Dysregulation of the urea cycle - potential targets for treatment and diagnosis in prostate cancer.

Severe traumatic brain injury (sTBI) is devastating and leaves survivors with profound, lasting disabilities [–]. Traumatic brain injury (TBI) has an enormous burden of disease financially, socially, emotionally, and physically [, ]. TBI is common, with some estimates placing the global prevalence as high as 55 million and the annual incidence around 369 per 100,000 people []. Mortality rates after sTBI differ across the literature, although most studies report rates around 30% []. TBI contributes significantly to the global economic burden of disease [, ]. Acute TBI care centers on prevention of secondary brain injury to optimize outcomes. Persistently raised intracranial pressure can worsen secondary neurological injury by reducing cerebral perfusion and oxygenation and by contributing to blood–brain barrier disruption, neuroinflammation, and excitotoxic injury [, ]. Invasive intracranial pressure (ICP) monitors are inserted through the skull into the intracranial compartment to provide continuous ICP measurement. Several types of monitoring devices are available, the most common are intraparenchymal strain gauge devices and ventriculostomy catheters. ICP monitoring (ICPm) may be particularly useful in sTBI when depressed consciousness, sedation, or extracranial injuries limit serial neurological assessment. An emerging body of literature describes the utilization and effectiveness of ICP monitoring in patients with sTBI. Previous reviews have primarily focused on mortality, with limited reporting of detailed data on functional neurological outcomes [, , ]. Some previous systematic reviews demonstrated inconsistency in study selection, omitting studies that were present in other reviews. Several additional comparative studies have been published since earlier systematic reviews and meta-analyses []. Large-scale prospective cohort studies have demonstrated variation in the utilization and application of ICPm, with variable outcomes regarding mortality and neurological recovery [–].