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Traumatic cerebrovascular injury

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https://www.readbyqxmd.com/read/29145182/pathological-yawning-laughing-and-crying
#1
Olivier Walusinski
Yawning, laughing, and crying are normal physiological behaviors of humans in good health. As with all physiological behaviors, their deregulation can reveal disorders. Pathological yawning occurs in salvos of 10-20 successive yawns, and the number of yawns per day can exceed one hundred. After listing the functional etiologies, we will give the clinical keys for differentiating the most serious causes: iatrogenic, tumors, strokes, amyotrophic lateral sclerosis, and intracranial hypertension. Sudden, uncontrollable episodes of emotional display involving pathological laughing and crying (PLC) may be encountered in various neurological diseases: amyotrophic lateral sclerosis, multiple system atrophy (cerebellar), cerebrovascular disease, traumatic brain injuries, mass lesions in the cerebellopontine junction, and epilepsy...
2018: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/29123850/delayed-massive-epistaxis-from-traumatic-intracranial-aneurysm-after-blunt-facial-injury
#2
Hajime Nakamura, Toshiyuki Fujinaka, Osamu Tasaki, Toshiki Yoshimine
Cases: Traumatic intracranial aneurysm following blunt head injury is uncommon but can be induced by extension of skull base fracture and causes unexpected hemorrhagic complications. We present two cases of traumatic intracranial aneurysm in the paraclinoid area that was revealed by delayed massive epistaxis. Lack of initial neurological deficits omitted screening for cerebrovascular injury. Outcome: Internal trapping was carried out using endovascular techniques in both cases, with extracranial-intracranial bypass in one case...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123083/identification-of-a-peptide-recognizing-cerebrovascular-changes-in-mouse-models-of-alzheimer-s-disease
#3
Aman P Mann, Pablo Scodeller, Sazid Hussain, Gary B Braun, Tarmo Mölder, Kadri Toome, Rajesh Ambasudhan, Tambet Teesalu, Stuart A Lipton, Erkki Ruoslahti
Cerebrovascular changes occur in Alzheimer's disease (AD). Using in vivo phage display, we searched for molecular markers of the neurovascular unit, including endothelial cells and astrocytes, in mouse models of AD. We identified a cyclic peptide, CDAGRKQKC (DAG), that accumulates in the hippocampus of hAPP-J20 mice at different ages. Intravenously injected DAG peptide homes to neurovascular unit endothelial cells and to reactive astrocytes in mouse models of AD. We identified connective tissue growth factor (CTGF), a matricellular protein that is highly expressed in the brain of individuals with AD and in mouse models, as the target of the DAG peptide...
November 10, 2017: Nature Communications
https://www.readbyqxmd.com/read/29065769/imaging-of-cerebrovascular-function-in-chronic-traumatic-brain-injury
#4
Franck Amyot, Kimbra Kenney, Carol Moore, Maraglit Harber, L Christine Turtzo, Christian N Shenouda, Erika Silverman, Yunhua Gong, Bao-Xi Qu, Leah Harburg, Hangzang Lu, Eric Wassermann, Ramon Diaz-Arrastia
Traumatic cerebrovascular injury (TCVI) is a common pathologic mechanism of traumatic brain injury (TBI) and presents an attractive target for intervention. The aims of this study were to assess cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) using magnetic resonance imaging (MRI), to assess their value as biomarkers of TCVI in chronic TBI, characterize the spatial distribution of TCVI, and assess the relationships between each biomarker and neuropsychological and clinical assessments. 42 subjects (27 chronic TBI, 15 age and gender-matched healthy volunteers) were studied cross-sectionally...
October 25, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29050524/transcranial-doppler-systolic-flow-index-and-icp-derived-cerebrovascular-reactivity-indices-in-tbi
#5
Frederick Adam Zeiler, Danilo Cardim, Joseph Donnelly, David Menon, Marek Czosnyka, Peter Smieleweski
To explore relationships between transcranial Doppler (TCD) indices of cerebrovascular reactivity and those derived from intracranial pressure (ICP). GOALS: A. Confirm previously described co-variance patterns of TCD/ICP indices, and B. Describe thresholds for Sx (correlation between systolic flow velocity (FVs) and cerebral perfusion pressure (CPP)) associated with outcome. Retrospective cohort of traumatic brain injury (TBI) patients: with TCD and ICP monitoring, we calculated various continuous indices of cerebrovascular reactivity: A...
October 19, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29043544/icp-versus-laser-doppler-cerebrovascular-reactivity-indices-to-assess-brain-autoregulatory-capacity
#6
F A Zeiler, J Donnelly, D Cardim, D K Menon, P Smielewski, M Czosnyka
BACKGROUND: To explore the relationship between various autoregulatory indices in order to determine which approximate small vessel/microvascular (MV) autoregulatory capacity most accurately. METHODS: Utilizing a retrospective cohort of traumatic brain injury patients (N = 41) with: transcranial Doppler (TCD), intracranial pressure (ICP) and cortical laser Doppler flowmetry (LDF), we calculated various continuous indices of autoregulation and cerebrovascular responsiveness: A...
October 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29037336/neuropsychiatry-towards-a-philosophy-of-praxis
#7
Jesús Ramirez-Bermudez, Rodrigo Perez-Esparza, Luis Carlos Aguilar-Venegas, Perminder Sachdev
Neuropsychiatry is a specialized clinical, academic and scientific discipline with its field located in the borderland territory between neurology and psychiatry. In this article, we approach the theoretical definition of neuropsychiatry, and in order to address the practical aspects of the discipline, we describe the profile of a neuropsychiatric liaison service in the setting of a large hospital for neurological diseases in a middle-income country. An audit of consecutive in-patients requiring neuropsychiatric assessment at the National Institute of Neurology and Neurosurgery of Mexico is reported, comprising a total of 1212 patients...
October 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/28993802/glycemia-is-related-to-impaired-cerebrovascular-autoregulation-after-severe-pediatric-traumatic-brain-injury-a-retrospective-observational-study
#8
Adam M H Young, Hadie Adams, Joseph Donnelly, Mathew R Guilfoyle, Helen Fernandes, Mathew R Garnett, Marek Czosnyka, Peter Smielewski, Mark Plummer, Shruti Agrawal, Peter J Hutchinson
INTRODUCTION: A strong association exists between hyperglycemia and outcome in pediatric traumatic brain injury (TBI). Herein, we describe observations of serum markers of glucose metabolism in a cohort of pediatric TBI patients and how these variables are related to parameters of intracranial pathophysiology. METHODS: A retrospective analysis was performed on pediatric severe TBI patients admitted to Addenbrookes Hospital Paediatric Intensive Care Unit (PICU) between January 2001 and December 2013...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28967326/cerebral-blood-flow-after-mild-traumatic-brain-injury-associations-between-symptoms-and-post-injury-perfusion
#9
Jaclyn A Stephens, Peiying Liu, Hanzang Lu, Stacy J Suskauer
Arterial spin labeling (ASL) has emerged as a technique for assessing mild traumatic brain injury (mTBI), as it can non-invasively evaluate cerebrovascular physiology. To date, there is substantial variability in methodology and findings of ASL studies of mTBI. While both increased and decreased perfusion are reported after mTBI, more consistency is emerging when perfusion is examined with regard to symptomology. We evaluated 15 teenage athletes 2 and 6 weeks after sports-related concussion (SRC group) using pseudo-continuous ASL...
October 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28956630/dynamics-of-clinical-recovery-during-the-early-phase-of-rehabilitation-in-patients-with-severe-traumatic-and-non-traumatic-brain-injury
#10
Lydia Oujamaa, Gilles Francony, Perrine Boucheix, Clotilde Schilte, Pierre Bouzat, Dominic Perennou, Jean-Francois Payen
PURPOSE: Our aim was to describe the changes in the functional outcome at the early phase of rehabilitation following severe brain injury and to identify the factors associated with faster recovery. METHODS: This retrospective analysis included 182 patients who were transferred from the intensive care unit (ICU) to a post-ICU neurorehabilitation unit following traumatic brain injury (TBI) (n = 82) or cerebrovascular accident (CVA) (n = 100). Admission, discharge and changes in scores were calculated for the Functional Independent Measurement (FIM) and the Wessex Head Injury Matrix (WHIM)...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28871418/time-spent-with-impaired-autoregulation-is-linked-with-outcome-in-severe-infant-paediatric-traumatic-brain-injury
#11
Konstantin Hockel, Jennifer Diedler, Felix Neunhoeffer, Ellen Heimberg, Carmen Nagel, Martin U Schuhmann
BACKGROUND: It could be shown in traumatic brain injury (TBI) in adults that the functional status of cerebrovascular autoregulation (AR), determined by the pressure reactivity index (PRx), correlates to and even predicts outcome. We investigated PRx, cerebral perfusion pressure (CPP) and intracranial pressure (ICP) and their correlation to outcome in severe infant and paediatric TBI. METHODS: Seventeen patients (range, 1 day to 14 years) with severe TBI (median GCS at presentation, 4) underwent long-term computerised ICP and mean arterial pressure (MAP) monitoring using dedicated software to determine CPP and PRx and optimal CPP (CPP level where PRx shows best autoregulation) continuously...
September 4, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28819737/further-controversies-about-brain-tissue-oxygenation-pressure-reactivity-after-traumatic-brain-injury
#12
Morten Andresen, Joseph Donnelly, Marcel Aries, Marianne Juhler, David Menon, Pja Hutchinson, Peter Smielewski
BACKGROUND: Continuous monitoring of cerebral autoregulation is considered clinically useful due to its ability to warn against brain ischemic insults, which may translate to a relationship with adverse outcome. It is typically performed using the pressure reactivity index (PRx) based on mean arterial pressure and intracranial pressure. A new ORx index based on brain tissue oxygenation and cerebral perfusion pressure (CPP) has been proposed that similarly allows for evaluation of cerebrovascular reactivity...
August 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28816837/individualizing-thresholds-of-cerebral-perfusion-pressure-using-estimated-limits-of-autoregulation
#13
Joseph Donnelly, Marek Czosnyka, Hadie Adams, Chiara Robba, Luzius A Steiner, Danilo Cardim, Brenno Cabella, Xiuyun Liu, Ari Ercole, Peter John Hutchinson, David Krishna Menon, Marcel J H Aries, Peter Smielewski
OBJECTIVES: In severe traumatic brain injury, cerebral perfusion pressure management based on cerebrovascular pressure reactivity index has the potential to provide a personalized treatment target to improve patient outcomes. So far, the methods have focused on identifying "one" autoregulation-guided cerebral perfusion pressure target-called "cerebral perfusion pressure optimal". We investigated whether a cerebral perfusion pressure autoregulation range-which uses a continuous estimation of the "lower" and "upper" cerebral perfusion pressure limits of cerebrovascular pressure autoregulation (assessed with pressure reactivity index)-has prognostic value...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28794982/symptom-correlates-of-cerebral-blood-flow-following-acute-concussion
#14
Nathan W Churchill, Michael G Hutchison, Simon J Graham, Tom A Schweizer
Concussion is associated with significant symptoms within hours to days post-injury, including disturbances in physical function, cognition, sleep and emotion. However, little is known about how subjective impairments correlate with objective measures of cerebrovascular function following brain injury. This study examined the relationship between symptoms and cerebral blood flow (CBF) in individuals following sport-related concussion. Seventy university level athletes had CBF measured using Arterial Spin Labelling (ASL), including 35 with acute concussion and 35 matched controls and their symptoms were assessed using the Sport Concussion Assessment Tool 3 (SCAT3)...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28789779/management-of-blunt-cerebrovascular-injury-bcvi-in-the-multisystem-injury-patient-with-contraindications-to-immediate-anti-thrombotic-therapy
#15
Michelle K McNutt, A Cozette Kale, Ryan S Kitagawa, Ali H Turkmani, David W Fields, Sarah Baraniuk, Brijesh S Gill, Bryan A Cotton, Laura J Moore, Charles E Wade, Arthur Day, John B Holcomb
INTRODUCTION: Practice management guidelines for screening and treatment of patients with blunt cerebrovascular injury (BCVI) have been associated with a decreased risk of ischemic stroke. TREATMENT: of patients with BCVI and multisystem injuries that delays immediate antithrombotic therapy remains controversial. The purpose of this study was to determine the timing of BCVI treatment initiation, the incidence of stroke, and bleeding complications as a result of antithrombotic therapy in patients with isolated BCVI in comparison to those with BCVI complicated by multisystem injuries...
July 31, 2017: Injury
https://www.readbyqxmd.com/read/28769857/hyperventilation-therapy-for-control-of-posttraumatic-intracranial-hypertension
#16
REVIEW
Daniel Agustín Godoy, Ali Seifi, David Garza, Santiago Lubillo-Montenegro, Francisco Murillo-Cabezas
During traumatic brain injury, intracranial hypertension (ICH) can become a life-threatening condition if it is not managed quickly and adequately. Physicians use therapeutic hyperventilation to reduce elevated intracranial pressure (ICP) by manipulating autoregulatory functions connected to cerebrovascular CO2 reactivity. Inducing hypocapnia via hyperventilation reduces the partial pressure of arterial carbon dioxide (PaCO2), which incites vasoconstriction in the cerebral resistance arterioles. This constriction decrease cerebral blood flow, which reduces cerebral blood volume and, ultimately, decreases the patient's ICP...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28754973/neuroprotective-effects-of-trigeminal-nerve-stimulation-in-severe-traumatic-brain-injury
#17
Amrit Chiluwal, Raj K Narayan, Wayne Chaung, Neal Mehan, Ping Wang, Chad E Bouton, Eugene V Golanov, Chunyan Li
Following traumatic brain injury (TBI), ischemia and hypoxia play a major role in further worsening of the damage, a process referred to as 'secondary injury'. Protecting neurons from causative factors of secondary injury has been the guiding principle of modern TBI management. Stimulation of trigeminal nerve induces pressor response and improves cerebral blood flow (CBF) by activating the rostral ventrolateral medulla. Moreover, it causes cerebrovasodilation through the trigemino-cerebrovascular system and trigemino-parasympathetic reflex...
July 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28742817/temporal-profile-of-intracranial-pressure-and-cerebrovascular-reactivity-in-severe-traumatic-brain-injury-and-association-with-fatal-outcome-an-observational-study
#18
Hadie Adams, Joseph Donnelly, Marek Czosnyka, Angelos G Kolias, Adel Helmy, David K Menon, Peter Smielewski, Peter J Hutchinson
BACKGROUND: Both intracranial pressure (ICP) and the cerebrovascular pressure reactivity represent the dysregulation of pathways directly involved in traumatic brain injury (TBI) pathogenesis and have been used to inform clinical management. However, how these parameters evolve over time following injury and whether this evolution has any prognostic importance have not been studied. METHODS AND FINDINGS: We analysed the temporal profile of ICP and pressure reactivity index (PRx), examined their relation to TBI-specific mortality, and determined if the prognostic relevance of these parameters was affected by their temporal profile using mixed models for repeated measures of ICP and PRx for the first 240 hours from the time of injury...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742798/cerebrovascular-pressure-reactivity-monitoring-using-wavelet-analysis-in-traumatic-brain-injury-patients-a-retrospective-study
#19
COMPARATIVE STUDY
Xiuyun Liu, Joseph Donnelly, Marek Czosnyka, Marcel J H Aries, Ken Brady, Danilo Cardim, Chiara Robba, Manuel Cabeleira, Dong-Joo Kim, Christina Haubrich, Peter J Hutchinson, Peter Smielewski
BACKGROUND: After traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure reactivity) is impaired, leaving patients vulnerable to cerebral hypo- or hyperperfusion. Although, the traditional pressure reactivity index (PRx) has demonstrated that impaired pressure reactivity is associated with poor patient outcome, PRx is sometimes erratic and may not be reliable in various clinical circumstances. Here, we introduce a more robust transform-based wavelet pressure reactivity index (wPRx) and compare its performance with the widely used traditional PRx across 3 areas: its stability and reliability in time, its ability to give an optimal cerebral perfusion pressure (CPPopt) recommendation, and its relationship with patient outcome...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28686115/letter-to-the-editor-biffl-scale-for-blunt-traumatic-cerebrovascular-injury
#20
Xiao Wu, Ajay Malhotra
No abstract text is available yet for this article.
July 7, 2017: Journal of Neurosurgery
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