Cerebral ischemic stroke (CIS) is an acute cerebrovascular disease that is caused by the sudden rupture of blood vessels inside the brain and the intervention of reperfusion to the brain, resulting in severe cerebral injury. Autophagy has been reported to be involved in the occurrence and progression of CIS. Betulinic acid (BA) is a pentacyclic triterpene acid mainly extracted from birch bark. Studies have shown the neuroprotective effects of BA. Here, the effect and mechanism of BA on ischemia-reperfusion induced cerebral injury was explored using a CIS model in vivo via 1 h middle cerebral artery occlusion (MCAO) and 24 h reperfusion in rats and in vitro via oxygen-glucose deprivation/reperfusion (OGD/R) of PC12 cells, respectively. We found that BA not only reduced cerebral injury by reducing oxidative stress but also activated the SIRT1/FoxO1 pathway to suppress autophagy and improve cerebral injury in MCAO rats. These results provide a basis for the potential clinical application of BA.
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http://dx.doi.org/10.1021/acschemneuro.1c00198 | DOI Listing |
Background: Paroxysmal sympathetic hyperactivity (PSH) occurs with high prevalence among critically ill patients with traumatic brain injury (TBI) and is associated with worse outcomes. The PSH-Assessment Measure (PSH-AM) consists of a Clinical Features Scale and a diagnosis likelihood tool (DLT) intended to quantify the severity of sympathetically mediated symptoms and the likelihood that they are due to PSH, respectively, on a daily basis. Here, we aim to identify and explore the value of dynamic trends in the evolution of sympathetic hyperactivity following acute TBI using elements of the PSH-AM.
View Article and Find Full Text PDFNeurotherapeutics
January 2025
Division of Neurosciences Critical Care, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:
A wide range of acute brain injuries, including both traumatic and non-traumatic causes, can result in elevated intracranial pressure (ICP), which in turn can cause further secondary injury to the brain, initiating a vicious cascade of propagating injury. Elevated ICP is therefore a neurological injury that requires intensive monitoring and time-sensitive interventions. Patients at high risk for developing elevated ICP undergo placement of invasive ICP monitors including external ventricular drains, intraparenchymal ICP monitors, and lumbar drains.
View Article and Find Full Text PDFBMJ Open
January 2025
Clinical and Research Center on Acute Lung Injury, Beijing Shijitan Hospital Capital Medical University, Beijing, Beijing, China
Objectives: The purpose of this study was to evaluate the predictive value of the cough peak flow (CPF) for successful extubation in postcraniotomy critically ill patients.
Design: This was a single-centre prospective diagnostic study.
Setting: The study was conducted in three intensive care units (ICUs) of a teaching hospital.
Clin Neurol Neurosurg
December 2024
Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran. Electronic address:
Progressive hemorrhagic injury (PHI) is a frequent complication of traumatic brain injury (TBI). This study aims to investigate the impact of coagulation factors (platelet [PLT], prothrombin time [PT], activated partial thromboplastin time [aPTT], international normalized ratio , fibrinogen [Fg], D-dimer [Dd], and fibrin [Fib]) at admission and PHI development through a comprehensive systematic review and meta-analysis based on PRISMA 2020 guideline. Databases including PubMed, Scopus, Web of Science, and Embase were searched up to March 2024.
View Article and Find Full Text PDFJ Neurosurg Pediatr
January 2025
4Department of Neurosurgery, Children's Hospital Colorado Anschutz Medical Campus, Aurora; and.
Objective: Pediatric traumatic brain injury (TBI) represents a significant public health concern and source of resource utilization. The aim of this study was to establish the ability of the previously published pediatric Brain Injury Guidelines (pBIG) to identify patients with traumatic intracranial hemorrhage (ICH) who might not require routine repeat neuroimaging, neurosurgical consultation, or hospital admission in a large level I and level II trauma cohort.
Methods: Pediatric patients who presented with traumatic ICH between 2018 and 2022 at the included institutions were retrospectively reviewed and sorted into pBIG categories using clinical and radiographic criteria.
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