1.Diagnostic History of Traumatic Axonal Injury in Patients with Cerebral Concussion and Mild Traumatic Brain Injury.
Brain & Neurorehabilitation 2016;9(2):e1-
Cerebral concussion and mild traumatic brain injury (TBI) have been used interchangeably, although the two terms have different definitions. Traumatic axonal injury (TAI) is a more severe subtype of TBI than concussion or mild TBI. Regarding the evidence of TAI lesions in patients with concussion or mild TBI, since the 1960’s, several studies have reported on TAI in patients with concussion who showed no radiological evidence of brain injury by autopsy. However, conventional CT and MRI are not sensitive to detection of axonal injury in concussion or mild TBI, therefore, previously, diagnosis of TAI in live patients with concussion or mild TBI could not be demonstrated. With the development of diffusion tensor imaging (DTI) in the 1990’s, in 2002, Arfanakis et al. reported on TAI lesions in live patients with mild TBI using DTI for the first time. Subsequently, hundreds of studies have demonstrated the usefulness of DTI in detection of TAI and TAI lesions in patients with concussion or mild TBI. In Korea, the term “TAI” has rarely been used in the clinical field while diffuse axonal injury and concussion have been widely used. Rare use of TAI in Korea appeared to be related to slow development of DTI analysis techniques in Korea. Therefore, we think that use of DTI analysis techniques for diagnosis of TAI should be facilitated in Korea.
Autopsy
;
Axons*
;
Brain Concussion*
;
Brain Injuries*
;
Diagnosis
;
Diffuse Axonal Injury
;
Diffusion Tensor Imaging
;
Humans
;
Korea
;
Magnetic Resonance Imaging
2.Expression of synaptophysin in experimental diffuse brain injury.
Shuan-liang FAN ; Ping HUANG ; Yan-feng LIU ; Pin ZHANG ; Zhen-yuan WANG
Journal of Forensic Medicine 2007;23(1):8-13
OBJECT:
To investigate the changes in the expression_level of synaptophysin following diffuse brain injury (DBI) in rats and to correlate the changes of the synaptophysin expression_level with the post injury time interval.
METHODS:
Wister rats were used as a DBI model induced by Marmarou method. The changes of synaptophysin immunoreactivity on coronal sections of the rats sampled at different post-injury time intervals were used as a marker. The densitometry of the synaptophysin immunoreactivity was documented by imaging technique and analyzed by SPSS software.
RESULTS:
The expression level of synaptophysin in DBI rats showed dynamic changes following DBI as well as during the repairing period.
CONCLUSION
The changes of synaptophysin level may be used as a marker for estimation of the post injury time interval in DBI.
Animals
;
Brain/pathology*
;
Brain Injuries/pathology*
;
Cerebral Cortex/pathology*
;
Diffuse Axonal Injury/pathology*
;
Disease Models, Animal
;
Immunohistochemistry
;
Intracranial Hemorrhage, Traumatic/pathology*
;
Neurons/pathology*
;
Rats
;
Rats, Sprague-Dawley
;
Staining and Labeling
;
Synapses/pathology*
;
Synaptophysin/metabolism*
;
Time Factors
3.Dizziness in Traumatic Brain Injury: Visual-Vestibular Dysfunction, Neurotological Approach
Journal of the Korean Balance Society 2019;18(2):27-31
Traumatic brain injury (TBI) could give rise to variable clinical manifestations based on the involved structures of our bodies. Although there are no structural abnormalities proven, the patients with mild TBI suffer from chronic dizziness and imbalance. Herein, I will discuss the visuo-vestibular interaction and neurotological finding in TBI, which could demonstrate the clue to the diagnosis and management in dizzy patients with TBI.
Brain Concussion
;
Brain Injuries
;
Diagnosis
;
Dizziness
;
Humans
;
Vestibular Diseases
4.Analysis of 112 cases with diffuse axonal injury.
Journal of Forensic Medicine 2009;25(5):370-372
OBJECTIVE:
To investigate the relationship between the diffuse axonal injury (DAI) and cerebral contusion, primary brain stem injury and brain concussion.
METHODS:
One hundred and twelve cases with DAI were analyzed according to the characteristics of clinical signs and imaging features.
RESULTS:
Of 112 cases of DAI, 70.5% injured in traffic accident, 60.7% injured with blunt trauma more than one time and 71.4% injured with cerebral contusion. And 90 cases with brain with hemorrhage were found in CT or MRI imaging.
CONCLUSION
DAI may be associated with cortical contusion and primary brain stem injury. The CT or MRI is useful to investigate the cause of death and to evaluate the personal disability.
Accidents, Traffic
;
Adolescent
;
Adult
;
Aged
;
Brain Concussion/pathology*
;
Brain Injuries/diagnosis*
;
Brain Stem/pathology*
;
Child
;
Child, Preschool
;
Diagnosis, Differential
;
Diffuse Axonal Injury/pathology*
;
Female
;
Forensic Pathology
;
Humans
;
Intracranial Hemorrhages/etiology*
;
Male
;
Middle Aged
;
Tomography, X-Ray Computed
;
Young Adult
5.Application of diffusion tensor imaging and 1H-magnetic resonance spectroscopy in diagnosis of traumatic brain injury.
Zhao ZHAO ; Jian-yun YU ; Kun-hua WU ; Hua-lin YU ; Ao-xiang LIU ; Yu-hua LI
Journal of Forensic Medicine 2012;28(3):207-210
Mild traumatic brain injury (mTBI) is a common type of brain disorders among young adults. The dysfunction of the brain is often exacerbated due to diffuse axonal injury (DAI) which based on the injury of white matter fibers and axons. Since mild and moderate brain injury or DAI are diffuse and subtle, conventional CT and MRI are difficult to make a positive diagnosis. Recent clinical study indicated that functional magnetic resonance imaging has a high detection rate in the diagnosis of acute mild and moderate brain injury, especially the diffusion tensor imaging (DTI) and 1H-magnetic resonance spectroscopy (1H-MRS). This paper has reviewed the principles and characteristics of DTI and 1H-MRS, and recent research in the clinical and animal experiments on brain injury.
Animals
;
Axons/pathology*
;
Brain/pathology*
;
Brain Concussion/pathology*
;
Brain Injuries/pathology*
;
Diagnosis, Differential
;
Diffuse Axonal Injury/pathology*
;
Diffusion Tensor Imaging
;
Humans
;
Magnetic Resonance Spectroscopy/methods*
;
Nerve Fibers, Myelinated/pathology*
;
Severity of Illness Index
6.Clinical Characteristics of Post-traumatic Seizures in Children.
Jon Soo KIM ; Hye Won RYU ; Sung Hwan BYUN ; Hunmin KIM ; Byung Chan LIM ; Jong Hee CHAE ; Jieun CHOI ; Ki Joong KIM ; Yong Seung HWANG ; Hee HWANG
Journal of the Korean Child Neurology Society 2012;20(4):228-233
PURPOSE: Post-traumatic seizures (PTS) are well-recognized complications from head injuries and children are particularly more vulnerable to them. The aim of this study was to investigate the clinical characteristics of PTS in children and the findings of several diagnostic tools and to determine the role of prophylactic anticonvulsants. METHODS: We retrospectively reviewed the medical records of patient under 18 years of age who presented with seizures after traumatic brain injuries. Data analyzed included patient's demographics, clinical presentations, radiological and electroencephalographic findings, management and outcomes. RESULTS: Thirty one patients with PTS were included in the study and consisted of 13 males and 18 females. A mean age of the accident was 3.2 years (4 months-6.8 years) and a mean duration of follow-up was 26.0 months (12 months-54 months). Twenty one patients (67.7%) developed seizures within 24 hours after injury. Focal radiological findings were observed in 83.8% and described as subdural or epidural hematoma (25.8%), intraparenchymal hemorrhage (19.3%) and intracerebral parenchymal lesions (51.6%). Electroecephalographic findings included background abnormalities in 32.2% and interictal epileptiform discharges in 45.1%. All patients were treated with anticonvulsants for a certain period of time and a mean duration of treatment was 12.5 weeks (4-40 weeks). Eight patients (25.8%) developed subsequent seizures during follow-up period and 2 patients (6.5%) were diagnosed afterward with post-traumatic epilepsy. CONCLUSION: PTS generally take a benign clinical course, but subsequent seizures including epileptic seizures can occur in minor proportion. In these cases, radiological and electroencephalographic findings are helpful in prediction of clinical course of PTS.
Anticonvulsants
;
Brain Injuries
;
Child
;
Craniocerebral Trauma
;
Demography
;
Epilepsy
;
Epilepsy, Post-Traumatic
;
Female
;
Follow-Up Studies
;
Hematoma
;
Hemorrhage
;
Humans
;
Male
;
Medical Records
;
Retrospective Studies
;
Seizures
7.Advances in Biomarkers of Mild Traumatic Brain Injury in Cerebrospinal Fluid and Blood.
Wen HUANG ; Shang-xun LI ; Xue-jian LI ; Hong-yun XU
Journal of Forensic Medicine 2015;31(6):466-469
Mild traumatic brain injury (MTBI) is defined as a mild brain trauma resulting in a short loss of consciousness and alteration of mental status. It may also occasionally develop persistent and progressive symptoms. It has been confirmed that MTBI causes changes of anatomic structures in central nervous system and biomarkers in the body fluid. However, there is no sufficient research on relevance among threshold for the brain injury, individual vulnerability and duration of disturbance of consciousness. Furthermore, there are no reliable diagnostic methods to establish whether a blow to the head is sufficient to cause the brain injury. This review provides references for biomarkers in cerebrospinal fluid and blood associated with TBI. It also provides application status and potential prospects for further assessment and diagnosis of MTBI.
Biomarkers/cerebrospinal fluid*
;
Brain Concussion/complications*
;
Brain Injuries/etiology*
;
Disease Progression
;
Humans
8.A Review of Sport-Related Head Injuries.
Yoshifumi MIZOBUCHI ; Shinji NAGAHIRO
Korean Journal of Neurotrauma 2016;12(1):1-5
We review current topics in sport-related head injuries including acute subdural hematoma (ASDH), traumatic cerebrovascular disease, cerebral concussion, and chronic traumatic encephalopathy (CTE). Sports-related ASDH is a leading cause of death and severe morbidity in popular contact sports like American football and Japanese judo. Rotational acceleration can cause either cerebral concussion or ASDH due to rupture of a parasagittal bridging vein. Although rare, approximately 80% of patients with cerebral infarction due to sport participation are diagnosed with ischemia or infarction due to arterial dissection. Computed tomography angiography, magnetic resonance angiography, and ultrasound are useful for diagnosing arterial dissection; ultrasound is particularly useful for detecting dissection of the common and internal carotid arteries. Repeated sports head injuries increase the risks of future concussion, cerebral swelling, ASDH, and CTE. To avoid fatal consequences of CTE, it is essential to understand the criteria for safe post-concussion sports participation. Once diagnosed with a concussion, an athlete should not be allowed to return to play on the same day and should not resume sports before the concussion symptoms have completely resolved. Information about the risks and management of head injuries in different sports should be widely disseminated in educational institutions and by sport organization public relations campaigns.
Acceleration
;
Angiography
;
Asian Continental Ancestry Group
;
Athletes
;
Brain Concussion
;
Brain Injuries
;
Brain Injury, Chronic
;
Carotid Artery, Internal
;
Cause of Death
;
Cerebral Infarction
;
Cerebrovascular Disorders
;
Craniocerebral Trauma*
;
Football
;
Head*
;
Hematoma, Subdural, Acute
;
Humans
;
Infarction
;
Ischemia
;
Magnetic Resonance Angiography
;
Martial Arts
;
Public Relations
;
Rupture
;
Sports
;
Ultrasonography
;
Veins
9.Traumatic Brainstem Hemorrhage Presenting with Hemiparesis.
Young Bem SE ; Choong Hyun KIM ; Koang Hum BAK ; Jae Min KIM
Journal of Korean Neurosurgical Society 2009;45(3):176-178
Traumatic brainstem hemorrhage after blunt head injury is an uncommon event. The most frequent site of hemorrhage is the midline rostral brainstem. The prognosis of these patients is poor because of its critical location. We experienced a case of traumatic brainstem hemorrhage. A 41-year-old male was presented with drowsy mentality and right hemiparesis after blunt head injury. Plain skull radiographs and brain computerized tomography scans revealed a depressed skull fracture, epidural hematoma, and hemorrhagic contusion in the right parieto-occipital region. But, these findings did not explain the right hemiparesis. T2-weighted magnetic resonance (MR) image of the cervical spine demonstrated a focal hyperintense lesion in the left pontomedullary junction. Brain diffusion-weighted and FLAIR MR images showed a focal hyperintensity in the ventral pontomedullary lesion and it was more prominent in the left side. His mentality and weakness were progressively improved with conservative treatment. We should keep in mind the possibility of brainstem hemorrhage if supratentorial lesions or spinal cord lesions that caused neurological deficits in the head injured patients are unexplainable.
Adult
;
Brain
;
Brain Stem
;
Brain Stem Hemorrhage, Traumatic
;
Contusions
;
Craniocerebral Trauma
;
Head
;
Head Injuries, Closed
;
Hematoma
;
Hemorrhage
;
Humans
;
Magnetic Resonance Spectroscopy
;
Male
;
Paresis
;
Prognosis
;
Skull
;
Skull Fracture, Depressed
;
Spinal Cord
;
Spine
10.Central Pain Due to Traumatic Axonal Injury of the Spinothalamic Tract in Patients with Mild Traumatic Brain Injury.
Sung Ho JANG ; Young Hyeon KWON
Brain & Neurorehabilitation 2018;11(1):e7-
Central pain, a neuropathic pain caused by an injury or dysfunction of the central nervous system, is a common, annoying sequela of mild traumatic brain injury (mTBI). Clarification of the pathogenetic mechanism of central pain is mandatory for precise diagnosis, proper management, and prognosis prediction. The introduction of diffusion tensor imaging allowed assessment of the association of the central pain and injury of the spinothalamic tract (STT), and traumatic axonal injury (TAI) in mTBI. In this review, 6 diffusion tensor tractography studies on central pain due to TAI of the STT in patients with mTBI are reviewed. The diagnostic approach for TAI of the STT in individual patients with mTBI is discussed, centering around the methods that these studies employed to demonstrate TAI of the STT.
Axons*
;
Brain Concussion
;
Brain Injuries*
;
Central Nervous System
;
Diagnosis
;
Diffusion
;
Diffusion Tensor Imaging
;
Humans
;
Neuralgia
;
Prognosis
;
Spinothalamic Tracts*