Post traumatic epilepsy （PTE） is a serious complication of traumatic brain injury and a difficult problem in forensic justice practice. In recent years, many biomarkers have been applied to the diagnosis, treatment and prognosis of injuries and diseases. There have been many studies on the biomarkers of PTE in the field of epilepsy. This paper reviews the progress in research on biomarkers of PTE in recent years in order to provide reference for the forensic identification of PTE.
Biomarkers/analysis* ; Brain Injuries, Traumatic/diagnosis* ; Epilepsy/etiology* ; Epilepsy, Post-Traumatic/etiology* ; Humans

OBJECTIVETo investigate the value of susceptibility weighted imaging(SWI)in the diagnosis of hemorrhagic foci early after blast injury and its role in the outcome prediction.

METHODSTotally 30 rabbits with blast-induced cerebral blast injury were used in this study. After routine CT/MRI and SWI scanning,quantified analysis was performed in regions of interest using post-processing technology. After dissecting the brains of the experimental rabbits,the cerebral histopathological changes were observed,and the results were compared with SWI findings.

RESULTSIn these 30 rabbits,22,102,221,and 738 hemorrhagic foci were detected by CT,T1WI,T2WI,and SWI,respectively. The number of cerebral microbleeds detected by SWI was significantly larger than those revealed by conventional T1WI and T2WI(Χ(2)=10.00,P<0.01). Furthermore,the SWI imaging displayed the punctiform(n=315,42.7%),lamellar(n=218,29.5%),slinar(n=205,27.8%)hypointense foci,with clear margin. The number of hemorrhagic foci detected by SWI was positively correlated with survival(r=-0.667,P<0.05).

CONCLUSIONSSWI remarkably increases the detection rate of hemorrhagic foci(particularly microbleeds)in rabbits with cerebral blast injury. The number of cerebral microbleeds and location of foci are closely related with the outcomes and therefore may facilitate clinical managment.

Animals ; Blast Injuries ; complications ; diagnosis ; Brain ; pathology ; Brain Injuries ; diagnosis ; etiology ; Cerebral Hemorrhage ; diagnosis ; etiology ; Female ; Image Enhancement ; Magnetic Resonance Imaging ; methods ; Male ; Prognosis ; Rabbits

Adult ; Brain Hemorrhage, Traumatic ; diagnosis ; etiology ; Humans ; Male ; Neck Injuries ; complications ; diagnosis ; Vertebral Artery

The permanent impairment evaluation for children in developmental stage is very difficult and it is even impossible in some cases. The impairment evaluation for developing children has not yet been included in the guideline of the American Medical Association. Due to frequent medical and social demands in Korea, we developed an impairment evaluation guideline for motor impairment, intellectual disability/mental retardation, developmental speech-language disorder and epilepsy caused by pediatric cerebral injuries, or cerebral lesions other than the developmental disorders such as autism. With the help of various literature and foreign institutions, we developed our in order to develop a scientific guideline for pediatric impairment that is suited to Korean cultural background and social condition.
Brain/physiopathology ; Brain Diseases/*complications ; Brain Injuries/complications ; Child ; Developmental Disabilities/classification/*diagnosis/etiology ; *Disability Evaluation ; *Disabled Children ; Humans ; Korea ; Language Development Disorders/classification/diagnosis/etiology ; Mental Disorders/classification/diagnosis/etiology ; Program Development ; Seizures/classification/diagnosis/etiology ; Severity of Illness Index

With the increasing incidence of blast injury, the research on its mechanisms and protective measures draws more and more attention. Blast injury has many characteristics different from general war injuries or trauma. For example, soldiers often have various degrees of visceral injury without significant surface damage, combined injuries and arterial air embolism. Researchers in China began to investigate blast injury later than the United States and Sweden, but the development is so fast that lots of achievements have been gained, including the development of biological shock tube, the mechanisms and characteristics of blast injury in various organs, as well as protective measures under special environments. This article reviews the past and current situation of blast injury research in China.
Animals ; Blast Injuries ; diagnosis ; etiology ; prevention & control ; therapy ; Brain Injuries, Traumatic ; etiology ; China ; Disease Models, Animal ; Ear ; injuries ; Eye Injuries ; etiology ; High-Energy Shock Waves ; Humans ; Lung Injury ; etiology ; Research

Accidental Falls ; Adult ; Brain Injuries ; diagnosis ; Female ; Glasgow Coma Scale ; Head Injuries, Closed ; diagnosis ; etiology ; Hematoma, Subdural ; diagnosis ; physiopathology ; therapy ; Humans ; Male ; Middle Aged

OBJECTIVE: To analyze the clinical characteristics of post-traumatic abortion and the relationship between trauma and abortion. METHODS: We collected and analyzed 23 cases of post-traumatic abortion encountered in the department of clinical forensic medicine, faculty of forensic medicine, China Medical University in recent years. RESULTS: All 23 post-traumatic abort inns were early abortions. Their traumata were mild and external only. Vagina bleeding and abortion occurred shortly after trauma. Most patients were older, from countryside, or unemployed. CONCLUSION The causes of abortion are complex. Post-traumatic abortion can only be diagnosed after excluding non-traumatic factors. For those cases abortion occur shortly after injuries and non-traumatic factors can not be excluded, trauma should be assessed for its role in abortions as primary, secondary or induction factors correlated with clinical symptoms and pre-
Abdominal Injuries/complications* ; Abortion, Spontaneous/etiology* ; Adult ; Brain Injuries/complications* ; Diagnosis, Differential ; Female ; Forensic Medicine ; Gestational Age ; Humans ; Pregnancy ; Retrospective Studies ; Uterine Hemorrhage/etiology* ; Young Adult

OBJECTIVETo assess the diagnostic value of amplitude-integrated electroencephalography (aEEG) in predicting outcome of newborns who were at high risk for central nervous system without severe hypoxic-ischemic encephalopathy.

METHODSForty-two consecutive patients at risks for neurological disorders referred to our level-III NICU were prospectively enrolled in the study over a period of 3 years. They were classified on the basis of their primary diagnoses including hypoglycemic brain damage, meningoencephalitis, bilirubin encephalopathy, and metabolic disease. Clinical data were collected. Amplitude-integrated and raw EEG tracings were assessed for background pattern, sleep-wake cycling, and epileptiform activity. The neuromotor development of survivors was assessed by using the Infant Neurological International Battery (INFANIB).

RESULTThe characteristic of aEEG tracings in 42 infants showed continuous normal voltage (CNV)(n = 15), discontinuous voltage (DC)(n = 9), burst-suppression (BS) BS(+) (n = 6), BS(-)(n = 7), flat (FT, n = 5); mature sleep-wake cycling (SWC, n = 4), immature SWC (n = 14), no SWC (n = 24); 30 infants (71.4%) had electrical seizures: single seizure (n = 6); repetitive seizures (n = 7), and status epilepticus (SE) (n = 17).aEEG of 20 infants who had poor outcome showed FT (n = 5), BS(-)/SE (n = 6), BS(-)/ repetitive seizures (n = 1) , BS(+)/SE (n = 1), BS(+)/repetitive seizures (n = 1), DC/SE(n = 6). Chi-square analysis and Spearman rank correlation analysis showed the classification of aEEG background pattern, SWC and comprehensive score (score system was developed by evaluation of the above 3 variables) were correlated with the outcome of these infants at high neurological risks.

CONCLUSIONAmplitude-integrated electroencephalography can provide important information of the status of cerebral function in neonates at high neurological risk and help to predict their outcome.

Brain ; physiology ; physiopathology ; Brain Injuries ; diagnosis ; etiology ; physiopathology ; Electroencephalography ; methods ; Epilepsy ; diagnosis ; etiology ; physiopathology ; Humans ; Hypoglycemia ; complications ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Kernicterus ; diagnosis ; physiopathology ; Meningoencephalitis ; diagnosis ; physiopathology ; Predictive Value of Tests ; Prognosis ; Sleep ; physiology

OBJECTIVETo explore the pathogenic characteristics and management of brain injury in patients injured by high voltage electricity.

METHODSOne hundred and thirty eight patients injured by electricity were enrolled in this study. Postburn brain injury was diagnosed by clinical sighs and imaging analysis. The brain injury was graded as mild, moderate, severe and most severe. The relationships among the inlet of the electric current and the electric voltage and the degree of brain injury were analyzed, and the causes and pathogenesis of the brain injury were suggested. Treatment modality was optimized for the patients according to the diagnostic data.

RESULTSIn this group of patients, brain injury was identified in 106 cases, mostly rated as mild and moderate. Only 4 cases were ranked as severe degree with positive imaging findings. The electric voltage seemed to be not correlated with the incidence of postburn brain injury. But the intensity of electric current and the locations of electrical current inlet and outlet were closely related to the degree of brain injury. Among all the patients in this group, 131 survived and 7 died after treatment. But there was no death due directly to brain injury.

CONCLUSIONThere was high incidence of postburn brain injury in patients injured by high voltage electricity. The injury might be related to the direct effect of electrical current on the brain tissue, to mechanical injury, to the cardio-pulmonary lesions caused by electrical current, or to massive skin burn. Early and accurate diagnosis of the injury was of key importance for lowering both mortality and disability.

Adolescent ; Adult ; Aged ; Brain Injuries ; diagnosis ; etiology ; therapy ; Burns, Electric ; complications ; diagnosis ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Young Adult

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