Applicability of traumatic brain injury rehabilitation interventions in natural disaster settings

Customized Neurotization for Hindlimb Hemiplegia After a Hemorrhagic Stroke

“…Hypertensive intracerebral hemorrhage(HICH) generally contributes to a catastrophic, life-changing damage with an incidence of approximately 150 in 100,000 worldwide annually,wherein >81.3% of these damages includes severe hemiplegia in the contr-alateral limbs [1][2][3][4].The victims with a limb motor dysfunction signi cantly lose self-help ability, placing a burden on family or forfeiting social engagement to some extent [5][6][7][8][9][10]. Traditionally,fundamental interventions to hemiplegia after HICH revolve around subsequent physical rehabilitation or physiotherapy [11][12][13][14].Nevertheless,res-ultant outcomes usually are discouraging or dissatisfactory,rousing uninterrupted quest for patient-oriented therapies.Many studies conducted in both humans and rodents have demonstrated that an injured brain cortex can re-control the contralateral limbs through a neural network remodeling across perilesional regions and contralesional hemisphere after rewiring an afferent circuit [15][16][17][18].Recently,peripheral nerve transfer,which can ignite compensational cerebral plasticity,has been exploited to rescue partial knee extension or hand prehension in patients with acute accid myelitis or central neurological diseases [19][20][21][22].Noticeably,though current neurotization stays in early stage and yet need to be polished [23,24],its highlights have activated our aspiration for its extrapolation to a lower-limb paralysis after HICH,and further interrogation of maneuvers for a dexterous motion during neurotization.…”