scholarly journals Elevated Serum Protein S100B and Neuron Specific Enolase Values as Predictors of Early Neurological Outcome after Traumatic Brain Injury

2017 ◽  
Vol 36 (4) ◽  
pp. 314-321 ◽  
Author(s):  
Branislava Stefanović ◽  
Olivera Đurić ◽  
Sanja Stanković ◽  
Srđan Mijatović ◽  
Krstina Doklestić ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Serum Protein ◽  
Neurological Outcome ◽  
Brain Injuries ◽  
Elevated Serum ◽  
Neuron Specific Enolase ◽  
Poor Outcome ◽  
Protein S100b ◽  
The Brain

SummaryBackground: The objective of our study was to determine the serum concentrations of protein S100B and neuron specific enolase (NSE) as well as their ability and accuracy in the prediction of early neurological outcome after a traumatic brain injury. Methods: A total of 130 polytraumatized patients with the associated traumatic brain injuries were included in this prospective cohort study. Serum protein S100B and NSE levels were measured at 6, 24, 48 and 72 hours after the injury. Early neurological outcome was scored by Glasgow Outcome Scale (GOS) on day 14 after the brain injury. Results: The protein S100B concentrations were maximal at 6 hours after the injury, which was followed by an abrupt fall, and subsequently slower release in the following two days with continual and significantly increased values (p<0.0001) in patients with poor outcome. Secondary increase in protein S100B at 72 hours was recorded in patients with lethal outcome (GOS 1). Dynamics of NSE changes was characterized by a secondary increase in concentrations at 72 hours after the injury in patients with poor outcome. Conclusion: Both markers have good predictive ability for poor neurological outcome, although NSE provides better discriminative potential at 72 hours after the brain injury, while protein S100B has better discriminative potential for mortality prediction.

scholarly journals Analysis of Neuron Specific Enolase Serum Levels in Traumatic Brain Injury

2021 ◽  
Vol 5 (4) ◽  
pp. 1218-1222
Author(s):  
Yuliarni Syafrita ◽  
Nora Fitri
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Neuron Specific Enolase ◽  
Serum Levels ◽  
Pathological Process ◽  
P Value ◽  
Secondary Brain Injury ◽  
Post Injury ◽  
The Brain

Background : Traumatic brain injury is still the main cause of death and disability in productive age. Assessment the level of consciousness and imaging examinations after a brain injury can not always describe the severity of damage in the brain, this is because the pathological process is still ongoing due to secondary brain injury. Therefore, it is necessary to examine biomarkers that can describe the severity of the pathological process that occurs. The purpose of this study was to assess serum neuron-specific enolase (NSE) levels and their relationship to the severity and outcome of a traumatic brain injury. Methods : A cross sectional design was conducted in the emergency department of DR M Djamil Hospital, Padang. There were 72 patients who met the inclusion criteria. A Glasgow Coma Scale examination was performed to assess the severity of brain injury and examination of NSE serum levels at 48 hours post- injury using ELISA technique and assess the Glasgow outcome scale (GOS) at 6 weeks post-injury. Data analysis using SPSS 22 program, the results are significance if the p value <0.05  Results : The average NSE level was higher in severe brain injuries than moderate and mild brain injuries and this difference was statistically significant (p<0.05).  The NSE serum levels were higher in poor outcomes than in good outcomes and this difference was statistically significant (p<0.05).  Conclusion : High NSE serum levels in the acute phase were associated with the severity of the brain injury and poor outcome 6 weeks after the brain injury. 

scholarly journals Lack of mitochondrial ferritin aggravated neurological deficits via enhancing oxidative stress in a traumatic brain injury murine model

2017 ◽  
Vol 37 (6) ◽  
Author(s):  
Ligang Wang ◽  
Libo Wang ◽  
Zhibo Dai ◽  
Pei Wu ◽  
Huaizhang Shi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Knockout Mice ◽  
Brain Injuries ◽  
Brain Infarction ◽  
Neurological Deficits ◽  
Important Correlation ◽  
The Brain ◽  
And Oxidative Stress

Oxidative stress has been strongly implicated in the pathogenesis of traumatic brain injury (TBI). Mitochondrial ferritin (Ftmt) is reported to be closely related to oxidative stress. However, whether Ftmt is involved in TBI-induced oxidative stress and neurological deficits remains unknown. In the present study, the controlled cortical impact model was established in wild-type and Ftmt knockout mice as a TBI model. The Ftmt expression, oxidative stress, neurological deficits, and brain injury were measured. We found that Ftmt expression was gradually decreased from 3 to 14 days post-TBI, while oxidative stress was gradually increased, as evidenced by reduced GSH and superoxide dismutase levels and elevated malondialdehyde and nitric oxide levels. Interestingly, the extent of reduced Ftmt expression in the brain was linearly correlated with oxidative stress. Knockout of Ftmt significantly exacerbated TBI-induced oxidative stress, intracerebral hemorrhage, brain infarction, edema, neurological severity score, memory impairment, and neurological deficits. However, all these effects in Ftmt knockout mice were markedly mitigated by pharmacological inhibition of oxidative stress using an antioxidant, N-acetylcysteine. Taken together, these results reveal an important correlation between Ftmt and oxidative stress after TBI. Ftmt deficiency aggravates TBI-induced brain injuries and neurological deficits, which at least partially through increasing oxidative stress levels. Our data suggest that Ftmt may be a promising molecular target for the treatment of TBI.

scholarly journals Manajemen Anestesia pada Evakuasi Epidural Haemorrhage (EDH) dengan Pendarahan Masif

2021 ◽  
Vol 10 (1) ◽  
pp. 29-39
Author(s):  
Nurul Huda ◽  
◽  
Buyung Hartiyo Laksono
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Brain Injuries ◽  
Good Condition ◽  
Massive Bleeding ◽  
Red Blood Cell Transfusion ◽  
Mortality And Morbidity ◽  
Hemodynamic Status ◽  
Poor Outcome

Traumatic brain injury causes mortality and morbidity worldwide. Epidural Haemorrhage (EDH) is a form of head injury where time is an indicator that must be considered in its management. The main focus during traumatic brain injury management is patient stabilization and control of intracranial pressure, as well as maintaining brain oxygenation and perfusion. Subsequently, surgical decompression was performed. Evacuation and bleeding control should be done in a short time to avoid further injury. The practice of neuroanesthesia, as a support in the management of traumatic brain injuries, is often associated with blood loss that results in anemia during the intraoperative and postoperative periods. Although anemia correlates with poor outcome in brain-injured patients, red blood cell transfusion to correct anemia also correlates with poor outcome in patients. There are still no clear recommendations regarding the administration of transfusions, whether restrictive or massive, regarding the benefits provided. Male patient, age 51 years with complaints of decreased consciousness and vomiting, referred from the previous hospital with a diagnosis of moderate head injury 225 with 96cc temporoparietal EDH, 11mm midline shift to the right, and cerebral edema. During the operation period, there was massive bleeding that interfered with the hemodynamic status so that blood components were transfused until a stable hemodynamic status was obtained. In postoperative care in the ICU, the patient is relatively in good condition.

Brain tissue oxygen monitoring after severe traumatic brain injury in children: relationship to outcome and association with other clinical parameters

2012 ◽  
Vol 10 (5) ◽  
pp. 383-391 ◽  
Author(s):  
Martina Stippler ◽  
Veronica Ortiz ◽  
P. David Adelson ◽  
Yue-Fang Chang ◽  
Elizabeth C. Tyler-Kabara ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Partial Pressure ◽  
Brain Tissue ◽  
Neurological Outcome ◽  
Brain Injuries ◽  
Brain Temperature ◽  
Clinical Variables ◽  
Arterial Blood ◽  
Favorable Neurological Outcome

Object Minimizing secondary brain injuries after traumatic brain injury (TBI) in children is critical to maximizing neurological outcome. Brain tissue oxygenation monitoring (as measured by interstitial partial pressure of O2 [PbO2]) is a new tool that may aid in guiding therapies, yet experience in children is limited. This study aims to describe the authors' experience of PbO2 monitoring after TBI. It was hypothesized that PbO2 thresholds could be established that were associated with favorable neurological outcome, and it was determined whether any relationships between PbO2 and other important clinical variables existed. Methods Forty-six children with severe TBI (Glasgow Coma Scale score ≤ 8 after resuscitation) who underwent PbO2 and brain temperature monitoring between September 2004 and June 2008 were studied. All patients received standard neurocritical care, and 24 were concurrently enrolled in a trial of therapeutic early hypothermia (n = 12/group). The PbO2 was measured in the uninjured frontal cortex. Hourly recordings and calculated daily means of various variables including PbO2, intracranial pressure (ICP), cerebral perfusion pressure (CPP), mean arterial blood pressure, partial pressure of arterial O2, and fraction of inspired O2 were compared using several statistical approaches. Glasgow Outcome Scale scores were determined at 6 months after injury. Results The mean patient age was 9.4 years (range 0.1–16.5 years; 13 girls) and 8554 hours of monitoring were analyzed (PbO2 range 0.0–97.2 mm Hg). A PbO2 of 30 mm Hg was associated with the highest sensitivity/specificity for favorable neurological outcome at 6 months after TBI, yet CPP was the only factor that was independently associated with favorable outcome. Surprisingly, instances of preserved PbO2 with altered ICP and CPP were observed in some children with unfavorable outcomes. Conclusions Monitoring of PbO2 demonstrated complex interactions with clinical variables reflecting intracranial dynamics using this protocol. A higher threshold than reported in studies in adults was suggested as a potential therapeutic target, but this threshold was not associated with improved outcomes. Additional studies to assess the utility of PbO2 monitoring after TBI in children are needed.

scholarly journals Drebrin controls scar formation and astrocyte reactivity upon traumatic brain injury by regulating membrane trafficking

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Juliane Schiweck ◽  
Kai Murk ◽  
Julia Ledderose ◽  
Agnieszka Münster-Wandowski ◽  
Marta Ornaghi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Membrane Trafficking ◽  
Brain Injuries ◽  
Damage Control ◽  
Cellular Level ◽  
Scar Formation ◽  
Surface Proteins ◽  
Actin Binding ◽  
The Brain

AbstractThe brain of mammals lacks a significant ability to regenerate neurons and is thus particularly vulnerable. To protect the brain from injury and disease, damage control by astrocytes through astrogliosis and scar formation is vital. Here, we show that brain injury in mice triggers an immediate upregulation of the actin-binding protein Drebrin (DBN) in astrocytes, which is essential for scar formation and maintenance of astrocyte reactivity. In turn, DBN loss leads to defective astrocyte scar formation and excessive neurodegeneration following brain injuries. At the cellular level, we show that DBN switches actin homeostasis from ARP2/3-dependent arrays to microtubule-compatible scaffolds, facilitating the formation of RAB8-positive membrane tubules. This injury-specific RAB8 membrane compartment serves as hub for the trafficking of surface proteins involved in astrogliosis and adhesion mediators, such as β1-integrin. Our work shows that DBN-mediated membrane trafficking in astrocytes is an important neuroprotective mechanism following traumatic brain injury in mice.

scholarly journals Head Impact Injury Mitigation to Vehicle Occupants: An Investigation of Interior Padding and Head Form Modeling Options against Vehicle Crash

2021 ◽  
Author(s):  
Ermias G. Koricho ◽  
Elizabeth Dimsdale
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Impact Load ◽  
Age Groups ◽  
Vehicle Crash ◽  
Materials Modeling ◽  
Head Form ◽  
The Brain

Traumatic Brain Injuries (TBI) occur approximately 1.7 million times each year in the U.S., with motor vehicle crashes as the second leading cause of TBI-related hospitalizations, and the first leading cause of TBI-related deaths among specific age groups. Several studies have been conducted to better understand the impact on the brain in vehicle crash scenarios. However, the complexity of the head is challenging to replicate numerically the head response during vehicle crash and the resulting traumatic Brain Injury. Hence, this study aims to investigate the effect of vehicle structural padding and head form modeling representation on the head response and the resulting causation and Traumatic Brain Injury (TBI). In this study, a simplified and complex head forms with various geometries and materials including the skull, cerebrospinal fluid (CSF), neck, and muscle were considered to better understand and predict the behavior of each part and their effect on the response of the brain during an impact scenario. The effect of padding thickness was also considered to further analyze the interaction of vehicle structure and the head response. The numeral results revealed that the responses of the head skull and the brain under impact load were highly influenced by the padding thickness, head skull material modeling and assumptions, and neck compliance. Generally, the current work could be considered an alternative insight to understand the correlation between vehicle structural padding, head forms, and materials modeling techniques, and TBI resulted from a vehicle crash.

scholarly journals Application of neuroprotectors in severe brain injuries

2011 ◽  
Vol 10 (5) ◽  
pp. 36-40
Author(s):  
O. Ye. Vaizova ◽  
N. A. Zautner ◽  
V. M. Alifirova ◽  
D. V. Kolmakov ◽  
Ye. L. Golovina ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Blood Brain Barrier ◽  
Blood Concentration ◽  
Brain Injuries ◽  
Neuron Specific Enolase ◽  
Brain Barrier ◽  
Blood Brain ◽  
Neuroprotective Therapy

Blood concentration of protein S100 was been decreased with choline-liked neuroprotectors citicoline and choline alfoscerate in clinical trial 52 patients in early day after stroke. Concentration of neuron-specific enolase was been decreased with three month mildronat therapy in blood of 16 patients with traumatic brain injury. Neuroprotective therapy has stabilization of blood-brain barrier as result.

Diagnostic features of traumatic brain injury in childhood

2013 ◽  
Vol 4 (4) ◽  
pp. 56-60 ◽  
Author(s):  
Mariy Lazarevna Chukhlovina
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Review Article ◽  
Brain Trauma ◽  
Diagnostic Features ◽  
Radiological Criteria ◽  
Trauma Diagnostics ◽  
The Brain

The review article concerns some issues of improved diagnostics and main neuro-radiological criteria of traumatic brain injuries in childhood. Special attention is given to anatomic and physiological features of brain in children, aiming for proper evaluation of severity in traumatic brain injury. We provide a summary of data concerning modern echniques of brain trauma diagnostics, and its consequences in children. Utility of neurovisualization, electrophysiological techniques, biochemical approaches for detecting the brain damage biomarkers, demonstrated in order to determine severity of brain trauma in childhood.

Diversion Courts, Traumatic Brain Injury, and American Vets

2020 ◽  
pp. 149-167
Author(s):  
Valerie Gray Hardcastle
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mental Health Treatment ◽  
Brain Injuries ◽  
Brain Disorders ◽  
Court System ◽  
Scientific Communities ◽  
Health Treatment ◽  
Control And Prevention ◽  
The Brain

The Centers for Disease Control and Prevention estimates that the lifetime traumatic brain injury (TBI) rates for prisoners are higher than for the general population. The impulsive and aggressive behaviors resulting from TBI also parallel incarceration rates. But how scientific communities understand the origins of behavior clashes with how our justice system does. Medicine, psychiatry, neuropsychology, and neurology all hold that deformities in the brain can influence or even determine a person’s thoughts, desires, impulses, and ability to control behavior. In contrast, U.S. law assumes that adults are rational beings who act for specific reasons and that, in each instance, an individual could have done otherwise. Yet, the American court system is beginning to differentiate returning combat vets with brain disorders from other offenders, creating diversion courts for veterans accused of a variety of crimes. These courts allow military offenders to enter a mental health treatment program instead of being jailed. Several questions arise from this practice. Should vets be treated differently than other noncombatant defendants with similar brain injuries? Should brain disorders affect how we assign or understand legal notions of punishment and responsibility? How do we connect data regarding neural interventions with punishment and remediation? And how do we distinguish “mad” from “bad”? This chapter attempts to answer these questions.

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