scholarly journals Lobectomy in traumatic brain injury patients with intracerebral hemorrhage and delayed contusion

2020 ◽  
Vol 12 (2) ◽  
2014 ◽  
Vol 34 (5) ◽  
pp. 870-875 ◽  
Author(s):  
Jan Hendrik Schaefer ◽  
Wendy Leung ◽  
Limin Wu ◽  
Elizabeth M Van Cott ◽  
Josephine Lok ◽  
...  

To date, only limited data are available on the effects of pretreatment with novel oral anticoagulants in the event of traumatic brain injury (TBI). We determined intracerebral hemorrhage volume and functional outcome in a standardized TBI model in mice treated with warfarin or dabigatran. Additionally, we investigated whether excess concentrations of dabigatran could increase bleeding and whether this was preventable by using prothrombin complex concentrate (PCC). C57 mice were treated orally with warfarin or dabigatran; sham-treated mice served as controls. Effective anticoagulation was verified by measurement of international normalized ratio and diluted thrombin time, and TBI was induced by controlled cortical impact (CCI). Twenty-four hours after CCI, intracerebral hemorrhage volume was larger in warfarin-pretreated mice than in controls (10.1 ± 4.9 vs 4.1 ± 1.7 μL; analysis of variance post hoc P = 0.001), but no difference was found between controls and dabigatran-pretreated mice (5.3 ± 1.5 μL). PCC applied 30 minutes after CCI did not reliably reduce intracerebral hemorrhage induced by excess dabigatran concentration compared with saline (10.4 ± 11.2 vs 8.7 ± 7.1 μL). Our data suggest pathophysiological differences in TBI occurring during warfarin and dabigatran anticoagulation. The reduced hemorrhage formation under dabigatran therapy could present a safety advantage compared with warfarin. An excess dabigatran concentration, however, can increase hemorrhage.


2021 ◽  
pp. 1-4
Author(s):  
Erickson Torio ◽  
Jonna Maala ◽  
Erickson Torio ◽  
Roy Allan Torcuator

In this study, we present a case of a 20-year-old male who suffered from severe traumatic brain injury with intracerebral hemorrhage, thus requiring decompressive craniectomy. Five months after, the patient underwent cranioplasty with the use of Osteomesh, a scaffold bone filler in reconstructing the post-operative cranial defect.


2012 ◽  
Vol 116 (6) ◽  
pp. 1299-1311 ◽  
Author(s):  
Michael L. James ◽  
Haichen Wang ◽  
Viviana Cantillana ◽  
Beilei Lei ◽  
Dawn N. Kernagis ◽  
...  

Background Microglial inhibition may reduce secondary tissue injury and improve functional outcome following acute brain injury. Utilizing clinically relevant murine models of traumatic brain injury and intracerebral hemorrhage, neuroinflammatory responses and functional outcome were examined in the presence of a potential microglial inhibitor, TT-301. Methods TT-301 or saline was administered following traumatic brain injury or intracerebral hemorrhage, and then for four subsequent days. The effect of TT-301 on neuroinflammatory responses and neuronal viability was assessed, as well as short-term vestibulomotor deficit (Rotorod) and long-term neurocognitive impairment (Morris water maze). Finally differential gene expression profiles of mice treated with TT-301 were compared with those of vehicle. Results Reduction in F4/80+ staining was demonstrated at 1 and 10 days, but not 28 days, after injury in mice treated with TT-301 (n = 6). These histologic findings were associated with improved neurologic function as assessed by Rotorod, which improved by 52.7% in the treated group by day 7, and Morris water maze latencies, which improved by 232.5% as a function of treatment (n = 12; P < 0.05). Similar benefit was demonstrated following intracerebral hemorrhage, in which treatment with TT-301 was associated with functional neurologic improvement of 39.6% improvement in Rotorod and a reduction in cerebral edema that was independent of hematoma volume (n = 12; P < 0.05). Differential gene expression was evaluated following treatment with TT-301, and hierarchical cluster analysis implicated involvement of the Janus kinase-Signal Transducer and Activator of Transcription pathway after administration of TT-301 (n = 3/group). Conclusions Modulation of neuroinflammatory responses through TT-301 administration improved histologic and functional parameters in murine models of acute neurologic injury.


2014 ◽  
Vol 38 (1) ◽  
pp. 129-136 ◽  
Author(s):  
Patrick Czorlich ◽  
Christos Skevas ◽  
Volker Knospe ◽  
Eik Vettorazzi ◽  
Gisbert Richard ◽  
...  

Blood ◽  
2015 ◽  
Vol 125 (16) ◽  
pp. 2558-2567 ◽  
Author(s):  
Nuha Hijazi ◽  
Rami Abu Fanne ◽  
Rinat Abramovitch ◽  
Serge Yarovoi ◽  
Muhamed Higazi ◽  
...  

Key Points Closed head trauma sequentially releases tPA followed by uPA from injured brain. Increased uPA is responsible for delayed intracerebral hemorrhage, which is prevented by a tPA variant that inhibits uPA activity.


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