Neuroscience. Shell shock revisited: solving the puzzle of blast trauma.
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ABSTRACT: The effectiveness of helmets in extenuating the primary shock waves generated by the explosions of improvised explosive devices is not clearly understood. In this work, the role of helmet on the overpressurisation and impulse experienced by the head were examined. The shock wave-head interactions were studied under three different cases: (i) unprotected head, (ii) head with helmet but with varying head-helmet gaps and (iii) head covered with helmet and tightly fitting foam pads. The intensification effect was discussed by examining the shock wave flow pattern and verified with experiments. A helmet with a better protection against shock wave is suggested.Computer Methods in Biomechanics and Biomedical Engineering 08/2011; DOI:10.1080/10255842.2011.597353 · 1.79 Impact Factor
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ABSTRACT: Blast injury to the brain is one of the major causes of death and can also significantly affect cognition and physical and psychological skills in survivors of blast. The complex mechanisms via which blast injury causes impairment of cognition and other symptoms are poorly understood. In this study, we investigated the effects of varying degrees of primary blast overpressure (BOP; 80 and 200 kPa) on the pathophysiological and magnetic resonance imaging (MRI) changes and neurocognitive performance as assessed by the monkey Cambridge Neuropsychological Test Automated Battery (mCANTAB) in non-human primates (NHP). The study aimed to examine the effects of neurobehavioral and histopathological changes in NHP. MRI and histopathology revealed ultrastructural changes in the brain, notably in the Purkinje neurons in the cerebellum and pyramidal neurons in the hippocampus, which were most vulnerable to the blast. The results correlated well with the behavioral changes and changes in motor coordination and working memory of the affected monkeys. In addition, there was white matter damage affecting myelinated axons, astrocytic hypertrophy, and increased aquaporin-4 (AQP-4) expression in astrocytes, suggesting cerebral edema. Increased apoptosis appeared to involve astrocytes and oligodendrocytes in the animals following blast exposure. The small sample size could have contributed to the non-significant outcome in cognitive performance post-blast and limited quantitative analyses. Nevertheless, the study has provided initial descriptive changes for establishing a primary BOP threshold for brain injury to serve as a useful platform for future investigations that aim to estimate brain injury potential and set safe limits of exposure.Journal of neurotrauma 06/2011; 29(7):1434-54. DOI:10.1089/neu.2010.1591 · 3.97 Impact Factor
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ABSTRACT: Traumatic Brain Injury (TBI) care systems are those that deliver care services to reduce mortality and morbidity rates, risks and incalculable human suffering from neuro-traumatic events. These care systems seek positive cognitive, functional and physical outcomes and social reintegration for TBI patients. Current TBI care systems are fragmented and operate in silos, each with diverse clinical and resource priorities and supported through disparate information systems. Paradoxically as each silo attempts to sustain life and mitigate the impact of patho-physiological aspects of TBI, the systemic sustainability of the entire TBI care system is compromised. This paper explores the implications for the future systemic sustainability of TBI care through regionalization, intelligence systems, virtual environments and transformational leadership.Global journal of health science 04/2011; 3(1). DOI:10.5539/gjhs.v3n119