• 한국임상수의학회지
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• 제40권1호
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• pp.56-61
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• 2023

A 5-month-old female domestic short-haired cat presented with a history of seizure episodes for two months following an animal bite injury to the head. There were no remarkable findings on physical and neurological examination or blood analysis. Computed tomography revealed a fracture of the left parietal bone with an inward displacement of the bone fragment while magnetic resonance imaging revealed an enlarged temporal horn of the left lateral ventricle and a pseudomeningocele compressing the adjacent cerebral parenchyma. Subsequently, cerebrospinal fluid analysis results were normal. The patient was diagnosed with traumatic brain injury (TBI), with subsequent post-traumatic hydrocephalus (PTH) and pseudomeningocele. Despite treatment with phenobarbital and levetiracetam, seizures were not sufficiently controlled. Craniectomy for bone fragment removal and duraplasty were performed after a week. The patient then returned to normal condition with no further seizure activity. On repeated MRI two months after discharge, the hydrocephalus of the lateral ventricle and pseudomeningocele were enlarged; however, the patient maintained a good clinical status without any neurological signs. To the best of our knowledge, PTH and intracranial pseudomeningoceles have not yet been reported in cats. PTH and pseudomeningocele are among the complications of TBI and may not have any significant relevance with the clinical signs in this case. Thus, to broaden our knowledge about PTH and pseudomeningocele in cats, we describe serial changes in the clinical findings of this cat over the treatment period.

• 생명과학회지
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• 제23권9호
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• pp.1096-1103
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• 2013

만성외상성뇌병증(Chronic traumatic encephalopathy, CTE)은 운동선수와 매우 밀접하게 관련되어 있으며 장기간에 걸쳐 반복적인 외상성뇌손상(traumatic brain injury, TBI)로 인한 퇴행성뇌질환이다. 신경영양인자(neurotrophic factor)는 여러 종류가 알려져 있으며 이들은 뇌와 척수의 물리적 손상시에 신경보호효과가 있다. 따라서, 신경영양인자의 혼합물인 cebrolysin을 이용하여 CTE질환에 가장 적합하다고 여겨지는 repetitive mild TBI (rmTBI) 모델에서 cerebrolysin의 신경보호효과를 알아보고자 하였다. 실험군은 5군(groups 1 and 2: rmTBI for 4 weeks following cerebrolysin injection for 4 weeks; groups 3 and 4: rmTBI for 8 weeks with or without cerebrolysin injection for 4 weeks; group 5: control)으로 나누어 진행하였다. CTE의 가장 대표적 표시인자인 tau 단백질의 인산화를 조직학적으로 조사한 결과, 대뇌겉질과 해마내 CA3 영역에서 phospho-tau단백질의 발현이 증가되었으며 cerebrolysin ($10{\mu}l$ of 1 mg/ml)를 미정맥으로 투여시 p-tau발현이 감소되었다. CTE의 병인으로 알려진 별아교세포와 미세아교세포의 활성을 각각의 표시인인 GFAP, iba-1을 이용하여 면역조직화학염색을 시행하였다. 별아교세포의 활성은 rmTBI에 의하여 증가하였으며 cerebrolysin에 의해 회복되었으나 미세아교세포의 활성은 관찰되지 않았다. 또한 rmTBI모델에서 체내 탐식세포(macrophage)의 뇌내유입유무를 관찰하고자 CD45 염색을 시행하였으나 유의한 차이를 관찰하지 못하였다. 이상의 결과를 종합하면, cerebrolysin이 rmTBI에 의한 tau단백질의 인산화 및 별아교세포의 활성을 조절하는 것으로 사료된다. 따라서 cerebrolysin이 CTE 환자에 대한 치료 약물의 후보가 될 수 있음을 시사한다.

• 한국콘텐츠학회논문지
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• 제13권2호
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• pp.370-377
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• 2013

외상성 뇌손상(TBI)은 외부적 충격에 의해 뇌가 손상되는 것을 의미한다. 이로 인해 주의력, 기억력, 추론력, 집행기능, 화용언어 등이 전반적으로 저하된다. 본 연구에서는 외상성 뇌손상 환자의 인지-화용언어 능력 평가도구(CAPTBI)를 개발한 후, 그 신뢰도 및 타당도를 구축하고, 정상군과 환자군 간 변별에 유용한 인지-화용언어의 하위 영역들이 무엇인지를 분석하였다. 연구 대상은 정상군 226명, TBI 환자군 62명으로 평균 연령은 각각 43.95(${\pm}11.92$), 46.37(${\pm}11.87$)세, 남녀 비율은 각각 110:116, 48:14였다. CAPTBI는 내적일관성 신뢰도와 검사-재검사 신뢰도가 높았고, 내적 구성타당도와 공인타당도가 입증되었다. 또한, 두 집단은 CAPTBI 총점 및 9개 하위 영역 모두에서 유의미한 차이를 보여 CAPTBI가 집단 간 변별에 유용한 것으로 입증되었다. 두 집단 간 변별에 기여하는 하위 영역은 조직화 능력, 기억력, 집행기능, 지남력, 문제해결력, 화용언어, 추론력, 주의력, 시지각력 순으로 높았다. CAPTBI의 판별기능 적중률은 95.5%로 전체 집단 사례 중 정상군의 97.3%, 환자군의 88.7%를 정확히 판별하였다. 이에 따라, CAPTBI는 TBI 환자의 인지-화용언어 능력 평가도구로서 신뢰도와 타당도가 높고, 정상군과 환자군 간 변별에 유용한 도구임을 확인하였다.

• 재활치료과학
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• 제8권4호
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• pp.41-51
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• 2019

목적 : 본 예비 연구는 가상현실 기반의 일상생활활동 훈련이 외상성 뇌손상 환자의 일상생활활동 및 재활동기에 미치는 영향을 알아보고자 한다. 연구방법 : 본 연구는 7명의 외상성 뇌손상 환자를 대상으로 중재 전-후 설계를 수행하였다. 대상자들은 하루 30분, 주 2~3회, 4주간 가상현실 기반의 일상생활활동 훈련을 수행하였다. 중재 전과 후로 평가를 수행하였다. 측정은 수정바델지수, 기능적 독립척도(인지), 의지 설문지가 평가되었다. 중재 전과 후의 변화는 윌콕슨 부호순위 검정으로 분석하였고, 상관관계는 스피어만 상관분석을 이용하였다. 결과 : 중재 후, 외상성 뇌손상 환자는 한국판 수정바델지수에서 유의한 향상을 보였다(p<.05). 기능적 독립척도(인지)와 재활동기는 유의한 변화가 없었다(p>.05). 기능적 독립척도(인지)는 재활동기와 유의한 상관이 있었다(p<.05, r=.755). 기능적 독립척도(인지)의 사회인지영역은 재활동기와 유의한 상관이 있었다(p<.05, r=826). 결론 : 가상현실 기반의 일상생활활동 훈련은 일상생활활동 수행능력을 향상시킬 수 있으나, 사회인지와 재활동기의 개선여부가 가능한지에 대해서는 연구가 더 필요하다.

• 대한물리의학회지
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• 제7권2호
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• pp.137-147
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• 2012

Objective : The purpose of this study was to describe the Progressive Intervention strategy applied ICF (International Classification of Functioning, Disability and Health) Tool about Gait for TBI(Traumatic Brain Injury) patient. Methods : The data was collected by TBI patient. We applied the progressive Intervention strategy applied ICF Tool to TBI patient. Parameters of result were collected for using the Berg balance scale, TETRAX, Timed up and go test, Sit to stand test and ICF Evaluation Display Results : Significant differences were observed the TBI patient for Berg balance scale, TETRAX, Timed up and go test, Sit to stand test and ICF Evaluation. TBI patient improved all test. Conclusion : Progressive Intervention strategy applied ICF Tool is very useful and effective. It is effective in clinical practice.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.275-277
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• 2012

An eipdural hematoma in an infant is a very rare entity. We report a case of an acute traumatic intracranial epidural hematoma that developed with a lucid interval in a 4-month-old infant after a fall down from a bed. The infant was admitted at the emergency room. The child had initially cried and may have had a decreased level of consciouseness due to brain injury, but then returned to normal level of consciousness for several hours prior to admission. However, the infant had vomited twice after taking milk and then was lethargic. The brain CT revealed a lentiform-shaped huge hematoma on the right parietal area with a midline shift of 8 mm. An osteoplastic craniotomy was performed, and the intracranial epidural hematoma was totally removed. Postoperatively, the infant recovered well and was dischaged.

• Journal of Trauma and Injury
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• 제30권2호
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• pp.41-46
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• 2017

Purpose: To determine the incidence of post-concussion syndrome (PCS) in Korean patients after minor traumatic brain injury. Methods: We conducted an observational cohort study of a convenience sample of patients presenting to the emergency department of a major academic Korean hospital. Patients who visited the Emergency Department for head trauma were screened. A researcher questioned the subject regarding his or her symptoms. Subjects were contacted by phone approximately 2 weeks after their Emergency Department visit and questioned about subsequent symptoms and subsequent visits for medical care. Results: Only 8% of subjects reported any post-concussion symptoms. Only 0.4% had three or more symptoms which might have met criteria for PCS. The median peak onset of symptoms was 3 days after injury. Conclusion: The incidence of PCS is Korean patients is much lower than that documented for patients in the United States or other western countries. On the other hand, this study results could give an idea that mild trauma could also cause the PCS. Further study is needed to replicate this finding and investigate possible explanations for this difference.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.212-217
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• 2021

Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

• BMB Reports
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• 제55권10호
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• pp.512-517
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• 2022

Traumatic brain injury (TBI) is brain damage which is caused by the impact of external mechanical forces. TBI can lead to the temporary or permanent impairment of physical and cognitive abilities, resulting in abnormal behavior. We recently observed that a single session of early exercise in animals with TBI improved their behavioral performance in the absence of other cognitive abnormalities. In the present study, we investigated the therapeutic effects of continuous exercise during the early stages of TBI in rats. We found that continuous low-intensity exercise in early-stage improves the locomotion recovery in the TBI of animal models; however, it does not significantly enhance short-term memory capabilities. Moreover, continuous early exercise not only reduces the protein expression of cerebral damage-related markers, such as Glial Fibrillary Acid Protein (GFAP), Neuron-Specific Enolase (NSE), S100β, Protein Gene Products 9.5 (PGP9.5), and Heat Shock Protein 70 (HSP70), but it also decreases the expression of apoptosis-related protein BAX and cleaved caspase 3. Furthermore, exercise training in animals with TBI decreases the microglia activation and the expression of inflammatory cytokines in the serum, such as CCL20, IL-13, IL-1α, and IL-1β. These findings thus demonstrate that early exercise therapy for TBI may be an effective strategy in improving physiological function, and that serum protein levels are useful biomarkers for the predicition of the effectiveness of early exercise therapy.

• 한방재활의학과학회지
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• 제20권1호
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• pp.1-12
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• 2010

Objectives : Cool Pharmacopuncture for static blood is a famous pharmacopuncture treatment that treated disease caused by static blood. Hyolhae(Sp10) is also a famous point of acupuncture that treated that. This study was designed to evaluate the effects of Cool Pharmacopuncture for static blood into Hyolhae(Sp10) on BAX and BCL-2 expression in the experimental traumatic brain injury(TBI) rats. Methods : Male rats were divided into 3 groups. I was no treatment after TBI. II was treatment with needle-prick acupuncture after TBI. III was treatment with Cool Pharmacopuncture for static blood into Hyolhae(Sp10) after TBI. The author carried out neurological motor behavioral test, histological assessment test. Neurological motor behavior tests consist of rotarod test, beam-walking test and postural reflex test. In the histological assessment test, BAX and BCL-2 expression, hematoxylin & eosin staining were experimented. Results : In neurological motor behavior tests, motor and cognitive function recovery was significantly increased in the II, III as compared with I (p<0.05). Especially III was significantly increased as compared with II (p<0.05). BAX expression was significantly decresed in order of the III, II, I after 7 and 14 days later. BCL-2 expression was investigated in the III, II as compared with I. Especially Most incresed expression was experimented in the III. Conclusions : According to the above results, Cool Pharmacopuncture for static blood can inhibit apoptosis of cells after TBI in rats by contol of BAX and BCL expression.