Traumatic Brain Injury and Mountains

Today, the traumatic epidemic is gaining momentum around the world. Having a complex pathogenesis, many aspects of the development and impact of traumatic brain injury (TBI) on the body remain undescribed. In particular, there is practically no information about the state of the body after a traumatic brain injury received in the highlands. The aim of the study is to establish the features of animal behavior, homeostatic blood parameters and functional morphology of the cerebellum in TBI in the highlands. The work was performed on 46 white male mongrel rats. The low-mountain series of experiments was modeled at an altitude of 760 m above sea level (Kyrgyzstan, Bishkek), the high-mountain series — at the Tuya-Ashu pass — 3200 m above sea level (Kyrgyzstan). The Weight Drop Method shock model was used to reproduce a traumatic brain injury. The ethology of animals was evaluated in the Open Field test. The lactic acid level was determined in the AQUA LAB (Bishkek). The microcirculation of the cerebellum was examined under the Olympus B×40 microscope (Japan). Statistical data processing was carried out in the SPSS 16.0 program. The visit to the outer squares of the field during TBI decreases (P<0.001) regardless of the height of the experiments, the number of racks in the highlands decreases by 60% (P < 0.001), the number of peeks into minks — by 76 % (P<0.01). The number of acts of defecation after TBI increases. The biochemical parameters of blood in TBI are characterized by an increase in the deficit of buffer bases to −3.8 mmol/l, a drop in the rate of oxygen consumption to 2.5 ml/min, an increase in the ratio between the rate of oxygen transport by arterial blood and the rate of its consumption to 4.8 rel. unit, and the concentration of lactic acid in the blood is up to 5 mmol/l. The microcirculatory bed of the cerebellum in TBI in the highlands is characterized by increased tortuosity, the appearance of swellings and interceptions along the course of blood vessels, activation of anastomoses, increased vascular porosity, hypercapillarization with erythrocyte sludge, parietal standing of leukocytes, the formation of blood clots in all parts of the vascular bed. There is vasogenic swelling of the cerebellum with the phenomena of dislocation of layers.

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Effect of Glibenclamide on Motor and Behavioral Activity of Animals with Traumatic Brain Injury in the Highlands

Bulletin of Science and Practice ◽

10.33619/2414-2948/67/04 ◽

2021 ◽

Vol 7 (6) ◽

Author(s):

M. Shuvalova ◽

Yu. Shidakov ◽

A. Shanazarov

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Locomotor Activity ◽

High Altitude ◽

Sea Level ◽

Brain Injuries ◽

White Male ◽

Statistical Processing ◽

Male Rats ◽

Behavioral Activity

Human activity is associated with the risk of injury. The rate of cases of traumatic brain injury (TBI) in high-altitude conditions is high. It should be assumed that exogenous hypoxia will have a significant impact on the development of the clinical consequences of TBI. However, information about the behavior of animals on the background of TBI in the highlands is scarce. The search for means of correcting brain injuries remains an urgent issue. To date, glibenclamide has been proposed for this purpose, but its effect in the highlands has not been studied. Objective: to evaluate the effect of glibenclamide on the behavioral activity of animals with TBI in the highlands. The object of the study is 82 white male rats weighing 250–310 g. The low-mountain series of the experiment was carried out at an altitude of 760 m above sea level (Bishkek). The high-altitude series was modeled on the Tuya-Ashu pass — 3200 m above sea level (Kyrgyzstan). TBI was reproduced according to the method of Y. Tang (1997). Correction with glibenclamide at a dose of 0.1 mg/kg per os. Behavioral activity was evaluated using the Open Field method, and muscle strength was evaluated using the S. V. Speransky method on the 3rd day of the experiment. Statistical processing of the obtained data was carried out in the SPSS 16.0 program. TBI in the low mountains resulted in a decrease in locomotor activity by 67% (P<0.001), and efficiency — by 43% (P<0.001). In the group of rats with TBI in the highlands, compared with the data of healthy animals that visited the same altitude, locomotor activity decreased by 44% (P<0.001), racks — by 60% (P<0.001), minks — by 76% (P< 0.01), grooming — by 55% (P<0.01), the number of boluses of defecation increases by 37% (P<0.05). Correction of TBI with glibenclamide in the highlands led to an increase in locomotion by 2 times (P<0.001), standing — by 2.3 times, peering into minks — by 4 times (P<0.01), working capacity — by 2.04 times (P<0.001). The level of defecation decreased by 70% (P<0.001). Violations of the behavior of rats in the highlands with TBI without the use of glibenclamide are more pronounced than in experiments in the foothills. Correction of TBI that occurred in the highlands demonstrates a positive neurotropic effect of glibenclamide.

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Artifact removal from neurophysiological signals: impact on intracranial and arterial pressure monitoring in traumatic brain injury

Journal of Neurosurgery ◽

10.3171/2019.2.jns182260 ◽

2020 ◽

Vol 132 (6) ◽

pp. 1952-1960 ◽

Cited By ~ 1

Author(s):

Seung-Bo Lee ◽

Hakseung Kim ◽

Young-Tak Kim ◽

Frederick A. Zeiler ◽

Peter Smielewski ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Neurological Status ◽

Cerebrovascular Reactivity ◽

Cerebral Hypoperfusion ◽

Clinical Parameters ◽

Artifact Removal ◽

Clinical Events ◽

Arterial Blood ◽

Before And After

OBJECTIVEMonitoring intracranial and arterial blood pressure (ICP and ABP, respectively) provides crucial information regarding the neurological status of patients with traumatic brain injury (TBI). However, these signals are often heavily affected by artifacts, which may significantly reduce the reliability of the clinical determinations derived from the signals. The goal of this work was to eliminate signal artifacts from continuous ICP and ABP monitoring via deep learning techniques and to assess the changes in the prognostic capacities of clinical parameters after artifact elimination.METHODSThe first 24 hours of monitoring ICP and ABP in a total of 309 patients with TBI was retrospectively analyzed. An artifact elimination model for ICP and ABP was constructed via a stacked convolutional autoencoder (SCAE) and convolutional neural network (CNN) with 10-fold cross-validation tests. The prevalence and prognostic capacity of ICP- and ABP-related clinical events were compared before and after artifact elimination.RESULTSThe proposed SCAE-CNN model exhibited reliable accuracy in eliminating ABP and ICP artifacts (net prediction rates of 97% and 94%, respectively). The prevalence of ICP- and ABP-related clinical events (i.e., systemic hypotension, intracranial hypertension, cerebral hypoperfusion, and poor cerebrovascular reactivity) all decreased significantly after artifact removal.CONCLUSIONSThe SCAE-CNN model can be reliably used to eliminate artifacts, which significantly improves the reliability and efficacy of ICP- and ABP-derived clinical parameters for prognostic determinations after TBI.

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Faculty Opinions recommendation of Differential influence of arterial blood glucose on cerebral metabolism following severe traumatic brain injury.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1158503.618678 ◽

2009 ◽

Author(s):

Arun Gupta

Keyword(s):

Traumatic Brain Injury ◽

Blood Glucose ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Cerebral Metabolism ◽

Arterial Blood ◽

Arterial Blood Glucose

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Study of Traumatic Brain Injury Due To Recent Earthquake in Manipal Teaching Hospital

Nepal Journal of Neuroscience ◽

10.3126/njn.v12i2.15895 ◽

2016 ◽

Vol 12 (2) ◽

pp. 63-66

Author(s):

Bal G Karmacharya ◽

Brijesh Sathian

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Teaching Hospital ◽

Brain Injuries ◽

Injury Severity ◽

Traumatic Brain Injuries ◽

The Body ◽

Mild Head Injury ◽

Associated Injuries

The objective of this study was to review the demographics, causes injury, severity, treatment and outcome of traumatic brain injuries in victims of the April 2015 earthquake who were admitted in Manipal Teaching Hospital, Pokhara. A total of 37 patients was admitted under Neurosurgery Services. Collapse of buildings was the commonest cause of head injury. The majority of them had mild head injury. Associated injuries to other parts of the body were present in 40.54% patients.Nepal Journal of Neuroscience 12:63-66, 2015

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Indigenous Theory Building for Māori Children and Adolescents with Traumatic Brain Injury and their Extended Family

Brain Impairment ◽

10.1017/brimp.2013.28 ◽

2013 ◽

Vol 14 (3) ◽

pp. 406-414 ◽

Cited By ~ 11

Author(s):

Hinemoa Elder

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Extended Family ◽

Child And Adolescent ◽

Specific Aspect ◽

The Body ◽

Brain Anatomy ◽

Indigenous Research ◽

Anatomy And Physiology ◽

Indigenous Theory

Background: International research identifies indigeneity as a risk factor for traumatic brain injury (TBI). Aotearoa New Zealand studies show that mokopuna (grandchildren; used here to encompass the ages and stages of infant, child and adolescent development and those in young adulthood) are significantly overrepresented in TBI populations. The important role of whānau (family) is also well established in child and adolescent TBI scholarship. Despite awareness of these factors, no studies have been identified that explore whānau knowledge about mokopuna TBI. The aim of this study was to explore two questions: (1) What do Māori people say about mokopuna TBI in the context of the Māori cultural belief that the head is the most sacred part of the body? and (2) How could this information be used to build theory that could inform addressing the rehabilitation needs of this group?Method: Eighteen marae wānanga (culture-specific fora in traditional meeting houses) were held. The wānanga typically lasted approximately 2 hours. Footage and written transcripts were analysed using Rangahau Kaupapa Māori (Māori indigenous research methods).Results: The wairua theory of mokopuna TBI proposes that TBI not only injures brain anatomy and physiology but also injures wairua (defined here as a unique connection between Māori and all aspects of the universe). Injury to wairua means that culturally determined interventions are both indicated and expected. The wairua theory of mokopuna TBI thereby provides a guide to intervention.Conclusion: A Māori theory of mokopuna TBI has been identified which describes a culture-specific aspect of TBI. This theory proposes that pre-existing whānau knowledge salient to TBI is critical to optimising recovery. Further research is needed to test this theory not only in TBI but also in other areas such as in mental illness, neurodegenerative disease and addiction.

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217 The end-tidal and arterial carbon dioxide gradient in serious traumatic brain injury after pre-hospital emergency anaesthesia: a retrospective observational study

Emergency Medicine Journal ◽

10.1136/emj-2020-rcemabstracts.43 ◽

2020 ◽

Vol 37 (12) ◽

pp. 847.1-847

Author(s):

James Price ◽

Daniel Sandbach ◽

Ari Ercole ◽

Alastair Wilson ◽

Ed Barnard

Keyword(s):

Carbon Dioxide ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Thoracic Injury ◽

Secondary Brain Injury ◽

Hospital Emergency ◽

Hospital Arrival ◽

Arterial Blood ◽

End Tidal ◽

Emergency Anaesthesia

Aims/Objectives/BackgroundIn the United Kingdom (UK), 20% of patients with severe traumatic brain injury (TBI) receive pre-hospital emergency anaesthesia (PHEA). Current guidance recommends an end-tidal carbon dioxide (ETCO2) of 4.0–4.5kPa to achieve a low-normal arterial partial pressure of CO2 (PaCO2), and reduce secondary brain injury. This recommendation assumes a 0.5kPa ETCO2-PaCO2 gradient. However, the gradient in the acute phase of TBI is unknown. Our primary aim was to report the ETCO2-PaCO2 gradient of TBI patients at hospital arrival.Methods/DesignA retrospective cohort study of adult patients with serious TBI, who received a PHEA by a pre-hospital critical care team in the East of England between 1st April 2015 to 31st December 2017. Linear regression was performed to test for correlation and reported as R-squared (R2). A Bland-Altman plot was used to test for paired ETCO2 and PaCO2 agreement and reported with 95% confidence intervals (95%CI). ETCO2-PaCO2 gradient data were compared with a two-tailed, unpaired, t-test.Results/Conclusions107 patients were eligible for inclusion. Sixty-seven patients did not receive a PaCO2 sample within 30 minutes of hospital arrival and were therefore excluded. Forty patients had complete data and were included in the final analysis; per protocol.The mean ETCO2-PaCO2 gradient was 1.7 (±1.0) kPa, with only moderate correlation of ETCO2 and PaCO2 at hospital arrival (R2=0.23, p=0.002). The Bland-Altman bias was 1.7 (95%CI 1.4–2.0) kPa with upper and lower limits of agreement of 3.6 (95%CI 3.0–4.1) kPa and -0.2 (95%CI -0.8–0.3) kPa respectively. There was no significant gradient correlation in patients with a co-existing serious thoracic injury (R2=0.13, p=0.10), and this cohort had a larger ETCO2-PaCO2 gradient, 2.0 (±1.1) kPa, p=0.01. Patients who underwent pre-hospital arterial blood sampling had an arrival PaCO2 of 4.7 (±0.2) kPa.Lower ETCO2 targets than previously recommended may be safe and appropriate. The use of pre-hospital PaCO2 measurement is advocated.

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Cognitive Training in Young Patients With Traumatic Brain Injury: A Fixel-Based Analysis

Neurorehabilitation and Neural Repair ◽

10.1177/1545968319868720 ◽

2019 ◽

Vol 33 (10) ◽

pp. 813-824 ◽

Cited By ~ 3

Author(s):

Helena Verhelst ◽

Diana Giraldo ◽

Catharine Vander Linden ◽

Guy Vingerhoets ◽

Ben Jeurissen ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

White Matter ◽

Cognitive Functioning ◽

Cognitive Training ◽

Cognitive Assessment ◽

Cognitive Intervention ◽

The Body ◽

Precentral Gyrus ◽

Time Point

Background. Traumatic brain injury (TBI) is associated with altered white matter organization and impaired cognitive functioning. Objective. We aimed to investigate changes in white matter and cognitive functioning following computerized cognitive training. Methods. Sixteen adolescents with moderate-to-severe TBI (age 15.6 ± 1.8 years, 1.2-4.6 years postinjury) completed the 8-week BrainGames program and diffusion weighted imaging (DWI) and cognitive assessment at time point 1 (before training) and time point 2 (after training). Sixteen healthy controls (HC) (age 15.6 ± 1.8 years) completed DWI assessment at time point 1 and cognitive assessment at time point 1 and 2. Fixel-based analyses were used to examine fractional anisotropy (FA), mean diffusivity (MD), and fiber cross-section (FC) on a whole brain level and in tracts of interest. Results. Patients with TBI showed cognitive impairments and extensive areas with decreased FA and increased MD together with an increase in FC in the body of the corpus callosum and left superior longitudinal fasciculus (SLF) at time point 1. Patients improved significantly on the inhibition measure at time point 2, whereas the HC group remained unchanged. No training-induced changes were observed on the group level in diffusion metrics. Exploratory correlations were found between improvements on verbal working memory and reduced MD of the left SLF and between increased performance on an information processing speed task and increased FA of the right precentral gyrus. Conclusions. Results are indicative of positive effects of BrainGames on cognitive functioning and provide preliminary evidence for neuroplasticity associated with cognitive improvements following cognitive intervention in TBI.

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Guilty Molecules, Guilty Minds? The Conflicting Roles of the Innate Immune Response to Traumatic Brain Injury

Mediators of Inflammation ◽

10.1155/2012/356494 ◽

2012 ◽

Vol 2012 ◽

pp. 1-18 ◽

Cited By ~ 17

Author(s):

Sarah Claire Hellewell ◽

Maria Cristina Morganti-Kossmann

Keyword(s):

Traumatic Brain Injury ◽

Immune Response ◽

Brain Injury ◽

Innate Immune Response ◽

Complex Disease ◽

Clinical Care ◽

The Body ◽

Innate Immune ◽

Neuroprotective Therapy ◽

Attractive Therapeutic Target

Traumatic brain injury (TBI) is a complex disease in the most complex organ of the body, whose victims endure lifelong debilitating physical, emotional, and psychosocial consequences. Despite advances in clinical care, there is no effective neuroprotective therapy for TBI, with almost every compound showing promise experimentally having disappointing results in the clinic. The complex and highly interrelated innate immune responses govern both the beneficial and deleterious molecular consequences of TBI and are present as an attractive therapeutic target. This paper discusses the positive, negative, and often conflicting roles of the innate immune response to TBI in both an experimental and clinical settings and highlights recent advances in the search for therapeutic candidates for the treatment of TBI.

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Impaired cerebral haemodynamic function associated with chronic traumatic brain injury in professional boxers

Clinical Science ◽

10.1042/cs20120259 ◽

2012 ◽

Vol 124 (3) ◽

pp. 177-189 ◽

Cited By ~ 74

Author(s):

Damian M. Bailey ◽

Daniel W. Jones ◽

Andrew Sinnott ◽

Julien V. Brugniaux ◽

Karl J. New ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Function Analysis ◽

Transcranial Doppler Ultrasound ◽

Cerebrovascular Reactivity ◽

Cerebral Hypoperfusion ◽

Mechanical Trauma ◽

Neurocognitive Dysfunction ◽

Arterial Blood ◽

Transfer Function Analysis

The present study examined to what extent professional boxing compromises cerebral haemodynamic function and its association with CTBI (chronic traumatic brain injury). A total of 12 male professional boxers were compared with 12 age-, gender- and physical fitness-matched non-boxing controls. We assessed dCA (dynamic cerebral autoregulation; thigh-cuff technique and transfer function analysis), CVRCO2 (cerebrovascular reactivity to changes in CO2: 5% CO2 and controlled hyperventilation), orthostatic tolerance (supine to standing) and neurocognitive function (psychometric tests). Blood flow velocity in the middle cerebral artery (transcranial Doppler ultrasound), mean arterial blood pressure (finger photoplethysmography), end-tidal CO2 (capnography) and cortical oxyhaemoglobin concentration (near-IR spectroscopy) were continuously measured. Boxers were characterized by fronto-temporal neurocognitive dysfunction and impaired dCA as indicated by a lower rate of regulation and autoregulatory index (P<0.05 compared with controls). Likewise, CVRCO2 was also reduced resulting in a lower CVRCO2 range (P<0.05 compared with controls). The latter was most marked in boxers with the highest CTBI scores and correlated against the volume and intensity of sparring during training (r=−0.84, P<0.05). These impairments coincided with more marked orthostatic hypotension, cerebral hypoperfusion and corresponding cortical de-oxygenation during orthostatic stress (P<0.05 compared with controls). In conclusion, these findings provide the first comprehensive evidence for chronically impaired cerebral haemodynamic function in active boxers due to the mechanical trauma incurred by repetitive, sub-concussive head impact incurred during sparring training. This may help explain why CTBI is a progressive disease that manifests beyond the active boxing career.

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