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acute brain injury

Brin Freund, James J Gugger, Alexandra Reynolds, William O Tatum, Jan Claassen, Peter W Kaplan
PURPOSE: Periodic discharges (PDs) are EEG patterns denoting brain dysfunction and ictal tendency. Their exact meaning regarding etiology and outcomes is not well known. In particular, bilateral independent PDs (BIPDs) are poorly described. METHODS: We performed a retrospective, multicenter study evaluating neuroimaging, epileptic, clinical, and EEG correlates of BIPDs. RESULTS: Twenty-five patients studied with a mean Glasgow Coma Scale 6...
March 15, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Wen Zhang, Jun-Ke Song, Rong Yan, Li Li, Zhi-Yong Xiao, Wen-Xia Zhou, Zhen-Zhong Wang, Wei Xiao, Guan-Hua Du
Diterpene ginkgolides meglumine injection (DGMI) is a therapeutic extract of Ginkgo biloba L, which has been used for the treatment of cerebral ischemic stroke in China. Ginkgolides A, B and C are the main components of DGMI. This study was designed to investigate the neuroprotective effects of DGMI components against ischemic stroke in vivo and in vitro. Acute cerebral ischemic injury was induced in rats by occlusion of the middle cerebral artery (MCA) for 1.5 h followed by 24 h reperfusion. The rats were treated with DGMI (1, 3 and 10 mg/kg, iv) at the onset of reperfusion and 12 h after reperfusion...
March 15, 2018: Acta Pharmacologica Sinica
Nelly Siller, Jens Kuhle, Muthuraman Muthuraman, Christian Barro, Timo Uphaus, Sergiu Groppa, Ludwig Kappos, Frauke Zipp, Stefan Bittner
BACKGROUND: Monitoring neuronal injury remains one key challenge in early relapsing-remitting multiple sclerosis (RRMS) patients. Upon axonal damage, neurofilament - a major component of the neuro-axonal cytoskeleton - is released into the cerebrospinal fluid (CSF) and subsequently peripheral blood. OBJECTIVE: To investigate the relevance of serum neurofilament light chain (sNfL) for acute and chronic axonal damage in early RRMS. METHODS: sNfL levels were determined in 74 patients (63 therapy-naive) with recently diagnosed clinically isolated syndrome (CIS) or RRMS using Single Molecule Array technology...
March 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Vasilije Stambolija, Martina Miklić Bublić, Marin Lozić, Jakob Nemir, Miroslav Ščap
Background: Low brain tissue oxygen tension (PbtO2 ), or brain hypoxia, is an independent predictor of poor outcome. Increasing inspirational fraction of oxygen could have a significant influence on treating lower PbtO2 . Combined PbtO2 therapy, compared to the approach that focus only on regulation of cerebral perfusion pressure and intracranial pressure, shows better patient outcomes. Monitoring of PbtO2 could be helpful in individualizing treatment, preventing or limiting secondary brain injury, and maintaining better patient outcome...
2018: Surgical Neurology International
Charlotte Zerna, Amy Y X Yu, Jayesh Modi, Shiel K Patel, Jonathan I Coulter, Eric E Smith, Shelagh B Coutts
BACKGROUND AND PURPOSE: White matter lesions (WML) are associated with cognitive decline, increased stroke risk, and disability in old age. We hypothesized that superimposed acute cerebrovascular occlusion on chronic preexisting injury (leukoaraiosis) leads to worse outcome after minor cerebrovascular event, both using quantitative (volumetric) and qualitative (Fazekas scale) assessment, as well as relative total brain volume. METHODS: WML volume assessment was performed in 425 patients with high-risk transient ischemic attack (TIA; motor/speech deficits >5 minutes) or minor strokes from the CATCH study (CT and MRI in the Triage of TIA and Minor Cerebrovascular Events to Identify High Risk Patients)...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Mei Jiang, Xinghui Liu, Denghai Zhang, Ying Wang, Xiaoxia Hu, Fengxia Xu, Mingming Jin, Fanfan Cao, Limin Xu
BACKGROUND: Acute ischemic stroke (AIS) is the most common type of cerebrovascular disease and is a leading cause of disability and death worldwide. Recently, a study suggested that transformation of microglia from the pro-inflammatory M1 state to the anti-inflammatory and tissue-reparative M2 phenotype may be an effective therapeutic strategy for ischemic stroke. Celastrol, a traditional oriental medicine, may have anti-inflammatory and neuroprotective effects. However, the underlying mechanisms remain unknown...
March 14, 2018: Journal of Neuroinflammation
Melanie Li, Swetlana Sirko
Building on the seminal work by Geoffrey Harris in the 1970s, the neuroendocrinology field, having undergone spectacular growth, has endeavored to understand the mechanisms of hormonal connectivity between the brain and the rest of the body. Given the fundamental role of the brain in the orchestration of endocrine processes through interactions among neurohormones, it is thus not surprising that the structural and/or functional alterations following traumatic brain injury (TBI) can lead to endocrine changes affecting the whole organism...
March 14, 2018: Journal of Clinical Medicine
Matthew Eisenberg, Rebekah Mannix
PURPOSE OF REVIEW: Concussion is an increasingly common injury in children. We aim to review the basic epidemiology and management of acute concussion and highlight recent studies that have contributed to our understanding of care for this injury. RECENT FINDINGS: While concussion is considered a 'mild' form of traumatic brain injury, recent evidence suggests that as many as 30% of children are still symptomatic 1 month after injury. Although there is increasing interest in finding objective measures of injury and recovery, emerging imaging and serum biomarkers are not ready for routine clinical use...
March 13, 2018: Current Opinion in Pediatrics
Jennifer A Kim, Emily Boyle, Alexander C Wu, Andrew J Cole, Kevin J Staley, Sahar Zafar, Sydney S Cash, M Brandon Westover
We hypothesize that epileptiform abnormalities (EA) in the electroencephalopgram (EEG) during the acute period following traumatic brain injury (TBI) independently predict first-year post-traumatic epilepsy (PTE1 ). We analyzed PTE1 risk factors in two cohorts matched for TBI severity and age (n=50). EA independently predict risk for PTE1 (OR 3.16[0.99 11.68]); subdural hematoma is another independent risk factor (OR 4.13 [1.18 39.33]). Differences in EA rates are apparent within 5 days following TBI. Our results suggest increased EA prevalence identifies patients at increased risk for PTE1 , and that EA acutely post-TBI can identify patients most likely to benefit from anti-epileptogenesis drug trials...
March 14, 2018: Annals of Neurology
Annabel Jain Sorby-Adams, Robert Vink, Renee Jade Turner
Acute central nervous system injury, encompassing traumatic brain injury (TBI) and stroke, accounts for a significant burden of morbidity and mortality worldwide. Studies in animal models have greatly enhanced our understanding of the complex pathophysiology that underlies TBI and stroke and enabled the pre-clinical screening of over 1000 novel therapeutic agents. Despite this, the translation of novel therapeutics from experimental models to clinical therapies has been extremely poor. One potential explanation for this poor clinical translation is the choice of experimental model, given that the majority of pre-clinical TBI and ischemic stroke studies have been conducted in small animals, such as rodents, which have small lissencephalic brains...
March 14, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Liu-Lin Xiong, Yu Zou, Yu Shi, Piao Zhang, Rong-Ping Zhang, Xie-Jie Dai, Bin Liu, Ting-Hua Wang
The aim of the present study was to determine the effect of implanted neural stem cells (NSCs) on the functional recovery of tree shrews (TSs) subjected to hemi‑sectioned spinal cord injury (hSCI), and to investigate the possible mechanism involved. NSCs (passage 2), derived from the hippocampus of TSs (embryonic day 20), were labeled with Hoechst 33342 and transplanted intraspinally into the hSC of TSs at thoracic level 10 in the acute (immediately after injury) and chronic (day 9 post‑injury) stages...
March 9, 2018: International Journal of Molecular Medicine
Rodrigo Ramos-Zúñiga, Elizabeth Sevilla, Yara Ursiel-Ortega
OBJETIVE: Traumatic Brain Injury (TBI) associated to alcohol consumption is a global public health problem. It is important to identify and rethink the strategies to approach this challenge for health institutions from a professional perspective. METHODS: An online survey, created with google forms, was sent to professional neurosurgeons in Mexico and Latin America. Participation was voluntary, and the responses were anonymous and confidential. Data were captured after a month and subjected to descriptive statistical analysis using Fisher's method and Chi Square...
March 9, 2018: World Neurosurgery
Sanuji Gajamange, David Raffelt, Thijs Dhollander, Elaine Lui, Anneke van der Walt, Trevor Kilpatrick, Joanne Fielding, Alan Connelly, Scott Kolbe
Long term irreversible disability in multiple sclerosis (MS) is thought to be primarily driven by axonal degeneration. Axonal degeneration leads to degenerative atrophy, therefore early markers of axonal degeneration are required to predict clinical disability and treatment efficacy. Given that additional pathologies such as inflammation, demyelination and oedema are also present in MS, it is essential to develop axonal markers that are not confounded by these processes. The present study investigated a novel method for measuring axonal degeneration in MS based on high angular resolution diffusion magnetic resonance imaging...
2018: NeuroImage: Clinical
Kelly M DeMars, Austin O McCrea, David M Siwarski, Brian D Sanz, Changjun Yang, Eduardo Candelario-Jalil
Ischemic stroke occurs when a clot forms in the brain vasculature that starves downstream tissue of oxygen and nutrients resulting in cell death. The tissue immediately downstream of the blockage, the core, dies within minutes, but the surrounding tissue, the penumbra is potentially salvageable. Prostaglandin E2 binds to four different G-protein coupled membrane receptors EP1-EP4 mediating different and sometimes opposing responses. Pharmacological activation of the EP4 receptor has already been established as neuroprotective in stroke, but the mechanism(s) of protection are not well-characterized...
2018: Frontiers in Neuroscience
Okihiro Onishi, Kazuya Ikoma, Ryo Oda, Tetsuro Yamazaki, Hiroyoshi Fujiwara, Shunji Yamada, Masaki Tanaka, Toshikazu Kubo
Although treatment protocols are available, patients experience both acute neuropathic pain and chronic neuropathic pain, hyperalgesia, and allodynia after peripheral nerve injury. The purpose of this study was to identify the brain regions activated after peripheral nerve injury using functional magnetic resonance imaging (fMRI) sequentially and assess the relevance of the imaging results using histological findings. To model peripheral nerve injury in male Sprague-Dawley rats, the right sciatic nerve was crushed using an aneurysm clip, under general anesthesia...
March 7, 2018: Neuroscience Letters
Seungyeop Lee, Si-On Lee, Gyu-Lee Kim, Dong-Kwon Rhee
AIMS: Streptococcus pneumoniae infection in acute bacterial meningitis can lead to widespread brain damage and mortality. Inflammatory responses by immune cells in the brain are thought to determine the degree of brain injury. Yet, the mechanisms underlying host responses to pneumococcal meningitis are largely unknown. To explore host responses as a potential therapeutic target for preventing brain injury after pneumococcal meningitis. METHODS: We evaluated signaling mechanisms that minimize neuronal damage caused by pneumococcal infection; specifically, we assessed pathways related to neuronal survival after enhancing estrogen receptor-β (ER-β) expression using a natural therapeutic substance known as ginsenoside Rb1 and Rg3 enhanced ginseng...
March 9, 2018: CNS Neuroscience & Therapeutics
Christopher G Hughes, Mayur B Patel, Nathan E Brummel, Jennifer L Thompson, J Brennan McNeil, Pratik P Pandharipande, James C Jackson, Rameela Chandrasekhar, Lorraine B Ware, E Wesley Ely, Timothy D Girard
PURPOSE: Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood-brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are associated with cognitive impairment and disability after discharge. METHODS: We enrolled adults with respiratory failure and/or shock and measured plasma concentrations of BBB (S100B), neuronal (UCHL1, BDNF), and endothelial (E-selectin, PAI-1) injury markers within 72 h of ICU admission...
March 9, 2018: Intensive Care Medicine
Alexandra Kovalčíková, Marianna Gyurászová, Diana Vavrincová-Yaghi, Peter Vavrinec, Ľubomíra Tóthová, Peter Boor, Katarína Šebeková, Peter Celec
Uremic encephalopathy is a severe complication of renal failure. The underlying pathogenesis is unknown although several mechanisms have been suggested. Renal failure causes oxidative stress leading to cardiovascular complications. It has been suggested as the potential mediator of uremic encephalopathy as well, but it is largely unknown whether brain tissue itself undergoes oxidative damage in uremia. The aim of our experiment was to analyze oxidative stress markers in different brain regions in an animal model of acute kidney injury (AKI)...
March 7, 2018: Metabolic Brain Disease
Nikos Schizas, N König, B Andersson, S Vasylovska, J Hoeber, E N Kozlova, N P Hailer
The acute phase of spinal cord injury is characterized by excitotoxic and inflammatory events that mediate extensive neuronal loss in the gray matter. Neural crest stem cells (NCSCs) can exert neuroprotective and anti-inflammatory effects that may be mediated by soluble factors. We therefore hypothesize that transplantation of NCSCs to acutely injured spinal cord slice cultures (SCSCs) can prevent neuronal loss after excitotoxic injury. NCSCs were applied onto SCSCs previously subjected to N-methyl-D-aspartate (NMDA)-induced injury...
March 7, 2018: Cell and Tissue Research
Gabriel Ziegler, Patrick Grabher, Alan Thompson, Daniel Altmann, Markus Hupp, John Ashburner, Karl Friston, Nikolaus Weiskopf, Armin Curt, Patrick Freund
OBJECTIVE: To quantify atrophy, demyelination, and iron accumulation over 2 years following acute spinal cord injury and to identify MRI predictors of clinical outcomes and determine their suitability as surrogate markers of therapeutic intervention. METHODS: We assessed 156 quantitative MRI datasets from 15 patients with spinal cord injury and 18 controls at baseline and 2, 6, 12, and 24 months after injury. Clinical recovery (including neuropathic pain) was assessed at each time point...
March 7, 2018: Neurology
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