TY - JOUR. T1 - Prognostic performance of computerized tomography scoring systems in civilian penetrating traumatic brain injury. T2 - an observational study. AU - Lindfors, Matias. AU - Lindblad, Caroline. AU - Nelson, David W.. AU - Bellander, Bo-Michael. AU - Siironen, Jari. AU - Raj, Rahul. AU - Thelin, Eric P.. PY - 2019/12. Y1 - 2019/12. KW - Traumatic brain injury. KW - Penetrating traumatic brain injury. KW - Computerized tomography. KW - Prognosis. KW - Outcome prediction. KW - CRANIOCEREBRAL GUNSHOT WOUNDS. KW - HEAD-INJURY. KW - CLASSIFICATION. KW - MORTALITY. KW - PREDICTORS. KW - MANAGEMENT. KW - SURVIVAL. KW - MARSHALL. KW - 3112 Neurosciences. KW - 3124 Neurology and psychiatry. KW - 3126 Surgery, anesthesiology, intensive care, radiology. U2 - 10.1007/s00701-019-04074-1. DO - 10.1007/s00701-019-04074-1. M3 - Article. VL - 161. SP - 2467. EP - 2478. JO - Acta Neurochirurgica. JF - Acta Neurochirurgica. SN - 0001-6268. IS - 12. ER - ...
Transorbital penetration accounts for one-quarter of the penetrating head injuries (PHIs) in adults and half of those in children. Injuries that traverse (with complete penetration of) the brainstem are often fatal, with survivors rarely seen in clinical practice. Here, the authors describe the case of a 16-year-old male who suffered and recovered from an accidental transorbital PHI traversing the brainstem-the first case of complete neurological recovery following such injury. Neuroimaging captured the trajectory of the initial injury. A delayed-onset carotid cavernous fistula and the subsequent development of internal carotid artery pseudoaneurysms were managed by endovascular embolization.. The authors also review the relevant literature. Sixteen cases of imaging-confirmed PHI traversing the brainstem have been reported, 14 involving the pons and 12 penetrating via the transorbital route. Management and outcome of PHI are informed by object velocity, material, entry point, trajectory, ...
OBJECTIVE: This study investigates the interaction between brain lesion location and monoamine oxidase A (MAO-A) in the genesis of aggression in patients with penetrating traumatic brain injury (PTBI). METHODS: We enrolled 155 patients with PTBI and 42 controls drawn from the Vietnam Head Injury Study registry. Patients with PTBI were divided according to lesion localization (prefrontal cortex [PFC] vs non-PFC) and were genotyped for the MAO-A polymorphism linked to low and high transcriptional activity. Aggression was assessed with the aggression/agitation subscale of the Neuropsychiatric Inventory (NPI-a). RESULTS: Patients with the highest levels of aggression preferentially presented lesions in PFC territories. A significant interaction between MAO-A transcriptional activity and lesion localization on aggression was revealed. In the control group, carriers of the low-activity allele demonstrated higher aggression than high-activity allele carriers. In the PFC lesion group, no significant differences
OBJECTIVES: The objective of this study is to evaluate the relationship between suicidal ideation (SI), structural brain damage, and cognitive deficits in patients with penetrating traumatic brain injury (pTBI). METHODS: Vietnam War veterans (n = 142) with pTBI to the prefrontal cortex (PFC) underwent combination of neuropsychological and psychiatric examinations and non-contrast CT brain scan. Patients were divided into SI positive (SI+) and SI negative (SI-) groups according to the SI item of the Beck Depression Inventory. RESULTS: Lesions to the left rostrolateral PFC (rlPFC) were associated with a lower risk of SI independent of depression and global functioning. Left rlPFC lesion also reduced abstract reasoning skills, which mediated the lesion effects on suicide ideation. CONCLUSIONS: The left rlPFC plays a crucial role in SI independently of depression and global functioning.
These results provide evidence for inflammasome activation in microglia and infiltrating leukocytes after penetrating traumatic brain injury and a role for pyroptotic cell death in the pathophysiology. In addition to inhibiting neuronal cell death, therapeutic treatments targeting inflammasome activ …
Institute of Medical Sciences, Department of Neurosurgery, Varanasi, India DOI : 10.5137/1019-5149.JTN.2838-09.3 AIM: To observe the neurological complications arising from various tribal practices and their management. Penetrating head injuries comprise only a small number of total head injuries. A penetrating head injury by deliberate attempt to treat an ailment is almost unheard of.. MATERIAL and METHODS: We present here a case of penetrating head injury caused by stabbing a scissor in head by a local witch doctor in order to treat a psychiatric ailment.. RESULTS: The patient was taken up for for surgery and managed accordingly. Relevant literature was reviewed regarding various foreign bodies in traumatic missile and non missile brain injuries and their surgical management. Keywords : Penetrating injury, Brain, Scissors, Tribal culture, Head injury ...
According to the U.S. Centers for Disease Control and Prevention, head traumas in young children are common. Children suffering from trauma-induced head injuries present with headaches, cognitive impairments, changes in personality, and sleep disturbances. Dizziness/vertigo is also a common diagnosis for a significant portion of children presenting with trauma (Faul et al., 2010). Head traumas are frequently subdivided into blunt head traumas and penetrating head traumas. Blunt head injuries, including whiplash injuries, can result in dizziness from fracture of the temporal bone or labyrinthine concussion. In cases of a fracture or concussion in which the labyrinth or vestibular nerve is affected, children can experience severe vertigo with nystagmus and nausea, indicating unilateral impairment in the peripheral vestibular system (i.e., end-organ or vestibular nerve). Penetrating head injuries have been reported to cause vertigo secondary to perilymphatic fistula. As in adults, pediatric benign ...
Penetrating traumatic brain injury (pTBI) has been difficult to model in small laboratory animals, such as rats or mice. Previously, we have established a non-fatal, rat model for pTBI using a modified air-rifle that accelerates a pellet, which hits a small probe that then penetrates the experimental animals brain. Knockout and transgenic strains of mice offer attractive tools to study biological reactions induced by TBI. Hence, in the present study, we adapted and modified our model to be used with mice. The technical characterization of the impact device included depth and speed of impact, as well as dimensions of the temporary cavity formed in a brain surrogate material after impact. Biologically, we have focused on three distinct levels of severity (mild, moderate, and severe), and characterized the acute phase response to injury in terms of tissue destruction, neural degeneration, and gliosis. Functional outcome was assessed by measuring bodyweight and motor performance on rotarod. The results
Learn more about Penetrating Brain Injury at Doctors Hospital of Augusta DefinitionCausesRisk FactorsSymptomsDiagnosisTreatmentPreventionrevision ...
The CDC defines a traumatic brain injury as a disruption of normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury. A traumatic brain injury is considered a type of Acquired Brain Injury (ABI) which is an injury to the brain that is not hereditary, congenital, or degenerative, and one that has occurred after birth. There are 3 broad classifications of TBI: mild, moderate, and severe, with such designations roughly matching the symptom severity associated with each. Even a mild traumatic brain injury (MTBI), however, can be significant and produce life-long challenges.. When brain damage occurs before birth, it is referred to as an InBorn brain injury which can include brain damage caused by decreased oxygen (hypoxia) during delivery and/or decreased blood flow (ischemia) to a babys brain. These events are often associated with medical error and can cause hypoxic-ischemic encephalopathy (HIE) and cerebral palsy (CP). We see this, for ...
Traumatic brain injury (TBI) is a form of nondegenerative acquired brain injury resulting from a bump, blow, or jolt to the head (or body) or a penetrating head injury that disrupts normal brain function (Centers for Disease Control and Prevention [CDC], 2015). TBI can cause brain damage that is focal (e.g., gunshot wound), diffuse (e.g., shaken baby syndrome), or both. Symptoms can vary depending on site of lesion, extent of damage to the brain, and the childs age or stage of development. The functional impact of TBI in children can be different than in adults-deficits may not be immediately apparent because the pediatric brain is still developing. TBI in children is a chronic disease process rather than a one-time event, because symptoms may change and unfold over time (DePompei & Tyler, in press; Masel & DeWitt, 2010). TBI can result from a primary injury or a secondary injury (see common classifications of TBI for more details). Severity of TBI may be categorized as mild, moderate, or ...
The majority of TBIs are closed head injuries meaning that the persons skull has not been pierced (although there may be scrapes, abrasions, bruises, etc. on the skull). An open head injury is typically defined as being an injury where the skull has been pierced and the brain has been exposed. The brain itself may or may not be penetrated in these cases.. Closed head injuries occur because of car accidents, being struck in the head, falls, etc. Most open head injuries occur because of objects penetrating the skull such as bullets, knives, pieces of metal of wood, etc. However, it is certainly possible to be hit in the head with a very heavy object such as a crowbar and have a penetrating head injury that would meet the criteria for a traumatic brain injury and that also qualifies as an open head injury.. Traumatic brain injuries are often very complicated. There are several different issues to consider. Just a few of these include:. Coup Injuries to the Brain: This refers to brain damage that ...
Traumatic brain injury (TBI), also known as intracranial injury, occurs when an external force injures the brain. TBI can be classified based on severity, mechanism (closed or penetrating head injury), or other features (e.g., occurring in a specific location or over a widespread area). Head injury is a broader category that may involve damage to other structures such as the scalp and skull. TBI can result in physical, cognitive, social, emotional, and behavioral symptoms, and outcome can range from complete recovery to permanent disability or death. Causes include falls, vehicle collisions, and violence. Brain trauma occurs as a consequence of a sudden acceleration or deceleration within the cranium or by a complex combination of both movement and sudden impact. In addition to the damage caused at the moment of injury, a variety of events in the minutes to days following the injury may result in secondary injury. These processes include alterations in cerebral blood flow and the pressure within ...
The brain is probably the most important organ in the human body. It is highly complex, is made up of many parts, and performs many functions. The brain is unique and highly sensitive to its environment. Our brain controls our ability to walk, talk, and balance. It coordinates and regulates our body systems, such as circulation and respiration breathing. It allows us to understand and retain information, make decisions, and feel emotions.. When a persons brain is injured, it may not process or serve all of these functions as it did before the injury. All brain injuries are potentially serious injuries. Even if you believe you only have a mild concussion, you should seek treatment.. There are two basic types of brain injuries:. A traumatic brain injury (TBI) is caused by an external force. These can be non-penetrating (or closed) or penetrating (open.) According to the CDC, traumatic brain injury is caused by a bump, blow, or jolt to the head; or a penetrating head injury that disrupts the ...
Traumatic Brain Injury (TBI), also referred to as intracranial injury, occurs when an external force traumatically injures the brain. TBI might be classified primarily based on severity, mechanism (closed or penetrating head injury), or other features (e.g., occurring in a specific place or more than a widespread region). Head injury typically...
By Richard H. Adler, Attorney at Law. Over 1.4 million individuals sustain traumatic brain injuries each year in the United States. Between 400,000 and 500,000 of these head injuries are severe enough to require hospitalization annually. The financial cost of the diagnostic and rehabilitative/medical programs for traumatic head injury is estimated to be 3.9 billion dollars per year. The cost to society is far greater when one considers how traumatic head injuries may prevent individuals from achieving their full potential and contributing to society, while disrupting the lives of their family and friends.. Head injuries are generally classified as open or closed. An open head injury is one in which damage to the brain is caused by a fracture or penetrating wound. In a penetrating head injury, the dural covering of the brain has been breached by an object, such as a bullet or a piece of fractured skull. In such cases, damage is more likely to be focal -that is, the symptoms (such as ...
Pain, especially headache, is a common complication following a TBI.[1] Being unconscious and lying still for long periods can cause blood clots to form (deep venous thrombosis), which can cause pulmonary embolism.[21] Other serious complications for patients who are unconscious, in a coma, or in a vegetative state include pressure sores, pneumonia or other infections, and progressive multiple organ failure.[1]. The risk of post-traumatic seizures increases with severity of trauma (image at right) and is particularly elevated with certain types of brain trauma such as cerebral contusions or hematomas.[22] As many as 50% of people with penetrating head injuries will develop seizures.[20] People with early seizures, those occurring within a week of injury, have an increased risk of post-traumatic epilepsy (recurrent seizures occurring more than a week after the initial trauma)[23] though seizures can appear a decade or more after the initial injury and the common seizure type may also change over ...
Traumatic Brain Injury (TBI) is defined as a bump, blow, or jolt to the head or a penetrating head injury that disrupts the function of the brain. Not all blows or jolts of the head result in a TBI. The severity of such an injury may range from mild (a brief change in mental status or consciousness) to severe (an extended period of unconsciousness or amnesia after the injury). A TBI can result in short or long-term problems with thinking, learning, language, behavior, emotions and/or physical function ...
Science & Technology, Social Sciences, Life Sciences & Biomedicine, Neurosciences, Psychology, Psychology, Experimental, Neurosciences & Neurology, NEUROSCIENCES, PSYCHOLOGY, PSYCHOLOGY, EXPERIMENTAL, facial emotion recognition, voxel-based lesion symptom mapping, labeling task, basic emotions, traumatic brain injury, ANTERIOR TEMPORAL INVOLVEMENT, FRONTAL-LOBE DAMAGE, HUMAN AMYGDALA, IMPAIRED RECOGNITION, PREFRONTAL CORTEX, COGNITIVE-ABILITIES, RIGHT-HEMISPHERE, BASIC EMOTIONS, NEURAL BASES, HEAD-INJURY. ...
Disorders of fluid and electrolyte balance in the U.S. military result in at least 125 hospitalizations, two lost duty days per event, and 9,300 ambulatory hospital visits per year (60% hyponatremia, 40% dehydration) (Carter et al., 2005; DoD, 2008). Diarrhea is a major infectious disease threat which requires aggressive i.v. fluid replacement in 30% of U.S. troops deployed to Iraq or Afghanistan (Brown et al., 2009). It is also important to recognize that the management and outcome of the 662 severe or penetrating traumatic brain injuries (TBI) reported for the military in 2009 (DoD, 2010) may be hindered by dehydration (Clifton et al., 2002). Fluid and electrolyte imbalances also contribute to heat illness (Carter et al., 2005) and can substantially impair combat fighting effectiveness (Dupont, 2003).. The importance of developing a valid assessment measure of human hydration status for clinical and field use is recognized by the military community as a high priority medical technology gap ...
0036]FIGS. 8-9 show another embodiment of a polyaxial screwdriver 80 engaged with the polyaxial bone screw assembly 35. The construction of the polyaxial screwdriver 80 is similar to the polyaxial screwdriver 20 in many respects. Therefore, only the features of the polyaxial screwdriver 80 that are different from the polyaxial screwdriver 20 are described hereafter. Same reference numeral denotes parts that are similar across various embodiments. The outer sleeve 82 of the polyaxial screwdriver 80 has a collet 84 formed at the end that is near the screw engaging end 24. Projections (not seen in figures) are formed on the internal surface of the collet 84. The end of the sleeve 82 that is closer to the handle 22 has external threads 86 formed on it. A nut 88 is next to the threads 86. The nut 88 has internal threads that are adapted to threadably engage threads 86. The nut 88 is in contact with a shoulder formed on shaft 21 such that it is prevented from sliding towards the collet 84. When the ...
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Several classifications of CCF exist depending on anatomy, aetiology, and pathophysiology. One categorisation divides between traumatic and spontaneous fistulas. Another classification is established according to fistulous supply to the cavernous sinus as follows: type A, internal carotid artery (ICA); type B, dural branches of the ICA; type C, dural branches of the external carotid artery (ECA); type D, combined forms.1 2 This leads to a further classification into direct, high flow, and indirect low flow fistulas because therapeutic management of CCF is strongly dependent on their haemodynamics.3-5 Finally, considering aetiology, there are several entities responsible for the development of a CCF: closed or penetrating head trauma, surgical damage, rupture of an intracavernous aneurysm, connective tissue disorders, vascular disease, and dural fistulas.6 7 Direct shunting CCFs are mainly caused by a tear of the internal carotid artery itself. In most cases, these CCFs are high flow, and ...
Introduction and purpose Traumatic intracranial aneurysms are rare and represent fewer than 1% of all intracranial aneurysms. They may develop as the result of blunt or penetrating head trauma and are associated with a significant mortality of up to 50%. Traumatic aneurysms typically involve the anterior circulation or the internal carotid artery at the level of the skull base. They rarely involve the posterior circulation. We present three pediatric patients with traumatic aneurysms in the posterior circulation and describe their clinical presentation, angiographic findings and clinical outcome after being treated by endovascular technique. ...
Manufacturer: SMT - Country of manufacture: Ireland / Belgium / EU / India. + Nylon 12 material, with ≥ 3 folds, displayed well in PCI. + Good torsional resistance, low expansion, strong body, RBP ≥ 20 bar, quick blow ≤ 8 seconds. + Size from 9-49mm and diameter of 2-4.5mm. + Pressure 10-30 atm. + The penetrating head is soft and flexible, the lens penetrates 0.41mm. + PTFE-coated control shaft, marked at 90cm and 100cm. ...
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The real Sonic Screwdriver didnt even turn up until the second Doctor, who generally used it to prove how alien he was. Unlike a regular screwdriver which removes screws by physically rotating them, the sonic screwdriver removes them without physical contact - clearly a huge advance and, more importantly to the plot, incontestable proof that the character so notably played by Patrick Troughton, wasnt a human.. There are, according to official sources, nine different models of Sonic Screwdriver, and a handful of similar devices (mainly) wielded by characters from well-equipped futures.. Fan Will Marler has created a particularly beautiful rendition of the whole range. But the casual fan will probably only recognise four distinct models, with perhaps the most well-known being the stick-with-a-red-circle-on-top as used by John Pertwee. Pertwee, of course, lacked gadgets having been stranded on Earth for budgetary reasons. Tom Baker got to use it too and so, briefly, did Peter Davison.. Making ...
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British engineers are exploring the possibility of a real-life sonic screwdriver.. Bruce Drinkwater, professor of ultrasonics at Bristol University, doesnt expect to make a working model particularly soon. But hes working on at least proving the concept is possible.. The idea is to build on existing work using ultrasonic forcefields to separate out diseased cells from healthy cells. Engineers are also already experimenting with using ultrasonic waves to move small objects.. The theory is that ultrasound could be used to simulate the mechanics of a real screwdriver. A rotating forcefield could perform the function of a head, while spinning ultrasonic waves at high speed could create a tornado-like force to turn the screws.. As is often the case with physics, it seems the logic behind the system is sound (so to speak), but generating the necessary force might be more troublesome.. In the TV series, the sonic screwdriver was initially portrayed as a sound wave-based tool for opening locks, along ...
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Today for Tuesdays Tools I talk about the tool I probably use second most to tweezers, my screwdrivers. I use the standard 9 screwdriver set from Bergeon. There are better screwdrivers out there. I would really like a set with ball bearings instead of a friction bearing but Ill probably wait until this set wears…
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Industrial Corded Electric Screwdriver Market Report provides access to the research methodology, industry analysis, value chain analysis and market analysis by product, application & geography for the Industrial Corded Electric Screwdriver industry worldwide. The market size in terms of revenue (USD MN) is calculated and provided for the study period along with the dynamics of the market such as the drivers and the restraints for the forecasted period from 2021 to 2027.. The comprehensive value chain analysis of the market will assist in attaining better product differentiation, along with detailed understanding of the core competency of each activity involved. The market attractiveness analysis provided in the report aptly measures the potential value of the market providing business strategists with the latest growth opportunities.. The report classifies the market into different segments. These segments are studied in detail incorporating the market estimates and forecasts at regional and ...
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Reactive gliosis is a key feature and an important pathophysiological mechanism underlying chronic neurodegeneration following traumatic brain injury (TBI). In this study, we have explored the effects of intramuscular IGF-1 gene therapy on reactive gliosis and functional outcome after an injury of the cerebral cortex. Young adult male rats were intramuscularly injected with a recombinant adenoviral construct harboring the cDNA of human IGF-1 (RAd-IGF1), with a control vector expressing green fluorescent protein (RAd-GFP) or PBS as control. Three weeks after the intramuscular injections of adenoviral vectors, animals were subjected to a unilateral penetrating brain injury. The data revealed that RAd-IGF1 gene therapy significantly increased serum IGF1 levels and prevent working memory deficits after one week of TBI. At the same time, when we analyzed the effects of therapy on glial scar formation, the treatment with RAd-IGF1 did not modify the number of glial fibrillary acidic protein but we ...
Scientists from Northwestern University in Illinois claim they have discovered a connection between head trauma and a persons unwillingness to accept new ideas - a link, researchers say, makes some people more zealous about their faith.. Writing in the journal Neuropsychologia, the studys lead neurologist, Jordan Grafman, says that religious flexibility is dependent on the health of the area of the brain governing openness.. After consulting a registry of around 2,000 US soldiers who had suffered head trauma during the Vietnam War, Grafman conducted tests - including a religious fundamentalism scale - on 119 veterans who had experienced penetrating brain injuries.. Grafmans team then used CT scans to identify lesions on the area of participants brains known as the ventromedial prefrontal cortex. This area is thought to play a cognitive role in critical thinking, problem-solving, planning, and spiritual experiences.. Article here. ...
Medical procedures could be executed on mass lesions or to do away with objects that have penetrated the brain. Mass lesions which include contusions or hematomas causing a major mass impact (shift of intracranial buildings) are viewed as emergencies and therefore are eliminated surgically.[fifteen] For intracranial hematomas, the collected blood might be removed applying suction or forceps or it might be floated off with drinking water.[15] Surgeons search for hemorrhaging blood vessels and seek to manage bleeding.[15] In penetrating brain injury, weakened tissue is surgically debrided, and craniotomy could possibly be get more info essential ...
Dr. Haase is an emergency medicine physician who trained and specializes in both medical and surgical critical care. The majority of his clinical practice is in the Critical Care Resuscitation Unit in the R Adams Cowley Shock Trauma Center, an intensive care unit which focuses on the resuscitation and transfer of patients with time-sensitive critical illness requiring emergent interventions. His ongoing research focuses on the use of bedside ultrasound and echocardiography in the intensive care unit as well as educational research studying the acquisition of ultrasound skills by varying levels of medical providers. He has also presented research studying the acquisition of ultrasound skills by varying levels of medical providers. He has also presented research on penetrating brain injury and predictors of survival and organ donation as well as the utility of antibiotic prophylaxis in PBI. He also develops and runs the high risk procedures simulation curriculum for the critical care ...
Acute posttraumatic period of severe craniocerebral trauma is associated with sharp activation of LPO processes and rapid exhaustion of antioxidant enzymes and especially low-molecular-weight antioxidant system in the liquor. This leads to the development of severe oxidative stress and ...read more ...
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