• Journal of Trauma and Injury
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• 제27권3호
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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.

• 한국동물위생학회지
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• 제47권2호
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• pp.101-105
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• 2024

Three dogs (7-year-old, neutered male Chihuahua; case 1, 1-year-old, spayed female mixed breed; case 2, 10-month-old, female Maltese; case 3) were referred to Jeju Veterinary Medicine Teaching Hospital for traumatic brain injury. All three patients exhibited abnormal neurological symptoms. The patients were diagnosed through medical history obtained from their caregivers and through computed tomography (CT) or magnetic resonance imaging (MRI) scans. Structural brain abnormalities were observed in two dogs through CT scans and in one dog through MRI. Decompression therapy with mannitol was administered to all three dogs. Case 1, which showed CT findings of pulmonary hemorrhage but no significant brain injury, and case 2, which had mild brain damage on CT imaging, showed improvement in neurological symptoms and gait abnormalities after decompression therapy. However, case 3, which showed suspected brain hemorrhage and brain edema on MRI, did not respond to decompression therapy and was euthanized one month later. Imaging evaluation through CT or MRI in dogs with traumatic brain injury can assist clinical veterinarians in assessing the prognosis of patients.

• 한방재활의학과학회지
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• 제29권4호
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• pp.73-79
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• 2019

Objectives The purpose of this study is to provide Korean version of mild traumatic brain injury assessment tool. Methods The original version of acute concussion evaluation (ACE) was translated into Korean, and it was then back-translated into English without any prior knowledge of ACE. Finally, the pre-final version of Korean version of acute concussion evaluation (K-ACE) was derived. 49 Korean patients who had been diagnosed with mild traumatic brain injury participated in the study and completed K-ACE. Overall, 44 data were used to analyze findings. Validity of the study was assessed based on Concurrent validity. Reliability was also evaluated using Cronbach's ${\alpha}$ and the intraclass correlation coefficient. Results The Cronbach's ${\alpha}$ value for each item presented a proper level of internal consistency with results of 0.711 to 0.893 in two evaluations, respectively. The intraclass correlation coefficient of the retest reliability was marked as 0.892 (95% CI 0.840~0.933). Concurrent validity demonstrated positive correlations between K-ACE and Korean version of postconcussional syndrome questionnaire. Conclusions The K-ACE is concluded as a valid and reliable tool for measuring mild traumatic brain injury and post-concussion symptoms. Upon completion of the follow-up study, the K-ACE will be well-utilized by both clinicians and researchers.

• 생물정신의학
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• 제2권2호
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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.

• 생물정신의학
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• 제2권2호
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• pp.157-168
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• 1995

The neuropsychiatric sequelae of traumatic brain unjury(TBI) are effects on complex aspect of behavior, cognition and emotional expression. They include psychiatric disorders such as depression, psychosis, personality change, dementia, and postconcussion syndrome. The damage is done not only to the cortex of the brain but also to subcortical and axial structures. The diffuse degeneration of cerebral white mailer is axonal damage that is caused by mechanical forces shearing the neuronal fiber at the moment of impact(diffuse axonal injury, DAI). The DAI and the changed receptor-agonist mechanism ore the most important mechanisms in genesis of neuropsychiatric sequalae by mild TBI. The most important instrument for diagnosis of neuropsychiatric sequalae of TBI is a physician or psychiatrist with experience and knowledge. The most effective therapeutic tool is a professional who understands the nature of the problem.

• Journal of Trauma and Injury
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• 제22권2호
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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.

• 한국엔터테인먼트산업학회논문지
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• 제13권6호
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• pp.277-286
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• 2019

본 연구의 목적은 전산화 인지재활과 전통적 인지훈련이 경도 외상성 뇌손상 환자의 작업기억과 실행기능에 미치는 영향을 탐색하기 위함이다. 본 연구는 재활병원에서 재활치료를 받는 경도 외상성 뇌손상 환자 20명이 참여하였다. 대상자들은 실험군 10명과 대조군 10명으로 할당되었다. 실험군은 전산화 인지재활과 전통적인 인지훈련을 30분씩 60분을 받았으며, 대조군은 전통적인 인지훈련을 60분 수행하였다. 두 군은 하루 60분, 주 5회, 4주 동안 배정된 훈련을 수행하였다. 작업기억과 실행기능을 평가하기 위하여, 숫자외우기 검사(정방향, 역방향)와 MVPT-3의 시각기억, 그리고 선추적 검사와 스트룹 검사 A와 B를 중재 전과 후에 실시하였다. 두 군 간 변화량 비교에서 실험군은 대조군보다 시각기억과 스트룹 검사 A에서 유의하게 더 큰 향상을 보였다. 이러한 결과는 전산화 인지재활과 전통적 인지훈련이 전통적인 인지훈련보다 작업기억과 실행기능에 긍정적인 변화를 제공할 수 있음을 시사한다.

• Journal of Korean Neurosurgical Society
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• 제29권9호
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• pp.1233-1237
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• 2000

Objectives : In order to evaluate the metabolic changes associated with pericontusional edematous area in mild head injury, proton magnetic resonance spectroscopy(1H-MRS) was performed in mild head injury patients (initial GCS score 13-15) with focal brain contusion. Methods : Seven head injury patients with initial GCS 13-15(3 males and 4 females : age range 15-65 years, mean age 33 years) have underwent 1H-MRS evaluations. The patients were examined within 7 days after injury(n=7) and 2 months after injury(n=5). The region of interest(ROI) was selected in the edematous area adjacent to traumatic brain contusion upon T2-weighted MR images and a corresponding region of the contralateral hemisphere (ROC, region of contralateral corresponding hemisphere) was examined as well. The metabolic ratios of NAA/Cr and lactate/Cr were compared between ROIs, ROCs and control values. Results : In initial NAA/Cr ratios, the values of ROIs were significantly lower than those of the controls(p=0.009), but there was no difference either between ROIs and ROCs(p=0.410) or between ROCs of patients and the control (p=0.199). In lactate/Cr ratios, the ROIs in all seven patients and the ROCs in two showed increased lactate signals. The lactate/Cr ratios of the ROIs were significantly elevated as compared to those of the ROCs(p=0.02) and the control(p=0.015). In two months follow-up, lactate signals were absent or significantly reduced(p=0.015). In no patients, clinical or radiological deterioration has been observed. Conclusion : Our 1H-MRS results demonstrate that there are significant ischemic changes in pericontusional edematous areas as indicated by elevated lactate signals in the patients with mild head injury. But there were no consistent neural loss or dysfunction in these area. There findings suggest that pericontusional edematous areas can be vulnerable to secondary brain insults even in the patients with mild head injury.

• 생물정신의학
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• 제15권3호
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• pp.194-203
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• 2008

Objectives : This study was aimed at evaluating the relationship between somatic symptoms, depression, anxiety and cognitive function in the patients with Mild Traumatic Brain Injury(MTBI). Methods : Thirty seven patients with MTBI were selected from those patients who had visited the Department of Neuropsychiatry of Wonkwang University Hospital from 2003 to 2007. To assess and quantify the somatic symptoms, depression and anxiety, Personality Assessment Inventory(PAI) was used. Assessment of cognitive function was carried out by using Korean Wechsler Adult Intelligence Scale(K-WAIS), Rey-Kim Memory Test, and Kims Executive Function Test. The effects of somatic symptoms, depression, and anxiety on the cognitive function were evaluated by Pearson correlation test. Results : Somatic symptoms, depression, and anxiety, all showed inverse correlation to cognitive function. Specifically, 1) an increase in somatic symptoms was associated with a decrease in attention, verbal short term memory, verbal recall and recognition, and visual memory. 2) An increase in anxiety was associated with a decrease in verbal recall and recognition. 3) An increase in depression was associated with a decrease in cognitive function that requires high attention and verbal memory. Conclusion : The patients with MTBI displayed diverse symptoms ranging from cognitive impairment to somatic symptoms, depression, and anxiety. Somatic and emotional symptoms were correlated with cognitive function(especially executive function). Importantly, this study raises the possibility of treating the cognitive impairment associated with MTBI by treating somatic symptoms, depression, and anxiety.

• Journal of Korean Neurosurgical Society
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• 제46권5호
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• pp.459-467
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• 2009

Objective : The purpose of this study was to assess memory dysfunction in patients with mild and moderate traumatic brain injury (TBI) with and without frontal lobe injury (FLI). Methods : The subjects were 110 TBI patients, who had recovered from the acute clinical phase, and comprised 20 (18.2%) mild TBI (MTBI) patients with FLI, 16 (14.5%) MTBI patients without FLI, 51 (46.4%) moderate TBI (MOTBI) patients with FLI and 23 (20.9%) MTBI patients without FLI. All patients were administrated the Korean version of the Memory Assessment Scale (K-MAS). Results : Almost all the Summary Scale scores on the K-MAS failed to show any differences between TBI patients with and without FLI, but differences did emerge by types at severities. TBI patients with FLI showed higher Global Memory ability than TBI patients without FLI if their TBI was only mild, but when their TBI was more severe, this finding was reversed, and TBI patients with FLI showed lower Verbal and Global Memory abilities than TBI patients without FLI. Conclusion : Different kinds of assessment tools are needed for the measurement of memory abilities in TBI patients with FLI, and that the selection of the appropriate tool depends on the severity of the TBI.