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Fluid Balance In Traumatic Brain Injury

Fengchen Zhang, Hui Wu, Yichao Jin, Xiaohua Zhang
OBJECTIVE: A ketogenic diet (KD) improves cellular metabolism and functional recovery after moderate-to-severe traumatic brain injury. Here, we evaluated the changes of neurochemical metabolites after KD therapy for repetitive mild traumatic brain injury (rmTBI) and its possible role in neurodegeneration. METHODS: Postnatal day 35 rats were randomly divided into 3 groups: sham, control, and KD groups. Rats in control and KD groups were given 3 rmTBI by a fluid percussion traumatic brain injury device 24 hours apart...
September 17, 2018: World Neurosurgery
Andrew Jung, Mark Johnson, Rosalie Veile, Lou Ann Friend, Sabre Stevens-Topie, Joel Elterman, Timothy Pritts, Amy Makley, Michael Goodman
BACKGROUND: Resuscitation strategies for combined traumatic brain injury (TBI) with haemorrhage in austere environments are not fully established. Our aim was to establish the effects of various saline concentrations in a murine model of combined TBI and haemorrhage, and identify an effective resuscitative strategy for the far-forward environment. METHODS: Male C57BL/6 mice underwent closed head injury and subjected to controlled haemorrhage to a systolic blood pressure of 25 mmHg via femoral artery cannulation for 60 min...
August 23, 2018: Brain Injury: [BI]
Sonny Thiara, Donald E Griesdale, William R Henderson, Mypinder S Sekhon
BACKGROUND: Increased cerebral perfusion pressure (CPP)>70 mmHg has been associated with acute respiratory distress syndrome (ARDS) after traumatic brain injury (TBI). Since this reported association, significant changes in ventilation strategies and fluid management have been accepted as routine critical care. Recently, individualized perfusion targets using autoregulation monitoring suggest CPP titration>70 mmHg. Given these clinical advances, the association between ARDS and increased CPP requires further delineation...
May 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Nicole Hausser, Kathia Johnson, Margaret A Parsley, Jutatip Guptarak, Heidi Spratt, Stacy L Sell
With the increasing incidence of traumatic brain injury (TBI) in both civilian and military populations, TBI is now considered a chronic disease; however, few studies have investigated the long-term effects of injury in rodent models of TBI. Shown here are behavioral measures that are well-established in TBI research for times early after injury, such as two weeks, until two months. Some of these methods have previously been used at later times after injury, up to one year, but by very few laboratories. The methods demonstrated here are a short neurological assessment to test reflexes, a Beam-Balance to test balance, a Beam-Walk to test balance and motor coordination, and a working memory version of the Morris water maze that can be sensitive to deficits in reference memory...
January 30, 2018: Journal of Visualized Experiments: JoVE
Mohamad Hasyizan Hassan, Wan Mohd Nazaruddin Wan Hassan, Rhendra Hardy Mohd Zaini, Wan Fadzlina Wan Muhd Shukeri, Huda Zainal Abidin, Chong Soon Eu
Background: Normal saline (NS) is a common fluid of choice in neurosurgery and neuro-intensive care unit (ICU), but it does not contain other electrolytes and has the potential to cause hyperchloremic metabolic acidosis with prolonged infusion. These problems may be reduced with the availability of balanced fluid (BF), which becomes a more physiological isotonic solution with the presence of complete electrolyte content. This study aimed to compare the changes in electrolytes and acid-base between NS and BF (Sterofundin® ISO) therapy for post-operative severe traumatic brain injury (TBI) patients in neuro-ICU...
October 2017: Malaysian Journal of Medical Sciences: MJMS
Saurav Bhowmick, Veera D'Mello, Nizmi Ponery, P M Abdul-Muneer
Traumatic brain injury (TBI) can result in persistent sensorimotor and cognitive deficits, which occur through a cascade of deleterious pathophysiological events over time. In this study, we investigated the hypothesis that neurodegeneration caused by TBI leads to impairments in sensorimotor function. TBI induces the activation of the caspase-3 enzyme, which triggers cell apoptosis in an in vivo model of fluid percussion injury (FPI). We analyzed caspase-3 mediated apoptosis by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining and poly (ADP-ribose) polymerase (PARP) and annexin V western blotting...
January 6, 2018: Brain Sciences
Mario Ricciardi
Magnetic resonance imaging (MRI) in small animal practice is largely based on classic two-dimensional spin-echo, inversion recovery and gradient-echo sequences which are largely limited by low spatial resolution, especially in low-field (LF)-MRI scanners. Nowadays, however, the availability of volumetric sequences can open new perspectives and enhance the diagnostic potential of this imaging modality. Balanced steady-state free precession (bSSFP) is a three-dimensional gradient-echo sequence in which image contrast is given by the ratio of T2 and T1, resulting in low soft-tissue signal, poor cerebral grey/white matter distinction and a bright signal from free fluid and fat...
March 2018: Veterinary Research Communications
Tonia Sabo, Charlene Supnet, Sushmita Purkayastha
BACKGROUND: Cerebral edema peaks 36-72 h after moderate traumatic brain injury but thought to be uncommon after mild traumatic brain injury. Post-traumatic headache can develop 48-72 h post-injury, perhaps reflecting the developing cerebral edema. Pseudotumor cerebri can result from various causes, including cerebral edema, and is characterized by increased intracranial pressure, headache, visual, and other common symptoms. Our objective was to report a phenotypically identifiable post-traumatic headache subtype...
April 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Adrian M Sackheim, David Stockwell, Nuria Villalba, Laurel Haines, Chary L Scott, Sheila Russell, Sayamwong E Hammack, Kalev Freeman
INTRODUCTION: Understanding the extent to which murine models of traumatic brain injury (TBI) replicate clinically relevant neurologic outcomes is critical for mechanistic and therapeutic studies. We determined sensorimotor outcomes in a mouse model of TBI and validated the use of a standardized neurologic examination scoring system to quantify the extent of injury. MATERIALS AND METHODS: We used a lateral fluid percussion injury model of TBI and compared TBI animals to those that underwent sham surgery...
June 1, 2017: Journal of Surgical Research
Vijay Krishnamoorthy, Ali Rowhani-Rahbar, Nophanan Chaikittisilpa, Edward F Gibbons, Frederick P Rivara, Nancy R Temkin, Alex Quistberg, Monica S Vavilala
BACKGROUND: While systolic dysfunction has been observed following traumatic brain injury (TBI), the relationship between early hemodynamics and the development of systolic dysfunction has not been investigated. Our study aimed to determine the early hemodynamic profile that is associated with the development of systolic dysfunction after TBI. METHODS: We conducted a prospective cohort study among patients under 65 years old without cardiac comorbidities who sustained moderate-severe TBI...
June 2017: Neurocritical Care
Stacy L Sell, Kathia Johnson, Douglas S DeWitt, Donald S Prough
Although traumatic brain injury (TBI) is now considered a chronic disease, few studies have investigated the long-term behavioral deficits elicited by a well-established rodent model of injury. Here we evaluate behavioral measures, commonly used in TBI research, to determine which tests are useful for studying long-term effects of brain injury in rats. Male Sprague-Dawley rats were handled and pre-trained to neurological, balance, and motor coordination tests prior to receiving parasagittal fluid-percussion injury (FPI), sham injury, or maintenance as naïve cohorts...
March 1, 2017: Journal of Neurotrauma
Aruna Sharma, Preeti Menon, Dafin F Muresanu, Asya Ozkizilcik, Z Ryan Tian, José V Lafuente, Hari S Sharma
The blood-brain barrier (BBB) is a physiological regulator of transport of essential items from blood to brain for the maintenance of homeostasis of the central nervous system (CNS) within narrow limits. The BBB is also responsible for export of harmful or metabolic products from brain to blood to keep the CNS fluid microenvironment healthy. However, noxious insults to the brain caused by trauma, ischemia or environmental/chemical toxins alter the BBB function to small as well as large molecules e.g., proteins...
2016: CNS & Neurological Disorders Drug Targets
Zilong Zhao, Dong Wang, Ying Jia, Ye Tian, Yi Wang, Yingsheng Wei, Jianning Zhang, Rongcai Jiang
INTRODUCTION: A balance of fluid intake and output (fluid balance) influences outcomes of critical illness, but the level of such influence remains poorly understood for traumatic brain injury (TBI) and was quantitatively examined in this study. METHODS: We conducted a retrospective cohort study of 351 moderate and severe TBI patients to associate the degree of fluid balance with clinical outcomes of TBI. Fluid balance and intracranial pressure (ICP) were continuously recorded for 7days on patients admitted to neurocritical care unit (NCCU)...
May 15, 2016: Journal of the Neurological Sciences
Xavier Ekolle Ndode-Ekane, Irina Kharatishvili, Asla Pitkänen
We aimed to generate two-dimensional (2D) unfolded cortical maps from magnetic resonance (MR) images to delineate the location of traumatic brain injury (TBI)-induced cortical damage in functionally diverse cytoarchitectonic areas of the cerebral cortex, and to predict the severity of functional impairment after TBI based on the lesion location and extent. Lateral fluid-percussion injury was induced in adult rats and T2 maps were acquired with magnetic resonance imaging (MRI) at 3 days post-TBI. Somatomotor deficits were assessed based on the composite neuroscore and beam balance test, and spatial learning was assessed in the Morris water maze...
January 15, 2017: Journal of Neurotrauma
Megan Browning, Deborah A Shear, Helen M Bramlett, C Edward Dixon, Stefania Mondello, Kara E Schmid, Samuel M Poloyac, W Dalton Dietrich, Ronald L Hayes, Kevin K W Wang, John T Povlishock, Frank C Tortella, Patrick M Kochanek
Levetiracetam (LEV) is an antiepileptic agent targeting novel pathways. Coupled with a favorable safety profile and increasing empirical clinical use, it was the fifth drug tested by Operation Brain Trauma Therapy (OBTT). We assessed the efficacy of a single 15 min post-injury intravenous (IV) dose (54 or 170 mg/kg) on behavioral, histopathological, and biomarker outcomes after parasagittal fluid percussion brain injury (FPI), controlled cortical impact (CCI), and penetrating ballistic-like brain injury (PBBI) in rats...
March 15, 2016: Journal of Neurotrauma
Deborah A Shear, C Edward Dixon, Helen M Bramlett, Stefania Mondello, W Dalton Dietrich, Ying Deng-Bryant, Kara E Schmid, Kevin K W Wang, Ronald L Hayes, John T Povlishock, Patrick M Kochanek, Frank C Tortella
Nicotinamide (vitamin B3) was the first drug selected for cross-model testing by the Operation Brain Trauma Therapy (OBTT) consortium based on a compelling record of positive results in pre-clinical models of traumatic brain injury (TBI). Adult male Sprague-Dawley rats were exposed to either moderate fluid percussion injury (FPI), controlled cortical impact injury (CCI), or penetrating ballistic-like brain injury (PBBI). Nicotinamide (50 or 500 mg/kg) was delivered intravenously at 15 min and 24 h after injury with subsequent behavioral, biomarker, and histopathological outcome assessments...
March 15, 2016: Journal of Neurotrauma
Colin J Smith, Guoxiang Xiong, Jaclynn A Elkind, Brendan Putnam, Akiva S Cohen
More than 2.5 million Americans suffer a traumatic brain injury (TBI) each year. Even mild to moderate TBI causes long-lasting neurological effects. Despite its prevalence, no therapy currently exists to treat the underlying cause of cognitive impairment suffered by TBI patients. Following lateral fluid percussion injury (LFPI), the most widely used experimental model of TBI, we investigated alterations in working memory and excitatory/inhibitory synaptic balance in the prefrontal cortex. LFPI impaired working memory as assessed with a T-maze behavioral task...
2015: Frontiers in Neurology
Andrea Mountney, Helen M Bramlett, C Edward Dixon, Stefania Mondello, W Dalton Dietrich, Kevin K W Wang, Krista Caudle, Philip E Empey, Samuel M Poloyac, Ronald L Hayes, John T Povlishock, Frank C Tortella, Patrick M Kochanek, Deborah A Shear
Simvastatin, the fourth drug selected for testing by Operation Brain Trauma Therapy (OBTT), is a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor used clinically to reduce serum cholesterol. In addition, simvastatin has demonstrated potent antineuroinflammatory and brain edema reducing effects and has shown promise in promoting functional recovery in pre-clinical models of traumatic brain injury (TBI). The purpose of this study was to assess the potential neuroprotective effects of oral administration of simvastatin on neurobehavioral, biomarker, and histopathological outcome measures compared across three pre-clinical TBI animal models...
March 15, 2016: Journal of Neurotrauma
Lai Yee Leung, Ying Deng-Bryant, Deborah Shear, Frank Tortella
BACKGROUND: Traumatic brain injury often occurs with concomitant hypoxemia (HX) and hemorrhagic shock (HS), leading to poor outcomes. This study characterized the acute physiology and subacute behavioral consequences of these additional insults in a model of penetrating ballistic-like brain injury (PBBI). METHODS: Rats were randomly assigned into sham control, HX + HS (HH), 5% PBBI alone, 5% PBBI + HH, 10% PBBI alone, and 10% PBBI + HH groups. Mean arterial pressure, heart rate, and breathing rate were monitored continuously...
October 2015: Journal of Trauma and Acute Care Surgery
Julie L Proctor, Dominique Scutella, Yan Pan, Joshua Vaughan, Robert E Rosenthal, Adam Puche, Gary Fiskum
BACKGROUND: Many traumatic brain injury (TBI) patients experience additional injuries, including those that result in hemorrhagic shock (HS). Interactions between HS and TBI can include reduced brain O2 delivery, resulting in partial cerebral ischemia and worse neurologic outcome. This study tested the hypothesis that inspiration of 100% O2 during resuscitation following TBI and HS improves survival, reduces brain lesion volume, and improves neurologic outcome compared with resuscitation in the absence of supplemental O2...
October 2015: Journal of Trauma and Acute Care Surgery
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