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Brain Sciences
Special Issues
Traumatic CNS Injuries: Updates on Integral Guided Care Pathways
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Traumatic CNS Injuries: Updates on Integral Guided Care Pathways

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurorehabilitation".

Deadline for manuscript submissions: closed (15 October 2023) | Viewed by 1355

Special Issue Editors

Prof. Dr. Andres M. Rubiano

E-Mail Website
Guest Editor
1. NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, CB2 1TN, UK
2. Neurosciences Institute, El Bosque University, Bogotá 11001, Colombia
Interests: traumatic brain injury; spinal cord injuries; head trauma; spinal trauma
Dr. Gregory Hawryluk

E-Mail Website
Guest Editor
Cleveland Clin, 762 S Cleveland Massillon Rd, Akron, OH 44333, USA
Interests: neurosurgeon; spinal cord injuries; brain injury

Special Issue Information

Dear Colleagues,

Traumatic CNS injuries, including brain injuries and spinal cord injuries, are a leading cause of death and disability worldwide. Despite the economic and societal costs, clinical research efforts do not fulfill the potential for obtaining more personalized treatment options for all patients. In the context of this heterogeneity that frames the pathophysiology of these conditions, several efforts have been put in place by stakeholder groups, including scientists and healthcare providers of local and regional governments, academia, NGOs, and the medical industry to advance, through a coordinated effort, into more precise pathways of care for traumatic CNS injuries. As a result of this exercise, several proposals for organized management, including proposals of protocols, guidelines, and consensus, have been shared with the international community of healthcare experts, but there is a gap in the science related to understanding the impact of these proposals in different global scenarios. The aim of this Special Issue is to present primary and secondary studies, including experimental and observational studies, and systematic or non-systematic reviews related to the development, use, and evaluation of guided care pathways in the management of traumatic brain and spinal cord injuries. Discussion and deep analysis related to the context for knowledge transferability are encouraged. 

Prof. Dr. Andres M. Rubiano
Dr. Gregory Hawryluk
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • traumatic brain injury
  • spinal cord injuries
  • protocols of care
  • guidelines
  • consensus of experts
  • head trauma
  • spinal trauma

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Published Papers (1 paper)

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Research

9 pages, 423 KiB  
Article
Explanted Skull Flaps after Decompressive Hemicraniectomy Demonstrate Relevant Bone Avitality-Is Their Reimplantation Worth the Risk?
by Konstantinos Gousias, Ingo Stricker, Annika Hoyer, Theocharis Theocharous, Csilla Rompf, Arthur B. Pranada, Andrea Tannapfel, Rachit Agrawal and Iris Tischoff
Brain Sci. 2023, 13(9), 1277; https://doi.org/10.3390/brainsci13091277 - 1 Sep 2023
Cited by 1 | Viewed by 859
Abstract
Background: Reimplantations of autologous skull flaps after decompressive hemicraniectomies (DHs) are associated with high rates of postoperative bone flap resorption (BFR). We histologically assessed the cell viability of explanted bone flaps in certain periods of time after DH, in order to conclude whether [...] Read more.
Background: Reimplantations of autologous skull flaps after decompressive hemicraniectomies (DHs) are associated with high rates of postoperative bone flap resorption (BFR). We histologically assessed the cell viability of explanted bone flaps in certain periods of time after DH, in order to conclude whether precursors of BRF may be developed during their storage. Methods: Skull bone flaps explanted during a DH between 2019 and 2020 were stored in a freezer at either −23 °C or −80 °C. After their thawing process, the skulls were collected. Parameters of bone metabolism, namely PTH1 and OPG, were analyzed via immunohistochemistry. H&E stain was used to assess the degree of avital bone tissue, whereas the repeated assays were performed after 6 months. Results: A total of 17 stored skull flaps (8 at −23 °C; 9 at −80 °C) were analyzed. The duration of cryopreservation varied between 2 and 17 months. A relevant degree of bone avitality was observed in all skull flaps, which significantly increased at the repeated evaluation after 6 months (p < 0.001). Preservation at −23 °C (p = 0.006) as well as longer storage times (p < 0.001) were identified as prognostic factors for higher rates of bone avitality in a linear mixed regression model. Conclusions: Our novel finding shows a clear benefit from storage at −80° C, which should be carefully considered for the future management and storage of explanted skull flaps. Our analysis also further revealed a significant degree of bone avitality, a potential precursor of BFR, in skull flaps stored for several weeks. To this end, we should reconsider whether the reimplantation of autologous skull flaps instead of synthetic skull flaps is still justified. Full article
(This article belongs to the Special Issue Traumatic CNS Injuries: Updates on Integral Guided Care Pathways)
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