• Korean Journal of Biological Psychiatry
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• v.7 no.1
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• pp.46-54
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• 2000

Traumatic brain injury(TBI) is generally considered to be a risk factor for psychiatric disorders, especially depression and anxiety disorder. Despite the anxiety disorders are frequent sequelae after traumatic brain injury, the patients have not been payed medical attention and treated by doctors properly. The factors of precipitating and sustaining the anxiety disorders after TBI are brain injury itself, and the patient's or caregiver's response to the disability after TBI. To diagnose and treat them effectively, the knowledge about the mechanisms of and symptoms after TBI have to be needed. Psychiatrist should be a supportive and good listener to the patients who are complaining anxiety symptoms and differentiate whether the psychiatric symptoms are due to TBI or not. Because the TBI patients are very sensitive to drug side effects, doctors have to be familiar with the side effects as well as the mechanisms of action of the common psychotropics.

• Korean Journal of Biological Psychiatry
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• v.2 no.2
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• pp.177-185
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• 1995

외상후 뇌손상은 대표적이며, 가장 중요한 신경정신계 질환의 하나이다. 더욱이 외상후 뇌손상 환자들은 각종의 사고 및 산업재해 등으로 인해 그 수가 급증하고 있으며, 특히 인지기능의 장애로 인한 다양한 기질성 정신장애로 고통을 겪게 된다. 따라서 외상후 뇌손상은 손상의 시점에서부터 정확하고 올바른 평가는 물론 손상후의 경과 및 치료대책의 수립에 있어서 체계적이며 종합적인 신경인지기능의 평가는 필수적이다. 왜냐하면 신경인지기능평가는 뇌의 손상부위와 이와 관련된 기능장애 및 행동의 변화에 대한 객관적인 자료를 제시해 주기 때문이다. 신경인지기능 평가의 영역은 지각, 운동기능은 물론 주요인지기능인 기억, 언어, 실행 및 감정조절능력에 이르기까지 다양하며, 외상후 뇌손상환자들은 손상부위 및 정도에 따라 신경인지기능의 장애를 초래하게 된다. 대표적인 신경인지기능평가 도구로는 KWIS, Halstead-Reitan, Luria-Nebraska batteries, 특히 전두엽기능검사인 Wisconsin Card Sorting Test (WCST)를 비롯하여, 현재는 PC/S Vienna Test System 및 Stim등의 각종 전산화 인지기능검사가 개발되어 임상에서 활발히 사용되고 있다. 즉 외상후 뇌손상환자를 위한 신경인지기능평가의 목적은 뇌손상과 관련된 신경인지기능장애를 정확히 평가하여, 환자 개개인에 적합한 인지재활치료 계획을 수립하는데 있다. 물론 여기에는 신경정신상태검사(neuropsychiatric mental status examination)를 통하여 외상 후 뇌손상의 경과 및 예후에 결정적인 영향을 미칠 수 있는 나이, 의식소실 및 외상후 기억 손상 시간의 정확한 측정은 물론 심리 사회 문화적인 상태와 두부외상전 환자의 지적수준 및 사회 적용기능이 함께 평가되어야 할 것이다.

• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.156-161
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• 2001

We reported two cases of amantadine treatment in traumatic brain injury patients and reviewed the literature of amantadine treatment of those patients. Problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive deficit could occur following traumatic brain injury or other types of acquired brain injury. This report described results of amantadine using in two patients with this type of symptom profile. Patients received neuropsychiatric examination as well as BPRS and Barthel index. These patients were improved, respectively from 57 point to 82 point(case 1), from 85 to 94(case 2) in Barthel index, and from 66 point to 35 point(case 1), from 55 to 32 point(case 2) in BPRS. These two patients did not reveal any other adverse effect. The rationale for using amantadine were discussed.

• Journal of Digital Convergence
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• v.16 no.7
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• pp.511-516
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• 2018

This study examined the effectiveness of a short thumb splint and a glove type splint which combined features of a fitness glove in order to improve hand function and performance of functional task after traumatic brain injury. One subject with traumatic brain injury participated in this study and wore a short thumb splint and customized glove type splint. His hand function was significantly improved when comparing to that of not using those splints. In addition, using the glove type splint was more significant to perform functional tasks than using the short thumb splint. The findings of this study identified that hand function of people with traumatic brain injury was improved by using those splints as an occupational therapy service and it is necessary to adapt the customized splints according to the personal characteristics.

• Korean Journal of Biological Psychiatry
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• v.2 no.2
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• pp.169-176
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• 1995

두부 외상은 많은 발생율과 사망율을 차지하고 있으며, 건강한 생활을 위해 큰 관심을 갖게 되었다. 신경방사선영상은 외상성 뇌손상 환자들의 진단과 치료에 필수적인 방법이다. 뇌손상의 기본 기전, 병리, 그리고 영상 소견을 이해 하는 것은 매우 중요하다. 1970년대에 Glasgow coma scale의 형상과 전산화단층촬영(CT)의 발달은 임상의사들이 두부외상에 대한 평가와 환자들의 경과를 예상하는데 극적인 변화를 주었다. 최근 자기공명영상(MRI)의 발달로 외상성 뇌손상의 형태를 더욱 이해 하게 되었고, 두부 외상의 발견율이 높아지게 되었다.

• Journal of Korean Biological Nursing Science
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• v.3 no.1
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• pp.1-10
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• 2001

뇌손상이라고 하는 과도한 stress를 받았을 때 free cortisol의 분비되는 양과 urinary free cortisol의 circadian 리듬에 어떻게 영향을 주는지 확인하기 위하여 시도하였다. 연구대상은 대조군은 건강한 젊은 여성 6명과 실험군응 CT상 뇌에 손상을 받은 4명의 여성으로 30대 환자이었다. 담당의사와 중환자실 관리책임자의 동의하에서 시도되었으며, 실험기간은 2000년 7월 1일에서 7월 10일까지였다. 대조군과 실험군의 뇨를 채취하여 뇨중 free cortisol 농도의 circadian rhythm을 알아보기 위해 채뇨 후 분석하였다. 채뇨는 뇌손상을 받고 응급실을 통해 신경외과 중환자실에 입원한 지 5시간 이내에 해당된 환자로 24시간 유지되는 foley catherization 상태하에서 12:00부터 3일동안 72시간을 2시간 간격으로 채뇨하였고, 대조군은 오전 12시부터 24시간 동안 2시간 간격으로 채뇨하였다. 측정방법으로는 cortisol의 정량은 solid-phase radioimmuoassay 방법을 이용하였으며, 분석재료는 Coat-A-Count(R) Cortisol kit(DPC, U.S.A.)을 사용하여 DPC사의 측정방법을 따랐다. 연구대상자의 free cortisol의 총량은 대조군에서는 $42.8{\mu}g$이었고, 실험군은 1일에 $991.2{\mu}g$, 2일에 $809{\mu}g$, 3일에 $544.2{\mu}g$으로 대조군과 통계적으로 유의한 차이를 나타내(p<.05), 실험군에서 현저하게 증가된 양상을 보였고, 시간이 지나면서 점점 감소하는 경향을 나타냈다. 시간별로 t-검정으로 분석한 결과로는 모든 시간대에서 대조군과 실험군의 평균치는 통계적으로 유의한 차이를 나타냈다. Free cortisol의 circadian에서는 대조군에서는 정상인의 cortisol의 circadian의 경우와 같은 리듬을 보였으나, 손상을 받은 실험군의 경우 분비량은 현저하게 증가했음을 보여주었다. 최고치가 제1일에 18:00과 다음날 10:00에 나타나 최고치가 2회 나타났으며, 제2일에도 제1일과 마찬가지로 18:00에 나타났고, 제3일에는 24:00에 나타나 제1일보다 제2일에는 최고치가 한 번 나타난 리듬을 보여주었고, 분비량은 2일에 감소하였다. 제3일에는 최고치가 8시간 지연된 나타난 리듬의 변화를 보여주었다. 최저치는 제1일, 제2일, 제3일 모두 24:00에 나타난 리듬을 보여주었다. 이상의 결과에서 실험군인 뇌손상 환자군에서는 뇌손상이 과도한 stress로 작용하여 환자의 free cortisol 분비량과 circadian 리듬에도 영향을 주는 것으로 나타났다. 그러므로 뇌손상환자를 간호하는 간호사는 스트레스상태인 것을 인지하여 환자 개개인에 필요한 간호를 해야 할 것으로 사료된다.

• Therapeutic Science for Rehabilitation
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• v.7 no.1
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• pp.11-26
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• 2018

Objective : This case study was to verify effects of cognitive rehabilitation and swallowing rehabilitation on Hypoxic-Ischemic Brain Injury patient by Suicidal Attempt. Methods : The subject was a 32-year old Hypoxic-ischemic brain injury patient by suicidal attempt. He received treatment once a day five times a week, for a half an hour for each session from September 8th to December 16th, 2016. Treatment were cognitive and swallowing rehabilitation. He was assessed based on Mini-Mental State Examination-Korean (MMSE-K), Korean-Modified Barthel Index (K-MBI), Computerized Neurocognitive Function Test (CNT), Videofluoroscopic Dysphagia Scale (VDS), American Speech-Language-Hearing Association National Outcomes Measurements System (ASHA-NOMS). Results : The patient's total MMSE-K score increased from 25 to 27. His K-MBI score increased from 74 to 88. His memory, attention span, and executive function (DST, VST, SWCT, WCST) by CNT scores were improved. VDS score has no changes to 34, 44.5 and 34. ASHA-NOMS score also has no change to 6, 2 and 6. Conclusion : The study showed that the application of the treatment of cognitive and swallowing in hypoxic-ischemic brain injury patient by suicidal attempt results has positive effects on cognitive functions, and swallowing function.

• Journal of Industrial Convergence
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• v.21 no.2
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• pp.25-32
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• 2023

Constipation is the most common digestive disorder, and it occurs frequently in the early stages and affects the prognosis on rehabilitation stage in the patients with brain injury. The purpose of this study is to evaluate the bowel habits of brain-injured patients undergoing enteral nutrition immediately after admission to rehabilitation and transmission, and to investigate the effects of abdominal massage and lower extremity exercise. The study design is a quasi-experimental study to investigate the effect of a bowel care intervention (abdominal massage and lower extremity exercise) applicable to patients with brain lesions. As a result of the study, the number of bowel movements was significantly higher in the intervention group (p=.030), and the use of suppositories in the control group was statistically significantly higher than that in the intervention group (p=.004). The time of constipation relief was 1.73 days for the experimental group and 4.61 days for the control group, indicating that there was a difference in the time of constipation relief between the two groups (p<.001). Abdominal massage and lower extremity exercise were effective as nursing interventions to relieve constipation and prevent constipation in patients with brain injury from the early stage of rehabilitation.

• The Journal of the Korea Contents Association
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• v.11 no.4
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• pp.253-262
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• 2011

Cognitive-communicative disorders after traumatic brain injury(TBI) and right hemisphere damage(RHD) are different from other neurological disorders in nature. Therefore, it is not desirable to use aphasia tests in evaluating individuals with TBI or RHD. The aim of this study is to review assessment protocols on TBI and RHD, and literature related with them. As a result, it is recommended that individuals with TBI be examined in scope of the cognition including attention, memory, organization, reasoning, as well as the functional communication. Similarly, it is useful to consider high-order language related to various cognitive domains in assessing cognitive-communicative ability after RHD. In conclusion, we need to focus on the overall cognitive-communicative domains in an evaluative process of TBI and RHD. Furthermore, it is necessary to develop multiple items for individuals with cognitivecommunicative disorders for the purpose of differentiating these heterogeneous groups from other neurological disorders such as aphasia, and of making good use of them as a therapeutic manual.

• The Journal of the Korea Contents Association
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• v.14 no.3
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• pp.203-214
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• 2014

In this study, a meta-analysis was conducted to investigate the effect of community-based rehabilitation on patients with brain injury by ICF factor in previous studies and examine the application of recent community-based rehabilitation program. Total 15 articles that satisfied the selection criteria were divided by ICF factors to obtain the effect size. Homogeneity and publication bias were tested for those selected papers. As a result, the overall effect size of community-based rehabilitation was 0.22; the effect size by physical function and structure among the ICF factors came to be 0.21; and the effect size of activity and participation was 0.20, indicating a small effect size. The studies involved in a meta-analysis were considered as the absence of heterogeneity and publication bias, which indicates that the results of this study are subjectively reliable. These results well explained the level of change on ICF factors, especially physical function and structure, activity and participation, in other words, the intervention effect of community-based rehabilitation on patients with brain injury.