TEMPERATURE ALTERATIONS IN PATIENTS AT RISK FOR BRAIN INJURY ASSOCIATED WITH CARDIAC ARREST, SUBARACHNOID HEMORRHAGE, OR CLOSED HEAD INJURY

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.

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Return of Memory and Sleep Efficiency Following Moderate to Severe Closed Head Injury

Neurorehabilitation and Neural Repair ◽

10.1177/1545968308325268 ◽

2008 ◽

Vol 23 (4) ◽

pp. 320-326 ◽

Cited By ~ 52

Author(s):

Michael J. Makley ◽

Lisa Johnson-Greene ◽

Patrick M. Tarwater ◽

Andrew J. Kreuz ◽

J. Spiro ◽

...

Keyword(s):

Brain Injury ◽

Head Injury ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Closed Head Injury ◽

Recovery Phase ◽

Sleep Efficiency ◽

Rehabilitation Unit ◽

Closed Head ◽

Unit Increase

Objective. Sleep disturbance is common in the subacute recovery phase following brain injury. A previous study from the authors' group found 68% of patients with closed head injury (CHI) had disrupted sleep on a rehabilitation unit. In the present study, the authors investigated whether improvement in sleep efficiency correlates with duration of posttraumatic amnesia (PTA) after CHI. Methods. Fourteen CHI patients were enrolled and followed prospectively. Mechanism of injury included motor vehicle accident, fall, and blunt assault. An actigraph was placed on each subject's wrist within 72 hours of admission to the rehabilitation unit and recorded data for the duration of their stay. A minimum of 7 days of continuous actigraphy data was obtained on all subjects. PTA was measured daily using the Orientation Log (O-LOG). Results. Seventy-eight percent of subjects had mean week-1 sleep efficiency scores of ≤63%. Patients admitted having already cleared PTA had significantly better week-1 sleep efficiency scores than those with ongoing amnesia ( P = .032). For those patients admitted with ongoing PTA, each 10-unit increase in sleep efficiency score correlated with 1 unit increase in O-LOG score ( P = .056). Conclusions. Disrupted sleep is common in the postacute stage following CHI. Improved sleep efficiency correlates with resolution of PTA. Decreased sleep efficiency may negatively affect memory return after traumatic brain injury. Actigraphy is uniquely suited to study the sleep patterns of these patients.

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434 Selective attention in mild closed head injury and frontal brain injury: An ERP study

International Journal of Psychophysiology ◽

10.1016/s0167-8760(98)90433-0 ◽

1998 ◽

Vol 30 (1-2) ◽

pp. 167

Author(s):

A.K. Solbakk ◽

I. Reinvang ◽

K. Sundet ◽

C.S. Nielsen

Keyword(s):

Brain Injury ◽

Head Injury ◽

Selective Attention ◽

Closed Head Injury ◽

Frontal Brain ◽

Closed Head

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Clinical Concerns in Counseling Clients with Traumatic Brain Injury

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2019/v29i130047 ◽

2019 ◽

pp. 1-7

Author(s):

Michael F. Shaughnessy ◽

Aaron Johnson ◽

Lela Rucker

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Closed Head Injury ◽

Closed Head ◽

Areas Of Concern ◽

Counseling Clients ◽

Goals And Objectives

Counseling clients who have experienced an open or closed head injury can be quite problematic and present challenges in different realms. This paper explores some of these disparate realms and offers some insights as to counseling strategies that may need to be explored and examined. Realistic goals and objectives are needed and attention to specific areas of concern are examined.

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Multifactorial and closed head impact traumatic brain injuries cause distinct tactile hypersensitivity profiles

10.1101/2020.06.01.127944 ◽

2020 ◽

Author(s):

A-S. Wattiez ◽

W.C. Castonguay ◽

O.J. Gaul ◽

J.S. Waite ◽

C.M. Schmidt ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Brain Injuries ◽

Closed Head Injury ◽

Sensory Profile ◽

Nitric Oxide Donor ◽

Relative Risks ◽

Closed Head ◽

Post Traumatic

AbstractChronic complications of traumatic brain injury (TBI) represent one of the greatest financial burdens and sources of suffering in society today. A substantial number of these patients suffer from post-traumatic headache (PTH), which is typically associated with tactile allodynia. Unfortunately, this phenomenon has been under-studied, in large part due to the lack of well-characterized laboratory animal models. We have addressed this gap in the field by characterizing the tactile sensory profile of two non-penetrating models of PTH. We show that multifactorial TBI, consisting of aspects of impact, acceleration/deceleration, and blast wave exposure, produces long term tactile hypersensitivity and central sensitization, phenotypes reminiscent of PTH in patients, in both cephalic and extracephalic regions. By contrast, closed head injury induces only transient cephalic tactile hypersensitivity, with no extracephalic consequences. Both models show more severe phenotype with repetitive daily injury for three days, compared to either one or three successive injuries in a single day, providing new insight into patterns of injury that may place patients at greater risk of developing PTH. Importantly, even after recovery from transient cephalic tactile hypersensitivity, mice subjected to closed head injury had persistent hypersensitivity to established migraine triggers, including calcitonin gene-related peptide (CGRP) and sodium nitroprusside, a nitric oxide donor. Our results offer new tools for studying PTH, as well as preclinical support for a pathophysiologic role of CGRP in this condition.SummaryTwo models of post-traumatic headache after traumatic brain injury provide novel laboratory tools and insights in relative risks of injury and therapeutic opportunities.

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The Evidence for Brain Injury in Whiplash Injuries

Pain Research and Management ◽

10.1155/2003/360495 ◽

2003 ◽

Vol 8 (1) ◽

pp. 19-23 ◽

Cited By ~ 5

Author(s):

Michael P. Alexander

Keyword(s):

Brain Injury ◽

Head Injury ◽

Brain Damage ◽

Whiplash Injury ◽

Closed Head Injury ◽

Neck Injury ◽

Steering Wheel ◽

Whiplash Injuries ◽

Closed Head ◽

The Relationship

The evidence that brain damage can occur in injuries that produce whiplash is reviewed. The clinical phenomena for the two injuries are the same. Pure whiplash injury implies no, or minimal head contact, but many patients also have head contact against a head rest or the steering wheel or windshield. The relative severity of the neck injury and the head injury distinguishes whiplash from mild closed head injury. If there is brain injury is some patients with whiplash, it, by definition, falls at the mildest end of the concussion spectrum. The relationship between these two injuries is examined.

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A Systematic Review of Closed Head Injury Models of Mild Traumatic Brain Injury in Mice and Rats

Journal of Neurotrauma ◽

10.1089/neu.2018.6127 ◽

2019 ◽

Vol 36 (11) ◽

pp. 1683-1706 ◽

Cited By ~ 15

Author(s):

Colleen N. Bodnar ◽

Kelly N. Roberts ◽

Emma K. Higgins ◽

Adam D. Bachstetter

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Mild Traumatic Brain Injury ◽

Closed Head Injury ◽

Closed Head ◽

Injury Models

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Comparison of outcomes following decompressive craniectomy in children with accidental and nonaccidental blunt cranial trauma

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.11.peds09449 ◽

2012 ◽

Vol 9 (2) ◽

pp. 125-132 ◽

Cited By ~ 21

Author(s):

Chima O. Oluigbo ◽

C. Corbett Wilkinson ◽

Nicholas V. Stence ◽

Laura Z. Fenton ◽

Sean A. McNatt ◽

...

Keyword(s):

Brain Injury ◽

Head Injury ◽

Decompressive Craniectomy ◽

Fatal Outcome ◽

Closed Head Injury ◽

Fold Increase ◽

Common Mechanism ◽

Cranial Trauma ◽

Closed Head ◽

Clinical Records

Object The goal of this study was to compare clinical outcomes following decompressive craniectomy performed for intracranial hypertension in children with nonaccidental, blunt cranial trauma with outcomes of decompressive craniectomy in children injured by other mechanisms. Methods All children in a prospectively acquired database of trauma admissions who underwent decompressive craniectomy over a 9-year span, beginning January 1, 2000, are the basis for this study. Clinical records and neuroimaging studies were systematically reviewed. Results Thirty-seven children met the inclusion criteria. Nonaccidental head trauma was the most common mechanism of injury (38%). The mortality rate in patients with abusive brain injury (35.7%) was significantly higher (p < 0.05) than in patients with other causes of traumatic brain injury (4.3%). Children with inflicted head injuries had a 12-fold increase in the odds of death and 3-fold increase in the odds of a poor outcome (King's Outcome Scale for Closed Head Injury score of 1, 2, or 3). Conclusions Children with nonaccidental blunt cranial trauma have significantly higher mortality following decompressive craniectomy than do children with other mechanisms of injury. This understanding can be interpreted to mean either that the threshold for decompression should be lower in children with nonaccidental closed head injury or that decompression is unlikely to alter the path to a fatal outcome. If decompressive craniectomy is to be effective in reducing mortality in the setting of nonaccidental blunt cranial trauma, it should be done quite early.

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