Journal of neurotrauma
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Journal of neurotrauma · Jan 2013
Medial septal nucleus theta frequency deep brain stimulation improves spatial working memory after traumatic brain injury.
More than 5,000,000 survivors of traumatic brain injury (TBI) live with persistent cognitive deficits, some of which likely derive from hippocampal dysfunction. Oscillatory activity in the hippocampus is critical for normal learning and memory functions, and can be modulated using deep brain stimulation techniques. ⋯ Theta band stimulation of the medial septal nucleus (MSN) results in a transient increase in hippocampal theta activity, and when delivered 1 min prior to training in the Barnes maze, it significantly improves spatial working memory. These results suggest that MSN theta stimulation may be an effective neuromodulatory technique for treatment of persistent learning and memory deficits after TBI.
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Journal of neurotrauma · Jan 2013
Cognitive recovery and development after traumatic brain injury in childhood: a person-oriented, longitudinal study.
Influence of childhood traumatic brain injury (TBI) on cognitive recovery and subsequent development is poorly understood. In this longitudinal study we used cluster analysis to explore acute stage individual profiles of injury age and cognition in 118 children with traumatic brain injury. Repeated measures of cognitive function were conducted at 30 months, indicating recovery, and 10 years post-injury, indicating development. ⋯ This suggests that developmental change after TBI in childhood takes place on a continuum, with both chance of long-term catching up, and risk of poor development. An acute profile of higher FFD and lower PS seemed to reflect injury consequences and were followed by developmental gains. These results challenge previous findings, and warrant further investigation.
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Journal of neurotrauma · Jan 2013
Causes and trends in traumatic brain injury for United States adolescents.
Traumatic brain injury (TBI) is a leading cause of death and disability among United States adolescents. The authors sought to determine causes and trends for TBI-related hospitalizations in the United States adolescent population (10-19 years). The authors identified common causes and trends of adolescent TBI, overall and within 2-year age categories, using hospitalization data from 2005 to 2009 in the Nationwide Inpatient Sample. ⋯ Motor vehicle occupant injuries account for 42% of in-hospital mortality from adolescent TBI; however, firearms are the most lethal mechanism with 46% proportional mortality among victims of firearm-related TBI. Rates of adolescent TBI-related hospitalizations have decreased overall. Motor vehicle accidents and firearms were identified as leading causes of injury and mortality for adolescent TBI, and represent potential targets for intervention.
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Journal of neurotrauma · Jan 2013
A multiscale computational approach to estimating axonal damage under inertial loading of the head.
A computational modeling framework is developed to estimate the location and degree of diffuse axonal injury (DAI) under inertial loading of the head. DAI is one of the most common pathological features of traumatic brain injury and is characterized by damage to the neural axons in the white matter regions of the brain. We incorporate the microstructure of the white matter (i.e., the fiber orientations and fiber dispersion) through the use of diffusion tensor imaging (DTI), and model the white matter with an anisotropic, hyper-viscoelastic constitutive model. ⋯ Acceleration loading curves from accident reconstruction data were then applied to the FE models. The rotational (rather than translational) accelerations were shown to dominate the injury response, which is consistent with previous studies. Through this accident reconstruction, we demonstrate a conceptual framework to estimate the degree of axonal injury in the fiber tracts of the human brain, enabling the future development of relationships between computational simulation and neurocognitive impairment.
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Journal of neurotrauma · Jan 2013
Remote epidural hemorrhage after unilateral decompressive hemicraniectomy in brain-injured patients.
Epidural hemorrhage (EDH) that develops remote from the decompressed hemisphere can be associated with devastating morbidity after hemicraniectomy for traumatic brain injury (TBI). In this study, we investigated the incidence, risk factors, and outcome influence of post-craniectomy remote EDH. For this retrospective study, we enrolled 139 patients undergoing unilateral hemicraniectomy for TBI. ⋯ In conclusion, remote EDH in patients undergoing unilateral decompressive hemicraniectomy for TBI is not uncommon. The absence of contusional hemorrhage and presence of remote skull fracture are independent risk factors. Although postcraniectomy remote EDH is devastating, timely computed tomography scanning and immediate hematoma evacuation are efficient and crucial for patient outcomes.