Rapid progression of traumatic bifrontal contusions to transtentorial herniation: A case report

Rehman, Tausif; Ali, Rushna; Tawil, Isaac; Yonas, Howard

doi:10.1186/1757-1626-1-203

Cited by 20 publications

(15 citation statements)

References 3 publications

(2 reference statements)

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“…TBI is a neurological episode whereby head trauma instigates molecular, cellular, and structural pathology, which may result in functional disturbance to the central nervous system (CNS) (Rehman, Ali, Tawil, & Yonas, ). TBI exists on a continuum, from asymptomatic mild injuries to severe TBI, involving high focal contact forces that can lead to fracturing of the skull, subdural hematoma, cerebral contusion, and hemorrhage within the hemispheres (Bogoslovsky, Gill, Jeromin, Davis, & Diaz‐Arrastia, ).…”

Section: Introductionmentioning

confidence: 99%

Modeling sports‐related mild traumatic brain injury in animals—A systematic review

Hiskens

Angoa‐Pérez

Schneiders

et al. 2019

J of Neuroscience Research

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Sports-related head trauma has emerged as an important public health issue, as mild traumatic brain injuries (mTBIs) may result in neurodegenerative disorders such as chronic traumatic encephalopathy (CTE). Research into mTBI and CTE pathophysiology are difficult to undertake in athletes, with observational trials and post-mortem analysis the current mainstays. Thus, animal models play an important role in the study of mTBI, however, traditional animal models have focused on acute, severe injuries rather than the more typical mTBI's seen in sport injuries. Recently, a number of animal models have been developed that are both appropriately scaled and biomechanically relevant to the forces sustained by athletes. This review aimed to examine the literature for variables included in these animal models, and the resulting neurotrauma as evidenced by pathology and behavioral deficits. A systematic search of the literature was performed in multiple electronic databases. The inclusion criteria required mimicry of athlete mTBI conditions: freedom of head movement, lack of surgical alteration of the skull, and application of direct contact force. Studies were analyzed for variables including apparatus design features (impact force, change in animal head velocity, and kinetic energy transfer to the head), demonstrated pathology (phosphorylated tau, TDP-43 aggregation, diffuse axonal injury, gliosis, cytokine inflammation response, and genetic integrity), and behavioral changes. These studies suggested that appropriate animal models can assist in understanding the pathological and functional outcomes of athlete mTBI, and could be used as a platform for future studies of diagnostic/prognostic markers and in the development of treatment interventions. K E Y W O R D S animal models, chronic traumatic encephalopathy, concussion, neurotrauma | INTRODUC TI ONAthlete head impacts continue to attract significant media and research attention with sports such as soccer, football, ice hockey, lacrosse, and rugby displaying significant rates of head injury in American high school and collegiate athletes O'Connor et al., 2017). These impacts occur across a continuum of severity; from injuries resulting in unconsciousness and requiring the athlete to be assisted on the field, to contact with no immediate observable consequences, such as heading a soccer ball. The nature of many of these sports predicates that head impacts are not sustained in isolation, but are often an intrinsic by-product of the rules of the sport, and as such are repetitively sustained across a match | 1195 HISKENS Et al.

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Section: Introductionmentioning

confidence: 99%

Modeling sports‐related mild traumatic brain injury in animals—A systematic review

Hiskens

Angoa‐Pérez

Schneiders

et al. 2019

J of Neuroscience Research

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“…We define an ICH event as 5 successive 1-minute blocks with median ICP greater than 20 mmHg, which helps to avoid spurious labelings, following the recent work by Ziai et al [56], the earlier work by Hu et al [20], and the definition of 3 [3][4] sustained ICH from [57]. According to this definition, patients were in an acute ICH event state for 2.5% of their cumulative segment lengths.…”

Section: Acute Intracranial Hypertension Alarmsmentioning

confidence: 99%

“…This phenomenon is referred to as secondary brain injury, and often leads to long-term brain damage through e.g. cerebral ischemia (decrease of blood flow to the brain) [2], cerebral hypoxia (decrease of substrate/oxygen flow to the brain) [3] and brain herniation (swelling leading to compression of brain structures [4] Management of TBI patients in the neurological ICU focuses on mitigating and possibly reversing secondary injuries [5]. A key variable in the management of secondary brain injury is intracranial pressure (ICP) [6,7].…”

Section: Introductionmentioning

confidence: 99%

Forecasting intracranial hypertension using multi-scale waveform metrics

et al. 2020

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Objective: Acute intracranial hypertension is an important risk factor of secondary brain damage after traumatic brain injury. Hypertensive episodes are often diagnosed reactively, leading to late detection and lost time for intervention planning. A pro-active approach that predicts critical events several hours ahead of time could assist in directing attention to patients at risk. Approach: We developed a prediction framework that forecasts onsets of acute intracranial hypertension in the next 8 hours. It jointly uses cerebral auto-regulation indices, spectral energies and morphological pulse metrics to describe the neurological state of the patient. One-minute base windows were compressed by computing signal metrics, and then stored in a multi-scale history, from which physiological features were derived. Main results: Our model predicted events up to 8 hours in advance with alarm recall rates of 90% at a precision of 30.3% in the MIMIC-III waveform database, improving upon two baselines from the literature. We found that features derived from high-frequency waveforms substantially improved the prediction performance over simple statistical summaries of low-frequency time series, and each of the three feature classes contributed to the performance gain. The inclusion of long-term history up to 8 hours was especially important. Significance: Our results highlight the importance of information contained in high-frequency waveforms in the neurological intensive care unit. They could motivate future studies on pre-hypertensive patterns and the design of new alarm algorithms for critical events in the injured brain.

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“…(37)]. For the purpose of this brief overview, we will focus on closed-head injuries that fall within the mild end of the TBI severity spectrum.…”

Section: Clarity Of Definitionsmentioning

confidence: 99%

Considerations for Experimental Animal Models of Concussion, Traumatic Brain Injury, and Chronic Traumatic Encephalopathy—These Matters Matter

et al. 2017

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Animal models of concussion, traumatic brain injury (TBI), and chronic traumatic encephalopathy (CTE) are widely available and routinely deployed in laboratories around the world. Effective animal modeling requires careful consideration of four basic principles. First, animal model use must be guided by clarity of definitions regarding the human disease or condition being modeled. Concussion, TBI, and CTE represent distinct clinical entities that require clear differentiation: concussion is a neurological syndrome, TBI is a neurological event, and CTE is a neurological disease. While these conditions are all associated with head injury, the pathophysiology, clinical course, and medical management of each are distinct. Investigators who use animal models of these conditions must take into account these clinical distinctions to avoid misinterpretation of results and category mistakes. Second, model selection must be grounded by clarity of purpose with respect to experimental questions and frame of reference of the investigation. Distinguishing injury context (“inputs”) from injury consequences (“outputs”) may be helpful during animal model selection, experimental design and execution, and interpretation of results. Vigilance is required to rout out, or rigorously control for, model artifacts with potential to interfere with primary endpoints. The widespread use of anesthetics in many animal models illustrates the many ways that model artifacts can confound preclinical results. Third, concordance between key features of the animal model and the human disease or condition being modeled is required to confirm model biofidelity. Fourth, experimental results observed in animals must be confirmed in human subjects for model validation. Adherence to these principles serves as a bulwark against flawed interpretation of results, study replication failure, and confusion in the field. Implementing these principles will advance basic science discovery and accelerate clinical translation to benefit people affected by concussion, TBI, and CTE.

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Rapid progression of traumatic bifrontal contusions to transtentorial herniation: A case report

Cited by 20 publications

References 3 publications

Modeling sports‐related mild traumatic brain injury in animals—A systematic review

Modeling sports‐related mild traumatic brain injury in animals—A systematic review

Forecasting intracranial hypertension using multi-scale waveform metrics

Considerations for Experimental Animal Models of Concussion, Traumatic Brain Injury, and Chronic Traumatic Encephalopathy—These Matters Matter

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