Cerebral infarction in the caudate nucleus associated with acute epidural hematoma and diffuse brain injury in a child after severe head injury

2004 ◽  
Vol 20 (6) ◽  
pp. 430-433 ◽  
Author(s):  
Miki Fujimura ◽  
Motonobu Kameyama ◽  
Osamu Motohashi ◽  
Hiroyuki Kon ◽  
Kiyoshi Ishii ◽  
...  
Keyword(s):  
Brain Injury ◽  
Head Injury ◽  
Cerebral Infarction ◽  
Caudate Nucleus ◽  
Severe Head Injury ◽  
Epidural Hematoma ◽  
Diffuse Brain Injury ◽  
Acute Epidural Hematoma ◽  
Diffuse Brain

Significance of intracranial hypertension in severe head injury

1977 ◽  
Vol 47 (4) ◽  
pp. 503-516 ◽  
Author(s):  
J. Douglas Miller ◽  
Donald P. Becker ◽  
John D. Ward ◽  
Humbert G. Sullivan ◽  
William E. Adams ◽  
...  
Keyword(s):  
Brain Injury ◽  
Head Injury ◽  
Intracranial Hypertension ◽  
Severe Head Injury ◽  
Neurological Status ◽  
Content Type ◽  
Diffuse Brain Injury ◽  
Mass Lesions ◽  
Increased Icp ◽  
Diffuse Brain

✓ Measurements of intracranial pressure (ICP) were begun within hours of injury in 160 patients with severe brain trauma, and continued in the intensive care unit. Some degree of increased ICP (> 10 mm Hg) was present on admission in most cases (82%), and in all but two of the 62 patients with intracranial mass lesions requiring surgical decompression; ICP was over 20 mm Hg on admission in 44% of cases, and over 40 mm Hg in 10%. In patients with mass lesions only very high ICP (> 40 mm Hg) on admission was significantly associated with a poor neurological picture and outcome from injury, while in patients with diffuse brain injury any increase in ICP above 10 mm Hg was associated with a poorer neurological status and a worse outcome. Despite intensive measures aimed at prevention of intracranial hypertension, ICP rose over 20 mm Hg during the monitoring period in 64 of the 160 patients (40%). Postoperative increases in ICP over 20 mm Hg (mean) were seen in 52% of the patients who had had intracranial masses evacuated, and could not be controlled by therapy in half of these cases. Even in patients without mass lesions, ICP rose above 20 mm Hg in a third of the cases, despite artificial ventilation and steroid therapy. Of the 48 patients who died, severe intracranial hypertension was the primary cause of death in nearly half and even moderately increased ICP (> 20 mm Hg) was associated with higher morbidity in patients with mass lesions and those with diffuse brain injury. Measurement of ICP should be included in management of patients with severe head injury.

Intraoperative Development of Contralateral Epidural Hematoma during Evacuation of Traumatic Extraaxial Hematoma

Neurosurgery ◽  
1988 ◽  
Vol 23 (4) ◽  
pp. 480-484 ◽  
Author(s):  
Tony Feuerman ◽  
Phillip Ashley Wackym ◽  
George F. Gade ◽  
Todd Lanman ◽  
Donald Becker
Keyword(s):  
Head Injury ◽  
Intracranial Pressure ◽  
Early Diagnosis ◽  
Ct Scan ◽  
Severe Head Injury ◽  
Epidural Hematoma ◽  
Clinical Presentation ◽  
Elevated Intracranial Pressure ◽  
Burr Holes ◽  
Acute Epidural Hematoma

Abstract Intraoperative development of an epidural hematoma contralateral to a craniotomy for acute traumatic extraaxial hematoma has been previously reported. This entity, however, has never been distinctly defined and differentiated from either the delayed or the bilateral acute epidural hematoma. We present 3 new cases of intraoperative contralateral acute epidural hematoma and review the 14 previously reported cases. The typical clinical presentation is a severe head injury with an acute extraaxial hematoma and severe ipsilateral brain displacement during craniotomy. If brain displacement is not noted at craniotomy, then the contralateral hematoma is manifested by immediate postoperative neurological deterioration or intractable elevated intracranial pressure. The presence of any of these signs makes an immediate postoperative CT scan or burr holes contralateral to the original craniotomy mandatory for early diagnosis. In addition to defining “intraoperative contralateral epidural hematoma,” stricter definitions of the terms “delayed epidural hematoma” (no hematoma present on the initial CT scan but one present on a later scan) and “bilateral epidural hematomas” (present on the initial scan) are proposed.

Sir Hugh Cairns and World War II British advances in head injury management, diffuse brain injury, and concussion: an Oxford tale

2016 ◽  
Vol 125 (5) ◽  
pp. 1301-1314 ◽  
Author(s):  
James L. Stone ◽  
Vimal Patel ◽  
Julian E. Bailes
Keyword(s):  
World War Ii ◽  
Brain Injury ◽  
Head Injury ◽  
Critical Role ◽  
Military Hospital ◽  
Full Time ◽  
World War ◽  
Diffuse Brain Injury ◽  
Injury Management ◽  
Diffuse Brain

The authors trace the Oxford, England, roots of World War II (WWII)–related advances in head injury management, the biomechanics of concussion and brain injury, and postwar delineation of pathological findings in severe concussion and diffuse brain injury in man. The prominent figure in these developments was the charismatic and innovative Harvey Cushing–trained neurosurgeon Sir Hugh Cairns. Cairns, who was to closely emulate Cushing's surgical and scholarly approach, is credited with saving thousands of lives during WWII by introducing and implementing innovative programs such as helmets for motorcyclists, mobile neurosurgical units near battle zones, and the military usage of penicillin. In addition, he inspired and taught a generation of neurosurgeons, neurologists, and neurological nurses in the care of brain and spinal cord injuries at Oxford's Military Hospital for Head Injuries. During this time Cairns also trained the first full-time female neurosurgeon. Pivotal in supporting animal research demonstrating the critical role of acceleration in the causation of concussion, Cairns recruited the physicist Hylas Holbourn, whose research implicated rotary acceleration and shear strains as particularly damaging. Cairns' work in military medicine and head injury remain highly influential in efforts to mitigate and manage brain injury.

scholarly journals Differential Leukocyte and Platelet Profiles in Distinct Models of Traumatic Brain Injury

Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 500
Author(s):  
William Brad Hubbard ◽  
Meenakshi Banerjee ◽  
Hemendra Vekaria ◽  
Kanakanagavalli Shravani Prakhya ◽  
Smita Joshi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Closed Head Injury ◽  
Diffuse Brain Injury ◽  
Blood Brain ◽  
Closed Head ◽  
Leukocyte Counts ◽  
Neutrophil Aggregation ◽  
Blood Leukocyte

Traumatic brain injury (TBI) affects over 3 million individuals every year in the U.S. There is growing appreciation that TBI can produce systemic modifications, which are in part propagated through blood–brain barrier (BBB) dysfunction and blood–brain cell interactions. As such, platelets and leukocytes contribute to mechanisms of thromboinflammation after TBI. While these mechanisms have been investigated in experimental models of contusion brain injury, less is known regarding acute alterations following mild closed head injury. To investigate the role of platelet dynamics and bioenergetics after TBI, we employed two distinct, well-established models of TBI in mice: the controlled cortical impact (CCI) model of contusion brain injury and the closed head injury (CHI) model of mild diffuse brain injury. Hematology parameters, platelet-neutrophil aggregation, and platelet respirometry were assessed acutely after injury. CCI resulted in an early drop in blood leukocyte counts, while CHI increased blood leukocyte counts early after injury. Platelet-neutrophil aggregation was altered acutely after CCI compared to sham. Furthermore, platelet bioenergetic coupling efficiency was transiently reduced at 6 h and increased at 24 h post-CCI. After CHI, oxidative phosphorylation in intact platelets was reduced at 6 h and increased at 24 h compared to sham. Taken together, these data demonstrate that brain trauma initiates alterations in platelet-leukocyte dynamics and platelet metabolism, which may be time- and injury-dependent, providing evidence that platelets carry a peripheral signature of brain injury. The unique trend of platelet bioenergetics after two distinct types of TBI suggests the potential for utilization in prognosis.

scholarly journals Relationship between CT Findings and Prognosis in Diffuse Brain Injury

1984 ◽  
Vol 24 (12) ◽  
pp. 946-953
Author(s):  
Akihito SAITO ◽  
Nobumasa KUWANA ◽  
Yasuhiko MOCHIMATSU ◽  
Hideyo FUJINO ◽  
Kazuhiko TOKORO
Keyword(s):  
Brain Injury ◽  
Diffuse Brain Injury ◽  
Ct Findings ◽  
Diffuse Brain

scholarly journals Successful Use of Prolonged Mild Hypothermia in a Patient With Severe Head Injury and Diffuse Brain Swelling-Case Report-

2007 ◽  
Vol 47 (3) ◽  
pp. 116-120 ◽  
Author(s):  
Mamoru MURAKAMI ◽  
Tetsuya TSUKAHARA ◽  
Hiroyasu ISHIKURA ◽  
Taketo HATANO ◽  
Takuya NAKAKUKI ◽  
...  
Keyword(s):  
Case Report ◽  
Head Injury ◽  
Severe Head Injury ◽  
Mild Hypothermia ◽  
Brain Swelling ◽  
Diffuse Brain Swelling ◽  
Diffuse Brain

scholarly journals Biochemical, Structural, and Biomarker Evidence for Calpain-Mediated Cytoskeletal Change After Diffuse Brain Injury Uncomplicated by Contusion

2009 ◽  
Vol 68 (3) ◽  
pp. 241-249 ◽  
Author(s):  
Melissa J. McGinn ◽  
Brian J. Kelley ◽  
Linnet Akinyi ◽  
Monika W. Oli ◽  
Ming Cheng Liu ◽  
...  
Keyword(s):  
Brain Injury ◽  
Diffuse Brain Injury ◽  
Cytoskeletal Change ◽  
Diffuse Brain
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