Naslov
Distribution of the axonal injuries in the blunt head trauma - the coexistence of the "focal" and the "diffuse" axonal injury

Autori
Dmitrović, Branko ; Kurbel, Sven ; Hećimović, Ivan

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Zentralblatt fur Neurochirurgie. Abstracts. Neurotrauma 1998, European Meeting, Magdeburg, 1998 / - Magdeburg : Johann Ambrosius Barth, 1998, 207-207

Skup
Neurotrauma 1998

Mjesto i datum
Magdeburg, Njemačka, 01.10.1998. - 03.10.1998

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
brain trauma; axonal injury

Sažetak
There is a lot of confusion with the strict division between the deep traumatic cerebral lesions in the "focal" and "diffuse" ones among the clinicians. The classical hypotheses describing the patterns of the disputable lesions are the "inner cerebral trauma" concept (Grčević N, Jakob H, 1965) and the "diffuse axonal injury" concept (Adams JH, 1980). Tha aims of this study were: 1. to determine the distribution of the axonal lesions on the large hemispherical brain slices, and 2. to test statistically the above mentioned hypotheses. There were 18 cases of closed head acceleration/deceleration type injury that were examined in this research. The survival span ranged from couple of hours after sustaining the injury up to 348 days. The mean age was 36.4 ranging from 7 to 74 years. The hemispherical histological slides were stained with haematoxylin-eosin, trichrome Mallory technique, Kluever-Barrera myelin stain, and Gross-Bielschowsky silver impregnation method for axons vizualization. There were 41 histological slides examined. The representative brain stem sections were evaluated using antibodies targeting the neurofilament subunits. The ROC (Receiver Operating Characteristics) curve analysis was applied in the data statistics. The axonal injury was evident in all the brain stem specimens. Tha axonal retraction bulbs would mostly occur in the corpus callosum and the internal and external capsule. The results of examined sample statistics confirm both observed hypotheses: "diffuse axonal injury" and "inner cerebral trauma" or focal brain injury. The predilected focal areas (according to "inner cerebral trauma" hypothesis) were characterized with 5 and more axonal lesions per field (x2=378.57, p<0.001), and the fields with white and gray brain matter margins (according to "diffuse axonal injury" hypothesis) were characterized with 1 and more axonal lessions per field (x2=39.15, p<0.01). The results of the examined sample statistics confirm the both observed hypotheses: "inner cerebral trauma" and "diffuse axonal injury". The damages are more severe in the predilected focal regions (focal injury) than at the cortex/white matter margins (diffuse injury). In the minor head injury the focal injury is more probable than the diffuse one. The diffuse axonal injury is the result of the high intensity traumatic forces.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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