New methods for the identification and presentation of dynamic insults to the injured human brain following traumatic brain injury
File(s)
Author(s)
Jeffcote, Dominic Toby
Type
Thesis
Abstract
Severe traumatic brain injury (TBI) is a devastating disease that is a major cause of death and disability. Significant advances have been made in the clinical management of TBI, but the complexity of its pathophysiology, and barriers to measurement of brain physiology have slowed progress in the field.
This thesis documents the clinical monitoring of 36 patients with severe brain injury, and describes the development of a novel technique for the detection of cortical spreading depolarization (SD) in the injured human brain. It details the refinement of this technique, and its application to brain injured patients who do not undergo open cranial surgery. These patients are clinically managed according to data acquired from monitoring probes inserted via burr-hole access to the intra-cranial compartment. The unequivocal presence of SDs in this patient group is demonstrated for the first time in humans.
The clinical significance of SD events is emphasized with an analysis of how SD and seizure detected by intra-parenchymal ECoG electrodes result in profound changes to brain tissue oxygenation...
This thesis documents the clinical monitoring of 36 patients with severe brain injury, and describes the development of a novel technique for the detection of cortical spreading depolarization (SD) in the injured human brain. It details the refinement of this technique, and its application to brain injured patients who do not undergo open cranial surgery. These patients are clinically managed according to data acquired from monitoring probes inserted via burr-hole access to the intra-cranial compartment. The unequivocal presence of SDs in this patient group is demonstrated for the first time in humans.
The clinical significance of SD events is emphasized with an analysis of how SD and seizure detected by intra-parenchymal ECoG electrodes result in profound changes to brain tissue oxygenation...
Version
Open Access
Date Issued
2014-12
Date Awarded
2015-09
Advisor
Boutelle, Martyn
Sponsor
Wellcome Trust (London, England)
Great Britain. Dept. of Health
Publisher Department
Bioengineering
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)