scholarly journals Credibility of the Neutrophil-to-Lymphocyte Count Ratio in Severe Traumatic Brain Injury

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1352
Author(s):  
Dorota Siwicka-Gieroba ◽  
Wojciech Dabrowski
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Low Cost ◽  
Inflammatory Cells ◽  
Interferon Γ ◽  
T Cell Infiltration ◽  
Secondary Damage ◽  
Injured Brain ◽  
The Central Nervous System ◽  
Predicting Outcome

Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality worldwide. The consequences of a TBI generate the activation and accumulation of inflammatory cells. The peak number of neutrophils entering into an injured brain is observed after 24 h; however, cells infiltrate within 5 min of closed brain injury. Neutrophils release toxic molecules including free radicals, proinflammatory cytokines, and proteases that advance secondary damage. Regulatory T cells impair T cell infiltration into the central nervous system and elevate reactive astrogliosis and interferon-γ gene expression, probably inducing the process of healing. Therefore, the neutrophil-to-lymphocyte ratio (NLR) may be a low-cost, objective, and available predictor of inflammation as well as a marker of secondary injury associated with neutrophil activation. Recent studies have documented that an NLR value on admission might be effective for predicting outcome and mortality in severe brain injury patients.

scholarly journals Ribonuclease-1 treatment after traumatic brain injury preserve the integrity of the neurovascular unit, decreases inflammatory response and delays secondary brain damage in mice

2021 ◽  
Author(s):  
Tobias J. Krämer ◽  
Per Hübener ◽  
Bruno Pöttker ◽  
Christina Gölz ◽  
Axel Neulen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Vascular Dysfunction ◽  
Neurovascular Unit ◽  
Mechanical Damage ◽  
Inflammatory Cells ◽  
Systemic Circulation ◽  
Lesion Volume ◽  
Secondary Damage ◽  
Functional Benefit

Abstract Traumatic brain injury (TBI) involves primary mechanical damage and delayed secondary damage caused by vascular dysfunction and neuroinflammation. Intracellular components released into the parenchyma and systemic circulation, termed danger-associated molecular patterns (DAMPs), are major drivers of vascular dysfunction and neuroinflammation. These DAMPs include cell-free RNAs (cfRNAs), which damage the blood–brain barrier (BBB), thereby promoting edema, procoagulatory processes, and infiltration of inflammatory cells. We tested the hypothesis that intraperitoneal injection of Ribonuclease-1 (RNase1, two doses of 20, 60, or 180 µg/kg) at 30 min and 12h after controlled-cortical-impact (CCI) can reduce secondary lesion expansion compared to vehicle treatment 24h and 120h post-CCI. The lowest total dose (40 µg/kg) was most effective at reducing lesion volume (−31% RNase 40µg/kg vs. vehicle), brain water accumulation (−5.5%), and loss of BBB integrity (−21.6%) at 24h post-CCI. RNase1 also reduced perilesional leukocyte recruitment (−53.3%) and microglial activation (−18.3%) at 120h post-CCI, but there was no difference in lesion volume at this time and no functional benefit. Treatment with RNase1 in the early phase following TBI stabilizes the BBB and impedes leukocyte immigration, thereby suppressing neuroinflammation. RNase1-treatment may be a novel approach to delay brain injury to extend the window for treatment opportunities after TBI.

scholarly journals Long-Term Cognitive Deficits After Traumatic Brain Injury Associated With Microglia Activation

2021 ◽  
Author(s):  
Esber Saba ◽  
Mona Karout ◽  
Leila Nasralla ◽  
Firas Kobeissy ◽  
Hala Darwish ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Learning And Memory ◽  
Cognitive Deficits ◽  
Head Injuries ◽  
Spatial Learning And Memory ◽  
Post Injury ◽  
Color Flow ◽  
Injured Brain ◽  
The Central Nervous System

Abstract Traumatic Brain Injury (TBI) is the most prevalent of all head injuries, and based on the severity of the injury, it may result in chronic neurologic and cognitive deficits. Microglia play an essential role in homeostasis and diseases of the central nervous system. We hypothesize that microglia may play a beneficial or detrimental role in TBI depending on their state of activation and duration.In the present study, we evaluated whether TBI results in a spatiotemporal change in microglia phenotype and whether it affects sensory-motor or learning and memory functions in male C57BL/6 mice. We used a panel of neurological and behavioral tests and a multi-color flow cytometry-based data analysis followed by unsupervised clustering to evaluate isolated microglia from injured brain tissue. We characterized several microglial phenotypes and their association with cognitive deficits. TBI results in a spatiotemporal increase in highly activated microglia that correlated negatively with spatial learning and memory at 35 days post-injury. These observations could define therapeutic windows and accelerate translational research to improve patient outcomes.

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

scholarly journals Limited Fronto-Temporo- Parietal Craniectomy in Traumatic Brain Injury: My Experience

2016 ◽  
Vol 12 (1) ◽  
pp. 8-13
Author(s):  
Krishna Sharma
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Single Step ◽  
Temporalis Fascia ◽  
Related Literature ◽  
Primary Surgery ◽  
Injured Brain ◽  
Life Saving ◽  
Second Surgery ◽  
Different Types

Amidst the uncertainty of benefit of decompressive craniectomy (DC) in severe traumatic brain injury (TBI), the procedure is still widely performed as a life saving attempt. Different types of DC have been described. A timely performed limited fronto-temporoparietal (FTP) decompression is found to be adequate enough to reduce the intracranial pressure (ICP) quickly and sufficiently, preventing medial temporal herniation. This can be further augmented by an adequate, liberal and watertight duroplasty to accommodate the swollen injured brain, which can be achieved by using patients’ own tissues like thickened subcutaneous areolar tissue and temporalis fascia. DC is usually considered as a two-step surgery where decompression is done in the first step and cranioplasty in the second. It can be made a single step surgery by replacing the bone in small pieces extradurally during the primary surgery itself, to avoid second surgery (cranioplasty). The details of the procedure and its results have been described and review of related literature has been done.Nepal Journal of Neuroscience 12:8-13, 2015

scholarly journals The Roles of Neurotrophins in Traumatic Brain Injury

Life ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 26
Author(s):  
Ping-Hung Lin ◽  
Lu-Ting Kuo ◽  
Hui-Tzung Luh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neural Development ◽  
Tissue Destruction ◽  
Compensatory Mechanisms ◽  
Injured Brain ◽  
Severity Of Injury ◽  
Brain Barrier Permeability ◽  
Post Traumatic ◽  
Related Proteins

Neurotrophins are a collection of structurally and functionally related proteins. They play important roles in many aspects of neural development, survival, and plasticity. Traumatic brain injury (TBI) leads to different levels of central nervous tissue destruction and cellular repair through various compensatory mechanisms promoted by the injured brain. Many studies have shown that neurotrophins are key modulators of neuroinflammation, apoptosis, blood–brain barrier permeability, memory capacity, and neurite regeneration. The expression of neurotrophins following TBI is affected by the severity of injury, genetic polymorphism, and different post-traumatic time points. Emerging research is focused on the potential therapeutic applications of neurotrophins in managing TBI. We conducted a comprehensive review by organizing the studies that demonstrate the role of neurotrophins in the management of TBI.

scholarly journals Predicting outcome in traumatic brain injury: Sharing experience of pilot traumatic brain injury registry

2016 ◽  
Vol 6 (3) ◽  
pp. 127 ◽  
Author(s):  
Amit Agrawal ◽  
Ranabir Pal ◽  
Ashok Munivenkatappa ◽  
GeethaR Menon ◽  
Sagar Galwankar ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Predicting Outcome

Inflammatory Process in the Pathobiology of Secondary Damage After Traumatic Brain Injury

1997 ◽  
pp. 197-213 ◽  
Author(s):  
P. M. Kochanek ◽  
S. T. DeKosky ◽  
T. Carlos ◽  
R. S. B. Clark ◽  
M. Whalen
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Inflammatory Process ◽  
Secondary Damage

Multimodality Monitoring

2018 ◽  
pp. 155-164
Author(s):  
Maranatha Ayodele ◽  
Kristine O’Phelan
Keyword(s):  
Traumatic Brain Injury ◽  
Critical Care ◽  
Brain Injury ◽  
Early Recognition ◽  
Secondary Injury ◽  
Multimodality Monitoring ◽  
Injured Brain ◽  
Brain Injured ◽  
Physiologic Parameters ◽  
Injured Patients

Advancements in the critical care of patients with various forms of acute brain injury (traumatic brain injury, subarachnoid hemorrhage, stroke, etc.) in its current evolution recognizes that in addition to the initial insult, there is a secondary cascade of physiological events in the injured brain that contribute significantly to morbidity and mortality. Multimodality monitoring (MMM) in neurocritical care aims to recognize this secondary cascade in a timely manner. With early recognition, critical care of brain-injured patients may then be tailored to preventing and alleviating this secondary injury. MMM includes a variety of invasive and noninvasive techniques aimed at monitoring brain physiologic parameters such as intracranial pressure, perfusion, oxygenation, blood flow, metabolism, and electrical activity. This chapter provides an overview of these techniques and offers a practical guide to their integration and use in the intensive care setting.

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