Download Brain Injury - Pathogenesis, Monitoring, Rcvy., and Mgmt. - A. Agrawal (Intech, 2012) WW PDF

TitleBrain Injury - Pathogenesis, Monitoring, Rcvy., and Mgmt. - A. Agrawal (Intech, 2012) WW
TagsMedical
LanguageEnglish
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Total Pages534
Table of Contents
                            00 preface_Brain Injury – Pathogenesis, Monitoring, Recovery and Management
00a Part 1
01 Current Understanding and
Experimental Approaches to the
Study of Repetitive Brain Injury
02 Traumatic Brain Injury and Inflammation:
Emerging Role of Innate and Adaptive Immunity
03 Shared Genetic Effects among Measures of
Cognitive Function and Leukoaraiosis
04 Compensatory Neurogenesis
in the Injured Adult Brain
05 The Effects of Melatonin on Brain
Injury in Acute Organophosphate Toxicity
06 Alzheimer’s Factors in Ischemic Brain Inju
07 The Leukocyte Count, Immature
Granulocyte Count and Immediate
Outcome in Head Injury Patients
08 Animal Models of Retinal Ischemia
08a Part 2
09 Cerebral Blood Flow in Experimental and Clinical Neurotrauma: Quantitative Assessment
09a Part 3
10 MRI Characterization of Progressive Brain Alterations After Experimental Traumatic Brain Injury: Region Specific Tissue Damage, Hemodynamic Changes and Axonal Injury
11 Neurointensive Care Monitoring
for Severe Traumatic Brain Injury
12 The Dynamic Visualization Technology
in Brain Deceleration Injury Research
13 The Experimental Technology
on the Brain Impact Injuries
14 Towards Non-Invasive Bedside Monitoring
of Cerebral Blood Flow and Oxygen
Metabolism in Brain-Injured Patients
with Near-Infrared Spectroscopy
14a Part 4
15 Mechanisms of Neuroprotection
Underlying Physical Exercise
in Ischemia – Reperfusion Injury
16 Physiological Neuroprotective Mechanisms
in Natural Genetic Systems: Therapeutic
Clues for Hypoxia-Induced Brain Injuries
16a Part 5
17 Competing Priorities in the Brain Injured
Patient: Dealing with the Unexpected
18 Traumatic Brain Injury – Acute Care
19 Clinical Neuroprotection Against
Tissue Hypoxia During Brain Injuries;
The Challenges and the Targets
20 Clinical Neuroprotection Against
Tissue Hypoxia During Brain Injuries;
The Challenges and the Targets
21 Growth Hormone and Kynesitherapy
for Brain Injury Recovery
22 Novel Strategies for Discovery, Validation and
FDA Approval of Biomarkers for Acute
and Chronic Brain Injury
23 Decompressive Craniectomy:
Surgical Indications, Clinical
Considerations and Rationale
24 The Role of Decompressive Craniectomy in
the Management of Patients Suffering
Severe Closed Head Injuries
25 The Importance of Restriction from
Physical Activity in the Metabolic
Recovery of Concussed Brain
                        
Document Text Contents
Page 1

BRAIN INJURY –
PATHOGENESIS,

MONITORING, RECOVERY
AND MANAGEMENT



Edited by Amit Agrawal

Page 2

Brain Injury – Pathogenesis, Monitoring, Recovery and Management
Edited by Amit Agrawal


Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia

Copyright © 2012 InTech
All chapters are Open Access distributed under the Creative Commons Attribution 3.0
license, which allows users to download, copy and build upon published articles even for
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As for readers, this license allows users to download, copy and build upon published
chapters even for commercial purposes, as long as the author and publisher are properly
credited, which ensures maximum dissemination and a wider impact of our publications.

Notice
Statements and opinions expressed in the chapters are these of the individual contributors
and not necessarily those of the editors or publisher. No responsibility is accepted for the
accuracy of information contained in the published chapters. The publisher assumes no
responsibility for any damage or injury to persons or property arising out of the use of any
materials, instructions, methods or ideas contained in the book.

Publishing Process Manager Bojan Rafaj
Technical Editor Teodora Smiljanic
Cover Designer InTech Design Team

First published March, 2012
Printed in Croatia

A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from [email protected]

Brain Injury – Pathogenesis, Monitoring, Recovery and Management,
Edited by Amit Agrawal
p. cm.
ISBN 978-953-51-0265-6

Page 267

The Dynamic Visualization Technology in Brain Deceleration Injury Research



255




(a) (b)

Fig. 10. Slice Image of Head
(a) Raw CVH slice image; (b) Segmented CVH slice image




(a) (b) (c)

Fig. 11. 3D Reconstruction of Head
(a) skull; (b) fundus cranii; (c) brain

The solid skull model reconstructed from 3D images is of good correspondence with the
anatomy especially in facial and skull base parts. From three-dimensional image
reconstruction of the skull and three-dimensional image corresponding to the solid model is
good, no distortion. Solid models and surface subdivisions of skull and brain are shown in
Figure 12.
The quality tests results of Skewness (Skew), Warp (Warpage) and Jacoby number (Jacobian)
for the finite element grid meet the engineering requirements (Table 1) with uniform grid
cell size mainly in the 1.5 to 4.5. The nodes and elements numbers of the FE model are 31,223
and 119,911. All elements are solid elements. Head finite element model of the number of
nodes and elements are 31,223 and 119,911. There is no contact between the skull and the
brain. There is grid contact between the brain and the brain stem without Penetration.

Page 268

Brain Injury – Pathogenesis, Monitoring, Recovery and Management



256


(a) (b) (c)

Fig. 12. Reconstruction of Solid Model and Partition
(a) skull; (b) inferior maxilla; (c) cerebrum



Checking items
Engineering
requirements

Actual values

Nodes —— 31223

Elements —— 119911

Length Distribution 1.5~4.5

Skew <600 <500
Warpage <500 <500
Jacobian >0.7 >0.95
Aspect <5.0 <2.8

Table 1. Mesh Quality Check for Finite Element Model of Head

The finite element mesh of the skull includes two parts as skull and brain. The skull includes
three parts as the cranium, the facial bones and the mandible bones. The FE grid of the
cranium contains the frontal skull, the temporal bone, the occipital bone, the sphenoid, the
ethmoid, the parietal bone and the maxillofacial bone and other anatomical structures in detail.
Fine structure of the skull FE model has been carved out in detail as shown in Figure 13.

3.2 The brain deceleration injury research based on the finite element
(FE) model

3.2.1 A case for the brain deceleration injury
A male of 19 years old, height 1.70 m and weight 55 kg fell accidentally in the work from 4.0
m to the cement floor grounded with right occipital and immediately coma for 3.5 hours
with cerebrospinal fluid rhinorrhea not accompanied by incontinence and no vomiting. He
had been head injured and in disturbance of consciousness for 1 day and waked severe
headache with vomiting 2 times. Specialist examination: inspection cooperation, a right
occipital palpable size of about 1 × 2 cm scalp hematoma, lethargy, poor time orientation,
memory loss, calculated power loss and hallucinations. GCS score: Opening eyes responses
4, language 5, movement 6, total scores 15.
Brain CT images after injury: the right occipital scalp hematoma, linear fracture of the right
occipital whose fracture line extended to the right parietal bone and the left occipital, right
anterior and middle cranial fossa fracture, bilateral frontal lobe contusion with a small

Page 533

The Importance of Restriction from Physical
Activity in the Metabolic Recovery of Concussed Brain



521

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