scholarly journals Repeated Mild Closed Head Injuries Induce Long-Term White Matter Pathology and Neuronal Loss That Are Correlated With Behavioral Deficits

ASN NEURO ◽  
2018 ◽  
Vol 10 ◽  
pp. 175909141878192 ◽  
Author(s):  
Eric M. Gold ◽  
Vitaly Vasilevko ◽  
Jonathan Hasselmann ◽  
Casey Tiefenthaler ◽  
Danny Hoa ◽  
...  
Keyword(s):  
Cortical Neurons ◽  
Chronic Traumatic Encephalopathy ◽  
Head Injuries ◽  
Closed Head Injury ◽  
Neuronal Loss ◽  
Significant Loss ◽  
Behavioral Deficits ◽  
Closed Head ◽  
Behavioral Impairments

An estimated 5.3 million Americans are living with a disability from a traumatic brain injury (TBI). There is emerging evidence of the detrimental effects from repeated mild TBIs (rmTBIs). rmTBI manifests its own unique set of behavioral and neuropathological changes. A subset of individuals exposed to rmTBI develop permanent behavioral and pathological consequences, defined postmortem as chronic traumatic encephalopathy. We have combined components of two classic rodent models of TBI, the controlled cortical impact model and the weight drop model, to develop a repeated mild closed head injury (rmCHI) that produces long-term deficits in several behaviors that correlate with neuropathological changes. Mice receiving rmCHI performed differently from 1-hit or sham controls on the elevated plus maze; these deficits persist up to 6 months postinjury (MPI). rmCHI mice performed worse than 1-hit and control sham mice at 2 MPI and 6 MPI on the Morris water maze. Mice receiving rmCHI exhibited significant atrophy of the corpus callosum at both 2 MPI and 6 MPI, as assessed by stereological volume analysis. Stereological analysis also revealed significant loss of cortical neurons in comparison with 1-hit and controls. Moreover, both of these pathological changes correlated with behavioral impairments. In human tau transgenic mice, rmCHI induced increases in hyperphosphorylated paired helical filament 1 tau in the hippocampus. This suggests that strategies to restore myelination or reduce neuronal loss may ameliorate the behavioral deficits observed following rmCHI and that rmCHI may model chronic traumatic encephalopathy in human tau mice.

scholarly journals Chronic Traumatic Encephalopathy: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Michael Saulle ◽  
Brian D. Greenwald
Keyword(s):  
Military Service ◽  
Clinical Presentation ◽  
Chronic Traumatic Encephalopathy ◽  
Head Injuries ◽  
Emotional Disturbances ◽  
American Football ◽  
Closed Head Injuries ◽  
Apoe4 Allele ◽  
Closed Head

Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that is a long-term consequence of single or repetitive closed head injuries for which there is no treatment and no definitive pre-mortem diagnosis. It has been closely tied to athletes who participate in contact sports like boxing, American football, soccer, professional wrestling and hockey. Risk factors include head trauma, presence of ApoE3 or ApoE4 allele, military service, and old age. It is histologically identified by the presence of tau-immunoreactive NFTs and NTs with some cases having a TDP-43 proteinopathy or beta-amyloid plaques. It has an insidious clinical presentation that begins with cognitive and emotional disturbances and can progress to Parkinsonian symptoms. The exact mechanism for CTE has not been precisely defined however, research suggest it is due to an ongoing metabolic and immunologic cascade called immunoexcitiotoxicity. Prevention and education are currently the most compelling way to combat CTE and will be an emphasis of both physicians and athletes. Further research is needed to aid in pre-mortem diagnosis, therapies, and support for individuals and their families living with CTE.

scholarly journals Potentiating Hemorrhage in a Periadolescent Rat Model of Closed-Head Traumatic Brain Injury Worsens Hyperexcitability but Not Behavioral Deficits

2021 ◽  
Vol 22 (12) ◽  
pp. 6456
Author(s):  
Dounya Jalloul ◽  
Helene Hajjar ◽  
Rita Asdikian ◽  
Mariam Maawie ◽  
Leila Nasrallah ◽  
...  
Keyword(s):  
Rat Model ◽  
Neuronal Damage ◽  
Closed Head Injury ◽  
Significant Risk ◽  
Neuronal Loss ◽  
Significant Risk Factor ◽  
Coagulation System ◽  
Neurocognitive Deficits ◽  
Closed Head

Post-traumatic epilepsy (PTE) and neurocognitive deficits are devastating sequelae of head injuries that are common in adolescents. Investigating desperately needed treatments is hindered by the difficulties in inducing PTE in rodents and the lack of established immature rat models of pediatric PTE. Hemorrhage is a significant risk factor for PTE, but compared to humans, rats are less prone to bleeding because of their rapid blood coagulation system. In this study, we promoted bleeding in the controlled cortical impact (CCI) closed-head injury model with a 20 min pre-impact 600 IU/kg intraperitoneal heparin injection in postnatal day 35 (P35) periadolescent rats, given the preponderance of such injuries in this age group. Temporo-parietal CCI was performed post-heparin (HTBI group) or post-saline (TBI group). Controls were subjected to sham procedures following heparin or saline administration. Continuous long-term EEG monitoring was performed for 3 months post-CCI. Sensorimotor testing, the Morris water maze, and a modified active avoidance test were conducted between P80 and P100. Glial fibrillary acidic protein (GFAP) levels and neuronal damage were also assessed. Compared to TBI rats, HTBI rats had persistently higher EEG spiking and increased hippocampal GFAP levels (p < 0.05). No sensorimotor deficits were detected in any group. Compared to controls, both HTBI and TBI groups had a long-term hippocampal neuronal loss (p < 0.05), as well as contextual and visuospatial learning deficits (p < 0.05). The hippocampal astrogliosis and EEG spiking detected in all rats subjected to our hemorrhage-promoting procedure suggest the emergence of hyperexcitable networks and pave the way to a periadolescent PTE rat model.

Long-term effects of head injuries sustained during life in three male populations

1987 ◽  
Vol 67 (2) ◽  
pp. 197-205 ◽  
Author(s):  
Gudrun Silverbåge Carlsson ◽  
Kurt Svärdsudd ◽  
Lennart Welin
Keyword(s):  
Alcohol Intake ◽  
Head Injuries ◽  
Closed Head Injury ◽  
Cumulative Effect ◽  
Long Term Effects ◽  
Impaired Consciousness ◽  
Content Type ◽  
Closed Head ◽  
Self Assessed Health

✓ Data on defined head injuries, suffered during life, were related to possible long-term sequelae among 1112 men aged 30, 50, or 60 years who were sampled from the general population of Gothenburg, Sweden. There was a significant relationship between closed-head injury associated with reported impaired consciousness and occurrence of symptoms of the postconcussional type, self-assessed health variables, and the performance of finger-tapping and reaction-time tests. There was a cumulative effect of repeated head injuries: the more head injuries that were suffered, the more symptoms and more inferior performance were noted. Age at the time of the accident did not influence the occurrence of reported sequelae. Alcohol intake and smoking were powerful factors confounding the postinjury picture, but after taking these factors into account the results were generally the same. The study indicates that head injuries with impaired consciousness, no matter how short, are capable of causing permanent sequelae.

Inappropriate Discharge Instructions for Youth Athletes Hospitalized for Concussion

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 216-218
Author(s):  
Frank J. Genuardi ◽  
William D. King
Keyword(s):  
Head Injury ◽  
Injury Severity ◽  
Head Injuries ◽  
Closed Head Injury ◽  
Medical Society ◽  
Discharge Instructions ◽  
Youth Athletes ◽  
Closed Head Injuries ◽  
Closed Head ◽  
Grade 3

Objective. To evaluate the medical care, especially the discharge instructions regarding return to participation, received by youth athletes hospitalized for a closed head injury. Methods. We examined the records of all patients admitted over a 5-year period (1987 through 1991) to The Children's Hospital of Alabama for a sports-related closed head injury. Descriptive information was recorded and discharge instructions reviewed. Injury severity was graded according to guidelines current during the study period, as well as those outlined most recently by the Colorado Medical Society, which have been endorsed by a number of organizations including the American Academy of Pediatrics. Discharge instructions recorded for each patient were then compared with those recommended in the guidelines. Results. We identified 33 patients with sports-related closed head injuries. Grade 1 concussions (least severe) occurred in 8 patients (24.2%), grade 2 in 10 (30.3%), and grade 3 (most severe) in 15 (45.4%). Overall, discharge instructions were appropriate for only 10 patients (30.3%), including all with grade 1 concussions, but only 2 with a grade 2 (20.0%) and none with a grade 3 concussion. Conclusion. All who care for youth athletes must become familiar with the guidelines for management of concussion to provide appropriate care and counseling and to avoid a tragic outcome.

Long-term neuropsychological outcome of closed head injury

1979 ◽  
Vol 50 (4) ◽  
pp. 412-422 ◽  
Author(s):  
Harvey S. Levin ◽  
Robert G. Grossman ◽  
James E. Rose ◽  
Graham Teasdale
Keyword(s):  
Head Injury ◽  
Social Adjustment ◽  
Prognostic Significance ◽  
Closed Head Injury ◽  
Memory Storage ◽  
Acute Injury ◽  
Closed Head ◽  
Disabled Patients

✓ Long-term recovery from severe closed head injury was investigated in predominantly young adults whose Glasgow Coma score was 8 or less at the time of admission. Of the 27 patients studied (median follow-up interval of 1 year), 10 attained a good recovery, 12 were moderately disabled, and five were severely disabled. In contrast to previous studies suggesting that intellectual ability after severe closed head injury eventually recovers to a normal level, our findings showed that residual intellectual level, memory storage and retrieval, linguistic deficit, and personal social adjustment corresponded to overall outcome. All severely disabled patients and several moderately disabled patients exhibited unequivocal cognitive and emotional sequelae after long follow-up intervals. Analysis of persistent neuropsychological deficit in relation to neurological indices of acute injury severity demonstrated the prognostic significance of oculovestibular deficit.

A PET study of long-term rCBF changes during cognition after closed head injury

NeuroImage ◽  
1996 ◽  
Vol 3 (3) ◽  
pp. S492
Author(s):  
B.S. Kirkby ◽  
J.D. Van Horn ◽  
G. Esposito ◽  
T.E. Goldberg ◽  
D.R. Weinberger ◽  
...  
Keyword(s):  
Head Injury ◽  
Closed Head Injury ◽  
Closed Head

The impact-absorbing effects of facial fractures in closed-head injuries

1987 ◽  
Vol 66 (4) ◽  
pp. 542-547 ◽  
Author(s):  
K. Francis Lee ◽  
Louis K. Wagner ◽  
Y. Eugenia Lee ◽  
Jung Ho Suh ◽  
Seung Ro Lee
Keyword(s):  
Head Injuries ◽  
Closed Head Injury ◽  
Neurological Deficits ◽  
Facial Fractures ◽  
Contingency Table Analysis ◽  
Chi Square ◽  
Content Type ◽  
Closed Head ◽  
Table Analysis ◽  
The Impact

✓ A series of 210 patients with facial fractures sufficiently severe to require cranial computerized tomography (CT) to evaluate suspected closed-head injury (CHI) was studied. The injuries were separated into five grades of severity based on neurological examination, including cranial CT. The injuries were also grouped into three categories based on facial regional involvement, using chi-square contingency table analysis. The data demonstrated that patients with upper facial fractures were at greatest risk for serious CHI. Injuries to both the mandibular and the midfacial regions with no upper facial involvement more frequently resulted in mild CHI with a modest likelihood of no neurological deficits. Trauma to only the mandibular region or to only the midfacial region was least likely to involve CHI.

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