Journal of neurotrauma
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Journal of neurotrauma · Oct 2009
Hemostatic abnormalities in patients with closed head injuries and their role in predicting early mortality.
Abnormalities of blood coagulation are frequently found in patients following traumatic brain injury. Exposure to thromboplastin, which is abundant in brain, plays an important role in initiating coagulopathy. ⋯ Similarly, increased PT, FDP, and D-dimer values correlated with higher mortality in both groups, but platelet counts and a-PPTK values correlated with mortality only in the severe head injury group. From this study we conclude that hemostatic abnormalities are independent predictors of early mortality in moderate-to-severe head injury patients.
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Journal of neurotrauma · Oct 2009
Serial changes in bladder, locomotion, and levels of neurotrophic factors in rats with spinal cord contusion.
The aims of this study were to evaluate the evolution of the neurogenic bladder after spinal cord contusion and to correlate changes in bladder function with locomotor function and levels of neurotrophic factors. The MASCIS impactor was used to cause a mild contusion injury of the lower thoracic spinal cord of Sprague-Dawley rats. Rats were divided into four groups according to the length of time from injury to sacrifice, at 4, 14, 28, and 56 days after injury. ⋯ Brain-derived neurotrophic factor (BDNF) levels in the spinal cord, as detected by enzyme-linked immunosorbent assay, decreased with time, whereas neurotrophin-3 (NT-3) levels remained unchanged. The micturition pattern, bladder volume, and locomotor function continued to recover during the time of observation; BDNF levels in the spinal cord and bladder were inversely correlated with BBB scores and the restoration of bladder volume. We conclude that urodynamic changes in the bladder correlate with locomotion recovery but not with the levels of BDNF or NT-3 after modified mild contusion injury in rats.
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Journal of neurotrauma · Oct 2009
Electrical stimulation accelerates motor functional recovery in autograft-repaired 10 mm femoral nerve gap in rats.
Electrical stimulation has been shown to enhance peripheral nerve regeneration after nerve injury. However, the impact of electrical stimulation on motor functional recovery after nerve injuries, especially over long nerve gap lesions, has not been investigated in a comprehensive manner. In the present study, we aimed to determine whether electrical stimulation (1 h, 20 Hz) is beneficial for motor functional recovery after a 10 mm femoral nerve gap lesion in rats. ⋯ The rate of motor functional recovery was evaluated by single frame motion analysis and electrophysiological studies, and the nerve regeneration was investigated by double labeling and histological analysis. We found that brief electrical stimulation significantly accelerated motor functional recovery and nerve regeneration. Although the final outcome, both in functional terms and morphological terms, was not improved by electrical stimulation, the observed acceleration of functional recovery and axon regeneration may be of therapeutic importance in clinical setting.
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Journal of neurotrauma · Sep 2009
The persistent effects of concussion on neuroelectric indices of attention.
Mild traumatic brain injuries (mTBIs) that result from participation in sports are a major public health issue affecting 1.6-3.8 million individuals annually. The injury has been postulated as transient and void of long-term consequences when rapidly diagnosed and properly managed. Emerging evidence, however, has suggested an increased risk for late life cognitive dysfunction in those with previous injuries. ⋯ Significant decrements in the N2 and P3b amplitudes of the stimulus-locked ERP were noted for those with a history relative to those without a history of concussion. Although the previously concussed participants performed equal to those without injury on the clinical cognitive assessment, these findings support the notion that sport mTBI can no longer be thought of as a transient injury resulting in short-lived neurological impairment. It is not clear if these persistent deficits will manifest into clinical pathologies later in life.
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Journal of neurotrauma · Sep 2009
Apolipoprotein E4 as a predictor of outcomes in pediatric mild traumatic brain injury.
The epsilon4 allele of the apolipoprotein E (APOE) gene has been linked to negative outcomes among adults with traumatic brain injury (TBI) across the spectrum of severity, with preliminary evidence suggesting a similar pattern among children. This study investigated the relationship of the APOE epsilon4 allele to outcomes in children with mild TBI. Participants in this prospective, longitudinal study included 99 children with mild TBI between the ages of 8 and 15 recruited from consecutive admissions to Emergency Departments at two large children's hospitals. ⋯ Those with an epsilon4 allele exhibited better performance than children without an epsilon4 allele on a test of constructional skill, but the groups did not differ on any other neuropsychological tests. Children with and without an epsilon4 allele also did not differ on measures of post-concussive symptoms. Overall, the findings suggest that the APOE epsilon4 allele is not consistently related to the outcomes of mild TBI in children.