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1.
Brain Inj ; 34(5): 595-601, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32216554

RESUMO

Purpose: Functional outcome prediction for patients with traumatic axonal injury (TAI) is not highly related to the MRI classifications. The aim of this study was to assess the accuracy in predicting functional outcome in patients with TAI with several MRI scoring methods and to define the most accurate method.Methods: Patients with TAI (2008-2014) confirmed on MRI <6 months after injury were included in this retrospective study. Long-term functional outcome was prospectively assessed using the Glasgow Outcome Score Extended. The Gentry classification is most used in clinical practice. This method was compared to methods that score lesion load, lesion locations, and to modified Gentry classifications. The area under the curve (AUC) was calculated for the scoring methods.Results: A total of 124 patients with TAI were included, medium follow-up 52 months. The AUC for the Gentry classification was 0.64. All tested methods were poor predictors for functional outcome, except for the 6-location score (area under the curve: 0.71). No method was significantly better than the Gentry classification.Conclusion: The Gentry classification for TAI correlates with functional outcome, but is a poor predictor for the long-term functional outcome. None of the other tested methods was significantly better.


Assuntos
Lesões Encefálicas Traumáticas , Lesão Axonal Difusa , Axônios , Lesões Encefálicas Traumáticas/diagnóstico por imagem , Lesão Axonal Difusa/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Estudos Retrospectivos
2.
World Neurosurg ; 112: e576-e580, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29409948

RESUMO

OBJECTIVE: To compare a new method of noninvasive intracranial pressure (nICP) measurement with conventional lumbar puncture (LP) opening pressure. METHODS: In a prospective multicenter study, patients undergoing LP for diagnostic purposes underwent intracranial pressure measurements with HeadSense, a noninvasive transcranial acoustic device, and indirectly with LP. Noninvasive measurements were conducted with the head in a 30° tilt and in supine position before and after LP. The primary endpoint was the correlation between nICP measurement in supine position before LP and the LP opening pressure. RESULTS: There was no correlation between supine nICPs before LP and the LP opening pressures (r = -0.211, P = 0.358). The 30° head-tilt nICPs correlated with the supine nICPs before LP (r = 0.830, P < 0.01). There was no correlation between supine nICPs before and after LP (r = 0.056, P = 0.831) or between 30° head-tilt nICPs and LP opening pressures (r = -0.038, P = 0.861). CONCLUSIONS: There was no correlation between nICPs and LP opening pressures. Further development is warranted before transcranial acoustic HeadSense can become a clinical tool for investigating patients with neurologic conditions.


Assuntos
Hipertensão Intracraniana/diagnóstico , Pressão Intracraniana/fisiologia , Monitorização Fisiológica/métodos , Punção Espinal , Adulto , Idoso , Feminino , Humanos , Hipertensão Intracraniana/fisiopatologia , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente , Estudos Prospectivos , Adulto Jovem
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