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Clinical Workflows Supported by Patient Care Device Data
Published in John R. Zaleski, Clinical Surveillance, 2020
Changes or alterations in levels of alertness and responsiveness are typical in the case of stroke. But, in addition, and particularly in the case of hemorrhagic strokes, increases in blood pressure can and do result in increased intracranial pressure (ICP). As the pressure within the braincase (skull) increases due to bleeding within the skull, the brain can be forced down into the foramen magnum at the base of the skull (the entry point of the spinal cord). This not only causes changes in the patient level of consciousness, but the increasing pressure also results in changes in vital signs, including heart rate, respiration rate, and blood pressure. The increasing pressure at the base of the brain, where the medulla oblongata and the pons are centered, results in effects and changes in vital signs, in addition to the fact that the increasing pressure inside of the skull results in the need to counter that increasing pressure by raising the blood pressure in the arteries. This causes the heart to beat more forcefully and with greater volume, which causes the blood pressure in the body to rise concomitantly to counteract the increasing pressure within the skull. Needless to say, these are all emergent events and if not addressed directly, death can and often does result.
Sensing and Assessment of Brain Injury
Published in Mark A. Mentzer, Mild Traumatic Brain Injury, 2020
CT scans are of limited use in assessment of mTBI and will usually report negative results in mTBI patients (Stiell et al., 1997), as CT only detects structural brain damage. Small hemorrhages may also go undetected, especially with diffuse mTBI (Arrowhead Publishers, 2014). Brain swelling is measured using intracranial pressure (ICP) monitoring.
Advances in Portable Neuroimaging and Their Effect on Novel Therapies
Published in Yu Chen, Babak Kateb, Neurophotonics and Brain Mapping, 2017
Eric M. Bailey, Ibrahim Bechwati, Sonal Ambwani, Matthew Dickman, Joseph Fonte, Geethika Weliwitigoda
The standard for intrahospital transport is to provide the same level of care and intervention that are available in the ICU. Transporting a patient to and from the ICU is a common procedure, yet very risky especially for sicker patients. Patient may need to leave the ICU for regular therapeutic treatment or in response to an emergency situation such as a quick decline in the current medical status. Outside the ICU, critically ill patients will be exposed to clinically unsafe environment, for example, hallways and waiting room. The average time a patient spent outside the ICU is 62–95 minutes where the time range is 20–225 minutes (Stevenson and Hass 2002). The transport time of 157 patients were recorded, the average transport time was 47 minutes with transport time ranging from 20 to 204 minutes (Peace and Maloney-Wilensky, 2011). Intrahospital transport was the subject of several medical studies between 1999 and 2009 (Day, 2010) . These studies showed that some 60%–70% of the patients suffered complications during transports. Adverse events resulting from mishaps during patient transports include airway obstructions, respiratory arrest, hospital-acquired infections, cardiac arrest, bleeding, and finally disability related to neurological events such as increased intracranial pressure (ICP) or spinal cord destabilization. Ventilator-associated pneumonia (VAP) is a leading cause of death from hospital-acquired infections, with estimated mortality rates between 20% and 70%. Intrahospital transport is shown to increase the risk of acquiring VAP, a study by Bercault et al. Nicolas Bercault (2005) shows that 26% of patients who underwent an intrahospital transport have suffered from VAP, while only 10% of nontransported patients have suffered from VAP. A clinical study by Swanson and Mascitelli (2010) showed that the brain oxygen level is decreased in 54% of patients that underwent transport from the neurointensive care unit (NICU). Studies showed that sicker patients are at higher risks during transports; however, sicker patients are the most likely to require transports out of the ICU. Some studies also linked longer stays in the ICU to intrahospital stays (Day, 2010). Masaryk et al. state that 13% morbidity is associated with transporting critically ill patients (Thomas Masaryk, 2008). Intrahospital transportation, especially to and from the ICU, can be very hazardous to critically ill patients. Transporting patients out of the ICU may require disconnection from a ventilator which may aggravate the respiratory function of intubated patients.
A position- and time-dependent pressure profile to model viscoelastic mechanical behavior of the brain tissue due to tumor growth
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Fatemeh Abdolkarimzadeh, Mohammad Reza Ashory, Ahmad Ghasemi-Ghalebahman, Alireza Karimi
A custom Matlab script helped to define the load surface, equivalence the nodes, and write the final LS-Dyna *k file. A 10-core Intel® Xeon® CPU W-2155@3.30 GHz computer with 256GB RAM was used to run the simulations in explicit-dynamic LS-DYNA (Ansys/LST, Canonsburg, PA, US). The simulations were performed in one-step for 80 ms with time steps of 1 ms (80 time steps). Cerebrospinal fluid pressure (CSFP) was applied on the outer surface of the brain from 0-5 ms with the magnitude of −10 mmHg (-1.33 kPa) (Turner et al. 1996; Eklund et al. 2016) that is determined based on the human intracranial pressure in the supine body position. Thereafter, from 5-80 ms the pressure was set to +10 mmHg. The MRI images show the brain under applied CSFP, therefore, a negative CSFP would help to precondition the tissue and thereafter pressure it back to the same load boundary.
Research perspective and review towards brain tumour segmentation and classification using different image modalities
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2022
A brain tumour is caused by the mass of abnormal tissues that are developed in the brain. These tissues in the brain affect the skull regions and force them to stop normal brain functions (Popuri et al. 2012). These tissues can be defined as intracranial lesions, and it leads to intracranial pressure in the skull regions. Brain tumours are categorised into two types namely, benign and malignant tumours (Nanthagopal and Rajamony 2012). The benign types are known to be non-cancerous that are curable but sometimes grow back. On the other hand, the malignant types are said to be cancerous, which causes other healthy tissue in the brain to be affected at a faster rate. So, it is most essential to identify and classify brain tumours as benign and malignant types to precede the treatment for recovering the health of the patients (Rajendran and Dhanasekaran 2012). These brain tumours can be detected through various medical image modalities such as MRI, Positron Emission Tomography (PET), Computed Tomography (CT), etc. Here, MRI is defined as a non-invasive method for diagnosing the brain tumour that utilises radiofrequency pulses and magnetic fields to show the internal body structure. These MRIs are divided into three types, namely, “T1 weighted, T2 weighted, and Fluid Attenuated Inversion Recovery (FLAIR)” for brain tumour detection (Xia et al. 2012a). Some other image modalities are also used in brain tumour detection models and produce satisfactory results for tumour detection (Giridhar et al. 2020).
Biomechanical comparison of concussions with and without a loss of consciousness in elite American football: implications for prevention
Published in Sports Biomechanics, 2021
Janie Cournoyer, T. Blaine Hoshizaki
Limitations to this study include the hybrid III headform is not a fully biofidelic representation of a 50th percentile male and may not represent all the athletes included in this study. The reconstruction process involves the analysis of a two-dimensional video to replicate the three-dimensional conditions in which the injury has occurred. This may lead to some error in perception and may not accurately reflect the injury conditions. The WSUBIM also presents some limitations. The WSUBIM is a linear viscoelastic model that leads to increase strain with longer duration of acceleration. Newer finite element model of the brain use a hyperelastic model to account for the differences in stiffness and non-linearity on tension and compression. Unfortunately, this type of model was not available for this research. Moreover, the brain motion was only validated using one localised brain motion cases and the correlations were poor. This model’s validation was focused on skull fracture and intracranial pressure which can make conclusion on brain tissue deformation challenging. In addition, the WSUBIM model was not validated for all the brain regions used in this study. These limitations may alter the values of the variables measured in this study but were constant for both injury groups. It is therefore unlikely that it affected the results of the comparisons.