometimes the brain plays a trick and its malfunction, the product of traumatic brain injury that occurred in the same game, is what determines the score of an encounter. This is what happened to the Liverpool goalkeeper in the final of the 2018 Champions League, who, from our neuro-soccer reflection, had errors that cost him the match, due to an affectation of the cerebral magnocellular pathway that allows processing spatial visual perceptual information. In the featured article, we reflect on his brain state before and after the trauma suffered and highlight that a footballer who is awake and expressing that he can continue, is not necessarily an individual with his brain preserved, since it may be only a part of his brain mass speaking, but, as seen in Karius, however, other silencers may have been altered. We close the work by highlighting the need to incorporate neuropsychological knowledge to understand the effect of trauma on the playfield, since this work confirms that humans do not play soccer with their legs or hands, they do so with your brain.

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Futbolistas Talentosos, el Gran Secreto Está en el Cerebro: La Gran Tragedia del Marshal y la Suerte de los Magos con un Sistema Nervioso Indemne. Talented Soccer Players, The Big Secret Is In The Brain: The Great Tragedy Of The Star Player And The Fate Of Magicians With A Preserved Nervous Systems.

In previous work, we have presented case studies from fascinating films for the eye of the neuropsychologist;1,2,3 continuing with this line of research, we describe here for your consideration a critical analysis of the role of brain functions in one of the most fascinating sports, soccer. In this analysis, we will look more closely at the brain damage suffered by the great footballer Salvador Cabañas and the role of the highly complex brain functions that allow the magical players to stand out in this sport. In the next pages, we present the case of Salvador Cabañas, both before and after his cerebral accident, and later we analyze the cerebral functions that are activated in brilliant players like Messi or Ronaldinho. We conclude this article by reflecting on the role of the brain in our normal human activities, and how catastrophic it becomes on a daily basis when our brain tissue is damaged so that as a result of this condition we can lose everything.

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