Glutamate Receptor Peptides in Acute Neurotrauma

Neurotrauma ◽  
2018 ◽  
pp. 233-244
Author(s):  
S. A. Dambinova ◽  
J. D. Mullins ◽  
Thomas Gennarelli
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Glasgow Coma Scale ◽  
Ampa Receptor ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Feasibility Studies ◽  
Kainate Receptors ◽  
Kainate Receptor ◽  
Diagnostic Certainty

This chapter presents data supporting the hypothesis that glutamate neuroreceptor peptides are specific biomarkers of diffuse axonal injury (DAI) and compromised cerebral blood flow following neurotrauma. Specifically, the authors propose that three key brain biomarkers might be utilized to improve diagnostic certainty of the consequences of acute neurotrauma: α‎-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), N-methyl-D-aspartate (NMDA), and kainate receptor peptides. AMPA receptor peptides are associated with subcortical DAI, while NMDA and kainate receptors peptides predominantly reflect arterial and venous circulations in cortical and brainstem areas, respectively. Feasibility studies of these biomarkers in the blood of patients with neurotrauma are presented in conjunction with neuroimaging and Glasgow Coma Scale (GCS) scores.

scholarly journals Correlation of Acute-phase Cerebral Blood Flow and MRI Findings with Outcome in Patients with Diffuse Axonal Injury.

2003 ◽  
Vol 14 (1) ◽  
pp. 1-10
Author(s):  
Hideaki Akimoto ◽  
Yoshio Takasato ◽  
Hiroyuki Masaoka ◽  
Takanori Hayakawa ◽  
Hiroshi Yatsushige ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Acute Phase ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Mri Findings

Transcranial Doppler to Screen on Admission Patients With Mild to Moderate Traumatic Brain Injury

Neurosurgery ◽  
2011 ◽  
Vol 68 (6) ◽  
pp. 1603-1610 ◽  
Author(s):  
Pierre Bouzat ◽  
Gilles Francony ◽  
Philippe Declety ◽  
Céline Genty ◽  
Affif Kaddour ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
At Risk ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Pulsatility Index ◽  
Area Under Curve ◽  
Moderate Traumatic Brain Injury ◽  
Patients At Risk

Abstract BACKGROUND: Detecting patients at risk for secondary neurological deterioration (SND) after mild to moderate traumatic brain injury is challenging. OBJECTIVE: To assess the diagnostic accuracy of transcranial Doppler (TCD) on admission in screening these patients. METHODS: This prospective, observational cohort study enrolled 98 traumatic brain injury patients with an initial Glasgow Coma Scale score of 9 to 15 whose initial computed tomography (CT) scan showed either absent or mild lesions according to the Trauma Coma Data Bank (TCDB) classification, ie, TCDB I and TCDB II, respectively. TCD measurements of the 2 middle cerebral arteries were obtained on admission under stable conditions in all patients. Neurological outcome was reassessed on day 7. RESULTS: Of the 98 patients, 21 showed SND, ie, a decrease of ≥ 2 points from the initial Glasgow Coma Scale or requiring any treatment for neurological deterioration. Diastolic cerebral blood flow velocities and pulsatility index measurements were different between patients with SND and patients with no SND. Using receiver-operating characteristic analysis, we found the best threshold limits to be 25 cm/s (sensitivity, 92%; specificity, 76%; area under curve, 0.93) for diastolic cerebral blood flow velocity and 1.25 (sensitivity, 90%; specificity, 91%; area under curve, 0.95) for pulsatility index. According to a recursive-partitioning analysis, TCDB classification and TCD measurements were the most discriminative among variables to detect patients at risk for SND. CONCLUSION: In patients with no severe brain lesions on CT after mild to moderate traumatic brain injury, TCD on admission, in complement with brain CT scan, could accurately screen patients at risk for SND.

Traumatic Brain Injury (DRAFT)

2018 ◽  
Author(s):  
Tamara Kaplan ◽  
Tracey Milligan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Coma Scale ◽  
Common Causes

The video in this chapter explores traumatic brain injury (TBI), including common causes and injuries (coup, and contre-coup injuries, diffuse axonal injury, hemorrhages), as well as the use of the Glasgow Coma Scale to evaluate TBI.

Hepatic Encephalopathy and Cerebral Blood Flow Improved by Liver Dialysis Treatment

2003 ◽  
Vol 26 (2) ◽  
pp. 149-151 ◽  
Author(s):  
K.-W. Huang ◽  
A. Chao ◽  
N.-K. Chou ◽  
W.-J Ko
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Hepatic Encephalopathy ◽  
Glasgow Coma Scale ◽  
Cerebral Arteries ◽  
Transcranial Doppler Sonography ◽  
Post Treatment ◽  
Wilcoxon Test ◽  
Dialysis Treatment ◽  
Coma Scale

Eight acute liver failure patients, all in grade IV hepatic encephalopathy, were administered liver dialysis treatment with the Hemo Therapies Unit (Hemo Therapies Inc, San Diego, CA, USA). The patients were evaluated to determine whether the Glasgow Coma Scale score and cerebral blood flow improved with treatment. After the initial treatment, consciousness levels as measured by the Glasgow Coma Scale improved from a pre-treatment median of 5 (range 3 to 6) to a post-treatment median of 7 (range 5 to 9) (p=0.0005 by paired Wilcoxon test); mean blood flow velocity in the middle cerebral arteries as shown by transcranial Doppler sonography increased from a median of 37.85 cm/sec (range 20.3 to 114.0) to 57.90 (32.5 to 135.0) post-treatment(p=0.022); however, there was no significant change in the pulsatility index from a median of 1.18 (range 0.61 to 1.71) to 0.85 (range 0.70 ~ 1.79) post-treatment (p=0.13). The 8 patients received 2 to 7 (median 5.5) times of daily 6-h liver dialysis treatments. Following the completion of all liver dialysis treatments, hepatic coma was fully resolved in 4 of 8 patients (50%) Three of 8 patients (37.5%) survived to hospital discharge, whereas 5 patients did not survive due to irreversible liver function and associated complications. In conclusion, liver dialysis treatment could improve hepatic encephalopathy, but the prognosis still depended on the underlying diseases.

scholarly journals Brainstem Diffuse Axonal Injury and Consciousness

2019 ◽  
Vol 9 ◽  
pp. 32 ◽  
Author(s):  
Sukhwinder Sandhu ◽  
Erik Soule ◽  
Peter Fiester ◽  
Patrick Natter ◽  
Daryoush Tavanaiepour ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Prognostic Indicator ◽  
Coma Scale ◽  
Vehicle Accidents ◽  
Neurological Outcomes ◽  
Neurological Injuries

Background: Severe traumatic brain injuries (TBI), commonly due to motor vehicle accidents may cause death and long-term disability especially when the acceleration-deceleration force on the brain is massive. This may cause shearing of the axonal connections within the cerebral cortex and brainstem in a process referred to as diffuse axonal injury (DAI). Extensive DAI has been postulated to be a poor prognostic indicator for neurological recovery. In our institution, several patients with Grade 3 DAI were observed to recover and achieve neurological outcomes greater than expected given the presence of brainstem injury. Methods: MRI studies from 100 patients admitted to a large tertiary trauma center for TBI were retrospectively analyzed by two fellowship-trained neuroradiologists. The size of DAI lesions, location of injury within the brainstem, and the number of discrete DAI lesions were measured and recorded. Glasgow Coma Scale (GCS) on arrival and at discharge was noted, as well as the presence of other neurological injuries. Results: Of 20 patients initially noted to have DAI with lesions of the brainstem, eight of them were discharged with Glasgow Coma Scale (GCS) of 14–15. The 12 patients discharged with reduced consciousness (average GC 7.1) demonstrated a greater number of larger lesions, with a predilection for the dorsal pons. Conclusion: These results suggest that large, numerous pontine lesions may indicate worse neurological outcomes in patients with these findings.

Traumatic or diffuse axonal injury? Author's response

2000 ◽  
Vol 26 (5) ◽  
pp. 491-491 ◽  
Author(s):  
J. F. Geddes ◽  
H. L. Whitwell ◽  
D. I. Graham
Keyword(s):  
Axonal Injury ◽  
Diffuse Axonal Injury
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