The Effect of the Relationship of <i>APOE</i> Polymorphisms and Cerebral Vasospasm on Functional Outcomes in Children With Traumatic Brain Injury

Reuter‐Rice, Karin; Regier, Michael; Bennett, Ellen; Laskowitz, Daniel T.

doi:10.1177/1099800418785982

Cited by 6 publications

(4 citation statements)

References 47 publications

(69 reference statements)

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“…The pathophysiology of post-traumatic cerebral vasospasm is suggested to involve mechanical stretch, inflammation, calcium dysregulation, endothelin, contractile proteins, cerebral metabolic products, and cortical spreading depolarization [8]. Additionally, polymorphisms in the apolipoprotein E gene have been reported to be associated with post-traumatic cerebral vasospasm [9].…”

Section: Epidemiologymentioning

confidence: 99%

Cerebral Infarction Due to Post-traumatic Cerebral Vasospasm in a 12-Year-Old Female

Tanikawa,

Take,

Naito

et al. 2024

Cureus

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Cerebral infarction due to post-traumatic cerebral vasospasm is rare. Although some modalities are recommended to detect post-traumatic cerebral vasospasm, its diagnosis remains controversial and challenging. Therefore, in this report, we will use a case report to highlight challenges and to delineate the characteristics of post-traumatic cerebral vasospasm in pediatric patients, including the diagnostic and treatment options. A 12-year-old female was admitted to our hospital following a motor vehicle collision. Her consciousness was severely impaired. Initial computed tomography (CT) revealed an acute subdural hematoma along the tentorium, and a focal subarachnoid hemorrhage was observed in the Sylvian fissure. The patient underwent the insertion of an intracranial pressure sensor and received therapy for increased intracranial pressure (ICP) control under sedation. On the second day, CT angiography (CTA) revealed no signs of arterial abnormality. A patient who is comatose or under sedation has masked neurological symptoms. Thus, new neurological events could only be detected via an intracranial pressure sensor. Her ICP increased on the seventh day, and a CT scan showed a new cerebral infarction in the right middle cerebral artery (MCA) region. We performed decompressive craniectomy to reduce ICP. Postoperative CTA confirmed severe vasospasm in the right MCA. The severe cerebral vasospasm induced the cerebral infarction. Our review suggests that physicians in trauma departments should frequently perform vascular evaluations by CTA, magnetic resonance angiography (MRA), transcranial Doppler ultrasound, or digital subtraction angiography (DSA), especially within two weeks from onset, to detect post-traumatic cerebral vasospasm.

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Section: Epidemiologymentioning

confidence: 99%

Cerebral Infarction Due to Post-traumatic Cerebral Vasospasm in a 12-Year-Old Female

Tanikawa,

Take,

Naito

et al. 2024

Cureus

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“…As in adults, the apolipoprotein E4 genotype has been associated with worse outcomes in children with moderate-to-severe TBI. In one study of 70 children, those with the ApoE4 genotype were more likely to exhibit symptoms and have unfavorable neurological outcome after TBI [ 76 ]; however, results have been inconsistent [ 77 , 78 ]. Genetic factors have also been investigated as therapeutic targets.…”

Section: Pathophysiology Of Malnutrition After Acute Brain Injurymentioning

confidence: 99%

Optimization of Nutrition after Brain Injury: Mechanistic and Therapeutic Considerations

Poblete,

Yaceczko,

Aliakbar

et al. 2023

Biomedicines

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Emerging science continues to establish the detrimental effects of malnutrition in acute neurological diseases such as traumatic brain injury, stroke, status epilepticus and anoxic brain injury. The primary pathological pathways responsible for secondary brain injury include neuroinflammation, catabolism, immune suppression and metabolic failure, and these are exacerbated by malnutrition. Given this, there is growing interest in novel nutritional interventions to promote neurological recovery after acute brain injury. In this review, we will describe how malnutrition impacts the biomolecular mechanisms of secondary brain injury in acute neurological disorders, and how nutritional status can be optimized in both pediatric and adult populations. We will further highlight emerging therapeutic approaches, including specialized diets that aim to resolve neuroinflammation, immunodeficiency and metabolic crisis, by providing pre-clinical and clinical evidence that their use promotes neurologic recovery. Using nutrition as a targeted treatment is appealing for several reasons that will be discussed. Given the high mortality and both short- and long-term morbidity associated with acute brain injuries, novel translational and clinical approaches are needed.

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“…These range from adult-based criteria to variable criteria including Vm and some with or without the Lindegaard ratio. The most frequently reported criteria include: MCA Vm ≥ 2 standard deviations above age-based normative values and a LR ≥ 3 [ 15 , 40 , 41 ]. However, these studies did not have angiographic correlations.…”

Section: Applications In the Pediatric Intensive Care Unitmentioning

confidence: 99%

Transcranial Doppler Ultrasound, a Review for the Pediatric Intensivist

Lovett

O’Brien

2022

Children

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The Effect of the Relationship of APOE Polymorphisms and Cerebral Vasospasm on Functional Outcomes in Children With Traumatic Brain Injury

Abstract: Injury severity and the APOE noncoding promoter SNP rs405509 may modify the relationship between APOE and CV in children with TBI. More studies are needed to understand the role of APOE polymorphisms in outcomes in children with TBI.

Cited by 6 publications

References 47 publications

Cerebral Infarction Due to Post-traumatic Cerebral Vasospasm in a 12-Year-Old Female

Cerebral Infarction Due to Post-traumatic Cerebral Vasospasm in a 12-Year-Old Female

Optimization of Nutrition after Brain Injury: Mechanistic and Therapeutic Considerations

Transcranial Doppler Ultrasound, a Review for the Pediatric Intensivist

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