Brain Injuries
News
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Does Traumatic Brain Injury Trigger
Delayed Neuronal Death through
Apoptosis? |
Lawrence M. Lewis, Krikor
Dikranian, Philip V. Bayly, Erin Black,
Catherine Creeley and John W. Olney
Washington University, St. Louis, MO
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ABSTRACT
Background: There are conflicting data
on the role that apoptosis plays in
traumatic brain injury (TBI). Models by
different investigators differed in
species, age, mechanism/severity of
injury, and morphologic documentation of
neuronal cell death.
Objective: Determine if injury severity
is a trigger of apoptotic cell death in
juvenile mice.
Methods: Twelve 10-week-old male C57Bl/6
wild-type mice were divided into 2
groups of 6. Anesthetized animals were
placed in a stereotactic head-holder.
The scalp was incised and the lambdoid
suture identified. An electromagnetic
impactor with a metallic tip was set to
deliver an impact at 3.1 ± 0.1 m/sec,
20% from perpendicular, centered 3 mm
anterior and 2 mm left-lateral of
lambda. Indentation depth was set at 2
mm. The two groups differed only in that
group 1 was impacted with a 3-mm tip,
and group 2 with a 6-mm tip. Following
impact, the mice were recovered to
wakefulness. Histology using
silver/cupric nitrate and anti-caspase-3
staining was performed at 24 hours.
Results: No mice impacted with the 6-mm
tip displayed skull fracture or
hemorrhage. All recovered consciousness
within 2 minutes and interacted
normally. Silver stain indicative of
neuronal cell damage was confined mostly
to layer 1-3 of the ipsilateral parietal
cortex. None displayed caspase 3
immunostaining. All mice impacted with
the 3-mm tip had localized skull
fracture and subarachnoid hemorrhage.
They had prolonged unconsciousness (>5
minutes) and decreased motor activity.
Five animals survived 24 hours.
Histologic examination (silver staining)
showed bilateral neuronal injury in the
parietal cortex, hippocampus, and
thalamus. Caspase 3 positive cells were
seen in the penumbra and ipsilateral
hippocampus.
Conclusions: These results confirm
apoptosis is present at 24 hours in
animals with moderate to severe TBI, but
not with mild TBI. Further work is
needed to define the threshold of injury
at which apoptosis plays an important
role in secondary neuronal death.
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TRAUMATIC BRAIN INJURY
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Tamerla
Chavis, MD
Neurosurgeon
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When a physical force damages the brain,
it's known as a traumatic brain injury.
In the United States, it’s estimated
that 1.5 million people will sustain a
Traumatic Brain Injury each year.
Traumatic brain injury is caused by a
sudden blow to the head; either the head
strikes an object, or an object strikes
the head. And what it does is, it causes
the brain to actually shift within the
skull. And that shifting motion causes
injury to the brain, either by bruising
or by tearing small blood vessels.
Both open and closed head injuries can
cause severe brain damage, resulting in
the need for immediate medical
attention.
The first thing we do is, we stabilize
the patient. Once the patient is
stabilized, then we do a brief
neurological assessment to determine
urgency of imaging studies. We will
assess the patient’s level of alertness,
we will check their cranial nerves,
we’ll check their pupils, and we’ll
check their gross motor function.
If the patient has significant
intracranial injury, they will require
monitoring in the Intensive Care Unit.
They may require an intracranial
pressure monitor. They may also require
additional medications to control the
brain swelling.
The NeuroScience Department at CHRISTUS
St. Elizabeth provides diagnostic,
surgical, and acute care facilities for
those with traumatic brain injury.
St. Elizabeth has great facilities to
handle traumatic brain injury. We have a
fully staffed Neurological Intensive
Care Unit. We have full capacity for
intracranial monitoring. We also have
very good equipment for placement of
these monitors.
We have a full supportive staff in terms
of trauma services and pulmonary
services, which can also assist us.
For more information on traumatic brain
injury, including the signs and
symptoms, visit the CHRISTUS Web site.
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Cross-country cycle promotes brain
injury awareness |
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By PAMELA WOOD, Staff Writer |
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Armed with "a bicycle, two sets of
clothes, one eye and half a brain,"
Megan Timothy is on a mission to spread
a simple message of hope.
Ms. Timothy, a 63-year-old Californian
who stopped in Annapolis on Monday, said
she's bicycling across the country and
sharing her story of how she recovered
from a brain injury - a story she
painfully put down on paper and turned
into a book.
"Suddenly, everything in your life
disappeared and you don't know why or
how," Ms. Timothy said.
Ms. Timothy's brain injury is called an
arteriovenous malformation, an
abnormality in the arteries or veins in
the brain that can cause bleeding.
She had no idea she had a problem until
she awoke one night in 2003 feeling as
if she had an intense hangover, though
she doesn't drink. Her vision was off,
and when a friend called on the phone,
she thought she was talking normally,
but all that was coming out of her mouth
was nonsense.
After weeks in the hospital, surgery and
a stint in a rehab center, Ms. Timothy
was on a slow road to recovery. Now, she
said it's as though her brain thinks at
95 mph, she speaks at 85 mph and she
reads at 1 mph.
As her recovery progressed, Ms. Timothy
said the beginnings of a book formed in
her head. Writing it was difficult, she
said, because she couldn't write or
reread or edit as fast as she wanted to.
The result of her effort is "Let Me Die
Laughing! Waking up From the Nightmare
of a Brain Explosion."
The title comes from when she prepared
for brain surgery. She said she had "do
not resuscitate" orders plastered
everywhere. ("Dying is OK. Coming back
half-baked is what scared me," she
said.)
She was laughing about it with others
when a doctor interrupted that this was
a serious matter.
Ms. Timothy said she told the doctor,
"If I'm going to die, let me die
laughing."
She wants to inspire others overcoming
brain injuries and help doctors get a
better understanding of what their
patients are going through.
Her message to patients?
"You have to be strong. People can help
you, but they don't know everything.
They are not in your brain ... You have
to be patient and you can't pussyfoot."
For doctors: "You cannot forget, behind
this broken piece is a person with a
soul."
Ms. Timothy said she started her journey
Feb. 28 in her hometown of Hemet, S.C.
She biked across the South and up the
Atlantic Coast. After a stop in
Washington, D.C., for a publishing trade
show, she'll head north, go through the
Midwest to the Pacific Northwest, and
she plans to end up back home by
Thanksgiving.
For more information, visit
www.cronehousepublishing.com.
- No Jumps-
Published May 17, 2006, The Capital,
Annapolis, Md.
Copyright © 2006 The Capital, Annapolis,
Md.
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Blood Test Predicts Brain Injury Outcome
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04.27.06, 12:00 AM ET |
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THURSDAY, April 27 (HealthDay News) --
Blood levels of magnesium in patients
who've just suffered traumatic brain
injury could help predict outcomes,
researchers report.
A team at the University of Pittsburgh
Brain Trauma Research Center measured
initial blood magnesium levels in 83
patients with severe brain injuries.
They found that 35 of the patients had
normal magnesium levels when they
arrived at the brain trauma center,
while 48 had low levels. After six
months, the patients with the low serum
magnesium levels had significantly worse
outcomes.
"The simplest interpretation of this
data would support replenishing serum
magnesium levels as soon as possible in
traumatic brain injury patients.
However, the utility of this approach
needs to be proven," researcher Dr.
Martina Stippler said in a prepared
statement.
It's possible that blood magnesium
levels in some patients are low due to
the trauma itself, suggesting that low
levels are associated with a more severe
brain injury than might be indicated by
other clinical and radiographic tests.
The study was presented at this week's
annual meeting of the American
Association of Neurological Surgeons in
San Francisco.
Previous research in animals found that
blood magnesium levels affect secondary
brain injury that occurs in the hours
and days following the initial trauma.
More information
The U.S. Centers for Disease Control and
Prevention has more about traumatic
brain injury..
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