Articles: traumatic-brain-injuries.
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Journal of neurotrauma · Nov 2015
Eyeball pressure stimulation unveils subtle autonomic cardiovascular dysfunction in persons with a history of mild traumatic brain injury.
After mild traumatic brain injury (mTBI), patients have increased long-term mortality rates, persisting even beyond 13 years. Pathophysiology is unclear. Yet, central autonomic network dysfunction may contribute to cardiovascular dysregulation and increased mortality. ⋯ Even with only mild EP, our controls showed normal EP responses and shifted sympathetic-parasympathetic balance towards parasympathetic predominance. In contrast, our post-mTBI patients could not increase parasympathetic heart rate modulation but increased BP upon EP, indicating a paradox sympathetic activation. The findings support the hypothesis that central autonomic dysfunction might contribute to an increased cardiovascular risk, even years after mTBI.
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Journal of neurotrauma · Nov 2015
Clusters of low FDG uptake voxels in combat veterans with traumatic brain injury and post-traumatic stress disorder.
Individuals with mild traumatic brain injury (TBI) show diminished metabolic activity when studied with positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG). Since blast injury may not be localized in the same specific anatomical areas in every patient or may be diffuse, significance probability mapping may be vulnerable to false-negative detection of abnormalities. To address this problem, we used an anatomically independent measure to assess PET scans: increased numbers of contiguous voxels that are 2 standard deviations below values found in an uninjured control group. ⋯ Patients with mild TBI alone and patients with TBI+PTSD had larger clusters of low uptake voxels, and cluster size significantly differentiated the mild TBI groups from combat controls. Clusters were more irregular in shape in patients, and patients also had a larger number of low-activity voxels throughout the brain. In mild TBI and TBI+PTSD patients, but not healthy subjects, cluster volume was significantly correlated with verbal learning during FDG uptake.
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Journal of neurotrauma · Nov 2015
Septohippocampal neuromodulation improves cognition after traumatic brain injury.
Traumatic brain injury (TBI) often results in persistent attention and memory deficits that are associated with hippocampal dysfunction. Although deep brain stimulation (DBS) is used to treat neurological disorders related to motor dysfunction, the effectiveness of stimulation to treat cognition remains largely unknown. In this study, adult male Harlan Sprague-Dawley rats underwent a lateral fluid percussion or sham injury followed by implantation of bipolar electrodes in the medial septal nucleus (MSN) and ipsilateral hippocampus. ⋯ There were no benefits with 100 Hz gamma stimulation, and stimulation of sham animals at either frequency did not enhance performance. We conclude, therefore, that there was a theta frequency-specific benefit of DBS that restored cognitive function in brain-injured rats. These data suggest that septal theta stimulation may be an effective and novel neuromodulatory therapy for treatment of persistent cognitive deficits following TBI.
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Journal of neurotrauma · Nov 2015
Predictors of Hypopituitarism in Patients with Traumatic Brain Injury.
Hypopituitarism may often occur in association with traumatic brain injury (TBI). Identification of reliable predictors of pituitary dysfunction is of importance in order to establish a rational testing approach. We searched the records of patients with TBI, who underwent neuroendocrine evaluation in our institution between 2007 and 2013. ⋯ Central diabetes insipidus (DI) occurred in 6%, who were more likely to have experienced MVA (p < 0.001) or sustained moderate/severe TBI (p < 0.001). Patients with MVA and those with post-traumatic seizures, intracranial hemorrhage, petechial brain hemorrhages, and/or focal cortical contusions are at particular risk for serious pituitary dysfunction, including adrenal insufficiency and DI, and should be referred for neuroendocrine testing. However, a substantial proportion of patients without these risk factors also developed hypopituitarism.
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Journal of neurotrauma · Nov 2015
Observational StudyThe Effect of Platelet and Desmopressin Administration on Early Radiographic Progression of Traumatic Intracranial Hemorrhage.
Limited data exist regarding the use of hemostatic adjuncts on the progression of traumatic intracranial hemorrhage (tICH). The objective of this study was to examine the impact of platelet transfusion and desmopressin (DDAVP) administration on hemorrhage progression following tICH. We hypothesized that platelet and DDAVP administration would not result in decreased early hemorrhagic progression. ⋯ On multivariate analyses, platelet and DDAVP administration was not associated with either a decreased risk of hemorrhage progression (odds ratio [OR] = 1.40, confidence interval [CI] = 0.80-2.40; p = 0.2) or mortality (OR = 1.50, CI = 0.60-4.30; p = 0.4). The administration of platelets and DDAVP is not associated with a decreased risk for early radiographic hemorrhage progression in patients with tICH. Further prospective study of these potentially hemostatic adjuncts in patients with tICH is potentially warranted.