Acupuncture Therapy ; Adolescent ; Craniocerebral Trauma ; complications ; Humans ; Male ; Optic Nerve Injuries ; etiology ; physiopathology ; therapy ; Vision, Ocular

In the researches of biomechanics for child craniocerebral injury, the research progress of performance parameter detection for brain, skull, cranial suture and dura mater, and the finite element model construction for child's head were reviewed. Meanwhile, the shortcomings of the established finite element model construction of child's head were analyzed. Thus, it is necessary to strengthen the material properties parameter detection of child's head, and establish the relevant database, so as to lay the foundation for establishing an accurate finite element model of child's head.
Biomechanical Phenomena ; Brain/pathology* ; Child ; Craniocerebral Trauma/physiopathology* ; Finite Element Analysis ; Head/pathology* ; Humans ; Skull/pathology*

OBJECTIVETo explore the early rehabilitation effect of acupuncture on brain arousal in severe craniocerebral injury.

METHODSOne hundred and two cases of severe craniocerebral injury were randomly divided into an observation group and a control group, 51 cases in each one. Based on the conventional nursing care in neurological external medicine, in observation group, acupuncture was applied at Shuigou (GV 26), Neiguan (PC 6) and Sanyinjiao (SP 6) mainly. In control group, functional electric stimulation was applied at stimulate the affected muscles of the upper limbs. Thirty days later, the lucid rate from coma, lucid interval and clinical efficacy were compared between two groups. RESULTS; The lucid rate from coma was 82.4% (42/51) in observation group, which was higher than 56.9% (29/51) in control group (P < 0.01). The lucid interval in observation group was shortened remarkably as compared with control group (P < 0.01), and the clinical efficacy was superior apparently to that in control group (P < 0.01).

CONCLUSIONOn the basis of conventional treatment, acupuncture intervention at early stage can accelerate the recovery of brain arousal function in patients with severe craniocerebral injury.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Arousal ; Brain ; physiopathology ; Child ; Craniocerebral Trauma ; physiopathology ; rehabilitation ; therapy ; Humans ; Male ; Middle Aged ; Young Adult

UNLABELLEDOBJECTIVE; To observe the effects of early acupuncture on motor function of the limb in the severe head injury patients.

METHODSNinety-six patients were randomly divided into an observation group and a control group, 48 cases in each group. The patient in the control group were treated by routine treatment of neurosurgical operation and drug treatment (Mannitol, Citioline Sodium, Cefeazidime, etc.). While the patient in the observation group were treated by the routine treatment and acupuncture treatment 48 h(-1) week after operation in different stages with different acupoints selected when the situation was stable. The selected main points were Neiguan (PC 6), Qu-chi (LI 11), Waiguan (TE 5), Hegu (LI 4), Binao (LI 14), Jianyu (LI 15), Fengshi (GB 31), Xuehai (SP 10), Yinlingquan (SP 9), Sanyinjiao (SP 6), Taichong (LR 3), etc.. The limb motor function was evaluated with Fugl-Meyer Assessment (FMA) scale before treatment and after 10-week treatment.

RESULTSThere was a significant improvement in the FMA score in the two groups after the treatment (P < 0.01). The comparison between the two groups after the treatment showed that the improvement of FMA score in the observation group was significantly better than the control group (P < 0.05 or P < 0.01).

CONCLUSIONEarly acupuncture can improve the limb motor function in the severe head injury patients.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Craniocerebral Trauma ; physiopathology ; therapy ; Extremities ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Motor Activity

Adolescent ; Adult ; Aged ; Body Temperature ; Craniocerebral Trauma ; physiopathology ; therapy ; Female ; Humans ; Hypothermia, Induced ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Although nitric oxide (NO) plays an important role in the pathophysiological process of cerebral ischemia or severe traumatic brain injury, its contribution to the pathogenesis of moderate diffuse axonal injury (mDAI) remains to be clarified. The alterations in nitric oxide synthase (NOS) activity and the histopathological response after mDAI was investigated. Forty anesthetized Sprague-Dawley adult rats were injured with a Marmarou's weight-drop device through a Plexiglas guide tube. These rats were divided into 8 groups (control, 1 hr, 2 hr, 3 hr, 6 hr, 12 hr, 24 hr, 48 hr after trauma). The temporal pattern of apoptosis in the adult rat brain after mDAI was characterized using TUNEL histochemistry. In addition, the cDNA for NOS activity was amplified using RT-PCR. The PCR products were electrophoresed on a 2% agarose gel. eNOS activity was not detected, but nNOS activity was expressed after 3 hr and continuously 48 hr after impact, which was approximately double that of the control group at 12 and 24 hr. Subsequently, there was a decrease in activity after 48 hr. The iNOS activity increased dramatically after 12 hr and was constant for a further 12 hr followed by a dramatic decrease below the level of the control group. Significant apoptotic changes occurred 12 and 24 hr. after insult. nNOS and iNOS activity were affected after moderate diffuse axonal injury in a time-dependent manner and there was a close relation between the apoptotic changes and NOS activity. Although the nNOS activity was expressed early, its activity was not stronger th an iNOS, which was expressed later.
Animal ; *Apoptosis ; Craniocerebral Trauma/enzymology/*physiopathology ; Diffuse Axonal Injury/enzymology/*physiopathology ; Nitric-Oxide Synthase/*metabolism ; Rats ; Rats, Sprague-Dawley ; Wounds, Nonpenetrating/enzymology/*physiopathology

OBJECTIVETo study the effect and indications of intracranial pressure (ICP) monitoring for frontal lobe contusion patients.

METHODSDuring January 2005-December 2008, 34 cases of frontal lobe contusion received ICP monitoring in our department (monitoring group). Different treatment protocols were adopted according to the results of ICP. Meanwhile 46 cases of same type of head-injured patients who did not undergo ICP monitoring served as control group.

RESULTSWe found that ICP elevated dramatically within 24 hours after head injury if the contusions were located in frontal longitudinal dehiscence, bilateral undersurface of frontal lobe or dispersed in bilateral lobe. After half a year follow-up and on the basis of Glasgow Coma Scale assessment, the monitoring group showed better outcome than the control group with good recovery in 24 cases (70.6%) , moderate disability in 7 cases (20.6%), severe disability in 2 (5.88%) and death in 1 (2.94%). The outcome of control group displayed good condition in 25 cases (54.3%), moderate disabilities in 8 (17.4%), severe disability in 7 (15.2%), and death in 6 (13.0%).

CONCLUSIONSFrontal lobe contusions are vulnerable and complex head injuries, especially when the contusions are located in frontal longitudinal dehiscence, bilateral undersurface of frontal lobe or diffused in bilateral lobes. These patients should undergo ICP monitoring regardless of their consciousness status. If ICP elevates over 25 mm Hg, the craniotomy is mandatory and will markedly reduce the mortality and disability of these patients.

Adolescent ; Adult ; Aged ; Contusions ; physiopathology ; Craniocerebral Trauma ; physiopathology ; Female ; Frontal Lobe ; injuries ; Glasgow Coma Scale ; Humans ; Intracranial Pressure ; Male ; Middle Aged

A validated 5th and 95th percentile Chinese head model was used to investigate the influence of head dimensions on the biomechanical responses by comparing acceleration, intracranial pressure and shear stress of the heads with different dimensions under the same impact energy. Moreover, the reasonability of scaling method used in the research considering head dimensions was discussed by respectively scaling the small head to a big one and scaling the big head to a small one. It therefore more scientifically provides a newer and more scientific reference for the assessment of head injury.
Anthropometry ; Asian Continental Ancestry Group ; Biomechanical Phenomena ; Brain Injuries ; physiopathology ; Craniocerebral Trauma ; physiopathology ; Finite Element Analysis ; Head ; anatomy & histology ; Humans ; Models, Anatomic

OBJECTIVETo explore the maintenance effects of acupoint catgut embedding at early time on gastrointestinal function in patients with craniocerebral injury.

METHODSSixty craniocerebral injury patients with 5 to 12 points of Glasgow coma scale (GCS), according to treatment order, were alternately divided into an observation group and a control group, 30 cases in each one. Patients in the control group were treated with regular treatment and nursing care. Based on this, patients in the observation group, according to different pathogenesis and symptoms presented within 24 h into hospitalization, were additionally treated with acupoint catgut embedding. The recovery time of borborygmus, time of first anal aerofluxus, time of first defecation, abdominal pressure at different time points, the occurrence rate of complications (upper gastrointestinal hemorrhage, diarrhea, vomiting), time of enteral nutrition tolerance rate reaching 30 kcal/kg x d were observed and recorded.

RESULTSThe recovery time of borborygmus, time of first anal aerofluxus, time of first defecation and time of enteral nutrition tolerance rate reaching 30 kcal/kg x d in the observation group were all earlier to those in the control group (all P<0.01). At 48 h, 4 d and 7 d into hospitalization, the abdominal pressures in the observation group were all lower than those in the control group [(11.10 +/- 1.47) mmHg vs. (13.50 +/- 1.43) mmHg, (8.40 +/- 1.25) mmHg vs. (11.90 +/- 1.56) mmHg, (6.73 +/- 0.74) mmHg vs. (10.80 +/- 1.30) mmHg, all P<0.01]. There were 8 cases with complications of gastrointestinal hemorrhage, diarrhea and vomiting in the observation group with the occurrence rate o 27% (8/30), which was lower than those in the control group (70.0% (21/30), P<0.01.

CONCLUSIONThe acupoint catgut embedding at early time in craniocerebral injury patients could improve the recovery of gastrointestinal function, reduce intolerance of enteral nutrition and occurrence rate of various complications.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Catgut ; Craniocerebral Trauma ; physiopathology ; therapy ; Female ; Gastrointestinal Tract ; physiopathology ; Humans ; Male ; Middle Aged ; Young Adult

FEM combined with modern computer technology is a mathematical method for stress analysis. It has gradually become a significant experimental tool to explore the functions of biomechanically simulated human body structure and mechanism of craniocerebral injuries. This paper reviewed the features and biomechanical materials of the FEM human head models, materials assignment and their applications in blunt injury, fall, traffic accident. It also explore their merits and values in forensic head injury cases.
Accidents, Traffic ; Biomechanical Phenomena ; Computer Simulation ; Craniocerebral Trauma ; Finite Element Analysis ; Forensic Pathology ; Head/physiopathology* ; Humans ; Imaging, Three-Dimensional/methods* ; Models, Anatomic ; Models, Biological ; Skull Fractures/physiopathology*