Intractable epilepsy and mild brain injury: incidence, pathology and surgical outcome

Brain Injury ◽  
2002 ◽  
Vol 16 (6) ◽  
pp. 463-467 ◽  
Author(s):  
Bahman Jabbari ◽  
Olga Prokhorenko ◽  
Kaveh Khajavi ◽  
Hernando Mena
Keyword(s):  
Brain Injury ◽  
Surgical Outcome ◽  
Intractable Epilepsy ◽  
Injury Incidence ◽  
Mild Brain Injury

scholarly journals LANGUAGE REORGANIZATION IN APHASICS

Neurosurgery ◽  
2008 ◽  
Vol 63 (3) ◽  
pp. 487-497 ◽  
Author(s):  
Timothy H. Lucas ◽  
Daniel L. Drane ◽  
Carl B. Dodrill ◽  
George A. Ojemann
Keyword(s):  
Brain Injury ◽  
Temporal Lobe ◽  
Intractable Epilepsy ◽  
Cortical Lesions ◽  
Language Mapping ◽  
Neurosurgical Planning ◽  
Anatomic Distribution ◽  
And Performance ◽  
And Control ◽  
Language Profiles

ABSTRACT OBJECTIVE The purpose of this investigation was to determine whether clinical speech deficits after brain injury are associated with functional speech reorganization. METHODS Across an 18-year interval, 11 patients with mild-to-moderate speech deficits underwent language mapping as part of their treatment for intractable epilepsy. These “aphasics” were compared with 14 matched “control” patients with normal speech who also were undergoing epilepsy surgery. Neuroanatomic data were compared with quantitative language profiles and clinical variables. RESULTS Cortical lesions were evident near speech areas in all aphasia cases. As expected, aphasic and control patients were distinguished by quantitative language profiles. The groups were further distinguished by the anatomic distribution of their speech sites. A significantly greater proportion of frontal speech sites was found in patients with previous brain injury, consistent with frontal site recruitment. The degree of frontal recruitment varied as a function of patient age at the time of initial brain injury; earlier injuries were associated with greater recruitment. The overall number of speech sites remained the same after injury. Significant associations were found between the number of the speech sites, naming fluency, and the lesion proximity in the temporal lobe. CONCLUSION Language maps in aphasics demonstrated evidence for age-dependent functional recruitment in the frontal, but not temporal, lobe. The proximity of cortical lesions to temporal speech sites predicted the overall extent of temporal lobe speech representation and performance on naming fluency. These findings have implications for neurosurgical planning in patients with preoperative speech deficits.

scholarly journals Evaluación del discurso narrativo en pacientes con daño cerebral leve

2012 ◽  
Vol 4 (3) ◽  
pp. 61
Author(s):  
Ana María Cachón
Keyword(s):  
Clinical Practice ◽  
Brain Injury ◽  
Single Case ◽  
Speech Analysis ◽  
Recovery Stage ◽  
Language Therapist ◽  
Speech Evaluation ◽  
Mild Brain Injury ◽  
Oral Speech ◽  
The Subject

In clinical practice there are few test that language therapist can use for the oral speech evaluation. The battery that has been frecuently used for the aphasia assessment, doesn´t usually give us this type of data, and when it happens, it is just a global description of the language of the subject, which doesn't make possible a detailed pursuit of the evolution. The relevance of linguistic production´s assessment becomes more evident in the study of patients with mild injury as well as when patient is in an advanced recovery stage. An assessment without a speech analysis uses to overestimate the subject's capacities and usually ends in an incomplete and inadequate intervention. The aim of the present work was to review different studies that include the narrative speech as part of the assessment, and to explore, with the study of a single case, some applications in this kind of studies for language evaluation in mild brain injury patients.

scholarly journals Latent Class Analysis of Brain Injury Symptomatology among College Students

2017 ◽  
Vol 04 (01) ◽  
pp. e14-e22 ◽  
Author(s):  
Karen Hux ◽  
Jessica Brown ◽  
Matthew Lambert
Keyword(s):  
College Students ◽  
Brain Injury ◽  
Latent Class Analysis ◽  
General Health ◽  
Latent Class ◽  
Class Analysis ◽  
Grade Point ◽  
Significant Difference ◽  
Mild Brain Injury ◽  
Mean Equality

Background Incidents potentially causing mild brain injury (BI) are common, and most people recover rapidly; however, a subset experiences long-lasting challenges. Objective This study used latent class analysis to identify a subset of college students presenting chronic symptomatology consistent with a mild BI diagnosis and pseudo-class mean equality tests to examine relations between latent classes and BI event and academic outcome variables. Methods Participants were 118/423 undergraduates self-reporting possible mild BIs through a survey about general health, daily habits, academic performance, and potential BI events. Twenty-four cognitive, physiological, or socio-emotional sequelae served to identify symptomatology profiles. Results A three-class model including 11% with high symptomatology, 49% with moderate symptomatology, and 40% with negligible symptomatology provided excellent fit and entropy. Symptoms best separating high and moderate classes were memory, thinking speed, new learning, and attention problems. Mean equality tests revealed no significant difference in number of BI events across classes, but high symptomatology respondents were significantly less likely to lose consciousness and significantly more likely to have lower grade point averages and to have failed courses than moderate symptomatology respondents. Discussion Cognitive problems are paramount in distinguishing college students with chronic high symptomatology following BI from those with moderate and negligible symptomatology. Because high symptomatology class individuals differ academically from their counterparts, a functional consequence of mild BI appears to exist. Conclusion About 1 in 10 undergraduate students self-reporting BI events experiences chronic symptomatology affecting general health and academic achievement. Because they may benefit from supportive services, accurate identification is critical.

scholarly journals Clinical correlates in an experimental model of repetitive mild brain injury

2013 ◽  
Vol 74 (1) ◽  
pp. 65-75 ◽  
Author(s):  
Rebekah Mannix ◽  
William P. Meehan ◽  
Joseph Mandeville ◽  
Patricia E. Grant ◽  
Tory Gray ◽  
...  
Keyword(s):  
Brain Injury ◽  
Experimental Model ◽  
Clinical Correlates ◽  
Mild Brain Injury

scholarly journals Surgical outcome of cortical dysplasias presenting with chronic intractable epilepsy: A 10-year experience

2008 ◽  
Vol 56 (2) ◽  
pp. 138 ◽  
Author(s):  
PSarat Chandra ◽  
Manjari Tripathi ◽  
MahendraS Singh ◽  
MV Padma ◽  
Shailesh Gaikwad ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Intractable Epilepsy ◽  
Cortical Dysplasias

Blunt cerebrovascular injuries in severe traumatic brain injury: incidence, risk factors, and evolution

2017 ◽  
Vol 127 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Pierre Esnault ◽  
Mickaël Cardinale ◽  
Henry Boret ◽  
Erwan D'Aranda ◽  
Ambroise Montcriol ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Anticoagulation Therapy ◽  
Spine Injury ◽  
Hemorrhagic Complication ◽  
Injury Incidence ◽  
Severe Tbi ◽  
Systemic Anticoagulation

OBJECTIVEBlunt cerebrovascular injuries (BCVIs) affect approximately 1% of patients with blunt trauma. An antithrombotic or anticoagulation therapy is recommended to prevent the occurrence or recurrence of neurovascular events. This treatment has to be carefully considered after severe traumatic brain injury (TBI), due to the risk of intracranial hemorrhage expansion. Thus, the physician in charge of the patient is confronted with a hemorrhagic and ischemic risk. The main objective of this study was to determine the incidence of BCVI after severe TBI.METHODSThe authors conducted a prospective, observational, single-center study including all patients with severe TBI admitted in the trauma center. Diagnosis of BCVI was performed using a 64-channel multidetector CT. Characteristics of the patients, CT scan results, and outcomes were collected. A multivariate logistic regression model was developed to determine the risk factors of BCVI. Patients in whom BCVI was diagnosed were treated with systemic anticoagulation.RESULTSIn total, 228 patients with severe TBI who were treated over a period of 7 years were included. The incidence of BCVI was 9.2%. The main risk factors were as follows: motorcycle crash (OR 8.2, 95% CI 1.9–34.8), fracture involving the carotid canal (OR 11.7, 95% CI 1.7–80.9), cervical spine injury (OR 13.5, 95% CI 3.1–59.4), thoracic trauma (OR 7.3, 95% CI 1.1–51.2), and hepatic lesion (OR 13.3, 95% CI 2.1–84.5). Among survivors, 82% of patients with BCVI received systemic anticoagulation therapy, beginning at a median of Day 1.5. The overall stroke rate was 19%. One patient had an intracranial hemorrhagic complication.CONCLUSIONSBlunt cerebrovascular injuries are frequent after severe TBI (incidence 9.2%). The main risk factors are high-velocity lesions and injuries near cervical arteries.

scholarly journals Systemic PaO2 Oscillations Cause Mild Brain Injury in a Pig Model

2016 ◽  
Vol 44 (5) ◽  
pp. e253-e263 ◽  
Author(s):  
Klaus U. Klein ◽  
Amelie Johannes ◽  
Melanie Brückner ◽  
Rainer Thomas ◽  
Stephan Matthews ◽  
...  
Keyword(s):  
Brain Injury ◽  
Pig Model ◽  
Mild Brain Injury

scholarly journals Multiple Electrophysiological Markers of Visual-Attentional Processing in a Novel Task Directed toward Clinical Use

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Julie Bolduc-Teasdale ◽  
Pierre Jolicoeur ◽  
Michelle McKerral
Keyword(s):  
Brain Injury ◽  
Cognitive Processing ◽  
Diagnostic Tools ◽  
Attention And Memory ◽  
Cognitive Symptoms ◽  
Attentional Processing ◽  
Visual Spatial Attention ◽  
Visual Spatial ◽  
Mild Brain Injury ◽  
Cerebrovascular Stroke

Individuals who have sustained a mild brain injury (e.g., mild traumatic brain injury or mild cerebrovascular stroke) are at risk to show persistent cognitive symptoms (attention and memory) after the acute postinjury phase. Although studies have shown that those patients perform normally on neuropsychological tests, cognitive symptoms remain present, and there is a need for more precise diagnostic tools. The aim of this study was to develop precise and sensitive markers for the diagnosis of post brain injury deficits in visual and attentional functions which could be easily translated in a clinical setting. Using electrophysiology, we have developed a task that allows the tracking of the processes involved in the deployment of visual spatial attention from early stages of visual treatment (N1, P1, N2, and P2) to higher levels of cognitive processing (no-go N2, P3a, P3b, N2pc, SPCN). This study presents a description of this protocol and its validation in 19 normal participants. Results indicated the statistically significant presence of all ERPs aimed to be elicited by this novel task. This task could allow clinicians to track the recovery of the mechanisms involved in the deployment of visual-attentional processing, contributing to better diagnosis and treatment management for persons who suffer a brain injury.

A Multicomponent Writing Intervention for a College Student With Mild Brain Injury

2017 ◽  
Vol 39 (4) ◽  
pp. 490-500 ◽  
Author(s):  
Carly Dinnes ◽  
Karen Hux
Keyword(s):  
Brain Injury ◽  
Language Impairment ◽  
Linear Regression Analysis ◽  
Substantial Improvement ◽  
Written Expression ◽  
Language Performance ◽  
Mild Brain Injury ◽  
Semantic Associations ◽  
Line Slope ◽  
High Level

Written expression is a high-level language process susceptible to impairment given mild traumatic brain injury (mTBI); however, minimal research exists about assessing or treating this aspect of language performance. This study’s purpose was to determine the effect of a multicomponent intervention on the written expression of an undergraduate student with mTBI resulting in generalized expressive language impairment. Pretreatment, intervention, and posttreatment sessions extended over 11 weeks. Intervention addressed semantic associations, semantic mapping, proofreading, organization, foundational skills, and goal setting. Data reflected performance on intervention components, writing probes, and pre–posttreatment completion of a standardized writing measure. Calculation and plotting of correct writing sequence percentages revealed substantial improvement. Linear regression analysis confirmed the trend line slope for intervention probes differed significantly from baseline probes. Comparison of pre–posttreatment test results also confirmed substantial improvement. Multicomponent instruction similar to that recommended for other students with writing challenges may be effective for people with mTBI.

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