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Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
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Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...

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Controlled Cortical Impact Model for Traumatic Brain Injury
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Cortical Lesion Expansion in Chronic Traumatic Brain Injury.

Holly J Freeman1, Alexander S Atalay1, Jian Li1,2

  • 1Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Medrxiv : the Preprint Server for Health Sciences
|July 9, 2024
PubMed
Summary
This summary is machine-generated.

A new semi-automated tool accurately measures brain lesions in individuals with traumatic brain injury (TBI). This method reveals significant lesion volume expansion over time, offering insights into neurodegeneration after TBI.

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Area of Science:

  • Neuroimaging
  • Neurodegeneration
  • Traumatic Brain Injury (TBI)

Background:

  • Traumatic brain injury (TBI) is a known risk factor for neurodegeneration and cognitive decline.
  • The precise mechanisms driving these long-term effects remain poorly understood.
  • Current neuroimaging methods for quantifying cortical lesions are often inefficient and lack reliability.

Purpose of the Study:

  • To develop and validate a semi-automated tool for detecting and measuring cortical lesions in individuals with chronic TBI.
  • To apply this tool to investigate longitudinal changes in lesion volume over time.
  • To enhance the understanding of neurodegenerative processes following TBI.

Main Methods:

  • A semi-automated lesion detection tool was developed using FreeSurfer and SynthSR on T1-weighted MRI data.
  • The tool was applied to 24 individuals with chronic moderate-to-severe TBI from the LETBI study, with scans at least two years apart.
  • Trained raters manually edited automated segmentations, and accuracy was validated against manual segmentations and inter-rater variability.

Main Results:

  • The semi-automated lesion segmentation tool demonstrated high accuracy compared to manual "ground truth" segmentations.
  • A significant median increase in lesion volume of 4.91 mL was observed between the two time points (p<0.0001).
  • Sixty-five percent of measured lesions showed significant expansion, exceeding inter-rater variability.

Conclusions:

  • Reliable and efficient semi-automated lesion segmentation is feasible for longitudinal studies of chronic TBI.
  • This tool facilitates the study of post-traumatic neurodegeneration and lesion evolution.
  • The findings highlight ongoing structural changes in the brain years after TBI.