Biomarkers in acute brain trauma: A narrative review

Biomarkers have been used to diagnose, prognose, evaluate, and identify the severity and outcomes in traumatic brain injury (TBI) patients. This study explored if it is possible to predict the outcome of TBI patients by estimating the biomarkers in cerebrospinal fluid and serum. We searched data bases and literature about biomarkers, and found forty epidemiologic studies from 92 potentially relevant articles. However, limited data are available about postanoxic encephalopathy. It showed that presently, neurofilament, S100B, glial fibrillary acidic protein, and ubiquitin carboxyl terminal hydrolase-L1 seemed to have the best potential as diagnostic biomarkers for distinguishing focal and diffuse injury, whereas C-Tau, neuron-specific enolase, S100B, glial fibrillary acidic protein, and spectrin breakdown products appear to be candidates for reflective biomarkers of TBI. Point-of-care biomarkers are needed in TBI which is one of the most important additional risk factors in road traffic injuries. In a holistic approach, more researches about biomarkers of TBI are required. These biomarkers are very useful for treatment of patients with TBI.

The use of non-living animals as simulation models for cranial neurosurgical procedures: a literature review

Simulation plays a pivotal role in neurosurgical training by allowing trainees to develop the requisite expertise to enhance patient safety.Several models have been used for simulation purposes.Non-living animal models offer a range of benefits,including affordability,availability,biological texture,and a comparable similarity to human anatomy.In this paper,we review the available literature on the use of non-living animals in neurosurgical simulation training.We aim to answer the following questions:(1)what animals have been used so far,(2)what neurosurgical approaches have been simulated,(3)what were the trainee tasks,and(4)what was the experience of the authors with these models.A search of the PubMed Medline database was performed to identify studies that examined the use of non-living animals in cranial neurosurgical simulation between 1990 and 2020.Our initial search yielded a total of 70 results.After careful screening,we included 22 articles for qualitative analysis.We compared the reports in terms of the(1)animal used,(2)type of surgery,and(3)trainee tasks.All articles were published between 2003 and 2019.These simulations were performed on three types of animals,namely sheep,cow,and swine.All authors designed specific,task-oriented approaches and concluded that the models used were adequate for replicating the surgical approaches.Simulation on non-living animal heads has recently gained popularity in the field of neurosurgical training.Non-living animal models are an increasingly attractive option for cranial neurosurgical simulation training.These models enable the acquisition and refinement of surgical skills,with the added benefits of accessibility and cost-effectiveness.To date,16 different microneurosurgical cranial approaches have been replicated on three non-living animal models,including sheep,cows,and swine.This review summarizes the experience reported with the use of non-living animal models as alternative laboratory tools for cranial neurosurgical training,with particular attention to the set of tasks that could be performed on them.