• 생물정신의학
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• 제2권2호
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• pp.193-204
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• 1995

Traumatic brain injury(TBI) used to be developed after a severe traumatic event. Therefore TBI usually induces acute or chronic stress reaction. I reviewed the concept, epidemiology, biological or psychosocial etiology, diagnosis and treatment of post-traumatic stress disorder (PTSD), and discussed about PTSD or stress reaction after TBI. Early evaluation and management of stress reaction after TBI are important.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.354-360
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• 2022

Traumatic brain injury (TBI) is the leading cause of death and disability in children. Survivors of severe TBI are more susceptible to functional deficits, resulting in disability, poor quality of life, cognitive decline, and mental health problems. Despite this, little is known about the pathophysiology of TBI in children and how to manage it most effectively. Internationally, efforts are being made to expand knowledge of pathophysiology and develop practical clinical treatment recommendations to improve outcomes. Here we discuss recently updated evidence and management of severe pediatric TBI.

• The Journal of Korean Physical Therapy
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• 제35권6호
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• pp.190-194
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• 2023

Purpose: Traumatic brain injury (TBI) refers to brain damage caused by external forces or trauma. TBIs can vary in severity and result from accidents, falls, sports injuries, assaults, or other forms of physical trauma. The prefrontal cortex (PFC) is known have roles in various cognitive functions. We report on a patient with traumatic brain injury who showed prefrontal symptoms after injury of thalamocortical connections between mediodorsal nuclei (MD) of thalamus and PFC. Methods: A 54-year-old, male patient suffered a TBI as a result of a heavy object falling on his head. After onset of TBI, he showed typical symptoms of prefrontal lobe injury, including personality changes, memory impairment, and general cognition problem. The thalamocortical connections between MD and PFC (ventrolateral prefrontal cortex (VLPFC), dorsolateral prefrontal cortex (DLPFC), and obrbitofrontal cortex (OFC)) were reconstructed using diffusion tensor tractography. In terms of fractional anisotropy value, the right thalamocortical connections to the OFC were significantly lower than those of control subjects. Results: The value of mean diffusivity in the right thalamocortical connections to the DLPFC was significantly higher than that of control subjects. By contrast, both VLPFC and left OFC showed significant decrement in the tract volume of thalamocortical connections compared with that of control subjects. Conclusion: We reported on a patient who showed cognitive and neuropsychiatric impairment due to global injury of the thalamocoritcal connections between MD and PFC following TBI.

• Journal of Mechanical Science and Technology
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• 제19권7호
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• pp.1424-1431
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• 2005

In this study, head injury by impact force was evaluated by numerical analysis with 3-dimensional finite element (FE) model. Brain deformation by frontal head impact was analyzed to evaluate traumatic brain injury (TBI). The variations of head acceleration and intra-cranial pressure (ICP) during the impact were analyzed. Relative displacement between the skull and the brain due to head impact was investigated from this simulation. In addition, pathological severity was evaluated according to head injury criterion (HIC) from simulation with FE model. The analytic result of brain damage was accorded with that of the cadaver test performed by Nahum et al.(1977) and many medical reports. The main emphasis of this study is that our FE model was valid to simulate the traumatic brain injury by head impact and the variation of the HIC value was evaluated according to various impact conditions using the FE model.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.149-157
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• 2015

Purpose: Traumatic brain injury (TBI) is the most common cause of pediatric trauma patients came to the emergency department. Without guidelines, many of these children underwent repeat brain computed tomography (CT). The purpose of this study was to evaluate the value of repeat brain CT in children with TBI. Methods: We conducted a retrospective study of TBI in children younger than 19 years of age who visited the emergency department (ED) from January 2011 to December 2012. According to the Glasgow Coma Scale (GCS) and Pediatric Glasgow Coma Scale score of the patients, study population divided in three groups. Clinical data collected included age, mechanism of injury, type of TBI, and outcome. Results: A Total 83 children with TBI received repeat brain CT. There were no need for neurosurgical intervention in mild TBI (GCS score 13-15) group who underwent routine repeat CT. 4 patients of mild TBI group, received repeat brain CT due to neurological deterioration, and one patient underwent neurosurgical intervention. Routine repeat CT identified 12 patients with radiographic progression. One patient underwent neurosurgical intervention based on the second brain CT finding, who belonged to the moderate TBI (GCS score 9-12) group. Conclusion: Our study showed that children with mild TBI can be observed without repeat brain CT when there is no evidence of neurologic deterioration. Further study is needed for establish indication for repetition of CT scan in order to avoid unnecessary radiation exposure of children.

• 대한한의학회지
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• 제29권2호
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• pp.21-31
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• 2008

Backgrounds: Singihwan is used "to strengthen inborn energy" and we suspected a protective effect on brain neuron cells. Objectives: The aim of this study was to evaluate the effects of Singihwan (SGH) on traumatic brain injury-induced delayed apoptosis in rat hippocampal dentate gyrus. Methods: For a surgical induction of traumatic brain injury (TBI), a 5 mm diameter stainless rod was used to make traumatic attack from the surface of the brain used by an impactor. The protective effect of the aqueous extract of SGH against TBI in the rat hippocampal dentate gyrus was investigated by using step-down avoidance task, terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) assay, Bax immunohistochemistry, and 5-bromo-2'-deoxyuridine (BrdU) immunohistochemistry. Results: The aqueous extract of SGH suppressed the TBI-induced increase in apoptosis and cell proliferation in the hippocampal dentate gyrus. Conclusions: It is possible that the aqueous extract of SGH has a neuroprotective effect on TBI-induced neuronal cell death.

• Investigative Magnetic Resonance Imaging
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• 제25권2호
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• pp.76-80
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• 2021

Post-concussion syndrome (PCS) following mild traumatic brain injury (mTBI) is a major factor that contributes to the increased socioeconomic burden caused by TBI. Myelin loss has been implicated in the development of PCS following mTBI. Diffusion tensor imaging (DTI), a traditional imaging modality for the evaluation of axonal and myelin integrity in mTBI, has intrinsic limitations, including its lack of specificity and its time-consuming and labor-intensive post-processing analysis. More recently, various fast MR techniques based on multicomponent relaxometry (MCR), including QRAPMASTER, mcDESPOT, and MDME sequences, have been developed. These MCR-based sequences can provide myelin water fraction/myelin volume fraction, a quantitative parameter more specific to myelin, which might serve as a surrogate marker of myelin volume, in a clinically feasible time. In this review, we summarize the clinical application of the MCR-based fast MR techniques in mTBI patients.

• Journal of Korean Neurosurgical Society
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• 제64권2호
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• pp.255-260
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• 2021

Objective : We aimed to investigate the presence of brachial plexus injury (BPI) in traumatic brain injury (TBI) patients and to draw attention to BPI, which can be overlooked by physicians in TBI patients. Methods : The study was designed retrospectively by examining the files of 58 patients with moderate to severe TBI to investigate coexistence of TBI and BPI. Results : BPI was detected in six of 58 TBI patients (10.3%). BPI was detected after an average 116 days from the initial injury. Three patients had lower trunk BPI and three patients had panplexopathy. Conclusion : Diagnosis of BPI in patients with TBI is delayed in the acute period of injury. The clinicians should keep in mind that BPIs may occur and remain undiagnosed in patients with TBI.

• Journal of Korean Neurosurgical Society
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• 제59권5호
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• pp.485-491
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• 2016

Objective : The aims of the Korean Neuro-Trauma Data Bank System (KNTDBS) are to evaluate and improve treatment outcomes for brain trauma, prevent trauma, and provide data for research. Our purpose was to examine the mortality rates following traumatic brain injury (TBI) in a retrospective study and to investigate the sociodemographic variables, characteristics, and causes of TBI-related death based on data from the KNTDBS. Methods : From 2010 to 2014, we analyzed the data of 2617 patients registered in the KNTDBS. The demographic characteristics of patients with TBI were investigated. We divided patients into 2 groups, survivors and nonsurvivors, and compared variables between the groups to investigate variables that are related to death after TBI. We also analyzed variables related to the interval between TBI and death, mortality by region, and cause of death in the nonsurvivor group. Results : The frequency of TBI in men was higher than that in women. With increasing age of the patients, the incidence of TBI also increased. Among 2617 patients, 688 patients (26.2%) underwent surgical treatment and 125 patients (4.7%) died. The age distributions of survivors vs. nonsurvivor groups and mortality rates according the severity of the brain injury, surgical treatment, and initial Glasgow Coma Scale (GCS) scores were statistically significantly different. Among 125 hospitalized nonsurvivors, 70 patients (56%) died within 7 days and direct brain damage was the most common cause of death (80.8%). The time interval from TBI to death differed depending on the diagnosis, surgical or nonsurgical treatment, severity of brain injury, initial GCS score, and cause of death, and this difference was statistically significant. Conclusion : Using the KNTDBS, we identified epidemiology, mortality, and various factors related to nonsurvival. Building on our study, we should make a conscious effort to increase the survival duration and provide rapid and adequate treatment for TBI patients.

• Journal of Korean Neurosurgical Society
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• 제58권2호
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• pp.131-136
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• 2015

Objective : To investigate the incidence of corpus callosum injury (CCI) in patients with mild traumatic brain injury (TBI) using brain MRI. We also performed a review of the clinical characteristics associated with this injury. Methods : A total of 356 patients in the study were diagnosed with TBI, with 94 patients classified as having mild TBI. We included patients with mild TBI for further evaluation if they had normal findings via brain computed tomography (CT) scans and also underwent brain MRI in the acute phase following trauma. As assessed by brain MRI, CCI was defined as a high-signal lesion in T2 sagittal images and a corresponding low-signal lesion as determined by axial gradient echo (GRE) imaging. Based on these criteria, we divided patients into two groups for further analysis : Group I (TBI patients with CCI) and Group II (TBI patients without CCI). Results : A total of 56 patients were enrolled in this study (including 16 patients in Group I and 40 patients in Group II). Analysis of clinical symptoms revealed a significant difference in headache severity between groups. Over 50% of patients in Group I experienced prolonged neurological symptoms including dizziness and gait disturbance and were more common in Group I than Group II (dizziness : 37 and 12% in Groups I and II, respectively; gait disturbance : 12 and 0% in Groups I and II, respectively). Conclusion : The incidence of CCI in patients with mild TBI was approximately 29%. We suggest that brain MRI is a useful method to reveal the cause of persistent symptoms and predict clinical prognosis.