Consequences Of Severe Brain Injury Research Articles

Comorbidity Development in Patients with Severe Brain Injury Resulting in Chronic Critical Condition (Review)

Advances in intensive care have enabled patients to survive an acute critical condition, producing a growing population of patients in a chronic critical condition with long-term dependence on intensive care. These patients make up 5–10% of all patients with acute respiratory failure and require a disproportionate share of resources in the intensive care units, with an overall yearly survival rate of 40–50%. The aim of review is to identify the impact of comorbid complications on the course and outcome of patients with severe brain injury. Ninety-six sources were selected according to the data characterizing the clinical (syndromic) model of the patient with consciousness disorders after coma of different etiologies. This model takes into account the stages and phases of the syndrome as well as a number of comorbid conditions that determine the course and outcome of the disease. The list of sources includes papers addressing the issues of comorbidity in patients with brain injury and conditions such as strokes, consequences of severe brain injury and brain surgery. The sources reflecting the most significant mechanisms of consistent development of comorbidities were examined. These include metabolic disorders with subsequent protein and energy deficiency and comorbidities of the gastrointestinal tract. The role of microbiome in the development of comorbidity in patients in chronic critical condition was also identified. C onclusion. The comorbidity development starts from the moment of brain injury and extends until sustained stabilization or multi-organ failure and death. Timely detection and correction of comorbidities allows optimizing treatment and increasing efficiency of rehabilitation in patients with severe brain injury.

Towards a state of play: A case study exploring insight-oriented musical experiences with a woman with severe brain injury

This article presents an improvisational approach to insight-oriented therapy in music therapy with a woman with severe cognitive impairments following haemorrhagic stroke. Analysis of five clinical excerpts across 40 sessions demonstrates how a prepared improvised musical experience can facilitate meaningful self-exploration in dialogue, leading to a renewed self-identity in life after brain injury. The therapist’s reflective processing is integral to the therapeutic outcomes; these are examined alongside the casework material. This article suggests that insight-oriented musical experiences may be one way of supporting the emotional health of individuals living with the enduring consequences of severe brain injury in slow-stream rehabilitation or long-term neurological care.

Effect of Cell Therapy on Metabolite Content in Brain Structures of Children with Consequences of Severe Brain Injury: 1H Magnetic Resonance Spectroscopy Study

The effect of intravenous injection of human umbilical cord blood cells on the levels of N-acetylaspartate, creatine and phosphocreatine, choline-containing compounds, glutamine and glutamate, and myoinositol in morphologically intact areas of the cortex, white matter, and hippocampus of children with consequences of traumatic brain injury was studied by single voxel 1H magnetic resonance spectroscopy. It was shown that cell therapy increases the content of N-acetylaspartate, a marker of functional integrity of neurons, in the white matter and in the cortex at the boundary between the frontotemporal and parietal lobes and reduces neurological deficit.

Chorioamnionitis and Neonatal Encephalopathy in Term Infants With Fetal Acidemia: Histopathologic Correlations

The aim of this study was to determine whether the presence or severity of histologic abnormalities of infection/inflammation such as chorioamnionitis, vasculitis, or funisitis confers an additional risk for neonatal encephalopathy in term infants delivered in the presence of severe fetal acidosis. The medical records as well as placental pathology of term infants (n = 51) born with a cord umbilical arterial pH <7.00 were reviewed. Abnormal outcome was predefined as Sarnat stage 2 or 3 neonatal encephalopathy in the first week of life or neonatal death as a consequence of severe brain injury. Consistent with prior data, the presence of severe fetal acidemia, a low 5-minute Apgar score, and need for cardiopulmonary resuscitation were significantly associated with neonatal encephalopathy. However, the presence of histologic chorioamnionitis had a poor predictive value and did not confer additional risk for the subsequent development of neonatal encephalopathy.