Articles: brain-injuries.
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Reducing core temperature to protect the injured brain has become a new therapeutic measure. The scientific underpinnings based on animal experiments seem sound. Evidence of the therapy's effect in human trials is insufficient or even possibly absent, but the techniques to produce moderate hypothermia are available, without apparent significant complications, and are relatively easy to use for neurointensivists. This review summarizes the mechanisms of neuroprotection due to hypothermia and its application in clinical practice.
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Journal of neurotrauma · Jan 2004
Marked gender effect on lipid peroxidation after severe traumatic brain injury in adult patients.
Striking gender differences have been reported in the pathophysiology and outcome of acute neurological injury. Greater neuroprotection in females versus males may be due, in part, to direct and indirect sex hormone-mediated antioxidant mechanisms. Progesterone administration decreases brain levels of F(2)-isoprostane, a marker of lipid peroxidation, after experimental traumatic brain injury (TBI) in male rats, and estrogen is neuroprotective in experimental neurological injury. ⋯ To our knowledge, this is the first study showing gender differences in lipid peroxidation after clinical TBI. Lipid peroxidation occurs early after severe TBI in adults and is more prominent in males vs females. These results established that gender is an important consideration in clinical trial design, particularly in the case of antioxidant strategies.
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For many years, research focus on metallothioneins, small zinc binding proteins found predominantly within astrocytes in the brain, has centred on their ability to indirectly protect neurons from oxygen free radicals and heavy metal-induced neurotoxicity. However, in recent years it has been demonstrated that these proteins have previously unsuspected roles within the cellular response to brain injury. The aim of this commentary is to provide an overview of the exciting recent experimental evidence from several laboratories including our own suggesting a possible extracellular role for these proteins, and to present a hypothetical model explaining the newly identified function of extracellular metallothioneins in CNS injury and repair.
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Comparative Study
Receptive amusia: temporal auditory processing deficit in a professional musician following a left temporo-parietal lesion.
This study examined the musical processing in a professional musician who suffered from amusia after a left temporo-parietal stroke. The patient showed preserved metric judgement and normal performance in all aspects of melodic processing. By contrast, he lost the ability to discriminate or reproduce rhythms. ⋯ Since rhythm processing was selectively disturbed in the auditory modality, the arrhythmia cannot be attributed to a impairment of supra-modal temporal processing. Rather, our findings suggest modality-specific encoding of musical temporal information. Besides, it is proposed that the processing of auditory rhythmic sequences involves a specific left hemispheric temporal buffer.
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For both SCI and TBI, physicians are unable to affect reversal of the cellular injuries suffered at the time of trauma directly. Unfortunately, understanding such processes is just on the horizon. ⋯ Aggressive and pre-emptive attention to the ABC(D)s with attention to the needs of the injured nervous system, appropriate monitoring in all patients, meticulous medical management, and prompt surgical intervention when indicated have made marked improvements in outcome, particularly in TBI. Focusing on the basics and strict attention to detail appear to be the major roles played in the care of CNS trauma.