Background and Aim: Traumatic Brain injury (TBI) is a significant concern, often referred to as a "silent pandemic" due to its high prevalence and limited public awareness. This study explores TBIs in soccer, focusing on incidence, contact mechanisms, player positions, and the impact of Injuries. Methods and Materials/Patients: The authors went through PubMed, Scopus, and Google Scholar databases. The publications from the last two decades were considered. This review evaluates various leagues, including the German Bundesliga, American Soccer League, and the English Premier League (EPL), to analyze TBI occurrences and associated symptoms. Results:   Concussions were the most common type of TBIs in soccer players. Head-to-head contact mechanism with an aerial challenge during play frequently causes a concussion. Defensive and midfield players were suffering from TBIs more because they are defined to perform more "distance headers". Dizziness and headache were the frequent symptoms seen in soccer players. Medical staff is suggested to make a precise and timely diagnosis of probable injury, with educating the members by the latest guidelines.   Conclusion: Early injury diagnosis is crucial, and everyone involved, including officials, coaches, players, and medical personnel, must be aware of this issue. More research is necessary to develop preventive measures and management strategies prioritizing player safety.

Statement of Problem: Although advances in technology have led to improvements in man’s life in different aspects, statistics show that the incidence of fractures is increasing in different regions of the body. Recent studies show that midface fractures are strongly associated with patient's death. The exact relationship between different types of facial fractures and Brain Injuries is still controversial.Purpose: To evaluate individuals with midface fractures from different causes and determine if there is any relationship between various midface fractures and Brain Injuries.Materials and Methods: In this descriptive cross-sectional retrospective study, we assessed the hospital charts of all the patients with midface fractures at the trauma center of Poursina hospital. The complete medical record of each patient was reviewed. The etiologic and demographic data, the type of midface fracture and Brain injury, and Glasgow coma scale (GCS) were assessed. The data were analyzed by, the Chi-square, and the Fisher’s exact tests. The statistical package SPSS was used for all the analyses.Results: Of all the patients 47% had Brain injury. The Important significant correlations were as follows: Le Fort III with Brain Contusion (p=0.0001), nasal orbital ethmoid fractures with subdural hematoma (p=0.0001), frontal fracture with subdural hematoma (p=0.0001). Zygomatic complex fracture with Brain Contusion (p=0.009). Nasal fracture correlated with Brain Contusion (p=0.0001). The zygomatic complex fracture was the most prevalent fracture.Conclusion: Different midface fracture patterns have the risk of Brain injury simultaneously. So, midface fractures need more attention. According to the results, more attention is needed to be paid to driving rules specially the use of helmet and seat belt.

Background: Traumatic Brain injury , (TBI) is a leading cause of morbidity and mortality in young adults. The Extended Glasgow Outcome Score , (GOSE) has been introduced to assess the global outcome after Brain Injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: This was a multicenter cross‑, sectional study conducted on 144 , patients with TBI admitted at trauma emergency centers. The patients’,information, including demographic characteristics, duration of hospital stay, mechanical ventilation and on‑, admission laboratory measurements, and on‑, admission vital signs, were evaluated. The patients’,TBI‑, related symptoms and Brain computed tomography , (CT) scan findings were recorded. Results: GOSE assessments showed an increasing trend by the comparison of on‑, discharge , (7. 47 , ±,  , 1. 30), within a month , (7. 51 , ±,  , 1. 30) and within 3 , months , (7. 58 , ±,  , 1. 21) evaluations , (P , < , 0. 001). On‑, discharge GOSE was positively correlated with Glasgow Coma Scale , (GCS)(r , = , 0. 729, P , < , 0. 001), motor GCS , (r , = , 0. 812, P , < , 0. 001), Hb , (r , = , 0. 165, P , = , 0. 048), and pH , (r , = , 0. 165, P , = , 0. 048) and inversely with age , (r = −, 0. 261, P , = , 0. 002), hospitalization period , (r = −, 0. 678, P , < , 0. 001), pulse rate , (r = −, 0. 256, P , = , 0. 002), white blood cell , (WBC) (r = −, 0. 222, P , = , 0. 008), and triglyceride , (r = −, 0. 218, P , = , 0. 009). In multiple linear regression analysis, the associations were significant only for GCS , (B , = , 0. 102, 95% confidence interval , [CI]: 0–, 0. 202,P , = , 0. 05), hospitalization stay duration , (B = −, 0. 004, 95% CI: −, 0. 005–, −, 0. 003, P , = , 0. 001), and WBC , (B , = , 0. 00001, 95% CI: 0. 00000014–, 0. 000025,P , = , 0. 024). Among imaging signs and trauma‑, related symptoms in univariate analysis, intracranial hemorrhage , (ICH), interventricular hemorrhage , (IVH) , (P , = , 0. 006), subarachnoid hemorrhage , (SAH) , (P , = , 0. 06,marginally at P , < , 0. 1), subdural hemorrhage , (SDH) , (P , = , 0. 032), and epidural hemorrhage , (EDH) , (P , = , 0. 037) was significantly associated with GOSE at discharge in multivariable analysis. Conclusion: According to the current study findings, GCS, hospitalization stay duration, WBC and among imaging signs and trauma‑, related symptoms ICH, IVH, SAH, SDH, and EDH are independent significant predictors of GOSE at discharge in TBI patients.

Background: Over 90% of morbidity and mortality associated with traumatic Brain injury (TBI) occurs in low-and middle-income countries. Lack of reliable, high-quality data regarding TBI prevention and care hinders the ability to reduce TBI burden. We sought to identify current TBI data collection practices and capacity in Georgia, focusing on pre-hospital, hospital, and rehabilitation treatment. Methods: The eight level I and two level II Trauma Hospitals in Georgia with the highest number of TBI admissions in 2017 were selected for study. A semi-structured survey about various aspects of TBI care was designed and semi-structured interviews of healthcare providers treating TBI patients (e. g. neurologists, neurosurgeons) were conducted based on this survey. Results: Pre-hospital triage protocols were not routinely used to match patient treatment needs with hospital capacity. All hospitals provided specialist care for TBI 24 hours/day. MRI was available at only three (30%) centers, and in-hospital rehabilitation units were available in only one (10%). No center used a defined protocol for treating TBI patients and no national protocol exists. Conclusion: Even among the largest, most highly specialized hospitals in Georgia, TBI care varies in terms of diagnostic and treatment protocols. While TBI specialists are available, diagnostic equipment often is not. Gaps in pre-hospital coordination and access to rehabilitation services exist and provide areas of focus for future investment in reducing TBI burden.

Abstract Introduction: Traumatic Brain Injuries (TBI) are one of the most important causes of death in patients under the age of 25 years and is responsible for one third of total deaths caused by trauma. Therefore, knowing its epidemi-ologic pattern in different populations seems vital. Therefore, this study aims to examine the epidemiologic pattern of TBI in emergency department. Methods: In this cross-sectional study, the profiles of 1000 patients affected by TBI were selected using simple random sampling. The examined variables in this study included demographic, sea-son, mechanism of injury, accompanying Injuries, level of consciousness, hospitalization duration, computed to-mography (CT) scan results, needing surgery, admission to intensive care unit, and outcome of the patient. In the end, independent risk factors for the death of patients were determined. Results: 1000 patients suffering from were studied (81.8% male; mean age 38.5±21.7 years). The frequency of their referral to hospital in spring (31.4%) was more (p<0.01). 45.9% of the patients had a level of consciousness less than 9 based on the Glasgow Coma Scale (GCS). Subdural (45.9%) and epidural bleeding (23.7%) were the most common findings in CT scans in this study (p<0.001). Finally, 233 (23.3%) of the patients were dead. Over 60 years of age, falling and motorcycle accidents, intracranial hemorrhage accompanied by Brain contusion, subdural bleeding, a GCS of less than 9, and the need to be admitted to intensive care unit were independent risk factors of death in TBI. Conclusion: Age Over 60 years, falling and motorcycle accidents, intracranial hemorrhage accompanied by Brain contusion, subdural bleeding, a GCS of less than 9, and need to be admitted to intensive care unit were independent risk factors for the death in TBI patients.

Background: Experimental approaches have been promising with the use of therapeutic hypothermia after Traumatic Brain Injury (TBI) whereas clinical data have not supported its efficacy.Objectives: This study aimed to investigate whether using selective deeper Brain cooling correlates with a more neuroprotective effect on Intracranial Pressure (ICP) increments following TBI in rats.Materials and Methods: Adult male Sprague-Dawley rats (mean weight=300 g; n=25) were subjected to Brain injury using a modified Marmarou method. Immediately after the onset of TBI, rats were randomized into three groups. Selective Brain cooling was applied around the head using ice packages. Intracranial Temperature (ICT) and ICP were continuously measured at 0, 30, 60, 120, and 180 minutes and recorded for all groups. Group 1 (n=5) was normothermia and was assigned as the control group. Group 2 (n=10) received moderate hypothermia with a target ICT of between 32oC – 33oC and Group 3 (n=10) was given a deeper hypothermia with a target ICT of below 32oC.Results: All subjects reached the target ICT by the 30th minute of hypothermia induction. The ICT was significantly different in Group 2 compared to Group 1 only at the 120th minute (P=0.017), while ICP was significantly lower starting from the 30th minute (P=0.015). The ICT was significantly lower in Group 3 compared to Groups 1 and 2 starting from the 30th minute (P=0.001 and P=0.003, respectively). The ICP was significantly lower in Group 3 compared to Group 1 starting from 30th minute (P=0.001); however, a significant difference in ICP between Group 3 and Group 2 was observed only at the 180th minute (P=0.047).Conclusions: Results of this study indicate that selective Brain cooling is an effective method of decreasing ICP in rats; however, the deeper hypothermia caused a greater decrease in ICP three hours after hypothermia induction.