Serum pNF-H levels in the first six hours after experimental mild traumatic brain injury in rats.

OBJECTIVE: Mild traumatic brain injury (mTBI) cases with a normal CT scanning account for the vast majority of all TBI patients. The aim of this study was to investigate the course of serum Phosphorylated Neurofilament Heavy Chain (pNF-H) levels in the first six hours after trauma in rats in experimental mTBI. MATERIALS AND METHODS: In this experimental animal study, 32 female Sprague-Dawley rats were enrolled equally (n=8) into 3 experimental groups and 1 control group. In experimental groups, animals were exposed to a mTBI with a free fall of 50-gram metal disc from a height of 80 cm. We compared serum pNF-H levels at the 2nd, 4th, and 6th hours after traumatic brain injury in the experimental groups with the control group. RESULTS: Serum pNF-H levels at the 2nd and 4th hours after traumatic brain injury were statistically significantly higher than the control group. Serum pNF-H levels gradually decreased at the 4th and 6th hours compared to the 2nd hour and decreased to a similar level to the control group at the 6th hour after injury. CONCLUSIONS: A high serum pNF-H value, could be used in the diagnosis and management of mTBI patients.

The value of bedside ocular ultrasound assessment of optic nerve sheath diameter in the detection of increased intracranial pressure in patients presenting to the emergency room with headache.

INTRODUCTION: Headache is one of the most important complaints in emergency room (ER) admissions, and the rate of the increase in intracranial pressure in these cases should not be overlooked. This study was performed to investigate the value of the measurement of optic nerve sheath diameter (ONSD) by ocular ultrasound in ER patients with the complaint of headache and increase in intracranial pressure regarding this. MATERIALS AND METHODS: : A total of 100 patients who applied to the ER with the complaint of headache were included in this prospective study. Fifty patients with increased ONSD (≥5 mm) and 50 patients with normal ONSD (<5 mm) were obtained. ONSD measurements were performed with 7.5-10 MHz linear probe and closed-eye technique. In addition to this, all patients underwent cranial computerized tomography (CT) examinations, and CT results were compared with the results of the ocular ultrasound. RESULTS: The median right and left ONSD values were detected to be 4.3 mm (3.6-5.5 mm) and 4.4 mm (3.6-5.6 mm) in patients whose cranial CT results were within normal limits. However, the median right and left ONSD values were detected to be 5.5 mm (5.1-6.3 mm) and 5.5 mm (5.1-6.4 mm) in patients whose cranial CT examination results were abnormal. In all cases with abnormal CT findings, the right and the left ONSD measurements were significantly higher (P < 0.001). Furthermore, ONSD value in the ipsilateral side with the lesion was significantly higher than the contralateral side (P < 0.001). CONCLUSION: Bedside ocular ultrasound is a noninvasive and easily applicable method in ER for the detection and evaluation of intracranial hypertension with headache.