Book of abstracts - British Neuroscience Association

62.01
Complication outcome and clinical evaluation for the isolated and
combined craniocerebral trauma
Lim L W, Volkodav O V, Molchanov V I
Dept. of Psychiatry and Neuropsychology, Division of Cellular
Neuroscience, Faculty of Health, Medicine and Life Sciences,
Universitietssingel 50, 6229ER Maastricht. The Netherlands.
Craniocerebral trauma (CCT) has become a major cause of death and
disability worldwide. It usually results from a variety of etiologic factors
that significantly affect the cognitive, physical, and psychological
functions. Our objective is to evaluate the clinical diagnostic and
therapeutic method, and the complication outcome in both isolated
and combined CCT. Seventy-eight patients, aged 16-54 with 8%
isolated and 60% combined CCT were investigated at the
neurosurgical intensive-care unit (ICU). Approximately 2% mortality
rates result from the excessive hemorrhage during the moment of
accidents and eventually lead to cerebral hypoxia/ischemia. It was
estimated that 30% victims suffered with fatal consequences during
the ambulatory transportation to the hospital. The mortality rate in
isolated CCT accounts for 3.3% and the combined CCT consists of
20.4-35% with Glasgow-coma-scale score of 3-5. The reasons of
death were mainly due to the severe complication in combined CCT
especially caused by profuse hemorrhage and multiple injuries
including thoracic and abdominal trauma and long-bone fractures. The
therapeutic approach covers a wide range of critical care measures
including oxygenation and blood pressure, intracranial pressure
monitoring, cerebral perfusion pressure management, nutritional
support, hypertonic solution & mannitol infusion, decompressive
craniotomy, and pharmacological interventions for the severe CCT
patient in the neurosurgical ICU. The treatment of CCT requires a
fundamental understanding of its pathophysiological changes in the
primary impact and secondary insults that promote excitotoxic
secondary brain damage. It is an obligatory to conduct the initial
resuscitation, elimination of cerebral compression, neuro-rehabilitation
and the prevention of avoidable complications.
62.02
Complication outcome and clinical evaluation for the isolated and
combined craniocerebral trauma
Lim L W, Volkodav O V, Molchanov V I
Dept. of Psychiatry and Neuropsychology, Division of Cellular
Neuroscience, Faculty of Health, Medicine and Life Sciences,
Universitietssingel 50, 6229ER Maastricht. The Netherlands.
Craniocerebral trauma (CCT) has become a major cause of death and
disability worldwide. It usually results from a variety of etiologic factors that
significantly affect the cognitive, physical, and psychological functions. Our
objective is to evaluate the clinical diagnostic and therapeutic method, and
the complication outcome in both isolated and combined CCT. Seventyeight
patients, aged 16-54 with 8% isolated and 60% combined CCT were
investigated at the neurosurgical intensive-care unit (ICU). Approximately
2% mortality rates result from the excessive hemorrhage during the
moment of accidents and eventually lead to cerebral hypoxia/ischemia. It
was estimated that 30% victims suffered with fatal consequences during
the ambulatory transportation to the hospital. The mortality rate in isolated
CCT accounts for 3.3% and the combined CCT consists of 20.4-35% with
Glasgow-coma-scale score of 3-5. The reasons of death were mainly due
to the severe complication in combined CCT especially caused by profuse
hemorrhage and multiple injuries including thoracic and abdominal trauma
and long-bone fractures. The therapeutic approach covers a wide range of
critical care measures including oxygenation and blood pressure,
intracranial pressure monitoring, cerebral perfusion pressure management,
nutritional support, hypertonic solution and mannitol infusion,
decompressive craniotomy, and pharmacological interventions for the
severe CCT patient in the neurosurgical ICU. The treatment of CCT
requires a fundamental understanding of its pathophysiological changes in
the primary impact and secondary insults that promote excitotoxic
secondary brain damage. It is an obligatory to conduct the initial
resuscitation, elimination of cerebral compression, neuro-rehabilitation and
the prevention of avoidable complications.
62.03
Iatrogenic traumatic brain injury: Penetration of kirschner’s
knitting needle into the middle cranial cavity
Lim L W, Volkodav O V, Molchanov V I
Dept. of Psychiatry and Neuropsychology, Division of Cellular
Neuroscience, Faculty of Health, Medicine and Life Sciences,
Universiteitssingel 50, 6226ER Maastricht. The Netherlands.
Traumatic penetrations of foreign objects into the craniocerebral cavity
are often encountered in the department of emergency and
traumatology. A 5-year-old child who was brought to the department of
pediatric neurosurgery with complains of severe headache and
fatigue. On admission, the patient had initial neurological examinations
and radiological scans. The consciousness assessment by Glasgow
Coma Scale was thirteen. Neuroradiological studies revealed a long
hyperdensed object extending from extracranial cavity into the middle
cranial fossa. A thorough history was obtained with attention to how
and when the injury was sustained. Two weeks before the incident,
the child had a blunt trauma of mandibular fractures with dislocation of
the temporomandibular joint. Maxillomandibular surgery was
performed with a Kirschner’s knitting needle to fixate the
temporomandibular articulation and simple interdental ligatures for
mandibular fracture stabilization. The present radiological film
suggested that the mandibular fracture was not properly fixated which
allowing the mobilization of Kirschner’s needle moving either
externally or internally. A standard pterional access with Frontotemporo-shpenoidal
approach was performed according to the method
of M.G.Yasargil and Oikawa-Miyazawa; followed by an extradural
approach method of V.V.Dolenc to the middle cranial structure at the
skull base. Several stages of hemostasis were carried out with
electrohemocoagulation on the penetrated Kirschner’s needle during
the needle extracting process at the extradural space of middle cranial
fossa. Two weeks after post-operation, CT scan revealed the
supratentorial and middle-craniocerebral structures were in
symmetrical localization. The patient was free of neurological deficits
and no signs of excessive CSF volume formation.
63.01
Testing for the presence of viral infection in Multiple Sclerosis using a
new human panviral diagnostic array.
Trillo-Pazos G, Khan A, Kellam P, Reynolds R, Bell J, Weiss R, Miller D
University College London , Institute of Neurology, Dept Of
Neuroinflammation and Windeyer Institute, Division of Infection of
Immunity, London W1T 4JF
MS is a neuroinflammatory disorder characterised by microgliosis, gliosis,
neuronal damage and multifocal demyelinated plaques. Clinically, MS
manifests with motor and cognitive neurological impairments. MS has being
associated with a specific HLA-DR2 phenotype and a putative viral
aetiology based on epidemiological evidence. Over the last 30 years
numerous viruses have being associated with MS, currently EBV, HHV6
and endogenous retroviruses have being implicated in MS.
We have developed a Human Panviral Diagnostic Array (HVDA) to detect
viruses in primary and secondary progressive MS post-mortem tissue
lysates from the basal ganglia and cortical regions of the brain.
Histologically these cases have active and chronic plaques as
characterised by immunocytochemistry to different cellular antigens.
Panviral arrays designed to date are based on the detection of structural
viral genes that are predominantly expressed in lytic/acute viral infection. It
is likely that MS, if viral in aetiology, is associated with latent and chronic
infection. We designed the HVDA using a biology based approach with
probes to regulatory, replicator and structural genes corresponding to 210
Human viral genomes from 25 different viral families. These arrays were
validated by using cell culture lysates from known viral infections (HIV-1,
EBV, KSHV, HHV6). We detected different patterns of viral gene
expression in latent versus lytic infection in 10, 000 to 100 cells infected
with HIV-1 or EBV using our HVDA. To conclude, we have designed and
validated a Human Panviral array to test for the presence of viruses MS
and other brain diseases ex vivo.
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