• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.348-353
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• 2022

Traumatic brain injury (TBI) is a major public health issue that causes significant morbidity and mortality in the pediatric population. Pediatric minor TBIs are the most common and are widely underreported because not all patients seek medical attention. The specific management of these patients is distinct from that of adult patients because of the different physiologies in these age groups. This article focuses on minor TBIs, particularly growing skull fractures, traumatic cerebrospinal fluid leakage, and concussion.

• The Journal of Korean Physical Therapy
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• 제32권6호
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• pp.391-393
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• 2020

Objectives: We investigated injury of corticostriatal (CStr) tract in patient with mild traumatic brain injury (mTBI), which was demonstrated by DTT. Method: A 44-year-old female with no previous history of neurological, physical, or psychiatric illness had suffered from head trauma resulting from a pedestrian car accident. She complained that could not quickly move the left hand with her intension. After three month's administration, her slowness movement of left hand recovered rapidly to the point that she was able to extend all fingers quickly. Results: On DTT configuration, the integrity of the left CStr tract was well-preserved, however the right CStr tract showed narrowing and partial tearing in the subcortical white matter on a DTT at 25 months after onset. Conclusion: Injury of the right CStr tract was demonstrated in a patient who developed mild motor control problems following mild TBI. We believe that the evaluation of the CStr tract from the secondary motor area for patients who showed unexplained motor control problem is necessary.

• 생물정신의학
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• 제9권2호
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• pp.152-158
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• 2002

Background & Purpose:Neuropsychological disorders after traumatic brain injury(TBI) are poorly correlated with structural lesions detected by structural neuroimaging techniques such as computed tomography(CT) scan or magnetic resonance imaging(MRI). It is well known that patients with TBI have cognitive and behavioral disorders even in the absence of structural lesions of the brain. This study investigated whether there are abnormalities of regional cerebral blood flow(rCBF) in TBI patients without structural abnormality on MRI, using technetium 99m ethyl cysteinate dimer(Tc-99m-ECD) single photon emission computed tomography(SPECT) scans. Materials and Methods:Twenty-eight TBI patients without structural abnormality on MRI(mild, n=13/moderate, n=9/severe, n=6) and fifteen normal controls were scanned by SPECT. A voxel-based analysis using statistical parametric mapping(SPM) was performed to compare the patients with the normal controls. Results:rCBF was reduced in the right uncus and the right lateral orbitofrontal gyrus in the TBI patients. However, no increase of rCBF was noted in the patients in comparison to the normal controls. Conclusions:These results suggest that the TBI patients, even in the absence of structural lesion of the brain, may have dysfunction of the brain, particularly of the orbitofrontal and anterior pole of the temporal cortex. They also suggest that SPECT can be a useful method to identify brain dysfunctions in combination with structural brain imaging and neuropsychological tests.

• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.390-398
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• 2013

Objective : We determined whether the relationship between the neuropsychological performance of patients with mild traumatic brain injury (TBI) and their psychopathological characteristics measured by disability evaluation are interrelated. In addition, we assessed which psychopathological variable was most influential on neuropsychological performance via statistical clustering of the same characteristics of mild TBI. Methods : A total of 219 disability evaluation participants with mild brain injury were selected. All participants were classified into three groups, based on their psychopathological characteristics, via a two-step cluster analysis using validity and clinical scales from the Minnesota Multiphasic Personality Inventory (MMPI) and Symptom Checklist-90-revised (SCL-90-R). The Korean Wechsler Adult Intelligence Scale (K-WAIS), Korean Memory Assessment Scale (K-MAS) and the Korean Boston Naming Test (K-BNT) were used to evaluate the neurocognitive functions of mild TBI patients. Results : Over a quarter (26.9%) experienced severe psychopathological symptoms and 43.4% experienced mild or moderate psychopathological symptoms, and all of the mild TBI patients showed a significant relationship between neurocognitive functions and subjective and/or objective psychopathic symptoms, but the degree of this relationship was moderate. Variances of neurocognitive function were explained by neurotic and psychotic symptoms, but the role of these factors were different to each other and participants did not show intelligence and other cognitive domain decrement except for global memory abilities compared to the non-psychopathology group. Conclusion : Certain patients with mild TBI showed psychopathological symptoms, but these were not directly related to cognitive decrement. Psychopathology and cognitive decrement are discrete aspects in patients with mild TBI. Furthermore, the neurotic symptoms of mild TBI patients made positive complements to decrements or impairments of neurocognitive functions, but the psychotic symptoms had a negative effect on neurocognitive functions.

• Journal of Korean Neurosurgical Society
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• 제44권5호
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• pp.295-302
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• 2008

Objective: Premorbid demographic backgrounds of injured individuals are likely to reflect more accurately the status of patients with traumatic brian injury (TBI) than clinical factors. However, the concrete study about the relationship between the demographic factors and neurocognitive function in TBI patients has not been reported. The object of this study was to evaluate the effect of premorbid demographic factors on the recovery of neurocognitive function following TBI. Methods: From July 1998 to February 2007, 293 patients (male: 228, female: 65) with a history of head injury, who had recovered from the acute phase, were selected from our hospital to include in this study. We analyzed the effect of premorbid demographic factors including age, sex, educational level and occupation on the recovery of neurocognitive function in each TBI subgroup as defined by Glasgow Coma Scale (GCS) score. Intelligence and memory are components of neurocognitive function, and the Korean Wechsler Intelligence Scale (K-WAIS) and the Korean memory assessment scale (K-MAS) were used in this study. The results were considered significant at p<0.05. Results: The higher level of education was a good prognostic factor for intelligence regardless of GCS score and younger age group showed a better result for memory with an exception of severe TBI group. In the severe TBI group, the meaningful effect of demographic factors was not noted by the cause of influence of severe brain injury. Conclusion: The demographic factors used in this study may be helpful for predicting the precise prognosis and developing an appropriate rehabilitation program for TBI patients.

• 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.

• 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 Korean Neurosurgical Society
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• 제65권2호
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• pp.196-203
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• 2022

Objective : To perform a comparative analysis of therapeutic effects associated with two different shapes of ceria nanoparticles, ceria nanorods (Ceria NRs) and ceria nanospheres (Ceria NSs), in an in vitro model of traumatic brain injury (TBI). Methods : In vitro TBI was induced using six-well confluent plates by manually scratching with a sterile pipette tip in a 6×6-square grid. The cells were then incubated and classified into cells with scratch injury without nanoparticles and cells with scratch injury, which were treated separately with 1.16 mM of Ceria NSs and Ceria NRs. Antioxidant activities and anti-inflammatory effects were analyzed. Results : Ceria NRs and Ceria NSs significantly reduced the level of reactive oxygen species compared with the control group of SH-SY5Y cells treated with Dulbecco's phosphate-buffered saline. The mRNA expression of superoxide dismutases was also reduced in nanoparticle-treated SH-SY5Y cells, but apparently the degree of mRNA expression decrease was not dependent on the nanoparticle shape. Exposure to ceria nanoparticles also decreased the cyclooxygenase-2 expression, especially prominent in Ceria NR-treated group than that in Ceria NS-treated group. Conclusion : Ceria nanoparticles exhibit antioxidant and anti-inflammatory effects in TBI models in vitro. Ceria NRs had better anti-inflammatory effect than Ceria NSs, but showed similar antioxidant activity.

• Advances in biomechanics and applications
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• 제1권4호
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• pp.253-267
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• 2014

The human head is identified as the body region most frequently involved in life-threatening injuries. Extensive research based on experimental, analytical and numerical methods has sought to quantify the response of the human head to blunt impact in an attempt to explain the likely injury process. Blunt head impact arising from vehicular collisions, sporting injuries, and falls leads to relative motion between the brain and skull and an increase in contact and shear stresses in the meningeal region, thereby leading to traumatic brain injuries. In this paper the properties and material modeling of the subarachnoid space (SAS) as it relates to Traumatic Brain Injuries (TBI) is investigated. This was accomplished using a simplified local model and a validated 3D finite element model. First the material modeling of the trabeculae in the Subarachnoid Space (SAS) was investigated and validated, then the validated material property was used in a 3D head model. In addition, the strain in the brain due to an impact was investigated. From this work it was determined that the material property of the SAS is approximately E = 1150 Pa and that the strain in the brain, and thus the severity of TBI, is proportional to the applied impact velocity and is approximately a quadratic function. This study reveals that the choice of material behavior and properties of the SAS are significant factors in determining the strain in the brain and therefore the understanding of different types of head/brain injuries.

• 대한간호학회지
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• 제36권4호
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• pp.621-629
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• 2006

Purpose. The purpose of this study was to identify the clinical variables that predict functional and cognitive recovery at 1- and 6-month in both severe and moderate/mild traumatic brain injury patients. Methods. The subjects of this study were 82 traumatically brain-injured patients who were admitted to a Neurological Intensive Care Unit at a university hospital. Potential prognostic factors included were age, motor and pupillary response, systolic blood pressure, heart rate, and the presence of intracranial hematoma at admission. Results. The significant predictors of functional disability in severe traumatic brain injury subjects were, age, systolic blood pressure, the presence of intracranial hematoma, motor response, and heart rate at admission. In moderate/mild traumatic brain injury patients, motor response, abnormal pupil reflex, and heart rate at admission were identified as significant predictors of functional disability. On the other hand, the significant predictors of cognitive ability for severe traumatic brain injury patients were motor response and the presence of intracranial hematoma at admission, whereas those for moderate/mild patients were motor response, pupil reflex, systolic blood pressure at admission, and age. Conclusions. The results of the present study indicate that the significant predictors of TBI differ according to TBI severity on admission, outcome type, and outcome measurement time. This can be meaningful to critical care nurses for a better understanding on the prediction of brain injury patients. On the other hand, the model used in the present study appeared to produce relatively low explicabilities for functional and cognitive recovery although a direct comparison of our results with those of others is difficult due to differences in outcome definition and validation methods. This implies that other clinical variables should be added to the model used in the present study to increase its predicting power for determining functional and cognitive outcomes.