Determination of Diffuse Brain Injury Thresholds Using Retrospective Analysis

2007 ◽  
Author(s):  
Ronald J. Fijalkowski ◽  
Brian D. Stemper ◽  
Frank A. Pintar ◽  
Narayan Yoganandan ◽  
Thomas A. Gennarelli
Keyword(s):  
Brain Injury ◽  
Retrospective Analysis ◽  
Neurological Deficit ◽  
Injury Severity ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Rotational Acceleration ◽  
Diffuse Brain Injury ◽  
Diffuse Brain

Diffuse brain injury (DBI) severity can be clinically diagnosed as concussion or diffuse axonal injury (DAI). Concussion the least severe DBI, is associated with neurological deficit limited to disorientation and unconsciousness lasting minutes to hours [1–4]. In contrast, DAI, a severe injury, commonly results in death or permanent vegetation [1]. It is generally accepted that injury severity is modulated by increased mechanical measures such as rotational acceleration and velocity [5–11].

scholarly journals Temporal Profile of Microtubule-Associated Protein 2: A Novel Indicator of Diffuse Brain Injury Severity and Early Mortality after Brain Trauma

2018 ◽  
Vol 35 (1) ◽  
pp. 32-40 ◽  
Author(s):  
Linda Papa ◽  
Steven A. Robicsek ◽  
Gretchen M. Brophy ◽  
Kevin K.W. Wang ◽  
H. Julia Hannay ◽  
...  
Keyword(s):  
Brain Injury ◽  
Injury Severity ◽  
Early Mortality ◽  
Brain Trauma ◽  
Diffuse Brain Injury ◽  
Temporal Profile ◽  
Diffuse Brain

scholarly journals The Association of Early Electrocardiographic Abnormalities With Brain Injury Severity and Outcome in Severe Traumatic Brain Injury

2021 ◽  
Vol 11 ◽  
Author(s):  
Jelmer-Joost Lenstra ◽  
Lidija Kuznecova-Keppel Hesselink ◽  
Sacha la Bastide-van Gemert ◽  
Bram Jacobs ◽  
Maarten Willem Nicolaas Nijsten ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Mortality ◽  
Cardiac Arrhythmias ◽  
Injury Severity ◽  
Thoracic Injury ◽  
Diffuse Brain Injury ◽  
Severe Tbi ◽  
Ecg Abnormalities ◽  
Diffuse Brain

The aim of this study was to evaluate the frequency of electrocardiographic (ECG) abnormalities in the acute phase of severe traumatic brain injury (TBI) and the association with brain injury severity and outcome. In contrast to neurovascular diseases, sparse information is available on this issue. Data of adult patients with severe TBI admitted to the Intensive Care Unit (ICU) for intracranial pressure monitoring of a level-1 trauma center from 2002 till 2018 were analyzed. Patients with a cardiac history were excluded. An ECG recording was obtained within 24 h after ICU admission. Admission brain computerized tomography (CT)-scans were categorized by Marshall-criteria (diffuse vs. mass lesions) and for location of traumatic lesions. CT-characteristics and maximum Therapy Intensity Level (TILmax) were used as indicators for brain injury severity. We analyzed data of 198 patients, mean (SD) age of 40 ± 19 years, median GCS score 3 [interquartile range (IQR) 3–6], and 105 patients (53%) had thoracic injury. In-hospital mortality was 30%, with sudden death by cardiac arrest in four patients. The incidence of ECG abnormalities was 88% comprising ventricular repolarization disorders (57%) mostly with ST-segment abnormalities, conduction disorders (45%) mostly with QTc-prolongation, and arrhythmias (38%) mostly of supraventricular origin. More cardiac arrhythmias were observed with increased grading of diffuse brain injury (p = 0.042) or in patients treated with hyperosmolar therapy (TILmax) (65%, p = 0.022). No association was found between ECG abnormalities and location of brain lesions nor with thoracic injury. Multivariate analysis with baseline outcome predictors showed that cardiac arrhythmias were not independently associated with in-hospital mortality (p = 0.097). Only hypotension (p = 0.029) and diffuse brain injury (p = 0.017) were associated with in-hospital mortality. In conclusion, a high incidence of ECG abnormalities was observed in patients with severe TBI in the acute phase after injury. No association between ECG abnormalities and location of brain lesions or presence of thoracic injury was present. Cardiac arrhythmias were indicative for brain injury severity but not independently associated with in-hospital mortality. Therefore, our findings likely suggest that ECG abnormalities should be considered as cardiac mimicry representing the secondary effect of traumatic brain injury allowing for a more rationale use of neuroprotective measures.

A New Model for Diffuse Brain Injury by Rotational Acceleration: I. Model, Gross Appearance, and Astrocytosis

2001 ◽  
Vol 18 (3) ◽  
pp. 247-257 ◽  
Author(s):  
Elena Gutierrez ◽  
Yinglai Huang ◽  
Kenneth Haglid ◽  
Feng Bao ◽  
Hans-Arne Hansson ◽  
...  
Keyword(s):  
Brain Injury ◽  
Rotational Acceleration ◽  
New Model ◽  
Diffuse Brain Injury ◽  
Diffuse Brain

The Neuropsychiatric Aspects of Boxing

1995 ◽  
Vol 25 (3) ◽  
pp. 249-262 ◽  
Author(s):  
Mario F. Mendez
Keyword(s):  
Brain Injury ◽  
Neuropsychological Tests ◽  
Chronic Traumatic Encephalopathy ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Memory Deficits ◽  
Active Movement ◽  
Rotational Acceleration ◽  
Cognitive Changes ◽  
The Brain

Objective: To review the neuropsychiatry of boxing. Method: This update considers the clinical, neuropsychological, diagnostic, neurobiological, and management aspects of boxing-related brain injury. Results: Professional boxers with multiple bouts and repeated head blows are prone to chronic traumatic encephalopathy (CTE). Repeated head blows produce rotational acceleration of the brain, diffuse axonal injury, and other neuropathological features. CTE includes motor changes such as tremor, dysarthria, and parkinsonism; cognitive changes such as mental slowing and memory deficits; and psychiatric changes such as explosive behavior, morbid jealousy, pathological intoxication, and paranoia. Screening with neuropsychological tests and neuroimaging may help predict those boxers at risk for CTE. Conclusions: Boxing results in a spectrum of CTE ranging from mild, nonprogressive motor changes to dementia pugilistica. Recent emphasis on safety in the ring, rehabilitation techniques, and other interventions do not eliminate the risk for CTE. For this reason, there is an active movement to ban boxing.

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
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