• Title/Summary/Keyword: Mild injury

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The Emerging Role of Fast MR Techniques in Traumatic Brain Injury

  • Yoo, Roh-Eul;Choi, Seung Hong
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.2
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    • pp.76-80
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    • 2021
  • Post-concussion syndrome (PCS) following mild traumatic brain injury (mTBI) is a major factor that contributes to the increased socioeconomic burden caused by TBI. Myelin loss has been implicated in the development of PCS following mTBI. Diffusion tensor imaging (DTI), a traditional imaging modality for the evaluation of axonal and myelin integrity in mTBI, has intrinsic limitations, including its lack of specificity and its time-consuming and labor-intensive post-processing analysis. More recently, various fast MR techniques based on multicomponent relaxometry (MCR), including QRAPMASTER, mcDESPOT, and MDME sequences, have been developed. These MCR-based sequences can provide myelin water fraction/myelin volume fraction, a quantitative parameter more specific to myelin, which might serve as a surrogate marker of myelin volume, in a clinically feasible time. In this review, we summarize the clinical application of the MCR-based fast MR techniques in mTBI patients.

Assessment and Treatment of Postconcussion Syndrome (뇌진탕증후군의 평가와 치료)

  • Rho, Seung Ho
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.186-192
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    • 1995
  • The Neuropsychiatric assessment and management of postconcussion syndrome(PCS), the most prevalent and controversial neuropsychiatric sequelae of traumatic brain injury, were reviewed. First, the definition and general concept of postconcussion syndrome Were summerized. This summary was followed by an overview of the clinical manifestation including cognitive, somatic, and behavioral components of PCS. Next, neuropsychological findings related to PCS were presented. Finally, the treatment issues including psychotherapy and pharamacotherapy were briefly summerized.

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A Study of patients with Head Injuries (뇌 손상 환자의 특성과 인지능력의 회복에 관한 연구)

  • 최스미
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.464-475
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    • 1992
  • Head Injuries due to traffic accidents are now the leading cause of death and long term disability in males between 30-50 years. Many patients with head injuries experience mild dysfunction of cognition without major neurosurgical problems, and this may interfere with successful rehabilitation. However, not many studies have been done to investigate the cognitive functioning following mild head injuries. The purpose of this study was to obtain injured patient's dermographic data including medical, neuropsychological and social data, and to investigate the cause of injury and alcohol use at the time of injury. This study focused on the recovery of cognitive function in patients with head injuries and used the Mini Mental State Examination(MMSE) score and its correlation with dermographic and social data. Data on 77 patients with minor head injuries who were admitted to the department of Neurosurgery in 3 and I hospital in Dae Jun from September 1991 to February 1992 were analyzed. The findings of this study are as follows ; 1) Out of the 77 cases reviewed in this study, 62 were male, 15 were female. 2) A higher incidence of injury was observed between 7:00 PM and 12:00 PM. 3) The most common cause of head injury in traffic accidents was pedestrian accidents, and the next most frequent cause was motorcycle accidents. 4) Thirteen of the 77 cases in this study were under the influence of alcohol at the time of injury, and they were all male. 5) The MMSE scores one month after injury and at discharge were significantly lower in patients with head injuries that included skull fractures than in patients without skull fractures, suggesting lower cognitive function in patients with skull fractures. 6) The level of consciousness at admission and three days after admission measured by the GCS for drivers under the influence of alcohol was lower than for sober drivers. The MMSE score was also lower for drunken drivers. 7) The MMSE score one month after the injury had a reciprocal relationship with the age of the patient. 8) The MMSE score one month after the injury and at discharge were highly correlated with the duration of unconsciousness. 9) The MMSE score one month after injury and at discharge were highly correlated with the GCS scores at admission, three days after admission, and one week after admission.

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Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology (소양인체질병증 임상진료지침: 소양상풍병)

  • Jeon, Soo-Hyung;Choi, Ae-Ryun;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.3
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    • pp.241-250
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soyangin Disease of Sasang Constitutional Medicine(SCM): Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, it was performed that search and collection of literature related SCM such as "Dongeuisusebowon", Textbook of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine. And journal search related to clinical trial or Human complementary medicine of SCM was performed domestic and overseas. Finally, 1 articles were selected and included in CPG for Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology of Spleen Cold-based Exterior Cold (Bisuhan-pyohan) disease in Soyangin Disease. Results & Conclusions The CPG of Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology in Soyangin Disease include classification, definition and standard symptoms of each pattern. Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology is classified into mild and moderate pattern by severity. Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology mild pattern is classified into initial pattern and advanced pattern. Lesser-Yang Wind-Injury (Soyang-sangpung) symptomatology moderate pattern is classified into Chest-binding (Gyeolhyoong) pattern and Chest-binding (Gyeolhyoong) advanced pattern.

The Use of Brain Computer Tomography Examination with Mild Traumatic Brain Injury in Pediatrics (일개 대학병원에서 경험한 소아의 경증 두부 외상에서 Brain CT 측정 및 효용성)

  • Kim, Ha Kyung;Kim, Jin Joo;Cho, Jin Seong;Jang, Jae Ho;Yang, Hyuk Jun;Lee, Gun
    • Journal of Trauma and Injury
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    • v.27 no.3
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    • pp.63-70
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    • 2014
  • Purpose: In children, mild traumatic brain injuries (TBI) account for 70~90% of head injuries. Without guidelines, many of these children may be exposed to excess radiation due to unnecessary imaging. The purpose of this study was to evaluate the impact of a mild TBI guideline in imaging of pediatric patients. Methods: The medical records of all children who had head computed tomography and were admitted to our hospital with a TBI with Pediatric Glasgow Coma Scale and Glasgow Coma Scale of 14 to 15 were retrospectively reviewed and compared with PECARN Rule. Results: A total of 1260 children were included and all children checked with head computed tomography. 61 pediatrics had CT positive and presented skull fracture 40, hemorrhage 8, hemorrhagic contusion 7, and diffuse axonal injury 1. Also, 4 patients diagnosed both skull fracture and brain haemorrhage and 1 patient diagnosed both haemorrhage and haemorrhagic contusion. Conclusion: There are many pediatric traumatic patients who exposed to radiation due to CT. But, the most of results were negative. So, consider to follow the CT guideline for children and many do not require brain CT.

Treatment of Nerve Root Injury during Cervical Epidural Block -A case report- (경부 경막외 블록 중 발생한 신경근 손상 치료경험 -증례 보고-)

  • Kim, Won-Hong
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.123-125
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    • 2001
  • A 50-year-old female patient developed severe right neck and upper extremity pain, hyperesthesia and allodynia during cervical epidural block. Her pain was diagnosed as neuropathic nature. She was treated with repeated stellate ganglion block (SGB) and electrical stimulation (EST). After 3 weeks of treatment, symptomatic relief was achieved, but a mild degree of hyperesthesia and motor weakness was remained. However, she refused all treatment. So treatment was stopped. In a follow-up done, 15 weeks after the nerve injury, she had recovered without complications.

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The Utility of Routine Serial Brain Computed Tomography for Referred Traumatic Brain Injury Patients According to the Severity of Traumatic Brain Injury (전원된 외상성 뇌 손상환자에서 중증도에 따른 일상적인 반복CT의 유용성)

  • Hwang, Jeong In;Cho, Jin Seong;Lee, Seung Chul;Lee, Jeong Hun
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.134-141
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    • 2009
  • Purpose: Patients with traumatic brain injury (TBI) were referred from other hospitals for further management. In addition, patients routinely underwent computed tomography examinations of the head (HCT) in the referral hospitals. The purpose of this study was to evaluate retrospectively the utility of routine HCT scans according to the severity of TBI. Methods: Patients with TBI referred to our hospital between December 2005 and July 2008 were included in this study. We investigated HCT findings, indications for repeat HCT examinations (routine versus a neurological change), and neurosurgical interventions. The head injury severity was divided into three categories according to the Glasgow Coma Scale (GCS) score, including mild, moderate, and severe TBI. The use of neurosurgical interventions between patients who underwent routine HCT scans and patients who underwent HCT scans for a neurological change were compared according to the severity of TBI. Results: A total of 81 patients met the entry criteria for this study. Among these patients, 67%(n=54) of the patients underwent HCT scans on a routine basis, whereas 33%(n=27) of the patients underwent HCT scans for a neurological change. A total of 21 patients showed signs of a worsening condition on the HCT scans. Neurosurgical intervention was required for 23(28.4%) patients. For patients who underwent routine HCT examinations, no patient with mild TBI underwent a neurosurgical intervention. However, one patient with moderate TBI and three(13%) patients with severe TBI underwent neurosurgical interventions. The kappa index, the level of agreement for HCT indications of intervention and referral reasons for intervention, was 0.65 for high hierarchy hospitals and 0.06 for low hierarchy hospitals. Conclusion: Routine serial HCT examinations in the referred hospitals would be useful for patients with severe head injury and for patients from low hierarchy hospitals where no emergency physicians or neurosurgeons are available.

Effect of Ginseng on Renal Function in Patient with Renal Injury (인삼이 신 질환 환자에서 신 기능에 미치는 영향)

  • Kim, Hyoung-Kyu;Cho, Won-Yong;Koo, Ja-Ryong
    • Journal of Ginseng Research
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    • v.21 no.1
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    • pp.49-52
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    • 1997
  • There are many mechanisms that mediate progression of renal injury, such as abnormalities of nitric oxide (NO) regulation, increased Platelet aggregatlon, and oxygen free radical injury. Ginseng has been known to have NO dependent vasorelaxant effect and antioxidant effect, also inhibit thrombin stimulated platelet aggregation. And these effects of ginseng may have some roles in prevention of renal injury. So we studied 24 patients with mild pathologic proteinuria and hypertension to evaluate the effect of ginseng on progression of renal injury. After 1 month treatment, creatinine clearance was significantly increased especially in the patient group with normal serum creatinine level without specific side effect. The result of this study suggest that ginseng may pre vent or retard the progression of renal injury especially in early stage.

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Predictive Indicators for the Severity of Pediatric Trauma and the Prevention of Injuries According to the General Characteristics and Pre-hospital Factors of Severe Pediatric Trauma Patients (소아 중증 외상환자의 병원 전 요인에 따른 중증 손상의 예측과 손상의 예방)

  • Woo, Jae-Hyug;Yang, Hyuk Jun;Lim, Yong Su;Cho, Jin Seong;Kim, Jin Joo;Park, Won Bin;Jang, Jae Ho;Lee, Gun
    • Journal of Trauma and Injury
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    • v.27 no.3
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    • pp.43-49
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    • 2014
  • Purpose: Trauma is one of the most common causes of death for children, and identifying severely injured children quickly in an overcrowded emergency room (ER) is difficult. Therefore, severe injury must be prevented, and the severity of injuries in children must be determined easily from their general characteristics and pre-hospital factors. Methods: Injured children younger than 15 years of age who visited the ER from June 2011 to May 2013 were enrolled. According to the revised trauma score (RTS) of the patients, the study population was divided in two groups, a severe group (RTS<7) and a mild group ($RTS{\geq}7$). The general characteristics and the pre-hospital factors were compared between the two groups. Results: Six hundred seventy-three children were enrolled, their mean age was 8.03 (${\pm}4.45$) years, and 476 (70.73%) patients were male. Of these patients, 22 patients (3.27%) were in the severe group, and 651 patients (96.73%) were in the mild group. Fewer males were in the severe group than in the mild group (50.00% vs. 71.43%, p=0.030), and children in the severe group were younger than children in the mild group (3.50 vs. 8.00 years, p=0.049). In the severe group, toddlers (54.55%, p=0.036) were the most common age group. Severe injuries occurred more often in spring (32.81%) and summer (54.56%) than in autumn (9.09%) and winter (4.55%) (p=0.026). The most common places of injury in the severe group were roads (50.00%, p=0.009), and the most common mechanisms of injury in the severe group were traffic accidents (50.00%), followed by falls (31.82%) (p=0.011). Most severely injured children were transferred by ambulance (72.73%, p=0.000). Conclusion: The results of this study may be helpful for identifying severely injured children quickly in the field and the ER. To prevent severe pediatric injuries, precautions and policies based on these results should be established.

The Effects of Computer-Based Cognitive Rehabilitation and Traditional Cognitive Training on the Working Memory and Executive Function in Patients with Mild Traumatic Brain Injury (전산화 인지재활과 전통적 인지훈련이 경도 외상성 뇌손상 환자의 작업기억과 실행기능에 미치는 영향)

  • Moon, Jong-Hoon;Yang, Seung-Bum;Jeon, Min-Jae
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.6
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    • pp.277-286
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    • 2019
  • The aim of this study was to investigate the effects of computer-based cognitive rehabilitation and traditional cognitive training on the working memory and executive function of patients with mild traumatic brain injury. The sample consisted of 20 patients with mild traumatic brain injury who had received rehabilitation treatment in a rehabilitation unit. The subjects were assigned to either the experimental (n = 10) or control group (n = 10). The experimental group received computer-based cognitive rehabilitation and traditional cognitive training for 60 minutes, whereas the control group received only traditional cognitive training for 60 minutes. Both the groups received their respective interventions for 60 minutes a day and 5 times per week across a period of 4 weeks. Working memory and executive function were assessed using the digit span test (forward and backward), visual memory 1 and 2 of the Motor-free Visual Perception Test-3, trail making test, and Stroop test (A and B) both before and after the intervention. The experimental group showed a significantly greater improvement in visual memory and performance on the Stroop test A than the control group. These findings suggest that computer-based cognitive rehabilitation and traditional cognitive training are more effective in promoting positive changes in the working memory and executive function of individuals with mild traumatic brain injury than traditional cognitive training.