Simulating Axonal Stretch During Traumatic Brain Injury Events

2010 ◽  
Author(s):  
Jean-Pierre Dollé ◽  
Jeffrey Barminko ◽  
Rene Schloss ◽  
Martin L. Yarmush
Keyword(s):  
Brain Injuries ◽  
Motor Vehicle ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
The United States ◽  
Motor Vehicle Accidents ◽  
Inertial Forces ◽  
Vehicle Accidents ◽  
Rapid Deceleration ◽  
The Brain

Traumatic Brain Injuries (TBI) affect up to 1.5 million people annually within the United States with as many as 250,000 being hospitalized and 50,000 dying [1]. TBI events occur when the brain experiences a sudden trauma such as a rapid deceleration of the brain that typically occurs during motor vehicle accidents. During rapid deceleration events, the brain is subjected to high inertial forces that can result in a shearing or elongation of axons that is commonly known as Diffuse Axonal Injury (DAI) [2,3].

Simulating Diffuse Axonal Injury During Traumatic Brain Injury Events

2011 ◽  
Author(s):  
Jean-Pierre Dolle ◽  
Rene Schloss ◽  
Martin L. Yarmush
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
The United States ◽  
Traumatic Brain Injuries ◽  
Inertial Forces ◽  
The Brain

Traumatic Brain Injuries (TBI) affect up to 1.5 million people annually within the United States with as many as 250,000 being hospitalized and 50,000 dying [1]. TBI events occur when the brain experiences a sudden trauma such as a rapid acc/deceleration. These events produce high inertial forces that result in a shearing or elongation of axons (commonly known as Diffuse Axonal Injury [2].

scholarly journals Brainstem Diffuse Axonal Injury and Consciousness

2019 ◽  
Vol 9 ◽  
pp. 32 ◽  
Author(s):  
Sukhwinder Sandhu ◽  
Erik Soule ◽  
Peter Fiester ◽  
Patrick Natter ◽  
Daryoush Tavanaiepour ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Prognostic Indicator ◽  
Coma Scale ◽  
Vehicle Accidents ◽  
Neurological Outcomes ◽  
Neurological Injuries

Background: Severe traumatic brain injuries (TBI), commonly due to motor vehicle accidents may cause death and long-term disability especially when the acceleration-deceleration force on the brain is massive. This may cause shearing of the axonal connections within the cerebral cortex and brainstem in a process referred to as diffuse axonal injury (DAI). Extensive DAI has been postulated to be a poor prognostic indicator for neurological recovery. In our institution, several patients with Grade 3 DAI were observed to recover and achieve neurological outcomes greater than expected given the presence of brainstem injury. Methods: MRI studies from 100 patients admitted to a large tertiary trauma center for TBI were retrospectively analyzed by two fellowship-trained neuroradiologists. The size of DAI lesions, location of injury within the brainstem, and the number of discrete DAI lesions were measured and recorded. Glasgow Coma Scale (GCS) on arrival and at discharge was noted, as well as the presence of other neurological injuries. Results: Of 20 patients initially noted to have DAI with lesions of the brainstem, eight of them were discharged with Glasgow Coma Scale (GCS) of 14–15. The 12 patients discharged with reduced consciousness (average GC 7.1) demonstrated a greater number of larger lesions, with a predilection for the dorsal pons. Conclusion: These results suggest that large, numerous pontine lesions may indicate worse neurological outcomes in patients with these findings.

What Kills Our Kids?

Pained ◽  
2020 ◽  
pp. 45-48
Author(s):  
Michael D. Stein ◽  
Sandro Galea
Keyword(s):  
United States ◽  
Motor Vehicle ◽  
Chromosomal Abnormalities ◽  
The United States ◽  
Motor Vehicle Accidents ◽  
Childhood Mortality ◽  
The Other ◽  
Past Century ◽  
Vehicle Accidents ◽  
Vision Zero

This chapter asks what kills children and what people can do about it. One of the greatest triumphs in health over the past century has been the dramatic decrease in childhood mortality, yet children still die. In 2016, there were, in the United States, about 38,000 deaths of children under the age of 19. Roughly half of deaths occur in early childhood due to genetic conditions, chromosomal abnormalities, and other perinatal conditions, many of which people do not know how to treat. However, we should be able to prevent most of the other half. The leading causes of injury deaths are motor vehicle deaths and gun-related deaths. Understanding how to prevent them can provide a template for stopping other childhood deaths. The chapter then considers the Vision Zero initiative, passed by the Swedish parliament 20 years ago, which aims to reduce traffic fatalities to zero. Just like motor vehicle accidents, childhood deaths from guns will not end until people work to create a safer environment by reducing the availability of firearms.

Trauma

2018 ◽  
Author(s):  
David A. Young
Keyword(s):  
Cause Of Death ◽  
Life Support ◽  
Motor Vehicle ◽  
The United States ◽  
Motor Vehicle Accidents ◽  
Advanced Trauma Life Support ◽  
Traumatic Injuries ◽  
Vehicle Accidents ◽  
One Year ◽  
Uncontrolled Bleeding

Traumatic injuries are the most common cause of death within the United States for children above one year of age Most traumatic injuries in children are a result of motor vehicle accidents, child abuse (or nonaccidental trauma), drowning, thermal injury, or falls. Motor vehicle accidents are the leading cause of death for children above the age of one year. Strategies of Advanced Trauma Life Support (ATLS) utilize a standardized approach to promptly identify and manage life-threatening traumatic injuries. These strategies include recognition of cardiopulmonary disorders, volume resuscitation, and prevention of additional injuries including to the cervical spine. A management plan for severe and uncontrolled bleeding is critically important to have established when caring for children with traumatic injuries. Many strategies have been developed to manage severe and uncontrolled bleeding including the use of massive transfusion protocols, damage control surgery, and hemostatic agents.

Diffuse Axonal Injury

Neurotrauma ◽  
2019 ◽  
pp. 63-72
Author(s):  
Hussein A. Zeineddine ◽  
Cole T. Lewis ◽  
Ryan S. Kitagawa
Keyword(s):  
Cerebral Perfusion ◽  
High Speed ◽  
Motor Vehicle ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Common Mechanism ◽  
White Matter Tract ◽  
Vehicle Accidents ◽  
Wide Range ◽  
Tract Damage

Diffuse axonal injury (DAI) is a type of traumatic brain injury (TBI) that results from a blunt head injury. In this particular subtype, accelerating-decelerating motions cause white matter tract damage and preferentially impact regions including the corpus callosum and brainstem. The neurological compromise therefore relates to the severity of the axonal insult. The most common mechanism for DAI is high-speed motor vehicle accidents, and the clinical presentation is typically out of proportion to the CT findings. As a result, MRI is the modality of choice. Currently, there are limited therapeutic options, and management is identical to other forms of TBI including intracranial pressure and cerebral perfusion pressure management. As this disease is heterogeneous, survivors have a wide range of functional outcomes.

scholarly journals Increased population density of neurosurgeons associated with decreased risk of death from motor vehicle accidents in the United States

2012 ◽  
Vol 117 (3) ◽  
pp. 599-603 ◽  
Author(s):  
Atman Desai ◽  
Kimon Bekelis ◽  
Wenyan Zhao ◽  
Perry A. Ball
Keyword(s):  
Population Density ◽  
General Practitioners ◽  
Cause Of Death ◽  
Motor Vehicle ◽  
The United States ◽  
Median Number ◽  
Motor Vehicle Accidents ◽  
Outcome Variable ◽  
Vehicle Accidents ◽  
Risk Of Death

Object Motor vehicle accidents (MVAs) are a leading cause of death and disability in young people. Given that a major cause of death from MVAs is traumatic brain injury, and neurosurgeons hold special expertise in this area relative to other members of a trauma team, the authors hypothesized that neurosurgeon population density would be related to reduced mortality from MVAs across US counties. Methods The Area Resource File (2009–2010), a national health resource information database, was retrospectively analyzed. The primary outcome variable was the 3-year (2004–2006) average in MVA deaths per million population for each county. The primary independent variable was the density of neurosurgeons per million population in the year 2006. Multiple regression analysis was performed, adjusting for population density of general practitioners, urbanicity of the county, and socioeconomic status of the county. Results The median number of annual MVA deaths per million population, in the 3141 counties analyzed, was 226 (interquartile range [IQR] 151–323). The median number of neurosurgeons per million population was 0 (IQR 0–0), while the median number of general practitioners per million population was 274 (IQR 175–410). Using an unadjusted analysis, each increase of 1 neurosurgeon per million population was associated with 1.90 fewer MVA deaths per million population (p < 0.001). On multivariate adjusted analysis, each increase of 1 neurosurgeon per million population was associated with 1.01 fewer MVA deaths per million population (p < 0.001), with a respective decrease in MVA deaths of 0.03 per million population for an increase in 1 general practitioner (p = 0.007). Rural location, persistent poverty, and low educational level were all associated with significant increases in the rate of MVA deaths. Conclusions A higher population density of neurosurgeons is associated with a significant reduction in deaths from MVAs, a major cause of death nationally. This suggests that the availability of local neurosurgeons is an important factor in the overall likelihood of survival from an MVA, and therefore indicates the importance of promoting neurosurgical education and practice throughout the country.

Changing Law from Barrier to Facilitator of Opioid Overdose Prevention

2013 ◽  
Vol 41 (S1) ◽  
pp. 33-36 ◽  
Author(s):  
Corey Davis ◽  
Damika Webb ◽  
Scott Burris
Keyword(s):  
Motor Vehicle ◽  
Unintentional Injury ◽  
The United States ◽  
Opioid Antagonist ◽  
Opioid Overdose ◽  
Injury Death ◽  
Overdose Prevention ◽  
Vehicle Accidents ◽  
The Brain ◽  
Hispanic White

Drug overdose has recently surpassed motor vehicle accidents to become the leading cause of unintentional injury death in the United States. The epidemic is largely driven by opioids such as oxycodone, hydrocodone, and methadone, which kill more Americans than heroin and cocaine combined. The demographics of overdose have changed over the past few decades as well: according to the latest data, the average overdose victim is now a non-Hispanic white man aged 45-54.These deaths — over 16,000 per year — are almost entirely preventable. Opioid overdose kills by slowly depressing respiration, a process that can take several hours. It can be quickly and effectively reversed by the timely administration of naloxone, an opioid antagonist that works by displacing opioids from the brain receptors to which they attach, reversing their depressant effect. Naloxone, also known as Narcan, has many benefits and minimal risks. Although it is a prescription drug, it is not a controlled substance and has no abuse potential.

scholarly journals Prediction and Detection of Epileptic Seizure

2016 ◽  
pp. 314-336
Author(s):  
Mohammad Zavid Parvez ◽  
Manoranjan Paul
Keyword(s):  
Epileptic Seizure ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Future Trends ◽  
Vehicle Accidents ◽  
Recent Developments ◽  
Seizure Syndrome ◽  
The Common ◽  
Prediction Techniques ◽  
The Brain

Epilepsy is one of the common neurological disorders characterized by a sudden and recurrent malfunction of the brain that is termed “seizure”, affecting around 65 million individuals worldwide. Epileptic seizure may lead to many injuries such as fractures, submersion, burns, motor vehicle accidents and even death. It is highly possible to prevent these unwanted situations if we can predict/detect electrical changes in brain that occur prior to onset of actual seizure. When building a prediction model, the goal should be to make a model that accurately classifies preictal period (prior to a seizure onset) from interictal (period between seizures when non-seizure syndrome is observed) period. On the hand, for the detection we need to make a model that can classify ictal (actual seizure period) from non-ictal/interictal period. This chapter describes the seizure detection and prediction techniques with its background, features, recent developments, and future trends.

scholarly journals Experience of a neurology service during the 2016 Olympic and Paralympic Games

2018 ◽  
Vol 8 (6) ◽  
pp. 482-485
Author(s):  
Ivan R.F. da Silva ◽  
Luciano Gouvea ◽  
Carlos Bruno Nogueira ◽  
Victor Cravo ◽  
Bernardo B. Liberato
Keyword(s):  
Neurocritical Care ◽  
Brain Injuries ◽  
Olympic Games ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Functional Deficits ◽  
Vehicle Accidents ◽  
Complex Events ◽  
Frequent Reason ◽  
Paralympic Games

BackgroundWe analyzed the utilization of acute neurologic care during the 2016 Olympic and Paralympic Games in Rio de Janeiro.MethodsWe conducted a retrospective analysis of data collected during the games.ResultsSixty-three neurologic evaluations were performed in patients from the Olympic Family (OF), 22 of these involving athletes from 19 countries. Traumatic brain injuries (TBIs) were the most frequent reason for assessment among athletes, some associated with polytrauma. Four patients were admitted to the neurocritical care unit (NICU): 2 acute ischemic strokes, 1 TIA, and 1 polytrauma with moderate TBI. Among nonathletes, evaluation of TBI associated with motor vehicle accidents was surprisingly high, with 10 assessments, none requiring admission. Also, nonathletes with seizures, multiple sclerosis flare, functional deficits, and psychiatric complaints received neurologic evaluation. During the Paralympic Games, 17 neurologic evaluations were performed in patients from the Paralympic Family (PF), 13 involving athletes from 10 countries. Five athletes presented with mild TBI. One PG training coach was admitted to the NICU after receiving alteplase for an acute ischemic stroke.ConclusionsAs expected, many athletes with sports-related injuries were evaluated, but cases of diverse acute neurologic pathologies were observed among nonathlete members of the OF and PF. Olympic Games are large, logistically complex events involving thousands of people. Our observations suggest that a comprehensive and detailed plan for neurologic emergencies should be considered for future games.

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