The body participating: a qualitative study of early rehabilitation participation for patients with severe brain injury and low level of consciousness

Pulmonary complications are prevalent in the critically ill neurological population. Respiratory failure, pneumonia, acute lung injury and the acute respiratory distress syndrome (ALI/ARDS), pulmonary edema, pulmonary contusions and pneumo/hemothorax, and pulmonary embolism are frequently encountered in the setting of severe brain injury. Direct brain injury, depressed level of consciousness and inability to protect the airway, disruption of natural defense barriers, decreased mobility, and secondary neurological insults inherent to severe brain injury are the main cause of pulmonary complications in critically ill neurological patients. Prevention strategies and current and future therapies need to be implemented to avoid and treat the development of these life-threatening medical complications.

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Infrequent near death experiences in severe brain injury survivors - A quantitative and qualitative study

Annals of Indian Academy of Neurology ◽

10.4103/0972-2327.107715 ◽

2013 ◽

Vol 16 (1) ◽

pp. 75 ◽

Cited By ~ 11

Author(s):

Ravi Prakash ◽

Suprakash Chaudhury ◽

Yongmei Hou ◽

Qin Huang

Keyword(s):

Brain Injury ◽

Qualitative Study ◽

Severe Brain Injury ◽

Near Death Experiences

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Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury

Diagnostics ◽

10.3390/diagnostics10030156 ◽

2020 ◽

Vol 10 (3) ◽

pp. 156 ◽

Cited By ~ 2

Author(s):

Chan-Hyuk Park ◽

Su-Hong Kim ◽

Han-Young Jung

Keyword(s):

Traumatic Brain Injury ◽

Cerebral Cortex ◽

Brain Injury ◽

Corticospinal Tract ◽

Diffusion Tensor ◽

The Body ◽

Diffusion Tensor Tractography ◽

Motor Weakness ◽

Level Of Consciousness ◽

The Right

This paper reports a mechanism for corticospinal tract injury in a patient with hemiplegia following traumatic brain injury (TBI) based on diffusion tensor tractography (DTT) finding. A 73-year-old male with TBI resulting from a fall, without medical history, was diagnosed as having left convexity epidural hematoma (EDH). He underwent craniotomy and suffered motor weakness on the right side of the body. Two weeks after onset, he was transferred to a rehabilitation department with an alerted level of consciousness. Four weeks after onset, his motor functions were grade 1 by the Medical Research Council’s (MRC) standards in the right-side limbs and grade 4 in the left-side limbs. The result of DTT using the different regions of interest (ROIs) showed that most of the right corticospinal tract (CST) did not reach the cerebral cortex around where the EDH was located, and when the ROI was placed on upper pons, a disconnection of the CST was shown and a connection of the CST in ROI with the middle pons appeared. However, the right CST was connected to the cerebral cortex below the pons regardless of ROI. This study is the first report to use DTT to detect that the discontinuation of the left CST in the cerebral cortex and injury lesions below the lower pons and between the upper and lower pons are responsible for motor weakness in a patient.

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Confronting the grey zone after severe brain injury

Emerging Topics in Life Sciences ◽

10.1042/etls20190115 ◽

2019 ◽

Vol 3 (6) ◽

pp. 707-711 ◽

Cited By ~ 1

Author(s):

Andrew Peterson ◽

Adrian M. Owen

Keyword(s):

Brain Injury ◽

Ethical Issues ◽

Vegetative State ◽

Clinical Care ◽

Grey Zone ◽

Severe Brain Injury ◽

New Methods ◽

Legal Decision Making ◽

Technological Developments ◽

The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

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