NeuroRehabilitation
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NeuroRehabilitation · Jan 2010
ReviewHypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms.
Hypoxic-ischemic brain injury is a well known consequence of cardiac arrest. Variable injuries can occur with purely hypoxic or histotoxic insults such as asphyxiation and carbon monoxide poisoning. ⋯ The nature and extent of the damage appears to depend on the severity, time course and duration of the oxygen deprivation and lack of blood supply, as well as on the underlying mechanism. This review describes the pathophysiological and molecular basis of hypoxic ischemic brain injury, and differentiates between the mechanisms of injury by cardiac arrest, pure respiratory arrest, and arrest secondary to cytotoxicity (e.g. carbon monoxide poisoning).
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Hypoxic-ischemic brain injury (HI-BI) after cardiac arrest commonly results in neurological injury and long term dysfunction, with outcomes ranging from coma and vegetative states to functional disability with various degrees of dependence. Increased rates of bystander CPR and cardiac defibrillation has led to a rapid increase in successful resuscitations. ⋯ Several neurological syndromes have been reported as consequences of HI-BI. This review will describe some of the more common syndromes seen after HI-BI, including the various levels of arousal, seizures, myoclonus, movement disorders, cognitive impairments, and other specific neurological abnormalities.
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NeuroRehabilitation · Jan 2010
Corpus callosum injury in patients with diffuse axonal injury: a diffusion tensor imaging study.
Little is known about diffusion tensor image (DTI) findings of corpus callosum (CC) injury in patients with diffuse axonal injury (DAI). In the present study, we investigated the presence and extent of CC injury in patients with DAI. Twenty patients with DAI and 20 age-and sex-matched normal healthy controls subjects were recruited. ⋯ FA values of the six sagittal segments in the CC (-) and (+) groups were significantly lower than those of controls, and ADC values were slightly higher, or showed no change. CC lesions may be present in DAI patients, irrespective of detection on conventional brain MRI. The authors suggest the probability that in cases of corpus callosum injury, DTI can offer a powerful means of detecting DAI.
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NeuroRehabilitation · Jan 2010
Posttraumatic stress symptoms in OIF/OEF service members with blast-related and non-blast-related mild TBI.
To examine the proportion and severity of stress-related symptoms in U.S. service members with mild traumatic brain injuries (mTBI) received during deployment to Operation Iraqi Freedom (OIF) or Operation Enduring Freedom (OEF). Stress-related symptoms reported by service members with mTBI from explosive munitions are compared to symptoms reported by those with mTBI received from other mechanisms (i.e. falls, motor vehicle accidents). ⋯ Consistent with prior reports, high levels of posttraumatic stress symptoms occur in a substantial proportion of service members who experienced deployment-related blast and non-blast mTBI. Results suggest that the psychological rehabilitation of OIF/OEF service members with mTBI from explosive blast should include particular attention to addressing re-experiencing symptoms.