Tesis sobre el tema "Brain injury"
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Keller, Kristen Jo. "Challenges to Secondary Brain Injury Prevention in Severe Traumatic Brain Injury". Diss., The University of Arizona, 2014. http://hdl.handle.net/10150/338712.
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BACKGROUND/AIMS: Inconsistency in the use of secondary brain injury prevention guidelines among US trauma centers after severe traumatic brain injury is prevalent in many literature sources. However, this phenomenon has not been thoroughly studied. The purpose of this DNP project is to identify the key barriers and challenges in compliance to the evidence-based guidelines for secondary brain injury prevention. DESIGN: An exploratory, emergent design was used to collect descriptive qualitative data through the use of a survey. SETTING: Six Phoenix Metropolitan Level 1 trauma centers. PARTICIPANTS: All survey participants who consented to survey completion, which had greater than six months of experience and directly worked with patients suffering from a severe TBI in the clinical setting. MEASUREMENTS: Participant demographics (work experience, area of work, job title), current awareness and use of Brain Trauma Foundation guidelines, and time duration for evidence based order set implementation. Narrative responses were also used to identify barriers to current use of the BTF guidelines and factors that may promote their use in the future. RESULTS: A total of 43 participants consented to the survey study, with completion by 35 participants. RNs (n=27), Physicians (n=2), NPs or PAs (n=5), with an average work experience of 6 to 14 years (42.86%). A total of n=22 (62%) of participants were unaware of the current BTF guidelines for severe TBI and only 25% (n=9) aware that their facility has a protocol based on the BTF guidelines for severe TBI, while 51% (n=18) were unsure if their facility had a protocol. Barriers were identified in narrative form and were consistent with awareness/education, provider congruence, communication, and order set/protocol process improvement. CONCLUSION: The understanding of current patient management for severe TBI based on the BTF guidelines is sporadic among the greater Phoenix area Level 1 trauma centers. Requiring proof of BTF guidelines compliance by the ACS at time of Level 1 certification may increase the consistent recommended use of the BTF guidelines for the care of severe TBIs.
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Abson, Jeanne Anne. "Grief following brain injury : a validation of the Brain Injury Grief Inventory". Thesis, Bangor University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.409238.
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McGrath, Joanna Ruth. "Fear following brain injury". Thesis, Oxford Brookes University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325266.
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Casey, Rebecca. "An exploration of brain injury : from the dependent child to the brain injury survivor". Thesis, University of Warwick, 2015. http://wrap.warwick.ac.uk/76997/.
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CHAPTER ONE: The literature review critically evaluates research that has explored the psychological impact of parental acquired brain injury (ABI) on children. The review identifies a number of factors that affect the psychological well-being of children, including both adverse and protective factors. Evidence from the studies reviewed indicates that children are vulnerable to experiencing a range of emotional and behavioural difficulties following parental ABI. Clinical implications of the review findings are discussed, and directions for future research considered. CHAPTER TWO: The empirical paper aimed to explore the role of mutual support in Traumatic Brain Injury (TBI) survivors’ reformation of their identity among individuals attending a mutual support group. Using a Grounded Theory approach, a model of the participants experience was developed. The core category reflected how participants regained a sense of self through getting to know the “new” me. Five conceptual categories were identified in relation to identity formation: pre-injury self, comparison with others; accessing the social world of brain injury; purpose and self-efficacy; and acceptance of the post-injury self. The findings highlight a potentially important role for mutual support in identity reformation following TBI and implications for brain injury rehabilitation programmes are discussed. CHAPTER THREE: The third paper presents my personal and professional reflections of the research process and how my views have changed over the course of training. To illustrate these changes, elements of the grounded theory model proposed in the empirical paper (Chapter 2) have been applied to my own experiences. It is hoped that this approach will evidence my experience and exploration of getting to know the scientist-practitioner.
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Butler, Mary y n/a. "Care ethics and brain injury". University of Otago. Department of Philosophy, 2008. http://adt.otago.ac.nz./public/adt-NZDU20080214.134301.
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It is generally supposed that a supportive family can have an influence on outcomes for an adult with severe brain injury, but there is very little known about what effective families actually do. In this research the families of five such individuals were involved in an ethnographic project that lasted for one year.
The literature review brought together insights from brain injury, care ethics, disability studies and anthropology. These insights were combined with a process of reflective equilibrium that was applied to the ethnographic material in order to determine the ethics of the carers. Ethics of care in this setting was conceived of as a positive practice ethic, rather than as a series of negative conundrums posed by the brain injury.
The practice ethic shared by carers meant that they all conceived of the need created by brain injury in humanistic terms, rather than in terms of pathology. Carers demonstrated virtues appropriate to their practice as they helped the adult with brain injury to connect with aspects of ordinary life. The best outcomes for the adult with brain injury included being able to engage in productive activity and to make a place in the world. These outcomes could only be achieved with due regard for their safety and subsistence. The practice ethic of carers was demonstrated in the skills and concern that ensured a satisfactory outcome for the adult with brain injury.
This research is a departure from recent research about families affected by brain injury, which has focused on the burden involved in care. An examination of what carers achieve suggests that burden may be associated with the development of caring practice. The transformative capacity of care, for both the carer and the adult with brain injury, is emphasized. However contextual factors, such as adequate compensation, are connected to the capacity of the carer to engage in good practice and these are explored also in this thesis. In particular, relevant aspects of the relationship between families and the Accident Compensation Corporation are explored.
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Thurston, Roy J. "Brain injury, memory and learning". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape3/PQDD_0024/NQ49543.pdf.
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Force, Lisa Marie. "Traumatic brain injury and acidosis /". view abstract or download text of file, 2006. http://hdl.handle.net/1794/3913.
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Lawson, Clare Helena. "Outcome from minor brain injury". Thesis, University of Southampton, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243071.
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Singh, Rajiv K. "Depression after traumatic brain injury". Thesis, University of Sheffield, 2017. http://etheses.whiterose.ac.uk/18730/.
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Background Depression is known to be common after traumatic brain injury (TBI) and associated with worse functional and psychosocial outcomes. However, there remains considerable uncertainty over the exact prevalence of the condition. Aims The aim of this study was to accurately assess the prevalence of post TBI depression and its changes over a period of one year. The associated demographic and injury features were also examined for possible association with risk of depression in the hope that those with higher susceptibility to depression may be identified. Methods The study population was a prospective cohort of TBI admissions to a teaching hospital emergency department over a two year period. Minimal exclusions were applied in order to recruit a representative TBI population who were then assessed in a specialist brain injury clinic at ten weeks and at one year post injury. Demographic and injury features were recorded to establish links with risk of depression which was recorded with a HADS (Hospital Anxiety and Depression Scale). Results Over a two year period, 774 individuals were recruited of whom 690 attended one year follow-up and 38 had died. Only 6% of the cohort was lost to follow-up after one year. The prevalence of depression at ten weeks was 56.3% [95% CI 52.8-59.8] and at one year 41.2% [95% CI 37.6-44.9] A multivariable analysis identified the independent predictors of depression; at ten weeks these were TBI severity, abnormal CT scan, past psychiatric history, alcohol intoxication at the time of injury, female gender and non-white ethnicity. At one year the independent predictors were; abnormal CT scan, past psychiatric history, alcohol intoxication at the time of injury and female gender. TBI severity was no longer significant. Features such as injury aetiology, social isolation, age, length of stay and medical comorbidity were not associated with depression risk. All other outcome measures in the study, including psychosocial function, symptom severity and global overall outcome showed very high correlations with depression. Discussion The prevalence of depression is very high after TBI and associated with a number of injury features. While the prevalence drops over a year it still remains considerably elevated. There is also evidence that features related to the injury itself, such as TBI severity, become less significant in long term outcome compared to the initial period. It is possible that other psychosocial features such as personality and coping mechanisms are more important in determining long term outcome than injury features such as severity and aetiology. Some population features have been identified that may allow targeting of susceptible populations for intervention. The close correlations between all 4 outcome measures including depression suggest that they might be measuring a similar construct of emotional distress. Future work will seek to reassess the prevalence of depression at three or five years as well as associated features, re-examining the relationship between various outcomes and use of interventions and treatments, especially in targeting at risk individuals.
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Perel, Pablo Andraes. "Prognosis in traumatic brain injury". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2009. http://researchonline.lshtm.ac.uk/1635515/.
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Introduction: The general purpose of this thesis was to study prognosis in traumatic brain injury (TBI) patients, with the aim of providing useful and practical information in clinical practice and clinical research. The specific objectives were: to develop and validate practical prognostic models for TBI patients and to assess the validity of the Modified Oxford Handicap Scale (mOHS) for predicting disability at six months. Methods: A survey was first conducted to understand the importance of prognostic information among physicians. A systematic review of prognostic models for TBI patients was then carried out. Prognostic models were developed using data from a cohort of 10,008 TBI patients (CRASH trial) and validated in a cohort of 8,509 TBI patients (IMPACT study). Two focus groups and a survey were conducted to develop a paper-based prognostic score card. The correlation between the mOHS and the Glasgow Outcome Scale (GOS) was assessed, the validity of different mOHS dichotomies was assessed, and the discriminative ability of the mOHS to predict GOS was evaluated. Results: Doctors considered prognostic information to be very important in the clinical management of TBI patients, and believed that an accurate prognostic model would change their current clinical practice. Many prognostic models for TBI have been published, but they have many methodological flaws which limit their validity. Valid prognostic models for patients from high income countries and low & middle income .countries were developed and made available as a web calculator, and as a paper based score card. The mOHS was strongly correlated with and was predictive of GOS at six months. Conclusion: The prognostic models developed are valid and practical to use in the clinical setting. The association between mOHS and GOS suggest that the mOHS could be used for interim analysis in randomised clinical trials in TBI patients, for dealing with loss to follow-up, or could be used as simple tool to inform patients and relatives about their prognosis at hospital discharge.
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Andrews, Courtney M. "Concussion IS a Brain Injury". Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7775.
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Akin, Faith W. y Owen D. Murnane. "Vestibular Consequences of Mild Traumatic Brain Injury (Blast Injury)". Digital Commons @ East Tennessee State University, 2008. https://dc.etsu.edu/etsu-works/1940.
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Lalani, Sanam Jivani. "Effects of Traumatic Brain Injury on Pediatric Brain Volume". BYU ScholarsArchive, 2018. https://scholarsarchive.byu.edu/etd/6924.
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This study investigated the effects of lesion presence within larger brain networks (e.g., default mode network (DMN), salience network (SN), and mentalizing network (MN)) in the chronic phase of a pediatric traumatic brain injury (TBI) and the effect on social function. We compared children with a TBI to children with an orthopedic injury (OI) with three different aims. The first aim was to determine whether network volume differed by group (e.g., TBI vs. OI). Second, investigate if lesion presence in a sub component region of the network resulted in total network volume loss for that network. Finally, learn whether network volume would predict outcome on the Behavior Assessment System for Children, Second Edition (BASC-2). Approximately 184 participants (65% male; 70% Caucasian) between the ages of 6-17 years completed testing and a structural MRI scan in the chronic stage (at least one-year post-injury) of the injury. Injury severity included complicated mild, moderate, and severe TBI. Radiological findings were analyzed using recommendations from the Common Data Elements' core (presence or absence of a lesion) and supplementary (lesion type and location) recommendations. Volumetrics for all participants were obtained with FreeSurfer to quantify total network volumes for the DMN, SN, and MN. The parent of each participant completed a behavioral measure for externalizing and internalizing behaviors. Three sets of statistical analyses were completed, including multivariate analysis of covariance, analysis of covariance, and multiple regression, for each of the three aims of the study, respectively. There were significant differences in total DMN volume between the two groups and participants with lesions solely in the MN had lower total MN volume. Moreover, lower total MN volume was associated with worse functioning on measures of externalizing and internalizing behaviors. The larger implications, including developmental and social implications, of these findings are discussed.
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Carter-Allison, Samantha Natalie. "Diagnosis threat and injury beliefs after mid traumatic brain injury". Thesis, King's College London (University of London), 2015. https://kclpure.kcl.ac.uk/portal/en/theses/diagnosis-threat-and-injury-beliefs-after-mid-traumatic-brain-injury(c6ba3d52-13d9-46ea-aeee-d34ed2e43943).html.
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Background: Diagnosis threat is a form of stereotype threat, where individuals with a history of mild traumatic brain injury (mTBI) have shown performance decrements on cognitive tasks, owing to negative expectancies around cognitive ability elicited by cues in the environment. This study systematically reviews experimental studies to gauge the presence/absence of an effect of diagnosis threat on neuropsychological task performance in mTBI. It also investigates whether methodological variation and methodological quality contribute to variation in study findings. Method: A systematic search of four online databases (Medline, PyscINFO, SportDISCUS, PsycEXTRA) was conducted to identify diagnosis threat studies that employed an experimental paradigm. Neuropsychological test outcomes were extracted, along with information on inclusion criteria, mTBI diagnostic criteria, participant characteristics and study design. Methodological quality was assessed using modified Scottish Intercollegiate Guidelines Network (SIGN) criteria. Results: A total of nine studies were identified. Evidence for diagnosis threat was found, although there was considerable heterogeneity across study results. The most robust finding was the impact of diagnosis threat on the cognitive domain of attention/working memory. No clear associations between methodological variation, methodological quality and study outcome were noted. Conclusions: The review found evidence for diagnosis threat, although the strength of this effect may be smaller than previously thought. Although there was heterogeneity across elements of study design, there was no obvious relationship between these factors and outcome. However, the substantial variation makes comparison difficult. These issues are similar to findings in other examinations of stereotype threat. Further research is needed to replicate findings and add clarity to the impact of diagnosis threat on both objective and subjective measures, and to further investigate the role of possible moderating variables. A more formal meta-analysis in the area may also be helpful to clarify findings in the research field. Future studies should aim to create established operational definitions and outcomes to improve consistency and comparability between studies.
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Malhotra, Rajiv. "GENE EXPRESSION FOLLOWING TRAUMATIC BRAIN INJURY". VCU Scholars Compass, 1998. http://scholarscompass.vcu.edu/etd/5082.
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The pathology which results from traumatic brain injury (TBI) have long been believed to be immediate and irreversible. However, recently it has been shown that, although the primary effects are virtually unavoidable, the secondary effects manifest themselves through biochemical processes set in motion at the time of the injury. These events are frequently mediated through the process of excitotoxicity, which results from a widespread release of excitatory neurotransmitters. These neurotransmitters go on to activate both ionotropic and metabotropic receptors. The signal transduction initiated through these receptor populations gives rise to changes in gene expression.
One result of this release of neurotransmitter is an influx of calcium by means of excitatory receptors on the cell. The neurotransmitters upon which most research is focused are glutamate, aspartate, and acetylcholine. Current research is aimed at investigating antagonists to this process as well as elucidating steps within the process. Antagonists primarily function to reduce the calcium toxicity through modulation of receptor activity. However, the therapeutic window for effective antagonist usage is short. Therefore, although they may represent a viable treatment option, they need to be administered as early as possible following the injury to have the greatest effect.
The purpose of this paper is to provide a summary of the available literature on TBI and excitotoxicity with a focus on changes in gene regulation. This paper will summarize information on the steps inVolved in the intracellular signaling cascade following brain injury and provide insight to further sites for regulation and treatment. This will also allow for development hypotheses on the possible roles of some of the genes whose expression is already known to be altered.
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Davies, Suzanne. "Personality change following traumatic brain injury". Thesis, University of Birmingham, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.397519.
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This thesis is submitted in partial fulfilment of the requirements for the degree of Clip. Psy, D. _ at the School of Psychology, University of Birmingham. It represents both the clinical work and research conducted over the course of the clinical training. Volume I contains the research components which are concerned with examining factors affecting adjustment following traumatic brain injury (TBI). The literature review explores-3 0 papers-written since 1998t hat examine the factors-purported to - affect the development of depression after a TBI. The empirical paper examines personality change following'TBI and includes the concurrent validation of a new measure of personality change in this population. Volume II contains five Clinical Practice Reports (CPRs) which were submitted over the course of the. clinical training. The first. four. reports represent the. core training components of the Clin. Psy. D. They include case examined from two psychological perspectives, a small-scale service-related report, a case study and a single-case experimental, design., The fifth report is a .case study from a. special t. paediatric neuropsychology placement. The fifth Clinical Practice Report was presented orally, therefore only-the abstract and references are presented.
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Jones, Kevin Dominic. "Psychological adjustment to acquired brain injury". Thesis, University of Oxford, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.556195.
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Acquired brain injury (ABI) has a significant impact upon wide areas of a person's life including cognition, physical health, mood and social functioning, thus posing significant challenges to psychological adjustment. However, the literature is unclear in defining the theoretical concept of adjustment, and is lackinq in synthesis, In addition, there is a growing body of research indicating that a wide range of psychological outcomes are experienced after ABI ranging from psychological distress to more positive outcomes such as posttraumatic growth, although traditionally a focus has been maintained on distress. The first paper considers psychological adjustment from a theoretical and empirical perspective in relation to traumatic brain injury (TBI). The second paper addressed a gap in the literature regarding positive outcomes after ABI by conducting a qualitative exploration of nine individuals' experiences of positive psychological changes after sustaining an ABI. Interpretative phenomenological analysis was used to investigate these experiences. Three overarching themes were identified: (1) positive psychological changes; (2) Drivers of positive changes; and (3) I'm the same as before, but I know things are different. The findings of this study make a contribution to the growing evidence that individuals' with ABI do experience positive outcomes, and highlights the complexity of these experiences. Both papers discuss future research and clinical implications.
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Pearson, Corinne. "Substance use and acquired brain injury". Thesis, University of Southampton, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.419003.
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Macqueen, Ruth. "Masculine identity after traumatic brain injury". Thesis, University of East Anglia, 2016. https://ueaeprints.uea.ac.uk/60949/.
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Background: Men are twice as likely to experience a Traumatic Brain Injury (TBI) as women suggesting that aspects of masculine identity play an important role in how people acquire their brain injury. Research also suggests that masculine identity influences how people manage their health experiences. Masculine identity may therefore be an important consideration for neuropsychological therapy and rehabilitation more generally particularly because part of the process of rehabilitation concerns helping individuals with their sense of self. This research aimed to explore men’s experiences of masculine identity following TBI. Method: Individual interviews were conducted with 10 men age 21-67 who had experienced a TBI who were living in the community. Interpretative phenomenological analysis was used to consider lived experiences and to explore the meaning of the TBI experience in relation to masculine identity. Results: Three superordinate themes emerged from the analysis: Doing life and relationships differently: Participants identified changes in aspects of their role as a man within relationships, family, occupation and social groups. Self-perceptions and the perceived view of others: Self-perceptions and others perceptions of the ability to perform roles as a man resulted in experiences of shame and loss of self-confidence. The invisibility of the injury appeared to both accentuate and protect from the experience of shame. Managing the impact: Participants identified ways in which they thought about their lives and reformulated their behaviour in order to protect their identity as a man. Conclusions: The findings suggest that men experience changes in masculine identity following TBI, particularly when ideals about independence and roles were challenged. The findings highlight how masculine identity may be a valuable aspect of self in considering threats to and reconstruction of self-identity after TBI. Aspects of gender identity should be considered in order to promote engagement, support adjustment and achieve meaningful outcomes in rehabilitation.
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Tiedt, Steffen. "Regeneration of neurons after brain injury". Diss., Ludwig-Maximilians-Universität München, 2015. http://nbn-resolving.de/urn:nbn:de:bvb:19-185089.
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Fowler, Jill H. "AMPA receptors : role in brain injury". Thesis, University of Glasgow, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274788.
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Murdoch, Iain. "Presynaptic pathology after acute brain injury". Thesis, University of Glasgow, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.340811.
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Helmy, Adel Ezzat. "Neuro-inflammation in traumatic brain injury". Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610114.
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Nagulavancha, Sruthi. "Traumatic brain injury options web application". Kansas State University, 2010. http://hdl.handle.net/2097/4626.
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Master of ScienceDepartment of Computing and Information Sciences
Daniel A. Andresen
According to the Division of Injury Response, Centers for Disease Control and Prevention, approximately 1.4 million Americans sustain a traumatic brain injury each year. The aim of the project is to create a web interface to link survivors, family members, and caregivers of individuals suffering from traumatic brain injuries (TBI) to potentially helpful agencies or service centers within their local communities. Often the TBI service centers located in the remote places are difficult to trace hence this website mainly concentrates on small rural centers which are located in Kansas State. The portal will offer two-dimensional and basic information about traumatic brain injury centers and specifically about access of resources. Within the portal, a link to an interactive map will be provided. A form for data entry helps the service centers to publish about their presence and the regions they serve. A search distance feature is also added into the website which interactively searches the nearest latitude, longitude values (TBI service center) to the user’s location by using the haversine formula.
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LeMay, Carrie C. y Jill D. Stinson. "Sex Offenders With Traumatic Brain Injury". Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7906.
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Loftspring, Matthew C. "Brain injury mechanisms in hemorrhagic stroke". University of Cincinnati / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1300118765.
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Osterstock, Guillaume. "Hypothalamic defaults after traumatic brain injury". Thesis, Montpellier 1, 2012. http://www.theses.fr/2012MON1T017/document.
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Les travaux de cette thèse ont porté sur le contrôle des neurones à GHRH dans des conditions physiologiques et pathologiques. Le but étant de caractériser les mécanismes cellulaires et moléculaires impliqués dans le fonctionnement ou dérégulations du réseau de neurones à GHRH. Ces neurones sont les principaux stimulateurs de la libération de l’hormone de croissance (GH). Nous avons d’abord montré que l’axe de la croissance et de l’appétit peuvent être régulés indépendamment au niveau de l’hypothamus. En effet, la ghréline, seule hormone produite par le tractus gastro-intestinal et connue pour stimuler la libération de GH en agissant principalement sur les neurones GHRH, stimule ces derniers de manière uniquement directe. Ces effets sont indépendants de ceux qu’elle exerce sur les neurones voisins à NPY, orexigéniques. De plus, la ghréline et les GHS (agonistes sélectifs du récepteur de la ghréline) ne changent pas le mode de décharge électrique des neurones à GHRH ni ne les synchronise. Enfin, ces effets ne présentent pas de dimorphisme sexuel. Dans un second temps, la somatostatine, principal inhibiteur de l’axe GH, induit un rythme d’activité électrique des neurones à GHRH médié par les récepteurs de sous-type SST1 et SST2. Ces effets sont donc temps-dépendants, et aussi sexuellement dimorphiques. Ils sont probablement impliqués dans la modulation de la pulsatilité ultradienne de la libération de GH. Enfin, après un traumatisme crânien, nous observons un déficit de la libération de GH qui apparaît tôt et est soutenu, comme ceux observés chez l’humain. Aucune inflammation ni changement histologique n’a été observe dans l’hypophyse. Cependant, l’inflammation, impliquant une réaction tanycytaire, microgliale, astrocytaire, est présente dans le noyau arqué et l’éminence médiane (EM), ou sont respectivement présents les corps cellulaires et terminaisons des neurones à GHRH. Ceci est lié à des changements morpho-fonctionnels de l’EM (augmentation perméabilité, rupture des barrières tanycytaires). Aucun changement n’a été observé dans le noyau périventriculaire, où sont localisés les neurones à somatostatine. Enfin, les propriétés électriques passives des neurones à GHRH ne sont pas modifiées. En conclusion, une dérégulation de leur activité au niveau des terminaisons nerveuses doit expliquer les défauts posttraumatiques de libération de GHThe works of this thesis were interested in the control of the hypothalamic GHRH neurons in physiological and pathological conditions. The goal was to clarify the molecular and cellular mechanisms involved in the control or impairments of GHR neuronal network functions. These neurons are the main stimulators of the GH release. We first showed that the hypothalamic growth axis could be regulated independently from the feeding network. Indeed, GHRH neurons are directly stimulated by ghrelin, which is the only hormone produced by the gastrointestinal tract known to stimulate the GH release through acting mainly on GHRH neurons. These effects are independent from its orexigenic effects exerted on the neighbourings NPY neurons. In addition, ghrelin and GHS (synthetic ghrelin receptor agonists) don’t change neither the firing rate of GHRH neurons, nor synchronize them. These effects are not gender-dependant; by contrast, Somatostatin, the major GH axis inhibitor, generates a sexual dimorphic and rhythmic inhibition of the GHRH neurons electrical activity mediated by its SST1 and SST2 receptors subtypes. These effects are so time-dependant direct and indirect effects and can probably be involved in the generation of the ultradian rhythm of the GH release. After a traumatic brain injury, we found an early and sustained deficiency of the GH release, like those observed in human. No pathological changes are visible in the pituitary gland. Inflammation occurs at the arcuate nucleus, and mainly at the median eminence levels; it involves a strong astrocyte reaction, tanycytes, and microglial and (or) infiltrated immune cells activations. These changes elicit morpho-functional impairments of the median eminence, permeability and leakage of the tanycyte barrier between the blood, CSF and Arc; at the opposite, nothing occur at the periventricular level, where are located SST neurons. Neither the number of GHRH neurons, neither their passive electrophysiological properties changed. Impairments of the activities of the GHRH nerve terminals, maybe associated to impairments of their regulated activity, must explain a GH deficiency
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Moazzez, Lesko Mehdi. "Prognosis in traumatic brain injury (TBI)". Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/prognosis-in-traumatic-brain-injury-tbi(8b69e340-7ecd-4890-9746-863089bf55f5).html.
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Introduction: Prognosis in Traumatic Brain Injury (TBI) can be made using prognostic models (the IMPACT and CRASH models) or brain injury biomarkers (S100B). Current prognostic models are derived from historic datasets recruited from heterogeneous countries in terms of trauma care and for the purpose of clinical trials. Objective: To construct a prognostic model suitable for British trauma care, to compare the prognostic performance of prognostic models with S100B and to assess the combination of prognosticators from the constructed models with S100B. Methods: A dataset of 802 TBI cases from the Trauma Audit and Research Network (TARN), Manchester, UK was used to construct the prognostic models.. During the modelling, criteria for well-developed models as per the literature review were followed such as the dataset being large, the variables being selected from the literature and missing information being imputed. A further dataset of TBI cases was used to validate these models Moreover, the resulting models were run on a dataset of 100 TBI cases who had their serum S100B recorded at 24 hours to compare their performance with S100B. Results: Two prognostic models were constructed (models A and B) to predict the discharge survival. Both models share age, admission Glasgow Coma Scale (GCS), admission pupillary reactivity and presence/absence of hypoxia and lowblood pressure (on admission) and brain stem injury. However, model A includes Injury Severity Score (ISS) which is replaced with cause of injury, extracranial injury, brain swelling and interaction of cause of injury and age in model B. Both models have high performance either on the derivation dataset (Area Under the ROC Curve (AUC) of model A: 0.92 and AUC of model B: 0.93) or the external validation set from a later time period in TARN (AUC of model A: 0.92 and AUC of model B: 0.82). Furthermore, in the S100B dataset, it appears that the performance of prognostic models is not significantly different to that of S100B (for example, AUC of model A in this dataset: 0.64 versus 0.69 of the model just including S100B for survival prediction). A combination of S100B and models prognosticators improved performance and S100 improved the performance of models A and B. Discussion: The proposed prognostic models have very high AUCs and since they have been validated on a different TBI dataset from TARN, they are valid to be used for the purpose of the British trauma care benchmarking. Unfortunately, the results of the analysis on the small S100B dataset are not adequately powerful to be conclusive. However, these findings highlight the importance of future research on this topic in larger datasets. Conclusion: Two prognostic models have been constructed which can be used for the British TBI patients.
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McPherson, Kathryn Margaret. "Functional recovery after brain injury rehabilitation". Thesis, University of Edinburgh, 1998. http://hdl.handle.net/1842/22481.
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The thesis has two main research goals. Firstly:- a descriptive study explored functional status in patients after brain injury following discharge from in-patient rehabilitation to their own homes in the community. Secondly:- an intervention study was carried out to explore the role of home based visits as part of post discharge follow-up of patients after inpatient rehabilitation to address the findings of the first study. In the first study, 89 patients admitted consecutively for early inpatient rehabilitation following a traumatic of haemorrhagic brain injury were visited at home by the researcher at six weeks after discharge and again at 15 months. Assessment using a number of measures of function characterised the disabilities that patients experienced and revealed that deterioration in everyday functioning was common after discharge home. These two factors led to the intervention study where 43 patients were recruited to evaluate whether visits to the patient's home in the early weeks after discharge would prevent deterioration and satisfy the carers' requests for information and support. Randomisation using the minimisation method led to an experimental group with 21 subjects and a control group with 22. Patients in the experimental group were visited weekly until the sixth week when both groups were assessed using a wide range of functional measures. Both groups were also assessed at 15 months after injury. The experimental group deteriorated less than the control group in the early post-discharge period and patients, carers and other professionals valued the service provided. However, this functional improvement was not maintained at the 15 month follow-up in some cases and factors contributing to this are discussed.
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Arietta, Luca. "Clinical Data Mining: Traumatic Brain Injury". Master's thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amslaurea.unibo.it/3897/.
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Il trauma cranico é tra le piú importanti patologie traumatiche. Ogni anno 250 pazienti ogni 100.000 abitanti vengono ricoverati in Italia per un trauma cranico. La mortalitá é di circa 17 casi per 100.000 abitanti per anno. L’Italia si trova in piena “media” Europea considerando l’incidenza media in Europa di 232 casi per 100.000 abitanti ed una mortalitá di 15 casi per 100.000 abitanti.
Degli studi hanno indicato come una terapia anticoagulante é uno dei principali fattori di rischio di evolutiviá di una lesione emorragica. Al contrario della terapia anticoagulante, il rischio emorragico correlato ad una terapia antiaggregante é a tutt’oggi ancora in fase di verifica.
Il problema risulta rilevante in particolare nella popolazione occidentale in quanto l’impiego degli antiaggreganti é progressivamente sempre piú diffuso. Questo per la politica di prevenzione sostenuta dalle linee guida nazionali e internazionali in termini di prevenzione del rischio cardiovascolare, in particolare nelle fasce di popolazione di etá piú avanzata.
Per la prima volta, é stato dimostrato all’ospedale di Forlí[1], su una casistica sufficientemente ampia, che la terapia cronica con antiaggreganti, per la preven- zione del rischio cardiovascolare, puó rivelarsi un significativo fattore di rischio di complicanze emorragiche in un soggetto con trauma cranico, anche di grado lieve. L’ospedale per approfondire e convalidare i risultati della ricerca ha condotto, nell’anno 2009, una nuova indagine. La nuova indagine ha coinvolto oltre l’ospedale di Forlí altri trentuno centri ospedalieri italiani.
Questo lavoro di ricerca vuole, insieme ai ricercatori dell’ospedale di Forlí, verificare: “se una terapia con antiaggreganti influenzi l’evolutivitá, in senso peggiorativo, di una lesione emorragica conseguente a trauma cranico lieve - moderato - severo in un soggetto adulto”, grazie ai dati raccolti dai centri ospedalieri nel 2009.
Il documento é strutturato in due parti. La prima parte piú teorica, vuole fissare i concetti chiave riguardanti il contesto della ricerca e la metodologia usata per analizzare i dati. Mentre, la seconda parte piú pratica, vuole illustrare il lavoro fatto per rispondere al quesito della ricerca.
La prima parte é composta da due capitoli, che sono:
• Il capitolo 1: dove sono descritti i seguenti concetti: cos’é un trauma cra- nico, cos’é un farmaco di tipo anticoagulante e cos’é un farmaco di tipo antiaggregante;
• Il capitolo 2: dove é descritto cos’é il Data Mining e quali tecniche sono state usate per analizzare i dati.
La seconda parte é composta da quattro capitoli, che sono:
• Il capitolo 3: dove sono state descritte: la struttura dei dati raccolti dai trentadue centri ospedalieri, la fase di pre-processing e trasformazione dei dati. Inoltre in questo capitolo sono descritti anche gli strumenti utilizzati per analizzare i dati;
• Il capitolo 4: dove é stato descritto come é stata eseguita l’analisi esplorativa dei dati.
• Il capitolo 5: dove sono descritte le analisi svolte sui dati e soprattutto i risultati che le analisi, grazie alle tecniche di Data Mining, hanno prodotto per rispondere al quesito della ricerca;
• Il capitolo 6: dove sono descritte le conclusioni della ricerca.
Per una maggiore comprensione del lavoro sono state aggiunte due appendici. La prima tratta del software per data mining Weka, utilizzato per effettuare le analisi. Mentre, la seconda tratta dell’implementazione dei metodi per la creazione degli alberi decisionali.
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Indja, Ben. "Subclinical brain injury after cardiac surgery". Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/24086.
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Brain injury continues to be one of the most feared complications following cardiac procedures. While clinically overt cerebrovascular accidents are extremely well characterised and relatively rare under optimised conditions, at the other end of the spectrum, subclinical brain injury – which consists of post-operative cognitive dysfunction and silent brain infarcts (SBIs) – is poorly defined but of greater incidence. The lack of knowledge of subclinical brain injury is in large part due to lack of an objective means of measurement, meaning it is quantified using variable definitions and generally subjective clinical assessments. Structural magnetic resonance neuroimaging techniques are a potentially useful tool that can objectively characterise subclinical brain injury by providing a means to measure the neural network disruption that underlies even subtle cognitive and emotional deviations. The aim of this thesis was (i) to frame the true extent of the problem that is subclinical brain injury after cardiac surgery and (ii) to develop structural MRI techniques that might produce a biomarker to objectively measure neural network changes associated with subclinical brain injury.
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Salas, Christian E. "Emotion regulation after acquired brain injury". Thesis, Bangor University, 2013. https://research.bangor.ac.uk/portal/en/theses/emotion-regulation-after-acquired-brain-injury(6bcd1d9b-8e25-43b6-ae26-d350cfd2c750).html.
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Emotion dysregulation is a common phenomenon after brain injury, often compromising socioemotional adjustment and participation. Nevertheless, there has been little research exploring the mechanisms by which brain damage impacts emotion regulation [ER]. In contrast, outside the field of neuropsychology, the study of ER has matured during the last decade, generating a robust body of evidence on the strategies that people use to modulate their feelings. The main goal of this thesis is to bring together, for the first time, these two fields of knowledge. Chapter two presents three articles touching key conceptual issues, such as the description of self-regulation and self-other regulation problems after brain injury, the relationship between neuropsychological profiles of impairment and ER strategies deficits, and the impact of concrete behaviour on emotional experience. Chapter three explore the problem of emotion elicitation and emotional reactivity. In two articles, the efficacy of internal and external forms of elicitation is explored on a student sample [n = 40], as well as compared between people with right hemisphere [RH] damage and matched healthy controls [RH: n = 10, HC: n = 15]. The main finding of both studies is that internal elicitation procedures generate higher levels of subjective reported emotion across populations of different age. In addition, patients with RH damage present similar levels of emotional reactivity compared to controls. Chapter four explores how specific ER strategies are compromised by focal brain injury. In the first study, people with RH frontal lesions [n = 10] were compared to healthy control [n = 15] on a response modulation task. It was found that RH patients were impaired voluntarily manipulating emotional facial expressions, and that a subgroup of RH patients was unable to inhibit emotional displays. The second study explored the impact of unilateral lesions in the capacity to reappraise [RH: n = 8, LH: n = 8, HC: n = 14]. Individuals with RH and LH lesions were equally slow, compared to controls, generating reappraisals. However, when time was not considered, both groups were equally productive. Finally, Chapter five uses a single case study methodology to explore the mechanism by which ER, and particularly reappraisal, is disrupted after left prefrontal lesions. Here, two articles offer important insight into how concreteness and executive impairment are associated to emotion dysregulation, and the mechanisms by which such dysregulation can be externally compensated.
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Akin, Faith W. "Vestibular Evaluation of Traumatic Brain Injury". Digital Commons @ East Tennessee State University, 2009. https://dc.etsu.edu/etsu-works/2448.
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Yin, Terry. "Neuroprotective strategies for traumatic brain injury". Diss., University of Iowa, 2015. https://ir.uiowa.edu/etd/1811.
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Traumatic brain injury (TBI) causes life-debilitating conditions. While patient survival after a TBI has improved, the outlook for quality of life after TBI currently remains poor. In order to address this problem, there is a significant unmet need for new therapeutic options to prevent progression of deficits associated with TBI. To this end, we investigated two strategies to combat the deleterious affect of TBI. First, we targeted cerebral acidosis associated with TBI by testing whether disruption of acid sensing ion channel 1a (ASIC1a) in CNS, or buffering acidosis with sodium bicarbonate, could prevent neurological deficits after TBI. We next tested whether treatment with the neovel class of aminopropyl carbozoles, known as the P7C3 series, could also prevent TBI-associated neurological decline.
Using the mouse fluid percussion injury model of TBI, we observed post-injury acidosis in the cortex, consistent with what has been shown in humans following brain injury. Administering HCO3- after fluid percussion injury prevented acidosis and reduced neurodegeneration. Because acidosis activates acid sensing ion channels (ASICs), we also studied AIC1a-/- mice and found reduced neurodegeneration after injury. Both HCO3-3 administration and loss of ASIC1a reduced functional deficits caused by fluid percussion injury. These results suggest that fluid percussion injury induces cerebral acidosis, which activates ASIC channels in the brain and contributes to neurodegeneration. Blocking ASIC1aactivity may thus offer a new therapeutic strategy to attenuate the adverse consequences of TBI.
We next applied the blast injury model of TBI to test whether the P7C3 class of neuroprotective aminopropyl carbazoles would be of therapeutic benefit. In addition to preventing neuronal cell death, P7C3 molecules also preserved axonal integrity before neuronal cell loss in this model. The mechanism of P7C3 neuroprotection may be linked to its ability to activate the enzyme, nicotinamide phosphoribosyltransferase, which catalyzed the rate limiting step of nicotinamide adenine dinucleotide salvage pathway. Administration of the lead compound in the series, P7C3-S243, 1 day after blast-mediated TBI blocked axonal degeneration and preserved normal synaptic activity. P7C3-S243 administration also reduced neuronal functional deficits, including impaired learning, memory, and motor coordination in mice. We additionally reported persistent neurologic deficits and acquisition of anxiety-like phenotype in untreated animals 8-months after blast-mediated TBI. Optimized variants of P7C3 thus offer hope for identifying neuroprotective agents for conditions involving axonal damage, neuronal cell death, or both. Together, the results of this body of work identify novel therapeutic interventions that may attenuate deficits associated with TBI, and thus improve the quality of life in people after TBI.
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Savicki, Laura Elizabeth. "Collaborative referencing in traumatic brain injury". Thesis, University of Iowa, 2012. https://ir.uiowa.edu/etd/2977.
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Traumatic brain injury (TBI) is a global health epidemic that has deleterious consequences for the individuals with the brain injury, their families, and society. The development and validation of effective treatments is imperative. The current study was inspired by Ylvisaker's collaborative intervention approach with individuals with TBI and draws on a line of work by Duff and colleagues (e.g., Duff et al., 2006; Gupta et al., 2011) documenting patterns of spared and impaired learning abilities in individuals with various types focal brain damage (e.g., hippocampus) and selective neuropsychological impairment (e.g., declarative memory) using a collaborative referencing paradigm. This study extends this line of work by examining the ability of individuals with mild to moderate traumatic brain injury to develop and use referential labels for novel picture cards across repeated interactions with a familiar partner as they complete a collaborative referencing task. Five TBI participant pairs (an individuals with TBI and their partner) and five healthy comparison pairs completed 24 trials (6 trials in each of 4 sessions) of the collaborative referencing task across two days. As a group, the performance of four of the five TBI pairs did not differ from healthy comparison pairs on the primary dependent variables of card placement accuracy, time to complete each trial, and reduction in communicative resources across trials. That is, despite having TBI, these individuals were able to develop and use unique and concise labels to reference the novel cards in collaboration with a familiar partner. The fifth TBI participant pair (3591) differed from the other TBI and healthy comparison pair on both quantitative and qualitative measures. Speculating that 3591's husband may have contributed to their poor performance, a follow-up study was conducted whereby 3591 was brought back to lab several months later and she complete one session of the collaborative referencing task with a new partner. The results of the follow-up study were striking. 3591 and her new partner were as successful as other pairs on all measures of learning in the study.
Given the complex nature of cognitive, neurological, behavioral, personality, and communicative impairments associated with TBI, the findings here, that all participants with TBI were successful in the task, are surprising and provides further evidence that these interactive sessions are potent learning environments. The results of the study support the idea that use of a social and collaborative interaction paradigm facilitates learning in adults at least one year time post injury with mild to moderate brain injuries. Aspects of the collaborative referencing task that exemplify Ylvisaker's contextualized invention approach are completion of a goal-directed task, working with a partner who was relevant to the participant's everyday life, supports were provided by the partner as needed, the task was repeated many times in order to increase chances of the pair's success, and skills were taught through collaboration rather than explicit instruction. Although this was not an intervention study, these findings provide further evidence supporting the use of Ylvisaker's social, interactive, and collaborative approach for individuals with TBI. This study is the first to our knowledge to investigate learning during a collaborative referencing task with individuals with TBI and the positive results obtained here suggest that this may be a fruitful way to deploy Ylvisaker's contextualized intervention approach in more controlled research settings.
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Sacho, Raphael Hillel. "Brain temperature, inflammation and outcome after severe traumatic brain injury". Thesis, University of Manchester, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.503675.
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Sauerbeck, Andrew David. "TRICHLOROETHYLENE EXPOSURE AND TRAUMATIC BRAIN INJURY INTERACT AND PRODUCE DUAL INJURY BASED PATHOLOGY AND PIOGLITAZONE CAN ATTENUATE DEFICITS FOLLOWING TRAUMATIC BRAIN INJURY". UKnowledge, 2011. http://uknowledge.uky.edu/gradschool_diss/133.
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The development of Parkinson's disease (PD) in humans has been linked to genetic and environmental factors for many years. However, finding common single insults which can produce pathology in humans has proved difficult. Exposure to trichloroethylene (TCE) or traumatic brain injury (TBI) has been shown to be linked to PD and it has also been proposed that multiple insults may be needed for disease development.
The present studies show that exposure to TCE prior to a TBI can result in pathology similar to early PD and that the interaction of both insults is required for impairment in behavioral function, and cell loss. Following exposure to TCE for 2 weeks there is a 75% impairment in mitochondrial function but it has yet to be shown if the addition of a TBI can make this worse. If the exposure to TCE is reduced to 1 week and combined with TBI a 50% reduction in mitochondrial function is observed following the dual injury which requires both insults. These studies provide further support for the hypothesis that PD may result from a multifactorial mechanism.
It had been established that regional differences exist in mitochondrial function across brain regions. The present studies indicate that previous findings are not likely to be the result of differences in individual mitochondria isolated from the cortex, striatum, and hippocampus. Further analysis of the effect of mitochondrial inhibitors on enzyme activity and oxygen consumption reveal that the different regions of the brain are similarly affected by the inhibitors. These results suggest that findings from previous studies indicating regionally specific deficits following systemic toxin exposure, such as with TCE, are not the result of regional differences in the individual mitochondria.
Given that TBI results in significant dysfunction, finding effective therapeutics for TBI will provide substantial benefits to individuals suffering an insult. Treatment with Pioglitazone following TBI reduced mitochondrial dysfunction, cognitive impairment, cortical tissue loss, and inflammation. These findings provide initial evidence that treatment with Pioglitazone may be an effective intervention for TBI.
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Moran, Lisa M. "Do post-concussive symptoms discriminate injury severity in pediatric mild traumatic brain injury?" The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1250198689.
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Grimm, Geoffrey G. "Brain injury survivors effects of targeted family counseling /". Morgantown, W. Va. : [West Virginia University Libraries], 2001. http://etd.wvu.edu/templates/showETD.cfm?recnum=2104.
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Thesis (Ph. D.)--West Virginia University, 2001.Title from document title page. Document formatted into pages; contains xix, 238 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 211-218).
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LaRoux, Charlene I. 1979. "Executive function deficits in traumatic brain injury". Thesis, University of Oregon, 2010. http://hdl.handle.net/1794/11063.
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xii, 98 p. : ill. (some col.)The short and long term pathophysiology of traumatic brain injury (TBI) has not been fully elucidated. Individuals recently suffering a mild TBI (mTBI) or having a history of TBI frequently suffer deficits in their ability to maintain and allocate attention within and between tasks. This dissertation examines the influence of mild and chronic TBI on performance of task switching. We employed spatial and numerical task switching paradigms to assess the behavioral deficits in mTBI, and we used an internally generated switching and an externally cued switching task along with functional Magnetic Resonance Imaging (fMRI) to assess the long term deficits in executive function resulting from chronic TBI. In the first experiment, individuals with mTBI were identified and tested within the first 48 hours of injury and then at a set interval 5, 14, and 28 days post injury. In the second investigation, individuals with chronic TBI were tested at least 12 months after their most recent injury. Healthy gender, age, and education matched controls were also tested in both studies. This research demonstrated that mTBI subjects display deficits in switching behavior within 48 hours of injury that failed to resolve a month post-injury; however, these costs did not generalize across the switching task types. Chronic TBI subjects performed internally generated and externally cued switching paradigms with a degree of success equivalent to that of healthy controls but displayed larger amounts of activation and recruited more areas of the brain at lower levels of difficulty and did not increase recruitment in a stepwise fashion at higher levels of difficulty. Mild TBI causes significant deficits in task switching, but there is specificity in these deficits. Chronic TBI patients performed at a level equivalent to that of controls but displayed different patterns and degree of activation. Taken together, these findings indicate that there may be a specific time frame during which task switching shows behavioral deficits, after which the subject may compensate for these deficits to produce normalized performance.
Committee in Charge: Dr. Paul van Donkelaar, Chair; Dr. Li-Shan Chou; Dr. Ulrich Mayr; Dr. Marjorie Woollacott
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Purins, Karlis. "Brain Tissue Oxygenation in Traumatic Brain Injury : Experimental and Clinical Studies". Doctoral thesis, Uppsala universitet, Neurokirurgi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-195867.
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Traumatic brain injury (TBI) is a major cause of death and disability. TBI is frequently followed by cerebral ischemia which is a great contributor to secondary brain damage. The main causes of cerebral ischemia are pathophysiological changes in cerebral blood flow and metabolism. Treatment of TBI patients is currently based on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) targeted treatment protocols. However, ICP and CPP alone do not provide information of the oxygen availability in the brain. Monitoring of brain tissue oxygenation (BtipO2) may give additional and valuable information about the risk for development of ischemia in TBI patients. The aims of this thesis were to study BtipO2 monitoring devices in-vitro regarding accuracy and stability, to detect threshold level of cerebral ischemia in-vivo and finally to examine the cerebral oxygen levels and cerebral metabolism in TBI patients. The BtipO2 probes performed with high accuracy and stability at different clinically relevant oxygen concentrations. A pig TBI model was developed by step-wise intracranial volume/pressure increase. Volume increase resulted in a gradual increased ICP, decreased CPP, intracranial compliance and BtipO2, respectively. Brain death (BD) was confirmed by negative CPP and negligible amount of previously injected microspheres in the brain tissue. The model simulated the clinical development of BD in humans with a classical pressure-volume response and systemic cardiovascular reactions. The model should be suitable for studies of brain injury mechanisms. From the same in-vivo model it was also possible to detect the threshold level of cerebral ischemia in the pig, where BtipO2 below 10 mmHg and CPP below 30 mmHg was associated with an impaired cerebral metabolism (microdialysis lactate to pyruvate ratio >30). BtipO2 together with cerebral microdialysis were studied in 23 severe TBI patients. We observed different patterns of changes in BtipO2 and cerebral microdialysis biomarkers in focal and diffuse TBI. Increased cerebral microdialysis levels of glutamate, glycerol or the lactate/pyruvate ratio were observed at BtipO2 < 5 mmHg, indicating increased vulnerability of the brain at this critical level of tissue oxygenation in TBI patients.
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Kinnunen, K. M. "Traumatic brain injury : relationships between brain structural abnormalities and cognitive function". Thesis, Goldsmiths College (University of London), 2011. http://research.gold.ac.uk/6498/.
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Traumatic brain injury (TBI) is the leading cause of disability in young adults and a major public health problem. Persistent cognitive impairments are common, and constitute a significant source of long-term disability. The specific pathophysiological mechanisms underlying these impairments remain poorly understood. As it disconnects brain networks, white matter damage can be a key determinant of cognitive impairment after TBI. Neuroimaging and neuropsychological methods were employed to explore the relationships between indices of brain structure and cognitive function. The participants were 40 TBI patients and 40 healthy controls. First, relationships between focal lesions and cognitive performance were investigated using structural magnetic resonance imaging (MRI) and a battery of neuropsychological tests. The results demonstrated that lesion location and load are not good indices of the cognitive deficits - probably because diffuse axonal injury is poorly assessed by standard MRI. By contrast, diffusion tensor imaging (DTI) can be used to quantify the microstructure of white matter. A ‘whole-brain’ technique, tract-based spatial statistics (TBSS), was used to flexibly analyse the structure of white matter tracts. Despite only small amounts of focal damage observed using standard MRI, TBSS revealed widespread white matter abnormalities after TBI. White matter damage was found in patients with no evidence of focal damage, and in patients classified as ‘mild’ clinically. Relationships between white matter tract structure and specific cognitive functions were then explored. The structure of the fornix, an important white matter pathway of the hippocampus, correlated with verbal associative memory across the patient and control groups. By contrast, structure of frontal lobe connections showed distinct relationships with executive function in these two groups. The results emphasise the importance of white matter pathology after TBI and suggest that disruption to specific white matter tracts is associated with particular patterns of cognitive impairment, but also highlight the complexity of these relationships.
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Skopin, Mark D. "The Induction of Traumatic Brain Injury by Blood Brain Barrier Disruption". University of Toledo / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1302125115.
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Bellander, Bo-Michael. "On the role of complement activation following traumatic brain injury /". Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-929-3/.
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Powell, Janet M. "Effectiveness of comprehensive inpatient rehabilitation following traumatic brain injury /". Thesis, Connect to this title online; UW restricted, 2001. http://hdl.handle.net/1773/10320.
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Gothers, Ellen B. "Quality of life in brain injury survivors and caregiver stress /". View abstract, 2000. http://library.ccsu.edu/ccsu%5Ftheses/showit.php3?id=1617.
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Thesis (M.A.)--Central Connecticut State University, 2000.Thesis advisor: Charles Mate-Kole. " ... in partial fulfillment of the requirements for the degree of Master of Arts [in Psychology]." Includes bibliographical references (leaves 67-76).
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Stejskal, Taryn Marie. "Evaluating an evidence-based intervention for families and survivors after traumatic brain injury the brain injury family intervention /". College Park, Md.: University of Maryland, 2008. http://hdl.handle.net/1903/8795.
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Thesis (Ph. D.) -- University of Maryland, College Park, 2008.Thesis research directed by: Dept. of Family Studies. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.
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Hånell, Anders. "Plasticity and Inflammation following Traumatic Brain Injury". Doctoral thesis, Uppsala universitet, Neurokirurgi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-146551.
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Traumatic Brain Injury (TBI) mainly affects young persons in traffic accidents and the elderly in fall accidents. Improvements in the clinical management have significantly improved the outcome following TBI but survivors still suffer from depression, memory problems, personality changes, epilepsy and fatigue. The initial injury starts a series of events that give rise to a secondary injury process and despite several clinical trials there is no drug available for clinical use that targets secondary brain injury mechanisms. Some recovery of function is seen during the first months following injury but is usually limited and there are no drugs that stimulate the recovery of lost function. Some of the recovery is attributed to plasticity, the brains ability to adapt to new circumstances, and enhancing plasticity via increased axonal growth has the potential to partly restore lost function. In this thesis mice were subjected to the controlled cortical impact model of TBI and functional outcome was evaluated using Morris water maze, the cylinder test and the rotarod. Brain tissue loss was measured in all Papers but the additional histological analyses differ among the Papers. Attempts to increase axonal growth were made by interfering with Nogo receptor function in Paper I and by conditional knockout of ephA4 in Paper II. Contrary to the hypothesis cognition was impaired in Paper I but otherwise no effects of treatment were detected in Paper I and II. Much is still unknown about plasticity and despite the discouraging results of Papers I and II this treatment approach is still worth further exploration. It is firmly established that TBI results in an inflammatory response and some aspects of it may damage brain tissue. In Papers III and IV the inflammatory response was attenuated using an IL-1β directed antibody which resulted in reduced tissue loss and edema while improving cognitive function. The results from Papers III and IV are encouraging and the possibility to find a treatment based on IL-1β inhibition appears promising.
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Van, der Merwe Jó-Marié. "Family needs following adult traumatic brain injury". Thesis, University of Port Elizabeth, 2004. http://hdl.handle.net/10948/335.
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Traumatic brain injury (TBI) represents a significant and growing type of disability in South Africa. Coping with the impact of traumatic brain injury is one of the most difficult tasks that can confront a family, and family members experience a wide range of needs as the injured person progresses through rehabilitation. In South Africa, research on family needs following traumatic brain injury has thus far been neglected and rehabilitation resources are sadly lacking. For this reason it is necessary to accumulate knowledge about these families’ needs so as to assist with the planning of future rehabilitation programmes. The study aimed to explore and describe the needs of a sample of families with adult traumatic brain injury individuals in the Eastern Cape utilizing the Family Needs Questionnaire (FNQ). The research approach followed could be described as descriptive and exploratory in nature and was conducted within a quantitative framework. A biographical questionnaire and the FNQ were administered to a heterogeneous sample of 32 family members, including significant others and primary caregivers, of 16 adult traumatically brain-injured individuals, who sustained the TBI one to three years previously, and who underwent rehabilitation treatment at a private rehabilitation hospital in Port Elizabeth. A non-probability, purposive, and convenient sampling method was used. Descriptive statistics were computed to determine the importance and the perceived fulfillment of the needs. The results of the present study indicated that all 40 needs were endorsed by at least half the sample as being important to very important. Furthermore, 52.50% of the needs were endorsed by more than two-thirds of the sample as being important to very important. The needs were rank-ordered according to their importance ratings and the 10 mostly rated as important or very important were identified. These 10 needs were endorsed by between 84.38% and 93.75% of the family members as being important to very important. Six of the important or very important needs related to health information, two to professional support, one to community support, and one to emotional support. The relation between various participant, traumatically brain-injured individual and brain injury characteristics and the 10 important or very important needs, as well as the 10 needs more frequently rated as met were investigated and found to either have a limited or varied relationship. The 10 needs most often rated as met were endorsed by between 43.75% and 56.25% of the family members. Six of the met needs related to health information, two to community support, one to instrumental support, and one to treatment decisions. The highest unmet need was endorsed by 46.88% of the participants and related to the need to discuss their feelings with someone who has gone through the same experience. Based on the findings of the present study, further research on family needs following traumatic brain injury is suggested. It is also recommended that the Family Needs Questionnaire be used to evaluate existing rehabilitation programmes so as to make suggestions as to how to improve them. The results of this study suggested that family members would benefit from receiving educational information material, as well as referrals to professionals for advice and support.
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Powell, Trevor J. "Working with people with acquired brain injury". Thesis, University of Surrey, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298039.
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