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PubMed2006

Leontiasis ossea and post traumatic cervical cord contusion in polyostotic fibrous dysplasia.

Leontiasis ossea (leonine facies) or cervical canal stenosis are rare complications of polyostotic fibrous dysplasia (PFD). This case report documents dramatic leontiasis ossea in PFD as well as post traumatic cervical cord contusion due to hyperextension injury in a patient with generalized PFD involving the cranio-facial bones, axial skeleton and entire spine with secondary cervical canal stenosis. Cervical cord contusion has not been reported earlier in PFD.

Accidental Falls↗

PubMed1991

Study of regional cerebral blood flow in experimental head injury: changes following cerebral contusion and during spreading depression.

Changes in regional cerebral blood flow (rCBF) following fluid-percussion brain injury (cerebral contusion) were studied in rats using the autoradiographic method. The direct current potential was monitored to identify spreading depression (SD). The rCBF was measured during SD and 2, 4, and 24 hours after injury. rCBF was almost nil in the contused area and decreased considerably in the cortices of the injured side for 4 hours after insult, then recovered by 24 hours. Focal relative rCBF increase occurred in the parietal cortex during SD, and was probably hyperperfusion due to SD. However, the rCBF did not increase over the sham-operated control. The injury probably caused hypoperfusion within 4 hours of insult and abolished the vascular response to SD.

Animals↗

PubMed1991

The use of physical restraint in patients with cerebral contusion.

Behavioral problems resulting in the use of physical restraint is a clinical problem seen in the acute phase of recovery from cerebral contusion. However, little is known about the frequency of physical restraint, factors that might predispose to its use, the pattern of adjunctive psychotropic drugs used or the outcome for patients needing this form of management. In order to examine these issues, a retrospective study of all patients (N = 34) admitted with cerebral contusion to a neurosurgical service over a one-year period was undertaken. Physical restraint was used in twelve patients (35%) for an average length of 4.3 days. The use of physical restraint was associated with presumptive evidence of alcohol abuse or dependence but not with level of consciousness on admission. Restrained patients were frequently prescribed psychotropic drugs during hospitalization. Patients requiring physical restraint stayed in hospital nearly twice as long as those not needing restraint. Close attention to the identification and treatment of alcohol problems and their complications in this population may reduce the need for physical restraint and shorten length of hospital stay.

Activities of Daily Living↗

PubMed1985

Spinal cord contusion injury: experimental dissociation of hemorrhagic necrosis and subacute loss of axonal conduction.

Previously reported experimental models for spinal cord contusion injury do not allow the independent control of compression and contact velocity required for interpretation of experimental data relating kinematics of vertebral injury to spinal cord injury. Therefore, controlled dynamic compression of the spinal cord was used to study compression and contact velocity as independent variables. Cord conduction was assessed using the latency of somatosensory evoked potentials in response to hindlimb stimulation. The latency increase at 4 hours after contusion differed significantly between control and 50% compression results, and between 25% and 50% compression results. A small nonsignificant increase in latency was observed with increase in contact velocity. The extent of hemorrhagic necrosis correlated with contact velocity rather than with the amount of compression. This study demonstrates, for the first time, a dissociation between hemorrhagic necrosis and loss of neuronal conduction in the subacute phase. Although long-term effects of hemorrhagic necrosis on cord structure and conduction remain to be evaluated, the data suggest that delayed loss of neuronal conduction seen clinically may result from moderate levels of cord compression at high contact velocity. Such an injury is not reproducible by weight-drop techniques for cord injury.

Animals↗

PubMed1996

A new experimental model of contusion in the rat. Histopathological analysis and temporal patterns of cerebral blood flow disturbances.

The authors have devised a simple reproducible rodent model of focal cortical injury that uses a mechanical suction force applied through intact dura. The time course and pattern of changes in neurons, glia, and microvasculature were investigated using this model. Early traumatic disruption of the blood-brain barrier and hemorrhage do not occur in this model; however, many of the features of human contusion seen with light and electron microscopy are closely reproduced. At the site of injury, early swelling and lucency of neural dendritic processes have been shown to precede an astrocyte response. In the absence of perivascular hemorrhage, delayed perivascular protein leakage and polymorphonuclear infiltration of the damaged cortex occurs, which is suggestive of an acute inflammatory response. Cerebral blood flow (CBF) has been measured using 14C-iodoantipyrine autoradiography at 30 minutes, 4 hours, and 24 hours after induction of negative-pressure injury in rats anesthetized with halothane and in time-matched sham-operated controls. A significant reduction in blood flow in the sensorimotor cortex at the site of the injury was present at 30 minutes, 4 hours, and 24 hours after induction of the lesion, compared to the contralateral cortex (superficial lamina, ipsilateral 50 +/- 7 ml/100 g/minute, contralateral 112 +/- 26 ml/100 g/minute). The CBF was significantly reduced at the ipsilateral entorhinal cortex at 30 minutes postinjury but no significant reduction was demonstrated at later time points. Although marked alterations in CBF occurred in this cortical injury model, the magnitude and duration of the reduction in CBF are not consistent with those necessary for production of ischemic cell damage. These data indicate that this model of cortical injury can be used to examine biomechanical aspects of contusion without domination by ischemic pathophysiology.

Animals↗

PubMed2003

Cytidinediphosphocholine treatment to decrease traumatic brain injury-induced hippocampal neuronal death, cortical contusion volume, and neurological dysfunction in rats.

OBJECT: In previous studies at their laboratory the authors showed that cytidinediphosphocholine (CDP-choline), an intermediate of phosphatidylcholine synthesis, decreases edema formation and blood-brain barrier disruption following traumatic brain injury (TBI). In the present study the authors investigate whether CDP-choline protects hippocampal neurons after controlled cortical impact (CCI)-induced TBI in adult rats. METHODS: After adult male Sprague-Dawley rats had been anesthetized with halothane, a moderate-grade TBI was induced with the aid of a CCI device set at a velocity of 3 m/second, creating a 2-mm deformation. Sham-operated rats, which underwent craniectomy without impact served as controls. The CDP-choline (100, 200, and 400 mg/kg body weight) or saline was injected into the animals twice (once immediately postinjury and once 6 hours postinjury). Seven days after the injury, the rats were neurologically evaluated and killed, and the number of hippocampal neurons was estimated by examining thionine-stained brain sections. By 7 days postinjury, there was a significant amount of neuronal death in the ipsilateral hippocampus in the CA2 (by 53 +/- 7%, p < 0.05) and CA3 (by 59 +/- 9%, p < 0.05) regions and a contusion (volume 34 +/- 8 mm3) in the ipsilateral cortex compared with sham-operated control animals. Rats subjected to TBI also displayed severe neurological deficit at 7 days postinjury. Treating rats with CDP-choline (200 and 400 mg/kg, intraperitoneally) significantly prevented TBI-induced neuronal loss in the hippocampus, decreased cortical contusion volume, and improved neurological recovery. CONCLUSIONS: Treatment with CDP-choline decreased brain damage following TBI.

Animals↗

PubMed2005

Survival, integration, and axon growth support of glia transplanted into the chronically contused spinal cord.

Due to an ever-growing population of individuals with chronic spinal cord injury, there is a need for experimental models to translate efficacious regenerative and reparative acute therapies to chronic injury application. The present study assessed the ability of fluid grafts of either Schwann cells (SCs) or olfactory ensheathing glia (OEG) to facilitate the growth of supraspinal and afferent axons and promote restitution of hind limb function after transplantation into a 2-month-old, moderate, thoracic (T8) contusion in the rat. The use of cultured glial cells, transduced with lentiviral vectors encoding enhanced green fluorescent protein (EGFP), permitted long-term tracking of the cells following spinal cord transplantation to examine their survival, migration, and axonal association. At 3 months following grafting of 2 million SCs or OEG in 6 microl of DMEM/F12 medium into the injury site, stereological quantification of the three-dimensional reconstructed spinal cords revealed that an average of 17.1 +/- 6.8% of the SCs and 2.3 +/- 1.4% of the OEG survived from the number transplanted. In the OEG grafted spinal cord, a limited number of glia were unable to prevent central cavitation and were found in patches around the cavity rim. The transplanted SCs, however, formed a substantive graft within the injury site capable of supporting the ingrowth of numerous, densely packed neurofilament-positive axons. The SC grafts were able to support growth of both ascending calcitonin gene-related peptide (CGRP)-positive and supraspinal serotonergic axons and, although no biotinylated dextran amine (BDA)-traced corticospinal axons were present within the center of the grafts, the SC transplants significantly increased corticospinal axon numbers immediately rostral to the injury-graft site compared with injury-only controls. Moreover, SC grafted animals demonstrated modest, though significant, improvements in open field locomotion and exhibited less foot position errors (base of support and foot rotation). Whereas these results demonstrate that SC grafts survive, support axon growth, and can improve functional outcome after chronic contusive spinal cord injury, further development of OEG grafting procedures in this model and putative combination strategies with SC grafts need to be further explored to produce substantial improvements in axon growth and function.

Animals↗

PubMed2002

Schwann cell but not olfactory ensheathing glia transplants improve hindlimb locomotor performance in the moderately contused adult rat thoracic spinal cord.

Cultured adult rat Schwann cells (SCs) or olfactory ensheathing glia (OEG), or both, were transplanted in the adult Fischer rat thoracic (T9) spinal cord 1 week after a moderate contusion (10 gm, 12.5 mm, NYU impactor). Rats received either a total of 2 x 10(6) cells suspended in culture medium or culture medium only (controls). At 12 weeks after injury, all grafted animals exhibited diminished cavitation. Although in medium-injected rats 33% of spinal tissue within a 5-mm-long segment of cord centered at the injury site was spared, significantly more tissue was spared in SC (51%), OEG (43%), and SC/OEG (44%) grafted animals. All three types of glial grafts were filled with axons, primarily of spinal origin. SC grafts contained more myelinated axons than SC/OEG and OEG grafts. Both types of SC-containing grafts expressed more intense staining for glial fibrillary acidic protein and chondroitin sulfate proteoglycan compared with OEG-only grafts. Retrograde tracing demonstrated that the number of propriospinal and brainstem axons reaching 5-6 mm beyond the grafted area was significantly higher with SC and SC/OEG grafts but not with OEG-only grafts compared with controls. Corticospinal fibers terminated closer to the lesion epicenter in all grafted animals than in controls. With SC-only grafts, a modest but statistically significant improvement in hindlimb locomotor performance was detected at 8-11 weeks after injury. Thus, in addition to this functional improvement, our results show that an SC graft is more effective in promoting axonal sparing/regeneration than an SC/OEG or OEG graft in the moderately contused adult rat thoracic spinal cord.

Animals↗

PubMed2000

Temporal profiles and cellular sources of three nitric oxide synthase isoforms in the brain after experimental contusion.

OBJECTIVE: Nitric oxide (NO) is a universal mediator of biological effects in the brain. It has been implicated in the pathophysiological processes of traumatic brain injury. Understanding its pathophysiological role in vivo requires an understanding of the cellular sources and tissue compartments of the differentially regulated NO synthase (NOS) isoforms. This study was undertaken to investigate the cellular sources and tissue compartments of NO produced after experimental brain contusions in rats, by analysis of the early expression of the three isoforms of NOS, i.e., the inducible, endothelial, and neuronal isoforms. METHODS: Focal brain contusions were produced in 24 rats using a weight-drop model. The animals were killed 6, 12, 24, 36, or 48 hours after trauma. Sections were analyzed by immunohistochemical and immunofluorescence analyses. Double staining assays were used to define which cells produced the different NOS isoforms. RESULTS: Increases in endothelial NOS-, inducible NOS (iNOS)-, and neuronal NOS-positive cells were detectable by 6 hours after trauma. Endothelial NOS and iNOS levels peaked at 6 and 12 hours, respectively. Expression of neuronal NOS initially increased to a peak at 12 hours but then decreased to a level lower than that in control samples at 36 hours. Endothelial NOS was expressed exclusively in endothelial cells, whereas iNOS was expressed in neutrophils and macrophages. Neuronal NOS was predominantly detected in neurons but was also unexpectedly detected in polymorphonuclear cells. CONCLUSION: In this model, the most striking finding regarding NO-producing enzymes was the expression of iNOS in polymorphonuclear cells and macrophages, cells that invade injured brain tissue. iNOS is thus implicated as a therapeutic target in contusional injuries. This pattern of NOS expression cannot be generalized to all types of brain injuries. The different compartments and cells that can produce NO are differentially regulated; therefore, compartmentalization can explain why NO is beneficial or detrimental, depending on the circumstances. A knowledge of different potential sites and sources of NO is required for any attempts to interfere with the pathophysiological properties of NO.

Animals↗

PubMed2001

[Contusion traumas with damaged entity of the eye globe].

PURPOSE: Examination of the etiology, the clinical history of the injury, the functional and anatomic result after contusion traumas with damaged entity of the eye globe. MATERIAL AND METHODS: Retrospective examination of the clinical documentation of 35 patients /35 eyes/, treated in Emergency Medical Center during the period 1994-1996. RESULTS AND DISCUSSION: The etiology shows that traumas resulting from housework prevail. According to their localization the ruptures are: scleral--19 eyes (54.28%), corneo-scleral--13 eyes (37.14%) and corneal--3 eyes (8.57%). Prolaps of uvea and vitreous was diagnosed with all the eyes. It was massive in the scleral and corneo-scleral ruptures. No eye underwent primary enucleation. The therapeutical behavior consists in primary reconstructive operation, general and local antibiotic, cortico-steroidal and non-steroidal anti-flammatory therapy. The functional and anatomic results are bad: absence of visual acuity with 51.42% of the eyes and vision up to 20/200 with 45.71%, subatrophy of the eye globe during the first 6 months after the trauma with 18 eyes (51.42%). CONCLUSION: The contusion traumas with damaged entity of the eye globe are hard traumatic injuries which usually end with bad functional, anatomic and cosmetic results. The consequence is constant invalidation of the patients.

Adult↗

PubMed2001

[Contusion eye trauma caused by explosion of vacuumed coffee tin].

PURPOSE: To report a rare case of eye contusion trauma, resulting from explosion of vacuumed coffee tin. MATERIAL AND METHODS: 7 years old patient underwent injury of the right eye while opening a vacuumed coffee tin. The examination consisted in: history, evaluation of the visual acuity and refraction, examination of intraocular pressure, biomicroscopy, ophthalmoscopy. RESULTS AND DISCUSSION: During the examination an edema has been found in the macula area. This edema lately degenerated. When the patient was admitted his visual acuity was 20/30 and did not change when he was released. The visual acuity of the left eye was 20/20. CONCLUSION: Contusion trauma, caused by vacuumed coffee, can be followed by constant changes in the area of the macula and result in decreasing of the visual acuity.

Adult↗

PubMed1992

[Nonspecific resistance and the immunological indices in brain contusion].

As many as 55 healthy persons and 69 victims with brain contusion of medium and severe degree were examined. Inhibition of cellular immunologic reactions and attenuation of nonspecific resistance as well as increase of immunoglobulins, immune complexes and cerebral antibodies were revealed. These changes were found to be more pronounced in a severe brain contusion.

Adolescent↗

PubMed1992

Continuous oscillation therapy for the treatment of pulmonary contusion.

Pulmonary contusion as a result of blunt trauma carries significant morbidity and mortality. In an attempt to improve therapy, a prospective study was performed in which 30 patients were randomized to either receive or not receive continuous oscillation therapy on the Kinetic Treatment Table. Pulmonary contusion was defined by mechanism of injury (blunt trauma secondary to a motor vehicle accident), hypoxemia, and radiographic confirmation. Patients who received continuous oscillation therapy had a significantly higher injury severity score (more severely injured group of patients), yet had a hospital course similar to those patients who did not receive continuous oscillation therapy and had a significantly lower injury severity score.

Adult↗

PubMed2004

[Neuroprotective effects of magnesium on cerebral ischemia and cerebral contusion].

Neuroprotective effects of magnesium (Mg(2+)) have been shown in experimental studies by using animal models of the cerebral ischemia and cerebral contusion. We review the neuroprotective effects of Mg(2+) in the histological and behavioral studies. In the animal models of cerebral ischemia, Mg(2+) treatment reduces the infarct volume, inhibits the neuronal death, and attenuates the motor impairments. In the animal models of cerebral contusion, Mg(2+) treatment inhibits the neuronal death and edema, and attenuates not only the motor impairments but also cognitive dysfunction.

Animals↗

PubMed2005

[Lung contusions: diagnostics, treatment stages].

The authors studied a group of patients with simple thorax injury, contusion of lungs and injury of thorax frame (1225 patients), who had been refused to be hospitalized to specialized poly-trauma departments due to some reasons. 34% of these patients had fractures of ribs, thorax and rib arcs and 15% of them had two-sided traumas. The group of the patients with simple thorax injury and lung contusion, but without injuries of thorax frame, consisted of 63% of the patients, who addressed for an aid at first hours after accidents. Clinical X-ray pictures have been not clearly expressive. 37% of patients, who had asked for medical aid in 3-5 days after accidents, had trauma complications. As a result, they had long-term outpatient treatment of pneumonia and pleurisy. In order to provide necessary aid to patients and carry out prophylactics of delayed complications it is recommended to hospitalize these people to therapeutic and pulmonary departments.

Adult↗

PubMed2005

Myocardial contusion.

OBJECTIVE: To utilise an evidence-based strategy to answer two clinical questions regarding myocardial contusion - How is the diagnosis made and how long does a patient require cardiac monitoring? METHODS: Pubmed search using appropriate MeSH terminology then selection of abstracts using a predetermined criteria. RESULTS: One meta-analysis, five descriptive reviews and thirty-two other articles were selected for detailed review. CONCLUSION: Myocardial contusion is an ill-defined term for traumatic cardiac injury. "Significant blunt chest trauma" appears to be a more useful term. Normal serially performed electrocardiograms and troponin I assays over 8 hours appear to exclude this condition. When complications occur, the onset is usually within 48 hours of injury. Monitoring of patients with abnormal ECG's or troponins for at least 48 hours post injury would therefore be prudent.

Journal Article↗

PubMed2006

[Relationship between expression of nestin in experimental brain contusion and injury time].

OBJECTIVE: To observe the alteration of nestin intervals in the experimental traumatic brain injury and investigate its relation to the injury intervals. METHODS: The rat brain contusion was conducted by falling impact injury. After various survival interval (0.5, 6, 12 h and 1, 3, 7, 14, 28 d), immunohistochemical SP method was used for observing the expression of nestin in the cortex, hippocampal dentate gyrus and the corpus callosum on injury side. RESULTS: Expression of nestin positive cells increased at 0.5 h and reached the maximum level in 7 d after brain contusion, then the expression decreased gradually. The intensity of nestin staining in the the cortex and the hippocampal dentate gyrus decreased to normal on 28 d. As to the corpus callosum of injury side it remained weak on 28 d. CONCLUSION: The changes of nestin immunohistochemical staining can be used as an index for forensic estimation of early injury time.

Animals↗

PubMed2006

[The relationship of injury timing with the change of neuronal apoptosis and the expression of caspase-3 after brain contusion].

OBJECTIVE: To investigate and analyze the changes of neuronal-apoptosis and the expression of caspase-3 for finding out a new method of injury timing after brain contusion in human. METHODS: The tissue was stained by TUNEL for apoptosis and by immunohistochemistry for caspase-3. Image analysis technique was employed. RESULTS: The nerve cells stained positive by TUNEL and Caspase-3 immunohistochemistry were distributed in the penumbra and central area. Both these areas were in striking contrast with the distal area or those of control group. The positive staining was more prominente in penumbra area than in central area (P < 0.05). The changes of TUNEL staining and expression of Caspase-3 in penumbra area gradually increased with the survival period after injury; they were parallel to each other. There were linear relationships between the time of injury in 48 hours and the increase in the mean of integral optical density (IOD), the coefficient of correlation (r) being 0.93 and 0.69 for the two staining methods, and two linear regression formulae were induced, respectively. CONCLUSION: Observations on the increasing of neuronal apoptosis and Caspase-3 expression in relation with the survival period after injury could be utilized in the timing of brain contusion.

Adolescent↗