scholarly journals Surgically-induced brain injury: where are we now?

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Zachary D. Travis ◽  
Prativa Sherchan ◽  
William K. Hayes ◽  
John H. Zhang
Keyword(s):  
Brain Injury ◽  
Brain Injuries ◽  
Neurosurgical Procedures ◽  
Cellular Mechanisms ◽  
The Past ◽  
Surgical Brain Injury ◽  
Neurosurgical Operation ◽  
Surgical Manipulations ◽  
Surgically Induced

AbstractNeurosurgical procedures cause inevitable brain damage from the multitude of surgical manipulations utilized. Incisions, retraction, thermal damage from electrocautery, and intraoperative hemorrhage cause immediate and long-term brain injuries that are directly linked to neurosurgical operations, and these types of injuries, collectively, have been termed surgical brain injury (SBI). For the past decade, a model developed to study the underlying brain pathologies resulting from SBI has provided insight on cellular mechanisms and potential therapeutic targets. This model, as seen in a rat, mouse, and rabbit, mimics a neurosurgical operation and causes commonly encountered post-operative complications such as brain edema, neuroinflammation, and hemorrhage. In this review, we elaborate on SBI and its clinical impact, the SBI animal models and their clinical relevance, the importance of applying therapeutics before neurosurgical procedures (i.e., preconditioning), and the new direction of applying venom-derived proteins to attenuate SBI.

scholarly journals Replicating infant astrocyte behavior in the adult after brain injury improves outcomes

2020 ◽  
Author(s):  
Leon Teo ◽  
Anthony G. Boghdadi ◽  
Jihane Homman-Ludiye ◽  
Iñaki Carril-Mundiñano ◽  
William C. Kwan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Brain Injury ◽  
Brain Injuries ◽  
Adult Patients ◽  
Long Term Outcomes ◽  
Neuroprotective Effects ◽  
Age Dependent ◽  
Underlying Mechanisms ◽  
Glial Scarring

AbstractInfants and adults respond differently to brain injuries. Specifically, improved neuronal sparing along with reduced astrogliosis and glial scarring often observed earlier in life, likely contributes to improved long-term outcomes. Understanding the underlying mechanisms could enable the recapitulation of neuroprotective effects, observed in infants, to benefit adult patients after brain injuries. We reveal that in primates, Eph/ ephrin signaling contributes to age-dependent reactive astrocyte behavior. Ephrin-A5 expression on astrocytes was more protracted in adults, whereas ephrin-A1 was associated only with infant astrocytes. Furthermore, ephrin-A5 exacerbated major hallmarks of astrocyte reactivity via EphA2 and EphA4 receptors, which was subsequently alleviated by ephrin-A1. Rather than suppressing reactivity, ephrin-A1 signaling shifted astrocytes towards GAP43+ neuroprotection, accounting for improved neuronal sparing in infants. Reintroducing ephrin-A1 after middle-aged ischemic stroke significantly attenuated glial scarring, improved neuronal sparing and preserved circuitry. Therefore, beneficial infant mechanisms can be recapitulated in adults to improve outcomes after CNS injuries.

scholarly journals Traumatic Injury to the Developing Brain: Emerging Relationship to Early Life Stress

2021 ◽  
Vol 12 ◽  
Author(s):  
Kaila N. Parker ◽  
Michael H. Donovan ◽  
Kylee Smith ◽  
Linda J. Noble-Haeusslein
Keyword(s):  
Brain Injury ◽  
Life Stress ◽  
Early Life ◽  
Brain Injuries ◽  
Traumatic Injury ◽  
Early Life Stress ◽  
Early Age ◽  
Functional Impairments ◽  
The Brain

Despite the high incidence of brain injuries in children, we have yet to fully understand the unique vulnerability of a young brain to an injury and key determinants of long-term recovery. Here we consider how early life stress may influence recovery after an early age brain injury. Studies of early life stress alone reveal persistent structural and functional impairments at adulthood. We consider the interacting pathologies imposed by early life stress and subsequent brain injuries during early brain development as well as at adulthood. This review outlines how early life stress primes the immune cells of the brain and periphery to elicit a heightened response to injury. While the focus of this review is on early age traumatic brain injuries, there is also a consideration of preclinical models of neonatal hypoxia and stroke, as each further speaks to the vulnerability of the brain and reinforces those characteristics that are common across each of these injuries. Lastly, we identify a common mechanistic trend; namely, early life stress worsens outcomes independent of its temporal proximity to a brain injury.

Whether erythropoietin can be a neuroprotective agent against premature brain injury: cellular mechanisms and clinical efficacy

2021 ◽  
Vol 19 ◽  
Author(s):  
Xueling Ma ◽  
Yuan Shi
Keyword(s):  
Brain Injury ◽  
Animal Models ◽  
Standard Treatment ◽  
Neuroprotective Effect ◽  
Cellular Mechanisms ◽  
Neuroprotective Strategy ◽  
Anti Oxidant ◽  
Premature Brain ◽  
Scientific Rationale

: Preterm infants are at high risk of brain injury. With more understanding of the preterm brain injury's pathogenesis, neuroscientists are looking for more effective methods to prevent and treat it, among which erythropoietin (Epo) is considered as a prime candidate. This review tries to clarify the possible mechanisms of Epo in preterm neuroprotection and summarize updated evidence considering Epo as a pharmacological neuroprotective strategy in animal models and clinical trials. To date, various animal models have validated that Epo is an anti-apoptotic, anti-inflammatory, anti-oxidant, anti-excitotoxic, neurogenetic, erythropoietic, angiogenetic, and neurotrophic agent, thus preventing preterm brain injury. However, although the scientific rationale and preclinical data for Epo's neuroprotective effect are promising, when translated to bedside, the results vary in different studies, especially in its long-term efficacy. Based on existing evidence, it is still too early to recommend Epo as the standard treatment for preterm brain injury.

scholarly journals Traumatic Brain Injury and Delayed Sequelae: A Review - Traumatic Brain Injury and Mild Traumatic Brain Injury (Concussion) are Precursors to Later-Onset Brain Disorders, Including Early-Onset Dementia

2007 ◽  
Vol 7 ◽  
pp. 1768-1776 ◽  
Author(s):  
Michael A. Kiraly ◽  
Stephen J. Kiraly
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Brain Injuries ◽  
Brain Disorders ◽  
Early Onset Dementia ◽  
Human Experiments ◽  
Delayed Consequences ◽  
Subsequent Onset

Brain injuries are too common. Most people are unaware of the incidence of and horrendous consequences of traumatic brain injury (TBI) and mild traumatic brain injury (MTBI). Research and the advent of sophisticated imaging have led to progression in the understanding of brain pathophysiology following TBI. Seminal evidence from animal and human experiments demonstrate links between TBI and the subsequent onset of premature, psychiatric syndromes and neurodegenerative diseases, including Alzheimer's disease (AD) and Parkinson's disease (PD). Objectives of this summary are, therefore, to instill appreciation regarding the importance of brain injury prevention, diagnosis, and treatment, and to increase awareness regarding the long-term delayed consequences following TBI.

scholarly journals Traumatic Brain Injury in Sports: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Christopher S. Sahler ◽  
Brian D. Greenwald
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Cognitive Impairment ◽  
Brain Injury ◽  
Head Trauma ◽  
Brain Injuries ◽  
Cognitive Impairments ◽  
The United States ◽  
Neurological Dysfunction

Traumatic brain injury (TBI) is a clinical diagnosis of neurological dysfunction following head trauma, typically presenting with acute symptoms of some degree of cognitive impairment. There are an estimated 1.7 to 3.8 million TBIs each year in the United States, approximately 10 percent of which are due to sports and recreational activities. Most brain injuries are self-limited with symptom resolution within one week, however, a growing amount of data is now establishing significant sequelae from even minor impacts such as headaches, prolonged cognitive impairments, or even death. Appropriate diagnosis and treatment according to standardized guidelines are crucial when treating athletes who may be subjected to future head trauma, possibly increasing their likelihood of long-term impairments.

Brain injury

2020 ◽  
pp. 171-180
Author(s):  
Niruj Agrawal
Keyword(s):  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Personality Change ◽  
Long Term Effects ◽  
Cerebrovascular Events ◽  
Chemical Factors ◽  
Physical Impact

Acquired brain injuries (ABIs) can be categorized as traumatic or non-traumatic brain injuries. Traumatic brain injuries (TBIs), sub-classified as either open or closed TBIs, depending on whether there is a fracture of the skull or a breach of the dura mater, are typically caused by a physical impact such as blunt trauma or a fall. Non-TBIs can be caused by cerebrovascular events, infections, or chemical factors. This chapter predominantly focuses on TBIs, exploring techniques to measure their extent, such as the Glasgow Coma Scale (GCS), and the aetiology of TBIs. Moreover, the long-term effects of TBIs are explored, such as anxiety disorders which often present themselves in their aftermath and the likelihood for TBI-induced personality change. The associated effects of non-TBIs are then examined, specifically with reference to anoxic brain injuries and those induced by drugs or alcohol.

scholarly journals Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Linnea Kjeldgård ◽  
Helena Stigson ◽  
Kristina Alexanderson ◽  
Emilie Friberg
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sequence Analysis ◽  
Sickness Absence ◽  
Disability Pension ◽  
Brain Injuries ◽  
Multinomial Logistic Regression ◽  
Road User ◽  
Full Time

Abstract Background Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.

scholarly journals Half a Century of Care

2007 ◽  
Vol 8 (3) ◽  
pp. 235-237
Author(s):  
Mary Ann McColl
Keyword(s):  
Brain Injury ◽  
Brain Injuries ◽  
Policy Issue ◽  
Term Care ◽  
Term Survival ◽  
New Information ◽  
Care And Support ◽  
Human Costs ◽  
Developed World

AbstractThe issue of long-term care and support of people with acquired brain injury has been a significant clinical and policy issue for some time; however. as evidence accrues about increases in incidence and survival from brain injury, the focus on this issue sharpens (Kolpan, 1990; McCluskey, 2005). The net effect of these increases (in the number of new brain injuries per year plus survival beyond the acute phase) is a sharp increase in prevalence, or the number of people living with the effects of brain injury in a given population. Add to that new information that has recently been published regarding long-term survival, and it becomes immediately apparent that factors are converging to produce an immanent increase in the economic and human costs of acquired brain injuries, at least in the developed world.

scholarly journals Basic special needs and related approaches – mainly medical – for patients following moderate/severe traumatic brain injury

2015 ◽  
Vol 10 (2) ◽  
pp. 107-110
Author(s):  
Cristina POPESCU ◽  
◽  
Aurelian ANGHELESCU ◽  
Cristina DAIA ◽  
Gelu ONOSE ◽  
...  
Keyword(s):  
Health Care ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Special Needs ◽  
Brain Injuries ◽  
Life Time ◽  
Health Care Team ◽  
Interdisciplinary Teams ◽  
Hospital Units

Traumatic brain injury (TBI) may affect almost every aspect of a person’s life. The relationships with family and friends, their roles and responsibilities, all, will require an adjustment period, preferably to be achieved one step at a time, with training and guidance of a specialized health care team. Consequently, such neurologically severe impaired patients have almost always including long term needs, which are quasi-permanent or permanent so endured for a life time. The only way these special needs can be fulfilled or – at best made unnecessary – is the discovery of the way to cure the central nervous system lesions. Because medicine is unfortunately not there yet, this article will review the respective specific numerous long-term needs that may be met by the tools medicine has to offer today, aiming to improve health care in hospital units with rehabilitation profile and to provide ongoing guideline constructs for patients with TBI and their families, after discharge too, aiming at an as complete as possible family social and professional reintegration. Post TBI evolution is influenced by a variety of factors making patients with brain injuries care a complicated and sustained process, the improvements being undoubtedly influenced by their multimodal way to be approached within interdisciplinary teams, applying individualized rehabilitation programs – all in purpose to reach a quasi-normal life or as close to its sense.

scholarly journals Advanced brain injury Neuroprotection therapy

2016 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
Sathik R T ◽  
Thanish K
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hyperbaric Oxygen ◽  
Oxygen Therapy ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Current Data ◽  
Long Term Effects ◽  
The People

Head injury typically talks about to TBI, but is a larger category because it can includeinjury to assemblies other than the intelligence, such as the scalp and skull. Traumatic brain injury (TBI) disturbs a rising portion of the people and endures to take national attention with early payment in imaging equipment and in debt of long-term effects. TBI is a most important cause of death and failure to wide-reaching, specifically in teen-agers and undeveloped adults. Males withstand traumatic brain injuries additional habitually than do females. Though, there is great variance in TBI handlingprocedures due to injury inconsistency and absence of both automatousconsiderate and robust treatment references. In Recent years proposes three differenthandlingmethods, all which key purpose at cheering neuroprotection after that TBI, show possibilities: instantaneous hypothermia, hyperbaric oxygen, and progesterone enhancement. The investigation is provocative at times, yet there are profuseopenings to develop the knowledgebehind schedule hypothermia and hyperbaric oxygen therapy which would confidently aid in make straight the current data. Additionally, while progesterone has already been packaged in nanoparticle form it may benefit from continued formulation and managementinvestigation. The treatments and the opportunities for development isgo through in the present paper.

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