1/12. intracranial pressure within a developing intracerebral haemorrhage.We report the time course of intracranial pressure within a developing intracerebral haemorrhage. Simultaneous readings of intracranial pressure were obtained from a contralateral parenchymal monitor and ventricular fluid pressure monitor. This recording demonstrates the existence of large pressure gradients in patients with expanding mass lesions.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/12. Reorganisation of the sensorimotor cortex after early focal brain lesion: a functional MRI study in monozygotic twins.Sensorimotor cortical reorganization after early brain lesions was studied by means of fMRI in two pairs of monozygotic twins, in each of which one member had a focal brain injury. This offered a unique opportunity to reduce the wide intersubject variability of the controls often found in similar studies. Activation images were acquired during a motor task (sequential opposition finger movements) and a sensory task (passive brushing of palm and fingers). During the tasks with the recovered hand, constant findings in the lesioned subjects were the activation of the undamaged areas adjacent to lesion site and the activation of the ipsilateral sensorimotor cortex. Bilateral activation of the primary sensorimotor cortex was never observed in the healthy co-twin controls.- - - - - - - - - - ranking = 0.0046211453303859keywords = brain (Clic here for more details about this article) |
3/12. Falcotentorial meningioma accompanied by temporal lobe hematoma.We report a case of a falcotentorial meningioma accompanied by hematoma in the temporal lobe. A healthy 51 year-old-female with no history of hypertension presented with sudden onset of consciousness disturbance and right hemiparesis. Computed tomography revealed a hematoma 5.5 cm in diameter surrounded by thick edematous brain in the left temporal lobe and a tumor 3.5 cm in diameter in the pineal region. Bilateral carotid angiography detected occlusion of the Galenic vein and straight sinus. No causative abnormality of hemorrhage was apparent. However, the left basal vein of Rosenthal had disappeared, and anastomotic venous channels could be observed in the medial left temporal lobe, contiguous to the hematoma. Emergency craniotomy failed to detect any abnormality which could cause hemorrhage in the brain parenchyma surrounding the hematoma. Subtotal removal of the tumor, histologically diagnosed as fibrous meningioma, was achieved three months later employing an occipital transtentorial approach. Venous congestion caused by compression due to the tumor was considered to be one of possible causes of the hemorrhage.- - - - - - - - - - ranking = 0.0015403817767953keywords = brain (Clic here for more details about this article) |
4/12. Penetrating brain injury with nasal entry by a plastic stick. Case report.A case of a 52-year-old male presented with an unusual penetrating brain injury with nasal entry. At admission he had erythema of periorbital soft tissue in the left eye and epistaxis. His neurological condition was lethargic (glasgow coma scale of 13) with nonfluent aphasia. Computed tomography scan revealed intracranial contusion hematoma in the left frontal lobe and fracture of the left frontal base, which were treated surgically. At the 6-month follow-up he still showed nonfluent aphasia. Disturbances, mostly cognitive, were noted on his psychological tests. A survey of the literature reveals a few cases of this nature in penetrating brain injury with nasal entry. A penetrating brain injury with nasal entry which causes nonfluent aphasia is discussing.- - - - - - - - - - ranking = 0.0053913362187835keywords = brain (Clic here for more details about this article) |
5/12. Cerebral endothelial injury in severe head injury: the significance of measurements of serum thrombomodulin and the von willebrand factor.thrombomodulin (TM), which is located in the surface of the endothelium in the arteries, veins, and capillaries of major organs such as the brain, lungs, liver, kidneys, skeletal muscles, and gastrointestinal tract, is one of several indicators of endothelial injury. von willebrand factor (vWf), which is synthesized by endothelial cells, is also an endothelial specific glycoprotein. The serum level of vWf increases in response to various stimuli without endothelial injury. An elevated serum level of vWf may suggest endothelial activation in severe head injury. We hypothesize that the degree of cerebral endothelial activation or injury depends on the type of head injury and that measuring the TM and vWf is useful for predicting delayed traumatic intracerebral hematoma (DTICH), produced by weakness of the vessel wall, occuring either as a direct or indirect effect of head injury. The values of vWf in focal brain injury (ranging from 332.5 /- 52.8% to 361.7 /- 86.2%) were significantly higher than those in diffuse axonal injury from 2 h to 7 days after the injury occurred (ranging from 201.6 /- 59.5% to 242.5 /- 51.7%). The serum level of TM in focal brain injury (ranging from 3.84 /- 1.54 to 4.12 /- 1.46 U/mL) was higher than that in diffuse axonal injury (ranging from 2.96 /- 0.63 to 3.67 /- 1.70 U/mL), but these differences were not statistically significant. In patients with DTICH, TM was significantly higher than in patients without DTICH (p < 0.01). The results of our study demonstrate that the degree of endothelial activation in focal brain injury was significantly higher than in diffuse brain injury. In addition, the serum level of TM in patients with DTICH was significantly higher than in patients without DTICH. These findings suggest that cerebral tissue injury is often accompanied by cerebral endothelial activation, and that these two phenomena should be distinguished from each other. The levels of serum TM and vWf appear to be good indicators of the cerebral endothelial injury and of endothelial activation in severe head injury.- - - - - - - - - - ranking = 0.0038509544419882keywords = brain (Clic here for more details about this article) |
6/12. Acute fatal haemorrhage during percutaneous dilatational tracheostomy.Percutaneous dilatational tracheostomy (PDT) is associated with a number of life-threatening complications. We present a case of massive and fatal arterial haemorrhage that occurred in the intensive care unit during an elective PDT on an 86-year-old woman following earlier evacuation of a traumatic subdural haematoma. An avulsed right subclavian artery was found at post mortem. Previous thyroid surgery and aberrant arterial anatomy contributed to the fatal outcome.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/12. Prefabricated galeal flap based on superficial temporal and posterior auricular vessels.scalp layers are widely used in reconstructive procedures. The authors used prefabricated galeal flaps based on the superficial temporal or postauricular vessels for ear, cheek, mandible, and cranium reconstructions in three cases. In case 1, synchronous beard and ear reconstructions were accomplished by using the temporoparietal and retroauricular flaps. In case 2, a buccomandibular defect was reconstructed by transposing the supra-auricular and retroauricular galea with prefabricated bone and skin. In case 3, an epidural hematoma in the left frontoparietal area was evacuated after a circular craniectomy. The harvested bone was not put back on the defect area but buried between the periosteal and galeal layers because of brain edema. These layers were raised as an osteogaleoperiosteal flap and transposed onto the defect area after 7 weeks. When used with a prefabrication method, scalp layers offer versatile options for repairing composite defects of the head region. A galeal flap based on the posterior auricular vessels is practical and reliable in reconstructive procedures. The authors suggest that this flap is an option in cases in which the temporoparietal fascia artery or the superficial temporal artery is not available. Prefabrication of the harvested cranial bone inside the adjacent tissues offers several advantages in that a viable bone is provided at the end of the procedure, intervention at a distant area is avoided, the graft is placed on osteogenic tissue (periosteum) that is also transposed onto the defect, and sophisticated procedures such as microsurgical techniques are not needed.- - - - - - - - - - ranking = 0.00077019088839765keywords = brain (Clic here for more details about this article) |
8/12. Fetal trauma: brain imaging in four neonates.The purpose of this paper is to describe brain pathology in neonates after major traffic trauma in utero during the third trimester. Our patient cohort consisted of four neonates born by emergency cesarean section after car accident in the third trimester of pregnancy. The median gestational age ( n=4) was 36 weeks (range: 30-38). Immediate post-natal and follow-up brain imaging consisted of cranial ultrasound ( n=4), computed tomography (CT) ( n=1) and post-mortem magnetic resonance imaging (MRI) ( n=1). pathology findings were correlated with the imaging findings ( n=3). Cranial ultrasound demonstrated a huge subarachnoidal hemorrhage ( n=1), subdural hematoma ( n=1), brain edema with inversion of the diastolic flow ( n=1) and severe ischemic changes ( n=1). In one case, CT demonstrated the presence and extension of the subarachnoidal hemorrhage, a parietal fracture and a limited intraventricular hemorrhage. Cerebellar hemorrhage and a small cerebral frontal contusion were seen on post-mortem MRI in a child with a major subarachnoidal hemorrhage on ultrasound. None of these four children survived (three children died within 2 days and one child died after 1 month). Blunt abdominal trauma during pregnancy can cause fetal cranial injury. In our cases, skull fracture, intracranial hemorrhage and hypoxic-ischemic encephalopathy were encountered.- - - - - - - - - - ranking = 0.0053913362187835keywords = brain (Clic here for more details about this article) |
9/12. Serial evaluation of diffusion tensor brain fiber tracking in a patient with severe diffuse axonal injury.Serial evaluation of diffusion tensor brain fiber tracking was performed in a 27-year-old female patient with diffuse axonal injury after a traffic accident. Although the result of brain fiber tracking was not necessarily parallel to her clinical symptoms, it may have predicted the neurologic prognosis.- - - - - - - - - - ranking = 0.0046211453303859keywords = brain (Clic here for more details about this article) |
10/12. An unusual missile-type head injury caused by a stone: case report and medicolegal perspectives.Missile head injury is predominantly caused by firearms; however, small blunt objects such as a stone can be propelled into the air and cause a low-velocity-type missile injury, as described in this case report. Since the cerebral damage in low-velocity missile injuries is usually focal, there might not be disturbance of consciousness until secondary brain damage occurs; therefore, adequate medical supervision is necessary to prevent and treat potentially fatal complications in a timely manner. This is a rare case of a penetrating missile wound of the head, most likely caused by the use of a stone propelled by a slingshot that penetrated the skull and lacerated the brain with the stone embedded within the substance of the brain. The deceased died at home 2 days later from focal suppurative meningitis with cerebral abscess formation and a subdural hemorrhage.- - - - - - - - - - ranking = 0.0023105726651929keywords = brain (Clic here for more details about this article) |
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