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Mavroudis I, Petridis F, Petroaie AD, Ciobica A, Kamal FZ, Honceriu C, Iordache A, Ionescu C, Novac B, Novac O. Exploring Symptom Overlaps: Post-COVID-19 Neurological Syndrome and Post-Concussion Syndrome in Athletes. Biomedicines 2024; 12:1587. [PMID: 39062160 PMCID: PMC11274969 DOI: 10.3390/biomedicines12071587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/06/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
The COVID-19 pandemic has introduced new challenges in managing neurological conditions, particularly among athletes. This paper explores the intersection of post-COVID-19 neurological syndrome (PCNS/PASC) and post-concussion syndrome (PCS), focusing on their implications in sports medicine. Our analysis covers the symptomatology, pathophysiology, and management strategies for PCNS/PASC and PPCS, with special attention paid to the unique challenges faced by athletes recovering from these conditions, including the risk of symptom exacerbation and prolonged recovery. Key findings reveal that both PCNS/PASC and PPCS present with overlapping symptoms such as cognitive difficulties, exercise intolerance, and mental health issues, but differ in specific manifestations like anosmia and ageusia, unique to COVID-19. Pathophysiological analysis reveals similarities in blood-brain barrier disruption (BBB) but differences in the extent of immune activation. Management strategies emphasize a gradual increase in physical activity, close symptom monitoring, and psychological support, with a tailored approach for athletes. Specific interventions include progressive aerobic exercises, resistance training, and cognitive rehabilitation. Furthermore, our study highlights the importance of integrating neurology, psychiatry, physical therapy, and sports medicine to develop comprehensive care strategies. Our findings underscore the dual challenge of COVID-19 and concussion in athletes, necessitating a nuanced, interdisciplinary approach to effective management. Future research should focus on the long-term neurological effects of both conditions and optimizing treatment protocols to improve patient outcomes. This comprehensive understanding is crucial for advancing the management of athletes affected by these overlapping conditions and ensuring their safe return to sports.
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Affiliation(s)
- Ioannis Mavroudis
- Department of Neuroscience, Leeds Teaching Hospitals NHS Trust, Leeds LS2 9JT, UK;
- Faculty of Medicine, Leeds University, Leeds LS2 9JT, UK
| | - Foivos Petridis
- Third Department of Neurology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
| | - Antoneta Dacia Petroaie
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street No. 16, 700115 Iasi, Romania; (A.I.); (O.N.)
| | - Alin Ciobica
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Bd. Carol I no. 20A, 700505 Iasi, Romania; (A.C.); (C.I.)
- Centre of Biomedical Research, Romanian Academy, Bd. Carol I, no. 8, 700506 Iasi, Romania
- Academy of Romanian Scientists, Str. Splaiul Independentei no. 54, Sector 5, 050094 Bucharest, Romania
- “Ioan Haulica” Institute, Apollonia University, Pãcurari Street 11, 700511 Iasi, Romania
| | - Fatima Zahra Kamal
- Higher Institute of Nursing Professions and Health Techniques, Marrakesh 40000, Morocco
- Laboratory of Physical Chemistry of Processes and Materials, Faculty of Sciences and Techniques, Hassan First University, B.P. 539, Settat 26000, Morocco
| | - Cezar Honceriu
- Faculty of Physical Education, Alexandru Ioan Cuza University of Iasi, Bd. Carol I no. 20A, 700505 Iasi, Romania;
| | - Alin Iordache
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street No. 16, 700115 Iasi, Romania; (A.I.); (O.N.)
| | - Cătălina Ionescu
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Bd. Carol I no. 20A, 700505 Iasi, Romania; (A.C.); (C.I.)
- Clinical Department, Apollonia University, Păcurari Street 11, 700511 Iasi, Romania
| | - Bogdan Novac
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street No. 16, 700115 Iasi, Romania; (A.I.); (O.N.)
| | - Otilia Novac
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street No. 16, 700115 Iasi, Romania; (A.I.); (O.N.)
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Mai G, Lee JH, Caporal P, Roa G JD, González-Dambrauskas S, Zhu Y, Yock-Corrales A, Abbas Q, Kazzaz Y, Dewi DS, Chong SL. Initial dysnatremia and clinical outcomes in pediatric traumatic brain injury: a multicenter observational study. Acta Neurochir (Wien) 2024; 166:82. [PMID: 38353785 DOI: 10.1007/s00701-024-05919-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/21/2023] [Indexed: 02/16/2024]
Abstract
PURPOSE We aimed to investigate the association between initial dysnatremia (hyponatremia and hypernatremia) and in-hospital mortality, as well as between initial dysnatremia and functional outcomes, among children with traumatic brain injury (TBI). METHOD We performed a multicenter observational study among 26 pediatric intensive care units from January 2014 to August 2022. We recruited children with TBI under 18 years of age who presented to participating sites within 24 h of injury. We compared demographics and clinical characteristics between children with initial hyponatremia and eu-natremia and between those with initial hypernatremia and eu-natremia. We defined poor functional outcome as a discharge Pediatric Cerebral Performance Category (PCPC) score of moderate, severe disability, coma, and death, or an increase of at least 2 categories from baseline. We performed multivariable logistic regression for mortality and poor PCPC outcome. RESULTS Among 648 children, 84 (13.0%) and 42 (6.5%) presented with hyponatremia and hypernatremia, respectively. We observed fewer 14-day ventilation-free days between those with initial hyponatremia [7.0 (interquartile range (IQR) = 0.0-11.0)] and initial hypernatremia [0.0 (IQR = 0.0-10.0)], compared to eu-natremia [9.0 (IQR = 4.0-12.0); p = 0.006 and p < 0.001]. We observed fewer 14-day ICU-free days between those with initial hyponatremia [3.0 (IQR = 0.0-9.0)] and initial hypernatremia [0.0 (IQR = 0.0-3.0)], compared to eu-natremia [7.0 (IQR = 0.0-11.0); p = 0.006 and p < 0.001]. After adjusting for age, severity, and sex, presenting hyponatremia was associated with in-hospital mortality [adjusted odds ratio (aOR) = 2.47, 95% confidence interval (CI) = 1.31-4.66, p = 0.005] and poor outcome (aOR = 1.67, 95% CI = 1.01-2.76, p = 0.045). After adjustment, initial hypernatremia was associated with mortality (aOR = 5.91, 95% CI = 2.85-12.25, p < 0.001) and poor outcome (aOR = 3.00, 95% CI = 1.50-5.98, p = 0.002). CONCLUSION Among children with TBI, presenting dysnatremia was associated with in-hospital mortality and poor functional outcome, particularly hypernatremia. Future research should investigate longitudinal sodium measurements in pediatric TBI and their association with clinical outcomes.
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Affiliation(s)
- Gawin Mai
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Jan Hau Lee
- Children's Intensive Care Unit, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
- SingHealth Paediatrics Academic Clinical Programme, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Paula Caporal
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
- Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Montevideo, Uruguay
| | - Juan D Roa G
- Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Montevideo, Uruguay
- Pediatric Intensive Care Unit, Los Cobos Medical Center, Universidad del Bosque, Ak. 9 #131a-40, Usaquén, Bogotá, Cundinamarca, Colombia
| | - Sebastián González-Dambrauskas
- Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Montevideo, Uruguay
- Departamento de Pediatría y Unidad de Cuidados Intensivos, de Niños del Centro Hospitalario Pereira Rossell, Facultad de Medicina, Universidad de la República, Bulevar Artigas 1590, Lord Ponsoby 2410, 11600, Montevideo, Uruguay
| | - Yanan Zhu
- Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation, 23 Rochester Park, #06-01, Singapore, 139234, Singapore
| | - Adriana Yock-Corrales
- Emergency Department, National Children's Hospital "Dr. Carlos Saenz Herrera" CCSS, San José, Costa Rica
| | - Qalab Abbas
- Departments of Pediatrics and Child Health, National Stadium Road, Aga Khan University Hospital, Karachi, Karachi City, Sindh, 74800, Pakistan
| | - Yasser Kazzaz
- Department of Paediatrics, Ministry of National Guards Health Affairs, Prince Mutib Ibn Abdullah Ibn Abdulaziz Rd, Ar Rimayah, Riyadh, 11426, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdul Aziz Medical City, Jeddah, 22384, Saudi Arabia
- King Abdullah International Medical Research Centre, King Abdul Aziz Medical City, Riyadh, 22384, Saudi Arabia
| | - Dianna Sri Dewi
- KK Research Centre, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Shu-Ling Chong
- Department of Emergency Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
- SingHealth Paediatrics Academic Clinical Programme, Emergency Medicine Academic Clinical Programme, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
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Tamagnone FM, Cheong I, Luna E, Previgliano I, Otero Castro V. Ultrasound-guided cerebral resuscitation in patients with severe traumatic brain Injury. J Clin Monit Comput 2023; 37:359-363. [PMID: 36454340 DOI: 10.1007/s10877-022-00954-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 11/24/2022] [Indexed: 12/04/2022]
Abstract
Traumatic brain injury (TBI) is a worldwide public health concern given its significant morbidity and mortality, years of potential life lost, reduced quality of life and elevated healthcare costs. The primary injury occurs at the moment of impact, but secondary injuries might develop as a result of brain hemodynamic abnormalities, hypoxia, and hypotension. The cerebral edema and hemorrhage of the injured tissues causes a decrease in cerebral perfusion pressure (CPP), which leads to higher risk of cerebral ischemia, herniation and death. In this setting, our role as physicians is to minimize damage by the optimization of the CPP and therefore to reduce mortality and improve neurological outcomes. Performing a transcranial doppler ultrasound (TCD) allows to estimate cerebral blood flow velocities and identify states of low flow and high resistance. We propose to include TCD as an initial assessment and further monitoring tool for resuscitation guidance in patients with severe TBI. We present an Ultrasound-Guided Cardio-cerebral Resuscitation (UGCeR) protocol in Patients with Severe TBI.
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Affiliation(s)
| | - Issac Cheong
- Argentinian Critical Care Ultrasonography Association (ASARUC), Buenos Aires, Argentina.
- Department of critical care medicine, Sanatorio De los Arcos, Buenos Aires, Argentina.
- Department of critical care medicine, Sanatorio De los Arcos, Juan B. Justo 909, Buenos Aires, Argentina.
| | - Ezequiel Luna
- Department of critical care medicine, Sanatorio Guemes, Buenos Aires, Argentina
| | - Ignacio Previgliano
- Maimonides University, Buenos aires, Argentina
- Hospital General de Agudos J. A. Fernández, Buenos Aires, Argentina
| | - Victoria Otero Castro
- Department of critical care medicine, Sanatorio De los Arcos, Buenos Aires, Argentina
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Hypertonic Saline Treatment in Traumatic Brain Injury: A Systematic Review. World Neurosurg 2022; 162:98-110. [DOI: 10.1016/j.wneu.2022.03.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022]
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Abstract
After a concussion, a series of complex, overlapping, and disruptive events occur within the brain, leading to symptoms and behavioral dysfunction. These events include ionic shifts, damaged neuronal architecture, higher concentrations of inflammatory chemicals, increased excitatory neurotransmitter release, and cerebral blood flow disruptions, leading to a neuronal crisis. This review summarizes the translational aspects of the pathophysiologic cascade of postconcussion events, focusing on the role of excitatory neurotransmitters and ionic fluxes, and their role in neuronal disruption. We review the relationship between physiologic disruption and behavioral alterations, and proposed treatments aimed to restore the balance of disrupted processes.
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Affiliation(s)
- David R Howell
- Sports Medicine Center, Children's Hospital Colorado, 13123 East 16th Avenue, B060, Aurora, CO 80045, USA; Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Julia Southard
- Sports Medicine Center, Children's Hospital Colorado, 13123 East 16th Avenue, B060, Aurora, CO 80045, USA; Department of Psychology and Neuroscience, Regis University, 3333 Regis Boulevard, Denver, CO 80221, USA
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Prognostic value of admission serum glucose-phosphate ratio in predicting the 6-month outcome of patients with severe traumatic brain injury: A retrospective study. Clin Chim Acta 2020; 510:659-664. [PMID: 32882225 DOI: 10.1016/j.cca.2020.08.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Serum glucose-phosphate ratio has been revealed to be associated with severity and prognosis of aneurysmal subarachnoid hemorrhage. Objective of this study was to investigate the relationship between serum glucose-phosphate ratio and severe traumatic brain injury outcome. METHODS Patients with severe traumatic brain injury were stratified in quartiles according to their serum glucose-phosphate ratio. Outcome parameters included mortality, overall survival and poor outcome defined as Glasgow outcome scale score of 1-3 at post-traumatic 6 months. Multiple logistic regression analysis was performed to evaluate the association between quartiles of serum glucose-phosphate ratio and outcome. RESULTS Data from 105 patients were retrospectively reviewed. Glasgow coma scale score declined, Glasgow outcome scale score decreased, Rotterdam computed tomography classification were raised, mortality increased, overall survival probability reduced and percentage of poor outcome rose significantly with each quartile of serum glucose-phosphate ratio. After adjusting for other confounding factors, serum glucose-phosphate ratio according to quartiles was substantially related to 6-month mortality, overall survival and poor outcome. Under receiver operating characteristic curve, serum glucose-phosphate ratio showed a significantly high prognostic predictive capability. CONCLUSIONS Serum glucose-phosphate ratio might be a potential variable that can reflect trauma severity and prognosis in patients with severe traumatic brain injury.
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Abstract
AbstractHead injury remains the most common cause of death and disability in young people. The most frequent consequences of traumatic brain injury (TBI) are extra-axial hemorrhage, i.e., an acute subdural hematoma (SDH) and epidural hematoma (EDH), which usually require a surgical treatment. The aim of the study is to present the distinguished clinical features associated with patients being surgically treated for post-traumatic EDH and SDH. The study included a group of 128 patients with isolated craniocerebral injuries. All the patients were operated. The following factors from the groups were analyzed: demographic data, physiological factors, laboratory factors, computed tomography scan characteristics, the time between trauma and surgery, and the in-hospital mortality. Using statistical analysis, we compared the studied factors in patients operated on due to EDH and SDH. Patients with SDH were older than patients with EDH. Most often, extra-axial hematomas affected men. Patients with SDH were more severe condition than patients with EDH on admission. Abnormal systolic blood pressure was the most common manifestation of dysautonomia in both groups. In the SDH group, we observed hypotension more often than hypertension. Hyperglycemia was one of the most common anomalies in laboratory factors in both groups. Hypotension and hyperglycemia were that factors significantly associated with outcome after head injuries. SDH caused greater midline shift and often pressed in basal cisterns. Patients with SDH died more often than patients with EDH.
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Rodríguez-Triviño CY, Torres Castro I, Dueñas Z. Hypochloremia in Patients with Severe Traumatic Brain Injury: A Possible Risk Factor for Increased Mortality. World Neurosurg 2019; 124:e783-e788. [PMID: 30682506 DOI: 10.1016/j.wneu.2019.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 01/01/2019] [Accepted: 01/02/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine association between electrolyte disturbances and mortality in patients with severe traumatic brain injury. METHODS Medical records of patients with severe traumatic brain injury and Glasgow Coma Scale score <8 and electrolyte alterations were reviewed in a retrospective cohort study. Electrolyte levels were analyzed to establish an association between patients who died and patients who survived. Bivariate analysis was performed using χ2 test with a statistical reliability of 95% for categorical variables. Analysis for electrolyte changes to determine association with mortality was performed using χ2 test with multiple comparisons. Logistic regression was performed between the electrolyte alterations and their association with mortality. The reliability of statistical tests was 95%. RESULTS There was a significant relationship between hypochloremia and increased risk of mortality in 23.1% of deceased patients (P = 0.03). Furthermore, there was a significant correlation with age (P < 0.01) and with the Acute Physiology and Chronic Health Evaluation APACHE II (P < 0.01). CONCLUSIONS Hypochloremia could be an important prognostic factor to determine mortality risk and to improve treatment in patients with severe traumatic brain injury.
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Affiliation(s)
- Claudia Yaneth Rodríguez-Triviño
- Departamento de Ciencias Fisiológicas, Grupo Navarra Medicina, Facultad de Ciencias de la Salud, Fundación Universitaria Navarra-UNINAVARRA, Neiva, Huila, Colombia; Departamento de Ciencias Fisiológicas, Grupo de Neurobiología y Comportamiento, Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá, Bogotá D.C., Colombia.
| | - Isidro Torres Castro
- Departamento de Ciencias Fisiológicas, Grupo Navarra Medicina, Facultad de Ciencias de la Salud, Fundación Universitaria Navarra-UNINAVARRA, Neiva, Huila, Colombia
| | - Zulma Dueñas
- Departamento de Ciencias Fisiológicas, Grupo de Neurobiología y Comportamiento, Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá, Bogotá D.C., Colombia
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Pin-on P, Saringkarinkul A, Punjasawadwong Y, Kacha S, Wilairat D. Serum electrolyte imbalance and prognostic factors of postoperative death in adult traumatic brain injury patients: A prospective cohort study. Medicine (Baltimore) 2018; 97:e13081. [PMID: 30407307 PMCID: PMC6250545 DOI: 10.1097/md.0000000000013081] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Electrolyte imbalances are common in traumatic brain injury. It shares the cause of perioperative morbidity and mortality. Types of intravenous fluid resuscitation, osmotic diuretics, massive blood loss, and intracranial pathology were considered as the potential factors to worsen electrolyte abnormalities in these patients. The aims of this study were to report the incidence of electrolyte imbalance in traumatic brain injured patients and to assess the association between electrolyte imbalance and other prognostic factors to death within 24 hours of the injury.The study was carried out in the northern university, tertiary-care hospital of Thailand. The patients aged from 18 to 65 years old, presented with traumatic brain injury, and needed for emergency craniotomy were included. We excluded the patients who had minor neurosurgical procedures, pregnancy, and undergone cardiopulmonary resuscitation from the Emergency Department.Among 145 patients recruited, 101 (70%) had Glasgow Coma Scale (GCS) score ≤ 8, 25 (17%) had GCS score 9 to 12, and 19 (13%) had GCS score 13 to 15. The most common diagnosis were subdural hematoma and epidural hematoma, 51% and 36%, respectively. Hypokalemia was the most common electrolyte imbalance at 65.5%. The results of the use of a multivariable logistic regression model show that the odds of postoperative death in TBI patients were increased with high levels of blood glucose, hypernatremia, and acidosis.Hypokalemia was the most common electrolyte imbalance in TBI patients. Hypernatremia, acidosis, and hyperglycemia significantly increased the odds ratio of death in the first 24 hours post TBI.
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Goyal K, Hazarika A, Khandelwal A, Sokhal N, Bindra A, Kumar N, Kedia S, Rath GP. Non- Neurological Complications after Traumatic Brain Injury: A Prospective Observational Study. Indian J Crit Care Med 2018; 22:632-638. [PMID: 30294128 PMCID: PMC6161576 DOI: 10.4103/ijccm.ijccm_156_18] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction and Aims Recognizing and treating nonneurological complications occurring in traumatic brain injury (TBI) patients during intensive care unit (ICU) stay are challenging. The aim is to estimate various nonneurological complications in TBI patients. The secondary aim is to see the effect of these complications on ICU stay, disability, and mortality. Materials and Methods This was a prospective observational study at the neuro-ICU of a Level-I trauma center. A total of 154 TBI patients were enrolled. The period of the study was from admission to discharge from ICU or demise. Inclusion criteria were patients aged >16 years and patients with severe TBI (Glasgow coma score [GCS] ≤8). Nonneurological complications were frequent in TBI patients. Results We observed respiratory complications to be the most common (61%). Other complications, in the decreasing order, included dyselectrolytemia (46.1%), cardiovascular (34.4%), coagulopathy (33.1%), sepsis (26%), abdominal complications (17.5%), and acute kidney injury (AKI, 3.9%). The presence of systemic complications except AKI was found to be significantly associated with increased ICU stay. Most of the patients of AKI died early in ICU. Respiratory dysfunction was found to be independently associated with 3.05 times higher risk of worsening clinical condition (disability) (P < 0.018). The presence of cardiovascular complications during ICU stay (4.2 times, P < 0.005), AKI (24.7 times, P < 0.02), coagulopathy (3.13 times, P < 0.047), and GCS <6 (4.2 times, P < 0.006) of TBI was independently associated with significantly increased risk of ICU mortality. Conclusion TBI patients tend to have poor outcome due to concomitant nonneurological complications. These have significant bearing on ICU stay, disability, and mortality.
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Affiliation(s)
- Keshav Goyal
- Department of Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Amarjyoti Hazarika
- Department of Anaesthesiology and Intensive Care, PGIMER, Chandigarh, India
| | - Ankur Khandelwal
- Department of Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Navdeep Sokhal
- Department of Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Bindra
- Department of Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Niraj Kumar
- Department of Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Shweta Kedia
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Girija P Rath
- Department of Neuroanaesthesiology and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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Traumatic Brain Injury Patients With a Glasgow Coma Scale Score of ≤8, Cerebral Edema, and/or a Basal Skull Fracture are More Susceptible to Developing Hyponatremia. J Neurosurg Anesthesiol 2016; 28:21-6. [DOI: 10.1097/ana.0000000000000192] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shang A, Feng X, Wang H, Wang J, Hang X, Yang Y, Wang Z, Zhou D. Neuroglobin upregulation offers neuroprotection in traumatic brain injury. Neurol Res 2012; 34:588-94. [PMID: 22664218 DOI: 10.1179/1743132812y.0000000052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this study was to investigate rat neuroglobin (rNGB) expression level after traumatic brain injury (TBI) and further study its neuroprotective effects in TBI when it was overexpressed in adenoviral vector. METHODS The Wistar rats (280-320 g) were divided into control, 12 and 36 hours after TBI groups (n = 3) and their TBI model was established. Subsequently, NGB expression level was examined by Western blot and immunohistochemical. Beyond that, adenoviral vectors pAdEasy-rNGB-GFP and pAdEasy-GFP were constructed and transfected into the rat brain respectively (pAdEasy-GFP was control), and the neuroprotective effects were examined by immunohistochemical. RESULTS Immunohistochemical and Western blot results demonstrated that NGB expression level was increased at 12 and 36 hours after TBI injury compare with control. Meanwhile, the pAdEasy-rNGB-GFP transfected rats suffered less necrosis and apoptosis compare to control. CONCLUSIONS NGB was upregulated in TBI and overexpressed rNGB had a significant neuroprotection in TBI. However, the mechanism remained unknown. This study suggested that rNGB overexpression may be a new strategy for treating of TBI.
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Affiliation(s)
- Aijia Shang
- Department of Neurosurgery, General Hospital of Chinese PLA, Beijing, China
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