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Mild traumatic brain injury cerebral blood flow

Corey M Thibeault, Samuel Thorpe, Michael J O'Brien, Nicolas Canac, Mina Ranjbaran, Ilyas Patanam, Artin Sarraf, James LeVangie, Fabien Scalzo, Seth J Wilk, Ramon Diaz-Arrastia, Robert B Hamilton
The microvasculature is prominently affected by traumatic brain injury (TBI), including mild TBI (concussion). Assessment of cerebral hemodynamics shows promise as biomarkers of TBI, and may help inform development of therapies aimed at promoting neurologic recovery. The objective of this study was to assess the evolution in cerebral hemodynamics observable with transcranial Doppler (TCD) ultrasound in subjects suffering from a concussion at different intervals during recovery. Pediatric subjects between the ages of 14 and 19 years clinically diagnosed with a concussion were observed at different points post-injury...
2018: Frontiers in Neurology
Peter Smielewski, Luzius Steiner, Corina Puppo, Karol Budohoski, Georgios V Varsos, Marek Czosnyka
OBJECTIVE: Brain arterial critical closing pressure (CrCP) has been studied in several diseases such as traumatic brain injury (TBI), subarachnoid haemorrhage, hydrocephalus, and in various physiological scenarios: intracranial hypertension, decreased cerebral perfusion pressure, hypercapnia, etc. Little or nothing so far has been demonstrated to characterise change in CrCP during mild hypocapnia. METHOD: We retrospectively analysed recordings of intracranial pressure (ICP), arterial blood pressure (ABP) and blood flow velocity from 27 severe TBI patients (mean 39...
2018: Acta Neurochirurgica. Supplement
Marika C Möller, Love Engström Nordin, Aniko Bartfai, Per Julin, Tie-Qiang Li
INTRODUCTION: Fatigue is the most frequently reported persistent symptom following a mild traumatic brain injury (mTBI), but the explanations for the persisting fatigue symptoms in mTBI remain controversial. In this study, we investigated the change of cerebral blood flow during the performance of a psychomotor vigilance task (PVT) by using pseudo-continuous arterial spin labeling (PCASL) MRI technique to better understand the relationship between fatigability and brain activity in mTBI...
2017: Frontiers in Neurology
Jaclyn A Stephens, Peiying Liu, Hanzhang Lu, Stacy J Suskauer
Arterial spin labeling (ASL) has emerged as a technique for assessing mild traumatic brain injury (mTBI), as it can noninvasively 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 two and six weeks after sports-related concussion (SRC group) using pseudo-continuous ASL...
January 15, 2018: Journal of Neurotrauma
Brooke Fehily, Melinda Fitzgerald
Mild traumatic brain injury (mTBI) represents a significant public healthcare concern, accounting for the majority of all head injuries. While symptoms are generally transient, some patients go on to experience long-term cognitive impairments and additional mild impacts can result in exacerbated and persisting negative outcomes. To date, studies using a range of experimental models have reported chronic behavioral deficits in the presence of axonal injury and inflammation following repeated mTBI; assessments of oxidative stress and myelin pathology have thus far been limited...
July 2017: Cell Transplantation
Iscander M Maissan, Rein Ketelaars, Boris Vlottes, Sanne E Hoeks, Dennis den Hartog, Robert J Stolker
OBJECTIVES: Rigid cervical collars are known to increase intracranial pressure (ICP) in severe traumatic brain injury (TBI). Cerebral blood flow might decrease according to the Kellie Monroe doctrine. For this reason, the use of the collar in patients with severe TBI has been abandoned from several trauma protocols in the Netherlands. There is no evidence on the effect of a rigid collar on ICP in patients with mild or moderate TBI or indeed patients with no TBI. As a first step we tested the effect in healthy volunteers with normal ICPs and intact autoregulation of the brain...
July 19, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Alexandra L Clark, Katherine J Bangen, Scott F Sorg, Dawn M Schiehser, Nicole D Evangelista, Benjamin McKenna, Thomas T Liu, Lisa Delano-Wood
OBJECTIVE: Cerebral blood flow (CBF) plays a critical role in the maintenance of neuronal integrity, and CBF alterations have been linked to deleterious white matter changes. Although both CBF and white matter microstructural alterations have been observed within the context of traumatic brain injury (TBI), the degree to which these pathological changes relate to one another and whether this association is altered by time since injury have not been examined. The current study therefore sought to clarify associations between resting CBF and white matter microstructure post-TBI...
2017: NeuroImage: Clinical
Hai-Bo Zhang, Shi-Xiang Cheng, Yue Tu, Sai Zhang, Shi-Ke Hou, Zhen Yang
AIM: To investigate the protective effect of hypothermia (HT) on brain injury in moderate traumatic brain injury (TBI) rat models and the potential mechanisms, especially the involvement of RIPK1 in apoptosis and necroptosis. METHODS: Adult Sprague-Dawley rats were randomized to four groups: sham+normothermia (sham+NT), sham+hypothermia (sham+HT), moderate TBI+normothermia (TBI+NT) and moderate TBI+hypothermia (TBI+HT). The sham+HT and TBI+HT groups were submitted to 32°C for 6 hours...
2017: Brain Injury: [BI]
Cillian E Lynch, Gogce Crynen, Scott Ferguson, Benoit Mouzon, Daniel Paris, Joseph Ojo, Paige Leary, Fiona Crawford, Corbin Bachmeier
PRIMARY OBJECTIVE: To investigate the status of the cerebrovasculature following repetitive mild traumatic brain injury (r-mTBI). RESEARCH DESIGN: TBI is a risk factor for development of various neurodegenerative disorders. A common feature of neurodegenerative disease is cerebrovascular dysfunction which includes alterations in cerebral blood flow (CBF). TBI can result in transient reductions in CBF, with severe injuries often accompanied by varying degrees of vascular pathology post-mortem...
2016: Brain Injury: [BI]
Sven Haller, Greg Zaharchuk, David L Thomas, Karl-Olof Lovblad, Frederik Barkhof, Xavier Golay
Arterial spin labeling (ASL) is a magnetic resonance (MR) imaging technique used to assess cerebral blood flow noninvasively by magnetically labeling inflowing blood. In this article, the main labeling techniques, notably pulsed and pseudocontinuous ASL, as well as emerging clinical applications will be reviewed. In dementia, the pattern of hypoperfusion on ASL images closely matches the established patterns of hypometabolism on fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) images due to the close coupling of perfusion and metabolism in the brain...
November 2016: Radiology
Nicole D Osier, C Edward Dixon
Controlled cortical impact (CCI) is a mechanical model of traumatic brain injury (TBI) that was developed nearly 30 years ago with the goal of creating a testing platform to determine the biomechanical properties of brain tissue exposed to direct mechanical deformation. Initially used to model TBIs produced by automotive crashes, the CCI model rapidly transformed into a standardized technique to study TBI mechanisms and evaluate therapies. CCI is most commonly produced using a device that rapidly accelerates a rod to impact the surgically exposed cortical dural surface...
2016: Frontiers in Neurology
Karen M Barlow, Lorenzo D Marcil, Deborah Dewey, Helen L Carlson, Frank P MacMaster, Brian L Brooks, R Marc Lebel
The biology of post-concussive symptoms is unclear. Symptoms are often increased during activities, and have been linked to decreased cerebrovascular reactivity and perfusion. The aim of this study was to examine cerebral blood flow (CBF) in children with different clinical recovery patterns following mild traumatic brain injury (mTBI). This was a prospective controlled cohort study of children with mTBI (ages 8 to 18 years) who were symptomatic with post-concussive symptoms at one month post-injury (symptomatic, n = 27) and children who had recovered quickly (asymptomatic, n = 24)...
March 1, 2017: Journal of Neurotrauma
Joseph O Ojo, Benoit Mouzon, Moustafa Algamal, Paige Leary, Cillian Lynch, Laila Abdullah, James Evans, Michael Mullan, Corbin Bachmeier, William Stewart, Fiona Crawford
Exposure to repetitive mild traumatic brain injury (mTBI) is a risk factor for chronic traumatic encephalopathy, which is characterized by patchy deposition of hyperphosphorylated tau aggregates in neurons and astrocytes at the depths of cortical sulci. We developed an mTBI paradigm to explore effects of repetitive concussive-type injury over several months in mice with a human tau genetic background (hTau). Two injuries were induced in the hTau mice weekly over a period of 3 or 4 months and the effects were compared with those in noninjured sham animals...
July 2016: Journal of Neuropathology and Experimental Neurology
Pierre Bouzat, Luc Almeras, Pauline Manhes, Laurence Sanders, Albrice Levrat, Jean-Stephane David, Raphael Cinotti, Russel Chabanne, Aurélie Gloaguen, Xavier Bobbia, Sophie Thoret, Lydia Oujamaa, Jean-Luc Bosson, Jean-François Payen, Karim Asehnoune, Philippe Pes, Jean-Yves Lefrant, Sébastien Mirek, François Albasini, Caron Scrimgeour, Jean-Marc Thouret, Freddy Chartier, Marc Ginet
BACKGROUND: To assess the performance of transcranial Doppler (TCD) in predicting neurologic worsening after mild to moderate traumatic brain injury. METHODS: The authors conducted a prospective observational study across 17 sites. TCD was performed upon admission in 356 patients (Glasgow Coma Score [GCS], 9 to 15) with mild lesions on cerebral computed tomography scan. Normal TCD was defined as a pulsatility index of less than 1.25 and diastolic blood flow velocity higher than 25 cm/s in the two middle cerebral arteries...
August 2016: Anesthesiology
Wei Li, Lora Watts, Justin Long, Wei Zhou, Qiang Shen, Zhao Jiang, Yunxia Li, Timothy Q Duong
The blood-brain barrier (BBB) can be impaired following traumatic brain injury (TBI), however the spatiotemporal dynamics of BBB leakage remain incompletely understood. In this study, we evaluated the spatiotemporal evolution of BBB permeability using dynamic contrast-enhanced MRI and measured the volume transfer coefficient (K(trans)), a quantitative measure of contrast agent leakage across the blood and extravascular compartment. Measurements were made in a controlled cortical impact (CCI) model of mild TBI in rats from 1h to 7 days following TBI...
September 1, 2016: Brain Research
Jason E Kisser, Allyssa J Allen, Leslie I Katzel, Carrington R Wendell, Eliot L Siegel, David Lefkowitz, Shari R Waldstein
Hypertension confers increased risk for cognitive decline, dementia, and cerebrovascular disease. These associations have been attributed, in part, to cerebral hypoperfusion. Here we posit that relations of higher blood pressure to lower levels of cerebral perfusion may be potentiated by a prior head injury. Participants were 87 community-dwelling older adults - 69% men, 90% white, mean age=66.9years, 27.6% with a history of mild traumatic brain injury (mTBI) defined as a loss of consciousness ≤30min resulting from an injury to the head, and free of major medical (other than hypertension), neurological or psychiatric comorbidities...
June 15, 2016: Journal of the Neurological Sciences
Yi Zhang, Xiuyun Liu, Luzius Steiner, Peter Smielewski, Eli Feen, John D Pickard, Marek Czosnyka
OBJECTIVE: Cerebral blood flow autoregulation is commonly impaired in patients with traumatic brain injury (TBI). This study was to investigate correlations between cerebral autoregulation and CO2 reactivity in patients with TBI during transient mild hypocapnia. METHODS: Patients with TBI who were on mechanical ventilation were hyperventilated for approximately 60 min. Indices of autoregulation, based on a model of the relationship between arterial blood pressure and blood flow velocity (FV) (ARIabp) and, separately, between cerebral perfusion pressure and FV (ARIcpp), were calculated...
2016: Acta Neurochirurgica. Supplement
Shu-Ping Peng, Yi-Ning Li, Jun Liu, Zhi-Yuan Wang, Zi-Shu Zhang, Shun-Ke Zhou, Fang-Xu Tao, Zhi-Xue Zhang
Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury remain poorly understood. This study sought to observe changes in cerebral blood flow in different regions after mild traumatic brain injury using pulsed arterial spin labeling. Our results demonstrate maximal cerebral blood flow in gray matter and minimal in the white matter of patients with mild traumatic brain injury...
February 2016: Neural Regeneration Research
Madhuvika Murugan, Vijayalakshmi Santhakumar, Sridhar S Kannurpatti
Mild to moderate traumatic brain injury (mTBI) leads to secondary neuronal loss via excitotoxic mechanisms, including mitochondrial Ca(2+) overload. However, in the surviving cellular population, mitochondrial Ca(2+) influx, and oxidative metabolism are diminished leading to suboptimal neuronal circuit activity and poor prognosis. Hence we tested the impact of boosting neuronal electrical activity and oxidative metabolism by facilitating mitochondrial Ca(2+) uptake in a rat model of mTBI. In developing rats (P25-P26) sustaining an mTBI, we demonstrate post-traumatic changes in cerebral blood flow (CBF) in the sensorimotor cortex in response to whisker stimulation compared to sham using functional Laser Doppler Imaging (fLDI) at adulthood (P67-P73)...
2016: Frontiers in Systems Neuroscience
Danilo Cardim, C Robba, M Bohdanowicz, J Donnelly, B Cabella, X Liu, M Cabeleira, P Smielewski, B Schmidt, M Czosnyka
Although intracranial pressure (ICP) is essential to guide management of patients suffering from acute brain diseases, this signal is often neglected outside the neurocritical care environment. This is mainly attributed to the intrinsic risks of the available invasive techniques, which have prevented ICP monitoring in many conditions affecting the intracranial homeostasis, from mild traumatic brain injury to liver encephalopathy. In such scenario, methods for non-invasive monitoring of ICP (nICP) could improve clinical management of these conditions...
December 2016: Neurocritical Care
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