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Traumatic Brain Injury—Clinical Translational Approaches, Demographic Change, and Neuro-Critical Care

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Brain Injury".

Deadline for manuscript submissions: 20 February 2026 | Viewed by 62

Special Issue Editors


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Guest Editor
1. Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinikum Ulm, Ulm, Germany
2. Service de Médecine Intensive-Réanimation et Médecine Hyperbare, Centre Hospitalier Universitaire, Angers, France
Interests: traumatic-haemorrhagic shock; sepsis and septic shock; traumatic brain injury; animal modeling; diving and hyperbaric medicine
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Neurosurgery, University Hospital Ulm, Albert-Einstein-Allee 23, 89071 Ulm, Germany
Interests: traumatic brain injury; secondary brain injury; stroke; subarachnoid hemorrhage; neuro-critical care; blood-brain-barrier; neurorehabilitation; spinal cord injury
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Despite advances in our understanding of the pathophysiology of secondary or delayed brain injury, in pre-hospital care, surgical management and intensive care treatments, there are still significant clinical, epidemiological and demographic challenges. The mean age of people with traumatic brain injury (TBI) is increasing in many high-income countries. However, there are currently no guidelines for treating TBI in elderly patients. Conversely, many middle- and low-income countries have a rapidly growing population of young TBI patients requiring treatment in under-resourced structures. Understanding and treating increased intracranial pressure, oedema formation, blood-brain barrier breakdown, cell metabolism, extracranial organ function, inflammatory processes and decompressive craniectomy remain controversial issues, especially in children.

Last year, we celebrated the 50th anniversary of the introduction of the Glasgow Coma Scale. It remains the most widely used method of assessing the severity of TBI based on level of consciousness. In the 21st century, however, questions have been raised as to whether this classification of severity, identification of patients at risk, assignment to special treatment procedures, and assessment of prognosis are still sufficient. Today, clinical, cellular, molecular-genetic and radiological biomarkers offer promising additions.

To further support interdisciplinary scientific discussion in this field, we invite basic scientists and clinicians to publish new findings from translational preclinical research integrating standard therapeutic measures into the experimental design, and new therapeutic approaches in our special issue. The aim is to minimise the gap between the bench and bedside in the field of TBI.

Prof. Dr. Peter Radermacher
Prof. Dr. Thomas Kapapa
Guest Editors

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Keywords

  • intracranial hypertension
  • cerebral perfusion pressure
  • decompressive craniectomy
  • brain tissue oxygenation
  • brain tissue microdialysis
  • blood brain barrier
  • neuro-critical care

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Published Papers (1 paper)

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Research

18 pages, 551 KiB  
Article
Mortality During In-Hospital Stay and the First 24 h After Decompressive Craniectomy in Severe Traumatic Brain Injury: A Multi-Center, Retrospective Propensity Score-Matched Study
by Thomas Kapapa, Martin Petkov, Andrej Pala, Dieter Woischneck, Franziska Schiller, Stefanie Jesuthasan, Frederike Schiller, Hendrik Bracht, Benjamin Mayer and Marcel Oehmichen
J. Clin. Med. 2025, 14(15), 5540; https://doi.org/10.3390/jcm14155540 - 6 Aug 2025
Abstract
Objectives: Early death after trauma has been described several times. Little is known about it after traumatic brain injury (TBI) and decompressive craniectomy (DC). The aim of this study was to characterize patients who die after a TBI and DC during their [...] Read more.
Objectives: Early death after trauma has been described several times. Little is known about it after traumatic brain injury (TBI) and decompressive craniectomy (DC). The aim of this study was to characterize patients who die after a TBI and DC during their in-hospital stay. Methods: In a subgroup analysis of a retrospective, multicenter, and observational study, non-survivors from in-hospital stays treated for severe TBI and DC were included. Propensity score matching (PSM) was used. Results: A total of 223 patients with severe TBI were treated with DC, and there were 65 (29.1%) patients who did not survive. Of these, 22 (33.8%) died within the first 24 h. Non-survivors were older (p = 0.010), and pupillomotor dysfunction and a higher heart rate on admission were more common (p < 0.001). PSM patients for overall survival (41, 18.4%) differed in mean heart rate from the deceased (p = 0.030). In a multivariate model, age (OR: 1.045, p = 0.013, CI95%: 1.010 to 1.082), Quick value (OR: 0.965, p = 0.049, CI95%: 0.931 to 1.000), and heart rate (OR: 1.099, p = 0.030, CI95%: 1.009 to 1.197) were confirmed as predictive factors. Conclusions: Even after DC, known factors, such as chronological age and comorbidities, have a significant influence on mortality. The value of DC in an aging society for a particular severity of TBI should be further assessed on the basis of prospective studies. Full article
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