No abstract available.
Subarachnoid Hemorrhage, Traumatic*

No abstract available.
Prognosis* ; Subarachnoid Hemorrhage, Traumatic*

No abstract available.
Stress Disorders, Post-Traumatic*

This case is noteworthy and the problem that it addresses will definitely be of interest to all, given that this is frequently encountered not only in the clinics, but in social media, on-line platforms, in community and disaster work, and within the confines of the homes given the stigma of borderline personality disorder (BPD) and the lack of understanding of PostTraumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (cPTSD). The objective of this case presentation is to look into the challenges that a mental health professional has to face when presented with a case of a patient with a chronic of history of sexual abuse, BPD and PTSD/cPTSD. First of all, given the case presentation, there is a need to determine the diagnosis and to work through the intricacies of symptomatology to be able to distinguish BPD, PTSD or CPTSD with a thorough discussion. Secondly, to present the neurobiology of early trauma and its impact on the developing brain, which often lead to adult symptomatology. Finally, to provide recommendations for treatment, both medical and psychological treatments, in order to find out what best fits the patient.
tress Disorders, Traumatic

Objectives: The objectives of this pilot study was to establish the preliminary data on the prevalence of Post-Traumatic Stress Disorder (PTSD) among VMMC Department of Psychiatry In-Patients and Out-Patients with combat experience. Methodology: It is a cross sectional study conducted by reviewing patients' charts. Case definition was based on the standardized ClinicianAdministered PTSD Scale (CAPS) - Filipino Version. In -patients were recruited directly while new and old OPD patients were recruited through chart review and invitations. Adequate combat exposure was measured with the United States Veterans Affairs Combat Exposure Scale (USVACES). Data was presented as lifetime and current prevalence among the exposed population. Results: The study showed that 17.85% of the subjects (n=28) of this pilot study had a lifetime diagnosis of PTSD. None of the subjects reached the symptom threshold for a current diagnosis of PTSD. Three out of 19 subjects (15.78%) diagnosed with Schizophrenia had a lifetime diagnosis of PTSD while two out of five subjects (40%) with Bipolar I Disorder had comorbid lifetime diagnosis of PTSD. The number of subjects needed to power the study using Daniel's (1999) formula was N= 225. Conclusion The pilot study showed that the lifetime prevalence rate of PTSD among VMMC Psychiatry patients (17.85%) was comparable to worldwide trends. The study did not report any new occurrences of PTSD.
Stress Disorders, Post-Traumatic

Introduction: Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disorder that is defined, neuropathologically, by the presence of aggregated hyperphosphorylated tau in the neurons and astrocytes of the perivascular area that is located deep in the cerebral sulci. The lesion is associated with repetitive brain trauma, from the spectrum of asymptomatic subconcussive head injury to grossly identifiable features of concussion. Although the diagnostic neuropathology of CTE is well-characterized, the precise mechanism that causes this to occur in CTE is not yet clearly elucidated. The features of hyperphosphorylated tau in CTE is quite similar with Alzheimer’s Disease (AD), as is the reduced expression of certain genes that are required to dephosphorylate tau, which is the putative culprit in the generation of amyloid aggregates and hyperphosphorylated tau.1 In comparison, Parkinson’s Disease (PD) is a neurodegenerative disease that is caused by accumulation of misfolded alpha-synuclein (α-syn) that causes the formation of intraneuronal Lewy Body aggregates. The pattern of accumulation for α-syn involves the olfactory bulb and the gut with progressive involvement of the posterior part of the brain.2 Despite establishing the presence of two different intraneuronal inclusions for CTE and PD, contact sports associated with the clinical spectrum of CTE has been shown to present with Parkinsonian features along with dementia. Mood disorders has been reported to occur in patients with these neurologic conditions. Several studies have documented that patients had a previous experience of traumatic brain injury prior to the diagnosis of Bipolar Disorder (BD). A review of electronic literature suggested that having an earlier diagnosis of BD increased the likelihood of having a diagnosis of PD in the future. Objectives: This research aimed to compare the over- and underexpressed genes in cases with Parkinson's Disease (PD), cases with Bipolar Disorder (BD), and cases with Chronic Traumatic Encephalopathy (CTE) versus normal controls. This was done to determine if parallel overexpression in certain genes may indicate the possible association at the level of gene expression. Identifying similar RNA sequence establishing gene expression may provide an insight to the relationship of the diseases in terms of pathobiological behavior. Determining the similar over- or underexpression pattern may provide an insight on the common pathobiologic mechanisms that may be the reason for the three disorders being associated by way of pre-morbid or co-morbid condition. Methodology: Transcripts from the public domain archive of the NCBI SRA were identified for the RNA sequence (RNAseq) of interest using the search string “Chronic Traumatic Encephalopathy”, “Bipolar Disorder”, and “Parkinson”. Only public domain transcriptome files of post-mortem brain samples labeled as RNAseq data extracted thru the Illumina platform that have a paired normal control were selected. A total of ten (10) cases for each disorder and thirty (30) normal subjects for control in the NCBI SRA RNAseq database with a whole exome sequence file that was available for public domain use was utilized for differential gene expression analysis. Results and Discussion: Among 21,122 identified genes from the RNAseq, the analysis was able to identify 26 genes exhibiting increased expression of up to >15 log2 fold change among cases with CTE, PD, and BD compared with normal controls. In contradistinction, only 6 well-described genes exhibited a decreased expression among cases with CTE and BD compared to normal controls. However, there were no identified genes that exhibited underexpression in cases with PD compared with normal controls. The identification of parallel gene overexpression among the CTE, BD, and PD groups with respect to structural integrity, cellular metabolism, homeo-stasis, and apoptosis may indicate a common pathway that have been initiated as part of the response to maintain tissue function or as a consequence of the underlying pathobiologic mechanism that caused the primary lesion. In comparison, the underexpressed genes detected in the CTE and BD cases compared to the normal controls and the PD cases may indicate the lack of genes that have a role in repressing the mRNA for protein coding. Conclusion The overexpression of genes responsible for homeostasis, regulation of inflammation, balance of apoptosis and anti-apoptosis, and maintenance of structural integrity among the CTE, BD, and PD groups indicate that there is an interrelated mechanism that serves converging pathways as part of the response to lesional- forming structures in the brain. The goal of studies such as this is to have a better understanding on the common pathways that explain the interrelatedness of brain disorders and the putative mechanism for being co-morbid and pre-morbid conditions of each other.
Chronic Traumatic Encephalopathy

Introduction: Traumatic brain injury (TBI) is one of the major global issues as it causes a serious health threatening condition for the injured persons, increased mortality rates, increased physical and cognitive impairment, as well as affecting the health care systems. Method: The aim of this study was to predict the association between the pre-injury socio-demographic, injury-related factors and cognitive impairments in post-TBI patients. Self-administered questionnaires were used for descriptive correlational study. Three instruments used included (1) pre-injury sociodemographic characteristics (age, gender, race, religion, education level, occupation) (2) injury-related factor characteristics (location of brain injury and GCS) and (3) Montreal Cognitive Assessment (MoCA) questionnaire to estimate cognitive impairment. Result: In this study, forty patients were recruited through purposive sampling from surgical based wards and 60.0% of TBI patients had cognitive impairments. This study found an association between injury factors (severity of TBI from GCS result) with cognitive impairment post-TBI among patients. However, there is no association between socio-demographic characteristics (age, gender, race, religion, education level, occupation) and cognitive impairment. Conclusions The study provided a better understanding on the association between pre-injury socio-demographic characteristics, injury related characteristics of the severity of TBI and cognitive impairments in post-TBI patients during hospitalisation. The results of this study can potentially be used as baseline information to improve the care and treatment needs of patients with cognitive impairment post-TBI during hospitalisation in relation to enhanced quality of life.
Brain Injuries, Traumatic

Background: The post-traumatic glaucoma is a major cause inducing blindness of traumatic eyes. Recent, researches have shown that 5 fluoruoracil (5 FU) combined with surgery, which have a better result in treatment of general glaucoma and post-traumatic glaucoma. Objectives: To describe the clinical characteristics of post - traumatic glaucoma and assess the results of trabeculectomy with intra-operative application of 5 FU. Subject and methods: A descriptive, prospective analysis was taken on 32 patients, who had trabeculectomy with intra-operative application of 5 FU from August 2005 to December 2007 in the Traumatic Department of National Institute of Ophthalmology. Results: Post-traumatic glaucoma was seen mainly in young adults 71.9%; anterior angle recession combined lesions accounted for 25%; cataract 62.5%; fluid in anterior chamber 25%; anterior haemorrhage 37.5%. The intraocular pressure (lOP) was successfully controlled at least up to the following six months in 93.8% and the visual acuity was 0.02 and better in 62.5%. Conclusions: Trabeculectomy with antimetabolite therapy is an effective procedure in reducing IOP in post - traumatic glaucoma.
5 Fluorouracil ; post-traumatic glaucoma

Amputation, Traumatic ; Ear ; surgery ; Humans ; Replantation

Due to its high incidence, high disability rate, and high mortality rate, traumatic brain injury (TBI) poses a serious threat to human health. This manuscript describes the urgent problems currently existing in China's TBI treatment and proposes a scheme of a nationwide collaboration platform for the treatment of TBI so as to improve the overall level of TBI treatment in China, and reduce disability and mortality rates in TBI patients.
Brain Injuries, Traumatic ; rehabilitation ; therapy ; China ; Humans