Journal of neurotrauma
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Journal of neurotrauma · Dec 2015
A cervical hemi-contusion spinal cord injury model for the investigation of novel therapeutics targeting proximal and distal forelimb functional recovery.
Cervical spinal cord contusion is the most common human spinal cord injury, yet few rodent models replicate the pathophysiological and functional sequela of this injury. Here, we modified an electromechanical injury device and characterized the behavioral and histological changes occurring in response to a lateralized C4 contusion injury in rats. A key feature of the model includes a non-injurious touch phase where the spinal cord surface is dimpled with a consistent starting force. ⋯ Significant differences in loss of ipsilateral unmyelinated and myelinated white matter was detected between injury severities. Demyelination was primarily localized to the dorsolateral region of the hemicord and extended further rostral following 0.8 mm injury. These findings establish the C4 hemi-contusion injury as a consistent, graded model for testing novel treatments targeting forelimb functional recovery.
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Journal of neurotrauma · Dec 2015
Traumatic Spinal Cord Injury Emergency Service Triage Patterns and the Associated Emergency Department Outcomes.
Paralysis is an indication for trauma patients to be preferentially triaged by emergency services to designated level I or II trauma centers (TC). We sought to describe triage practices for patients with acute traumatic spinal cord injury (TSCI) and its associated emergency department (ED) outcomes. Adults ages ≥ 18 years with a diagnosis of acute TSCI (International Classification of Diseases-9: 806 and 952) in the 2006-2011 United States Nationwide Emergency Department Sample were included in these analyses. ⋯ In conclusion, under-triage of adults with acute TSCI occurred in at least one-third of the cases. Patients triaged to NTC rather than TC-I experienced higher likelihood of death in the ED even after controlling for personal and injury characteristics. Further research is necessary to elucidate detailed clinical and logistical factors that may be associated with under-triage of acute TSCI, to facilitate interventions aimed at improving patient experience and outcomes.
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Journal of neurotrauma · Dec 2015
Conversion equation between the drop height in the New York University impactor and the impact force in the Infinite Horizon impactor in the contusion spinal cord injury model.
There are several widely used devices for controlled contusion of the spinal cord, including the Ohio State University device, the University of British Columbia multi-mechanisms injury device, the New York University (NYU) impactor, and the Infinite Horizon (IH) impactor. Although various devices and protocols have been used to generate consistent injury severities, further investigation of the relationship between the key parameters of different spinal cord injury (SCI) contusion devices (e.g., drop height in the NYU impactor and impact force in the IH impactor) will improve our understanding of SCI mechanisms. ⋯ The consistent correlation was represented as a simple equation (Force = (28.2 ± 3.2) · Height((0.83 ± 0.07))) under the experimental conditions of a 10-g rod in the NYU impactor and an impact velocity of 125 mm/sec in the IH impactor. Thus, the key biomechanical parameter for a contusion device can be converted or translated to that of another device to analyze experimental results from multiple contusion devices.
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Journal of neurotrauma · Dec 2015
ReviewLong-Term Consequences of Traumatic Brain Injury: Current Status of Potential Mechanisms of Injury and Neurologic Outcomes.
Traumatic brain injury (TBI) is a significant clinical problem with few therapeutic interventions successfully translated to the clinic. Increased importance on the progressive, long-term consequences of TBI have been emphasized, both in the experimental and clinical literature. Thus, there is a need for a better understanding of the chronic consequences of TBI, with the ultimate goal of developing novel therapeutic interventions to treat the devastating consequences of brain injury. ⋯ Recently, the increased incidence in age-dependent neurodegenerative diseases in this patient population has also been emphasized. Pathomechanisms felt to be active in the acute and long-term consequences of TBI include excitotoxicity, apoptosis, inflammatory events, seizures, demyelination, white matter pathology, as well as decreased neurogenesis. The current article will review many of these pathophysiological mechanisms that may be important targets for limiting the chronic consequences of TBI.
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Journal of neurotrauma · Dec 2015
Multicenter StudyMortality following Traumatic Brain Injury among Individuals Unable to Follow Commands at the Time of Rehabilitation Admission: A NIDRR TBI Model Systems Study.
Severe traumatic brain injury (TBI) has been associated with increased mortality. This study characterizes long-term mortality, life expectancy, causes of death, and risk factors for death among patients admitted within the National Institute on Disability and Rehabilitation Research (NIDRR) TBI Model Systems Programs (TBIMS) who lack command following at the time of admission for inpatient TBI rehabilitation. Of the 8084 persons enrolled from 1988 and 2009, 387 from 20 centers met study criteria. ⋯ The subset of individuals with TBI who are unable to follow commands upon admission to inpatient rehabilitation are at a significantly increased risk of death when compared with the U. S. general population and compared with all individuals with moderate to severe TBI receiving inpatient rehabilitation. Respiratory causes of death predominate, compared with the general population.