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Acquired Brain Injury Rehabilitation: What Can HRV Tell You?
Published in Herbert F. Jelinek, David J. Cornforth, Ahsan H. Khandoker, ECG Time Series Variability Analysis, 2017
Ian J. Baguley, Melissa T. Nott
Brain injuries are most usually classified according to their etiology. The first subdivision for brain injuries derives from their time of onset, with congenital brain injuries occurring before birth and ABIs accounting for all other forms of postpartum injury. Within ABI, two broad classes are recognized: traumatic and nontraumatic. The category of nontraumatic ABI is extremely eclectic, including etiologies such as infections, tumors, metabolic conditions, and various degenerative conditions (e.g., multiple sclerosis and dementia) (Entwistle and Newby 2013), along with environmental and other toxins. Among the most common nontraumatic ABI are cerebrovascular accidents (CVAs), otherwise known as stroke. Ischemic stroke follows blockage of the cerebral arterial supply by thrombus or plaque. Ischemic strokes are typically focal in nature and usually defined by clinical manifestations of large vessel syndromes specific to cerebrovascular territories (Eckerle and Southerland 2013). In contrast, hemorrhagic stroke, or intracerebral hemorrhage (ICH), refers to spontaneous bleeding into the brain parenchyma, often in the context of chronic hypertension or aneurysmal rupture, and accounts for about 5%–15% of acute strokes in Western countries (Kramer 2013). Hemorrhagic stroke can co-occur with subarachnoid hemorrhage (SAH), where bleeding occurs into the cerebrospinal fluid.
NonInvasive Monitoring of Vital Signs and Traumatic Brain Injuries
Published in Alexander D. Poularikas, Stergios Stergiopoulos, Advanced Signal Processing, 2017
Stergios Stergiopoulos, Andreas Freibert, Jason Zhang, Dimitrios Hatzinakos
ICP monitoring is a critically important diagnostic tool for trauma patients and patients undergoing neurosurgery. Elevated ICP is a pathological state and is an indicator of serious neurological damage and illness. Several pathological conditions and nonvisible head injuries cause the volume within the skull to increase, but the inability of the skull to expand significantly causes the ICP to increase exponentially [3]. The primary concern caused by increased ICP is that the brain will become herniated. Brain herniation is usually the result of cerebral edema, which is the medical term for the condition when the brain is swollen and edema is usually caused by head injury. This will result in progressive damage to the brain and can ultimately be fatal. Other metabolic, traumatic, infectious conditions such as hypoxia, ischemia, brain hemorrhage, tumor and meningitis may all cause elevated ICP. Hypoxia occurs when there is a lack of oxygen supplied to the brain, usually due to cardiac arrest. Hypoxia often leads to brain edema. Ischemia is the state in which there is a deprivation of blood flow to the brain. Ischemia often leads to stroke because blood flow is interrupted or blocked, thus glucose and oxygen cannot nourish the brain. Ischemia is usually caused by formation of a blood clot (thrombus) and can lead to the death of all or parts of the brain (cerebral infarction). Intracerebral hemorrhage is an increase in blood volume within the cranium. Increased blood flow is positively correlated with an increase in ICP. The main cause of intracerebral hemorrhage is a ruptured blood vessel in the brain. Ruptured blood vessels can be the result of a blow to the head, but is usually due to hypertension. Ischemic and hemorrhagic strokes can lead to variations in the ICP [4]. The added volume of a brain tumor can also cause an increase in ICP. In fact, an increase in ICP that occurs without any head injury is often a sign of the presence of a brain tumor. Meningitis is a bacterial or viral infection of the meninges, a three-layer membrane that surrounds the brain and spinal cord. Meningitis causes the meninges to swell, press against the skull and push down on the brain. As a result, intense pressure buildup occurs, and a rise in ICP is notable. If not treated rapidly, meningitis can lead to herniation.
An Unsupervised Parametric Mixture Model for Automatic Cerebrovascular Segmentation
Published in Ayman El-Baz, Jasjit S. Suri, Cardiovascular Imaging and Image Analysis, 2018
Mohammed Ghazal, Yasmina Al Khalil, Ayman El-Baz
A stroke is defined as rapid disturbance in the cerebral blood flow, resulting in a short-term or permanent change in cerebral function [5]. Based on its pathological background, stroke can be classified as either ischemic or hemorrhagic. Ischemic stroke is the most frequent type, caused by a brief interruption of the blood supply to a certain part of the brain. Ischemic strokes can further be classified as thrombotic and embolic. Thrombotic strokes are characterized by a blood clot (thrombus) blocking an artery to the brain, hence interrupting regular blood flow. Embolic strokes are a result of a thrombus travelling from its original location such that it blocks an artery downstream. The damage occurred by an embolic stroke depends on the depth of the blockage manifestation in the artery [6]. In most cases, arteries affected by thrombotic or embolic strokes are not entirely blocked, enabling a small stream of blood to the brain. However, reduced blood flow decreases the amount of nutrients coming to the cells, which quickly affects their functionality, leading to symptoms of stroke occurring [7]. To treat ischemic strokes, the obstruction blocking the blood flow needs to be removed to restore the functionality of the cells and affected brain regions. A common treatment is a tissue plasminogen activator (tPA), which must be applied within a maximum of three hours from the occurrence of symptoms. However, only 3–5 percent of patients are able to reach the hospital in time for the treatment to be administered. Moreover, the tPA treatment increases the risk for intracranial hemorrhage. Other treatment options include intra-arterial thrombolysis with drugs or mechanical devices, carotid endarterectomy, and stenting of the cervical and intracranial vessels [8]. A hemorrhagic stroke can occur due to hypertension, fracture of an aneurysm or vascular deformity, as well as a consequence of anticoagulation medications. Two types of hemorrhage exist, an intracerebral hemorrhage and subarachnoid hemorrhage. An intracerebral hemorrhage occurs as a result of direct bleeding into the brain tissue, which further causes a lump within the brain. When bleeding expands into the cerebrospinal fluid areas around the brain, we refer to subarachnoid hemorrhage [1]. Due to intracranial pressure caused by bleeding, hemorrhagic stroke requires surgical treatment to prevent further damage and additional strokes. Stroke treatment additionally involves recovery and rehabilitation.
Intracerebral Hemorrhage Detection in Computed Tomography Scans Through Cost-Sensitive Machine Learning
Published in Applied Artificial Intelligence, 2022
Intracerebral hemorrhage (ICH) is a neurological condition occurring due to the rupture of blood vessels in the brain parenchyma (Badjatia and Rosand 2005). It is the most severe form of stroke, with the chance of death or severe disability exceeding 75% and only 20% of survivors remaining capable of living independently after 1 month (Nawabi et al. 2021; Xinghua et al. 2021). It has an incidence of 24.6 per 100,000 person-years and accounts for 10–15% of all strokes (Ziai and Ricardo Carhuapoma 2018). An early diagnosis of ICH is crucial as half of the mortality occurs in the first 24 hours (Arbabshirani et al. 2018). Computed tomography (CT) scans are currently the preferred noninvasive approach for ICH detection (Hai et al. 2019). The diagnosis time for ICH remains very long—reaching 512 minutes in one study—which couples with a high misdiagnosis rate—13.6% according to one estimate—to make it a prime candidate for workflow improvement through machine learning (Arbabshirani et al. 2018; Hai et al. 2019).
A Cu(II) complex: treatment activity on intracerebral hemorrhage via inhibiting inflammatory response in vascular endothelial cells
Published in Inorganic and Nano-Metal Chemistry, 2021
Jing Liu, Hong-Wei Zhao, Yong-Pan Tian, Yu Yang, Ji-Xiang Wu
Intracerebral hemorrhage (ICH) can cause the brain edema or even neuronal death, inducing a strong oxidative stress response, an inflammatory response, and a large number of inflammatory cell infiltration, resulting in severe damage to the blood-brain barrier.[1] Current research shows that patients with cerebral hemorrhage continue to bleed after the onset of the disease, and this phenomenon will lead to further deterioration of the early condition. Various active substances released by hematoma have a destructive effect, which will lead to changes in certain local cerebral blood flow, cerebral edema, damage to the blood-brain barrier, and toxic damage to brain cells.[2,3] In addition, the inflammatory cytokine interleukin-6 and brain tumor necrosis factor-α also play an important role in the pathophysiology of cerebral hemorrhage. Therefore, intervention in the transformation of the role of inflammatory cytokines may become a new method for the treatment of cerebral hemorrhage.
A new Cu(II) complex: treatment activity on ICH via reduction the ROS production and inflammatory response in vascular endothelial cells
Published in Inorganic and Nano-Metal Chemistry, 2021
Intracerebral hemorrhage (ICH) can induce a strong oxidative stress (OS) response, an inflammatory response, and infiltration by a large number of inflammatory cells, resulting in severe damage to the blood–brain barrier, causing brain edema or even neuronal death.[1,2] These brain damages are closely related to neurological deterioration and prognosis in patients with cerebral hemorrhage. However, there are no effective method for the treatment of brain tissue damage after cerebral hemorrhage.[3,4] The purpose of this research if to develop new candidate for the excellent treatment activity against ICH via reducing ROS production in the vascular endothelial cells.