scholarly journals Notch inhibitor can attenuate apparent diffusion coefficient and improve neurological function through downregulating NOX2-ROS in severe traumatic brain injury

2018 ◽  
Vol Volume 12 ◽  
pp. 3847-3854 ◽  
Author(s):  
Hong-Mei Zhang ◽  
Wei Chen ◽  
Rui-Ning Liu ◽  
Yan Zhao
Keyword(s):  
Traumatic Brain Injury ◽  
Diffusion Coefficient ◽  
Brain Injury ◽  
Apparent Diffusion Coefficient ◽  
Severe Traumatic Brain Injury ◽  
Neurological Function ◽  
Apparent Diffusion

Decreased apparent diffusion coefficient in the pituitary and correlation with hypopituitarism in patients with traumatic brain injury

2015 ◽  
Vol 123 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Ping Zheng ◽  
Bin He ◽  
Yijun Guo ◽  
Jingsong Zeng ◽  
Wusong Tong
Keyword(s):  
Traumatic Brain Injury ◽  
Diffusion Coefficient ◽  
Brain Injury ◽  
Apparent Diffusion Coefficient ◽  
Neurological Outcome ◽  
Pituitary Function ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Apparent Diffusion ◽  
Adc Values

OBJECT The relationship between microstructural abnormality in patients with traumatic brain injury (TBI) and hormone-secreting status remains unknown. In this study, the authors aimed to identify the role of the apparent diffusion coefficient (ADC) using a diffusion-weighted imaging (DWI) technique and to evaluate the association of such changes with hypopituitarism in patients with TBI. METHODS Diffusion-weighted images were obtained in 164 consecutive patients with TBI within 2 weeks after injury to generate the pituitary ADC as a measure of microstructural change. Patients with TBI were further grouped into those with and those without hypopituitarism based on the secretion status of pituitary hormones at 6 months postinjury. Thirty healthy individuals were enrolled in the study and underwent MRI examinations for comparison. Mean ADC values were compared between this control group, the patients with TBI and hypopituitarism, and the patients with TBI without hypopituitarism; correlational studies were also performed. Neurological outcome was assessed with the Glasgow Outcome Scale (GOS) for all TBI patients 6 months postinjury. RESULTS In the TBI group, 84 patients had hypopituitarism and 80 had normal pituitary function. The pituitary ADC in TBI patients was significantly less than that in controls (1.83 ± 0.16 vs 4.13 ± 0.33, p < 0.01). Furthermore, the mean ADC was much lower in TBI patients with hypopituitarism than in those without pituitary dysfunction (1.32 ± 0.09 vs 2.28 ± 0.17, p < 0.05). There was also a significant difference in ADC values between patients with hyperprolactinemia and those with normal prolactin levels (p < 0.05). Additionally, the receiver operating characteristic curve analysis showed that the pituitary ADC could predict hypopituitarism with a sensitivity of 90.0% and a specificity of 90.1% at the level of 1.720 (ADC value). Finally, the ADC value was positively correlated with neurological outcome at 6 months following TBI (r = 0.602, p < 0.05). CONCLUSIONS Use of DWI demonstrated that the pituitary ADC is correlated with hormone-secreting status in TBI patients. The authors suggest that pituitary ADC may be a useful biomarker to predict pituitary function in patients with TBI.

scholarly journals Hyperbaric oxygen for severe traumatic brain injury: a randomized trial

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052093982
Author(s):  
Xianliang Zhong ◽  
Aijun Shan ◽  
Jianzhong Xu ◽  
Jian Liang ◽  
Ying Long ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hyperbaric Oxygen ◽  
Severe Traumatic Brain Injury ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Vital Signs ◽  
Neurological Function ◽  
Control Group ◽  
Experimental Group

Objective The present study aimed to explore the effects of hyperbaric oxygen therapy on the prognosis and neurological function of patients with severe traumatic brain injury. Methods A prospective study was carried out in 88 patients diagnosed with severe brain injury at our hospital and they were enrolled as research participants and randomly assigned to control and experimental groups (n = 44 per group) using a random number table method. Both groups underwent routine treatment. Patients in the experimental group were administered hyperbaric oxygen therapy approximately 1 week after admission when their vital signs had stabilized. Results No significant intergroup differences were observed in the Glasgow Coma Scale (GCS) and U.S. National Institutes of Health Stroke Scale (NIHSS) scores before treatment. However, after oxygen treatment, compared with the control group, the experimental group showed higher GCS and lower NIHSS scores. The GCS score at admission, tracheotomy status, and first hyperbaric oxygen therapy duration were independent prognostic factors in patients with severe traumatic brain injury. Conclusion Hyperbaric oxygen therapy may promote recovery of neurological function and improve the cognitive function and prognosis of patients with severe traumatic brain injury.

scholarly journals Utility of tubular retractors to minimize surgical brain injury in the removal of deep intraparenchymal lesions: a quantitative analysis of FLAIR hyperintensity and apparent diffusion coefficient maps

2016 ◽  
Vol 124 (4) ◽  
pp. 1053-1060 ◽  
Author(s):  
Evan D. Bander ◽  
Samuel H. Jones ◽  
Ilhami Kovanlikaya ◽  
Theodore H. Schwartz
Keyword(s):  
Diffusion Coefficient ◽  
Brain Injury ◽  
Apparent Diffusion Coefficient ◽  
Brain Lesions ◽  
Restricted Diffusion ◽  
Cellular Damage ◽  
Total Resection ◽  
Tubular Retractor ◽  
Apparent Diffusion ◽  
Apparent Diffusion Coefficient Maps

OBJECT Brain retraction systems are frequently required to achieve surgical exposure of deep-seated brain lesions. Spatula-based systems can be associated with injury to the cortex and deep white matter, particularly adjacent to the sharp edges, which can result in uneven pressure on the parenchyma over the course of a long operation. The use of tubular retractor systems has been proposed as a method to overcome these limitations. There have been no studies assessing the degree of brain injury associated with the use of tubular retractors. METHODS Twenty patients were retrospectively identified at Weill Cornell Medical College who underwent resection of deep-seated brain lesions between 2005 and 2014 with the aid of a METRx tubular retractor system. Using the Brainlab software, pre- and postoperative images were analyzed to assess volume, depth, extent of resection, and change in postoperative MR FLAIR hyperintensity and restricted diffusion on diffusion-weighted imaging (DWI). RESULTS The mean preoperative tumor volume was 16.25 ± 17.6 cm3. Gross-total resection was achieved in 75%, near-total resection in 10%, and subtotal resection in 15% of patients. There was a small but not statistically significant increase in average FLAIR hyperintensity volume by 3.25 ± 10.51 cm3 (p = 0.16). The average postoperative volume of DWI high signal area with restricted diffusion on apparent diffusion coefficient maps was 8.35 ± 3.05 cm3. Assuming that the volume of restricted diffusion on DWI around tumor was 0 preoperatively, this represented a statistically significant increase on DWI (p < 0.001). CONCLUSIONS Although tubular retractors do not appear to significantly increase FLAIR signal in the brain, DWI intensity around the retractors can be identified. These data indicate that although tubular retractors may minimize damage to surrounding tissues, they still cause cytotoxic edema and cellular damage. Objective comparison against other retraction methods, as compared by 3D volumetric analysis or similar methods, will be important in determining the true advantage of tubular retractor systems.

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