Korean Journal of Neurotrauma最新文献_第9页

Recent Updates on Controversies in Decompressive Craniectomy and Cranioplasty: Physiological Effect, Indication, Complication, and Management. 减压颅骨切除术和颅骨成形术争议的最新进展:生理效果、适应证、并发症和处理。

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e24

Jae Hyun Kim, Yoon-Hee Choo, Heewon Jeong, Moinay Kim, Eun Jin Ha, Jiwoong Oh, Seungjoo Lee

{"title":"Recent Updates on Controversies in Decompressive Craniectomy and Cranioplasty: Physiological Effect, Indication, Complication, and Management.","authors":"Jae Hyun Kim, Yoon-Hee Choo, Heewon Jeong, Moinay Kim, Eun Jin Ha, Jiwoong Oh, Seungjoo Lee","doi":"10.13004/kjnt.2023.19.e24","DOIUrl":"https://doi.org/10.13004/kjnt.2023.19.e24","url":null,"abstract":"Decompressive craniectomy (DCE) and cranioplasty (CP) are surgical procedures used to manage elevated intracranial pressure (ICP) in various clinical scenarios, including ischemic stroke, hemorrhagic stroke, and traumatic brain injury. The physiological changes following DCE, such as cerebral blood flow, perfusion, brain tissue oxygenation, and autoregulation, are essential for understanding the benefits and limitations of these procedures. A comprehensive literature search was conducted to systematically review the recent updates in DCE and CP, focusing on the fundamentals of DCE for ICP reduction, indications for DCE, optimal sizes and timing for DCE and CP, the syndrome of trephined, and the debate on suboccipital CP. The review highlights the need for further research on hemodynamic and metabolic indicators following DCE, particularly in relation to the pressure reactivity index. It provides recommendations for early CP within three months of controlling increased ICP to facilitate neurological recovery. Additionally, the review emphasizes the importance of considering suboccipital CP in patients with persistent headaches, cerebrospinal fluid leakage, or cerebellar sag after suboccipital craniectomy. A better understanding of the physiological effects, indications, complications, and management strategies for DCE and CP to control elevated ICP will help optimize patient outcomes and improve the overall effectiveness of these procedures.","PeriodicalId":36879,"journal":{"name":"Korean Journal of Neurotrauma","volume":"19 2","pages":"128-148"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/9c/kjn-19-128.PMC10329888.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9813368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Comparison of Preventable Trauma Death Rates in Patients With Traumatic Brain Injury Before and After the Establishment of Regional Trauma Center: A Single Center Experience. 区域创伤中心建立前后外伤性脑损伤患者可预防创伤死亡率的比较:单中心经验

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e16

Dae Han Choi, Tae Seok Jeong, Myung Jin Jang

{"title":"Comparison of Preventable Trauma Death Rates in Patients With Traumatic Brain Injury Before and After the Establishment of Regional Trauma Center: A Single Center Experience.","authors":"Dae Han Choi, Tae Seok Jeong, Myung Jin Jang","doi":"10.13004/kjnt.2023.19.e16","DOIUrl":"https://doi.org/10.13004/kjnt.2023.19.e16","url":null,"abstract":"Objective: To compare preventable trauma death rates (PTDRs) in patients with traumatic brain injury before and after the establishment of a regional trauma center (RTC) at a single center.Methods: Our institution established an RTC in 2014. A total of 709 patients were enrolled from January 2011 to December 2013 (before RTC) and 672 from January 2019 to December 2021 (after RTC). The revised trauma score, injury severity score, and trauma and injury severity score (TRISS) were evaluated. Definitive preventable (DP), possibly preventable (PP), and non-preventable deaths were defined as TRISS >0.5, TRISS 0.25-0.5, and TRISS <0.25, respectively. PTDR was the proportion of deaths from DP+PP out of all deaths, and the preventable major trauma death rate (PMTDR) was the proportion of deaths from DP+PP out of all DP+PP.Results: The overall mortality rates before and after the establishment of RTC were 20.3 and 13.1%, respectively. PTDR was lower after the establishment of RTC than before (90.3% vs. 79.5%). The PMTDR was also lower after the establishment of RTC than before (18.8% vs. 9.7%). The ratio of direct hospital visits was higher in patients before the establishment of RTC than in those after (74.9% vs. 61.3%, p<0.001).Conclusion: Establishing the RTC reduced PTDRs. Additional studies on factors associated with PTDR reduction are required.","PeriodicalId":36879,"journal":{"name":"Korean Journal of Neurotrauma","volume":"19 2","pages":"227-233"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/dc/kjn-19-227.PMC10329879.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9813371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term Tractography Evaluation of Corpus Callosum Impairment After Severe Traumatic Brain Injury in Patients With Isolated Intraventricular Hemorrhage on Admission CT: Two Illustrative Cases and a Literature Review. 入院CT对单纯脑室内出血重症颅脑外伤后胼胝体损伤的长期造影评价:2例并文献复习。

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e27

Polina Angelova, Ivo Kehayov, Edgar G Ordonez-Rubiano, Luisa F Figueredo, Dora Zlatareva

{"title":"Long-term Tractography Evaluation of Corpus Callosum Impairment After Severe Traumatic Brain Injury in Patients With Isolated Intraventricular Hemorrhage on Admission CT: Two Illustrative Cases and a Literature Review.","authors":"Polina Angelova, Ivo Kehayov, Edgar G Ordonez-Rubiano, Luisa F Figueredo, Dora Zlatareva","doi":"10.13004/kjnt.2023.19.e27","DOIUrl":"https://doi.org/10.13004/kjnt.2023.19.e27","url":null,"abstract":"Severe traumatic brain injury (TBI) is often associated with diffuse axonal injury. Diffuse axonal injury affecting the corpus callosum may present with intraventricular hemorrhage on baseline computed tomography (CT) scan. Posttraumatic corpus callosum damage is a chronic condition that can be diagnosed over the long term using various magnetic resonance imaging (MRI) sequences. Here, we present two cases of severe survivors of TBI with isolated intraventricular hemorrhage detected on an initial CT scan. After acute trauma management, long-term follow-up was performed. Diffusion tensor imaging and subsequent tractography revealed a significant decrease in the fractional anisotropy values and the number of corpus callosum fibers compared with those in healthy control patients. This study presents a possible correlation between traumatic intraventricular hemorrhage on admission CT and long-term corpus callosum impairment detected on MRI in patients with severe head injury by presenting demonstrative cases and conducting a literature review.","PeriodicalId":36879,"journal":{"name":"Korean Journal of Neurotrauma","volume":"19 2","pages":"249-257"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/4c/kjn-19-249.PMC10329887.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10189623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intracranial Pressure Monitoring for Acute Brain Injured Patients: When, How, What Should We Monitor. 急性脑损伤患者的颅内压监测:何时，如何监测，应该监测什么。

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e32

Youngbo Shim, Jungook Kim, Hye Seon Kim, Jiwoong Oh, Seungioo Lee, Eun Jin Ha

{"title":"Intracranial Pressure Monitoring for Acute Brain Injured Patients: When, How, What Should We Monitor.","authors":"Youngbo Shim, Jungook Kim, Hye Seon Kim, Jiwoong Oh, Seungioo Lee, Eun Jin Ha","doi":"10.13004/kjnt.2023.19.e32","DOIUrl":"https://doi.org/10.13004/kjnt.2023.19.e32","url":null,"abstract":"While there is no level I recommendation for intracranial pressure (ICP) monitoring, it is typically indicated for patients with severe traumatic brain injury (TBI) with a Glasgow Coma Scale (GCS) score of 3-8 (class II). Even for moderate TBI patients with GCS 9-12, ICP monitoring should be considered for risk of increased ICP. The impact of ICP monitoring on patient outcomes is still not well-established, but recent studies reported a reduction of early mortality (class III) in TBI patients. There is no standard protocol for the application of ICP monitoring. In cases where cerebrospinal fluid drainage is required, an external ventricular drain is commonly used. In other cases, parenchymal ICP monitoring devices are generally employed. Subdural or non-invasive forms are not suitable for ICP monitoring. The mean value of ICP is the parameter recommended for observation in many guidelines. In TBI, values above 22 mmHg are associated with increased mortality. However, recent studies proposed various parameters including cumulative time with ICP above 20 mmHg (pressure-time dose), pressure reactivity index, ICP waveform characteristics (pulse amplitude of ICP, mean ICP wave amplitude), and the compensatory reserve of the brain (reserve-amplitude-pressure), which are useful in predicting patient outcomes and guiding treatment. Further research is required for validation of these parameters compared to simple ICP monitoring.","PeriodicalId":36879,"journal":{"name":"Korean Journal of Neurotrauma","volume":"19 2","pages":"149-161"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/e6/kjn-19-149.PMC10329885.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10189631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deep Sedation in Traumatic Brain Injury Patients. 外伤性脑损伤患者的深度镇静。

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e19

Yoon-Hee Choo, Youngbeom Seo, Hyuk-Jin Oh

引用次数: 0

Neurocritical Care and Neurotrauma. 神经危重症护理和神经创伤。

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e23

Eun Jin Ha, Jiwoong Oh

引用次数: 0

The Importance of Headgear During Scooter Riding in the Pediatric Population, and Suggesting Recommendations. 儿童骑滑板车时戴头饰的重要性及建议。

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e18

Sunghoon Choi, Jung Jae Lee, Eunhye Lee, Min Ho Lee

{"title":"The Importance of Headgear During Scooter Riding in the Pediatric Population, and Suggesting Recommendations.","authors":"Sunghoon Choi, Jung Jae Lee, Eunhye Lee, Min Ho Lee","doi":"10.13004/kjnt.2023.19.e18","DOIUrl":"https://doi.org/10.13004/kjnt.2023.19.e18","url":null,"abstract":"Objective: The authors analyzed the characteristics of pediatric patients who visited trauma center due to injuries sustained while riding scooters and suggested recommendations on our concerns about pediatric scooter use.Methods: From January 2019 to June 2022, we collected data for those who visited due to accidents while riding scooters. And, the analysis was conducted by dividing it into pediatric (younger than 12 years) and adult (older than 20 years) patients.Results: There were 264 children (<12 years), and 217 adults (>19 years). We observed 170 head injuries (64.4%), in the pediatric population and 130 head injuries (60.0%) in the adult population. There were no significant differences between pediatric and adult patients for all three injured regions. Among pediatric patients, only 1 reported the use of protective headgear (0.4%). The patient suffered a cerebral concussion. However, 9 of the pediatric patients who did not wear protective headgear suffered major trauma. Among 217 adult patients, 8 (3.7%) had used headgear. 6 suffered major trauma and 2 suffered minor trauma. Of the patients who did not wear protective headgear, 41 suffered major trauma and 81 suffered minor trauma. Since there was only one patient in the pediatric group who wore headgear, no statistical inferences could be calculated.Conclusion: In the pediatric population, the head injury rate is as high as in adults. We were unable to statistically support the significance of headgear in the current study. However, in our general experience, the importance of headgear is overlooked in the pediatric population compared to adults. It is necessary to encourage the use of headgear actively publicly.","PeriodicalId":36879,"journal":{"name":"Korean Journal of Neurotrauma","volume":"19 2","pages":"242-248"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/27/kjn-19-242.PMC10329883.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9813375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Mini-Review: Role of Drugs Affecting Renin-Angiotensin System (RAS) in Traumatic Brain Injury (TBI): What We Know and What We Should Know. 小型综述:影响肾素-血管紧张素系统(RAS)的药物在创伤性脑损伤(TBI)中的作用:我们所知道的和我们应该知道的。

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e26

Mohammad Kazem Sarpolaki, Ali Vafaei, Mohammad Reza Fattahi, Arad Iranmehr

引用次数: 0

Optimizing Mannitol Use in Managing Increased Intracranial Pressure: A Comprehensive Review of Recent Research and Clinical Experiences. 优化甘露醇在颅内压升高中的应用:近期研究和临床经验的综合综述。

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e25

Jae Hyun Kim, Heewon Jeong, Yoon-Hee Choo, Moinay Kim, Eun Jin Ha, Jiwoong Oh, Youngbo Shim, Seung Bin Kim, Han-Gil Jung, So Hee Park, Jung Ook Kim, Junhyung Kim, Hye Seon Kim, Seungjoo Lee

{"title":"Optimizing Mannitol Use in Managing Increased Intracranial Pressure: A Comprehensive Review of Recent Research and Clinical Experiences.","authors":"Jae Hyun Kim, Heewon Jeong, Yoon-Hee Choo, Moinay Kim, Eun Jin Ha, Jiwoong Oh, Youngbo Shim, Seung Bin Kim, Han-Gil Jung, So Hee Park, Jung Ook Kim, Junhyung Kim, Hye Seon Kim, Seungjoo Lee","doi":"10.13004/kjnt.2023.19.e25","DOIUrl":"https://doi.org/10.13004/kjnt.2023.19.e25","url":null,"abstract":"Mannitol, derived from mannose sugar, is crucial in treating patients with elevated intracranial pressure (ICP). Its dehydrating properties at the cellular and tissue levels increase plasma osmotic pressure, which is studied for its potential to reduce ICP through osmotic diuresis. While clinical guidelines support mannitol use in these cases, the best approach for its application continues to be debated. Important aspects needing further investigation include: 1) bolus administration versus continuous infusion, 2) ICP-based dosing versus scheduled bolus, 3) identifying the optimal infusion rate, 4) determining the appropriate dosage, 5) establishing fluid replacement plans for urinary loss, and 6) selecting monitoring techniques and thresholds to assess effectiveness and ensure safety. Due to the lack of adequate high-quality prospective research data, a comprehensive review of recent studies and clinical trials is crucial. This assessment aims to bridge the knowledge gap, improve understanding of effective mannitol use in elevated ICP patients, and provide insights for future research. In conclusion, this review aspires to contribute to the ongoing discourse on mannitol application. By integrating the latest findings, this review will offer valuable insights into the function of mannitol in decreasing ICP, thereby informing better therapeutic approaches and enhancing patient outcomes.","PeriodicalId":36879,"journal":{"name":"Korean Journal of Neurotrauma","volume":"19 2","pages":"162-176"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/49/kjn-19-162.PMC10329884.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10189628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electron Microscopic Study in the Rat Model of Electrically Injured Myelopathy: Preliminary Report. 电损伤性脊髓病大鼠模型的电镜研究:初步报告。

Korean Journal of Neurotrauma Pub Date : 2023-06-01 DOI: 10.13004/kjnt.2023.19.e15

Je Hoon Jeong, Cheong Hoon Seo, Dae Hoon Lee

{"title":"Electron Microscopic Study in the Rat Model of Electrically Injured Myelopathy: Preliminary Report.","authors":"Je Hoon Jeong, Cheong Hoon Seo, Dae Hoon Lee","doi":"10.13004/kjnt.2023.19.e15","DOIUrl":"https://doi.org/10.13004/kjnt.2023.19.e15","url":null,"abstract":"Objective: The patient with electrically injured myelopathy showed mild motor weakness without somatosensory pathway abnormalities. Few reports have been reported on the pathophysiological mechanisms of electrically injured myelopathy, and there is controversy about the exact pathological causes. This study aimed to investigate the ultrastructural changes in the electron microscopic findings of electrical spinal cord injury.Methods: Nine rats were used in this study. We performed 7 electrical shocks (frequency, 120 Hz; pulse width, 0.9 ms; duration, 3 seconds; current, 99 mA) using an electroconvulsive therapy (ECT) apparatus (57800 ECT unit; UGO BASILE). We used one ear and one contralateral hind limb as entry and exit sites, respectively. We only enrolled rats with hind limb weakness and performed electron microscopy evaluations of the spinal cord on the first day and 4 weeks after injury.Results: On the first day after injury, an electron microscopic examination showed a directly damaged area that appeared to be torn as physical damage, damaged myelin sheath, vacuolated axons in the myelin sheath, swollen Golgi apparatus, and injured mitochondria. Looking at changes in motor and sensory nerves, the sensory neurons showed recovered mitochondria and Golgi apparatus 4 weeks after injury; however, motor neurons still showed injured mitochondria, swollen Golgi apparatus, and endoplasmic reticulum.Conclusion: This study showed that recovery from ultrastructural injury was more rapid in sensory neurons than in motor neurons.","PeriodicalId":36879,"journal":{"name":"Korean Journal of Neurotrauma","volume":"19 2","pages":"218-226"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/55/kjn-19-218.PMC10329894.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10189630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0