• Journal of Korean Neurosurgical Society
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• v.59 no.5
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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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• v.65 no.5
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• pp.680-687
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• 2022

Objective : The influence of moderate-to-severe traumatic brain injury (TBI) on acute pulmonary injury is well established, but the association between acute pulmonary injury and mild TBI has not been well studied. Here, we evaluated the histological changes and fluctuations in inflammatory markers in the lungs to determine whether an acute pulmonary inflammatory response occurred after mild TBI. Methods : Mouse models of mild TBI (n=24) were induced via open-head injuries using a stereotaxic impactor. The brain and lungs were examined 6, 24, and 72 hours after injury and compared to sham-operated controls (n=24). Fluoro-Jade B staining and Astra blue and hematoxylin staining were performed to assess cerebral neuronal degeneration and pulmonary histological architecture. Quantitative real-time polymerase chain reaction analysis was done to measure inflammatory cytokines. Results : Increased neuronal degeneration and the mRNA expression of interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-10, and transforming growth factor (TGF)-β were observed after mild TBI. The IL-6, TNF-α, and TGF-β levels in mice with mild TBI were significantly different compared to those of sham-operated mice 24 hours after injury, and this was more pronounced at 72 hours. Mild TBI induced acute pulmonary interstitial edema with cell infiltration and alveolar morphological changes. In particular, a significant infiltration of mast cells was observed. Among the inflammatory cytokines, TNF-α was significantly increased in the lungs at 6 hours, but there was no significant difference 24 and 72 hours after injury. Conclusion : Mild TBI induced acute pulmonary interstitial inflammation and alveolar structural changes, which are likely to worsen the patient's prognosis.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.579-583
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• 2010

An 18-month-old intact male Pomeranian dog was presented because of traumatic head injury from a fall. Based on physical and neurological examination, brain injury was suspected. On plain skull radiographs, bony fragment following fracture was identified in the region of the right occipital bone. On computed tomography (CT) images, there were specific findings associated with an intracranial hemorrhage. The patient expired few hours after diagnosis, and performed necropsy. On gross findings, intracerebral hemorrhage and edema was detected and those were consistent with CT images. This report describes the clinical findings, CT imaging characteristics, necropsy findings, and histopathologic features of severe traumatic brain injury in a dog.

• Journal of Trauma and Injury
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• v.33 no.4
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• pp.236-241
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• 2020

The goal of this study was to evaluate the hypothesis that not every patient with hydrocephalus after decompressive craniectomy needs cerebrospinal fluid diversion, and that cranioplasty should be performed before considering cerebrospinal fluid diversion. Methods: Data were collected from 67 individual traumatic brain injury patients who underwent cranioplasty between January 1, 2019 and December 31, 2019. Patients' clinical and radiographic progression was reviewed retrospectively based on their medical records. Results: Twenty-two of the 67 patients (32.8%) had ventriculomegaly on computed tomography scans before cranioplasty. Furthermore, 38 patients showed progressive ventriculomegaly after cranioplasty. Of these 38 patients, only six (15.7%) showed worsening neurologic symptoms, which were improved by the tap test; these patients eventually underwent ventriculoperitoneal shunt placement. Conclusions: Cerebrospinal fluid diversion is not always required for radiologically diagnosed ventriculomegaly in traumatic brain injury patients after decompressive craniectomy. A careful clinical and neurologic evaluation should be conducted before placing a shunt.

• Journal of Oral Medicine and Pain
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• v.48 no.4
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• pp.181-185
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• 2023

We present a case report of a 52-year-old male patient who suffered head trauma in a car accident and subsequently experienced taste and smell disorders. Following the accident, the patient reported difficulty detecting salty and sour tastes and diminished olfactory perception. Neurosurgical evaluation revealed subarachnoid and subdural hemorrhages, while otolaryngology investigations revealed hyposmia-a decreased sense of smell. Upon referral to the Department of Oral Medicine, a comprehensive assessment revealed a general bilateral reduction in taste sensation, particularly ageusia for salty taste. Electric taste-detection thresholds significantly exceeded the normal ranges. Integrating our findings from neurosurgery, otolaryngology, and oral medicine resulted in a diagnosis of mixed chemosensory disorder attributed to head trauma. This case highlights the intricate interplay of alterations in taste and smell following head injury, emphasizing the significance of multidisciplinary evaluations in diagnosing mixed chemosensory disorders resulting from traumatic brain injury.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.79-82
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• 2024

The potential for traumatic brain injury resulting from falling coconuts is frequently overlooked. These incidents can cause focal lesions in the form of brain hemorrhage. Corpus callosum hemorrhage due to blunt trauma from a falling object is rare and typically associated with poor prognosis. The purpose of this report is to detail a case of corpus callosum hemorrhage caused by a coconut fall and to discuss the conservative management approach employed. We report the case of a 54-year-old woman who was admitted to the hospital with symptoms of unconsciousness, headache, and expressive aphasia after being struck by a falling coconut. Notably, hemorrhage was detected within the body of the corpus callosum, as revealed by imaging findings. The patient received intensive monitoring and treatment in the intensive care unit, including oxygen therapy, saline infusion, an osmotic diuretic, analgesics, and medication to prevent stress ulcers. The patient demonstrated marked clinical improvement while undergoing conservative treatment. Despite the typically unfavorable prognosis of these rare injuries, our patient exhibited meaningful clinical improvement with conservative treatment. Timely diagnosis and appropriate interventions were crucial in managing the patient's condition. This report emphasizes the importance of considering traumatic brain injury caused by falling coconuts and highlights the need for further research and awareness in this area.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.29-33
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• 2018

Traumatic blunt aortic injury especially on proximal ascending aorta is a rare injury with a few reports. Generally emergency surgical management was performed. In this case, however, in multiple trauma with brain injury, emergency surgical management of aortic injury might result in unexpected secondary injury of the brain. Herein, we report a case of a 33-year-old man who was driving a truck was injured in a head-on collision. Evaluation revealed a pseudoaneurysm on his ascending aorta concomitant with epidural hemorrhage. He was treated by surgical management of his ascending aorta after 3 days from accident. There were no postoperative and neurologic complications and the patient was discharged after 18 days.

• Journal of Korean Neurosurgical Society
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• v.51 no.1
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• pp.24-30
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• 2012

Objective : This study was conducted to assess the clinical significance of traumatic brain stem injury (TBSI) reflected on Glasgow Coma Score (GCS) and Glasgow Outcome Score (GOS) by various clinical variables. Methods : A total of 136 TBSI patients were selected out of 2695 head-injured patients. All initial computerized tomography and/or magnetic resonance imaging studies were retrospectively analyzed according to demographic- and injury variables which result in GCS and GOS. Results : In univariate analysis, mode of injury showed a significant effect on combined injury (p<0.001), as were the cases with skull fracture on radiologic finding (p<0.000). The GCS showed a various correlation with radiologic finding (p<0.000), mode of injury (p<0.002), but less favorably with impact site (p<0.052), age (p<0.054) and skull fracture (p<0.057), in order of statistical significances. However, only GOS showed a definite correlation to radiologic finding (p<0.000). In multivariate analysis, the individual variables to enhance an unfavorable effect on GCS were radiologic finding [odds ratio (OR) 7.327, 95% confidence interval (CI)], mode of injury (OR; 4.499, 95% CI) and age (OR; 3.141, 95% CI). Those which influence an unfavorable effect on GOS were radiologic finding (OR; 25.420, 95% CI) and age (OR; 2.674, 95% CI). Conclusion : In evaluation of TBSI on outcome, the variables such as radiological finding, mode of injury, and age were revealed as three important ones to have an unfavorable effect on early stage outcome expressed as GCS. However, mode of injury was shown not to have an unfavorable effect on late stage outcome as GOS. Among all unfavorable variables, radiological finding was confirmed as the only powerful prognostic variable both on GCS and GOS.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.8
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• pp.171-180
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• 2017

The purpose of this study is to determine an effective training method to improve sequela, since traumatic brain injury sequela is a major factor in determining the quality of life. Neurofeedback training was conducted for an adolescent who had experienced traumatic brain injury during his childhood and who had difficulty in cognitive learning and emotional aspects. The assessment of an adolescent was conducted using K-WAIS-IV intelligence test and QEEG brain wave analysis. In the neurofeedback training, T3 alpha wave compensation and T4 alpha wave inhibition training were performed 36 times for 30 minutes three times a week. In addition to the neurofeedback training, respiratory meditation was also made available to the adolescent. As a result, the adolescent showed a stable condition as indicated by taking a good sleep, reducing test anxiety, and satisfaction with final exam results. This study revealed the possibility for hidden physical and psychological problems arising due to childhood brain trauma. It has also recently been discovered that a more diverse set of tools can be found. In addition, these childhood traumatic brain injuries can be improved through brain training and meditation. The study finding is meaningful for its suggestion of a fusion method for developing mind and body therapy in terms of brain science.

• Journal of Korean Neurosurgical Society
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• v.55 no.4
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• pp.222-225
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• 2014

Traumatic intracranial aneurysms (TICAs) are rare and are associated with high rates of morbidity and mortality. TICAs usually result from head injuries caused by traffic accidents, industrial accidents, or gunshots. We report a traumatic aneurysm of the callosomarginal artery-cortical artery junction arising from a penetrating injury by scissors. A 51-year-old woman was admitted to our hospital after suffering a penetrating injury caused by scissors. Computed tomography (CT) and CT-angiography demonstrated a right orbital roof fracture, subarachnoid hemorrhage, frontal lobe hemorrhage, intraventricular hemorrhage, and a traumatic aneurysm of the right callosomarginal artery-cortical artery junction. We trapped the traumatic aneurysm and repositioned a galeal flap. Postoperative CT showed a small infarction in the left frontal lobe. Follow-up angiography two months later showed no residual aneurysm. We suggest that an aggressive surgical intervention be performed whenever TICA is diagnosed.