Korean Journal of Neurotrauma最新文献

Intracranial hypertension (IH) is a critical neurological emergency that requires prompt intervention because failure to treat it properly can lead to severe outcomes, including secondary brain injury. Traditionally, mannitol (MNT) has been the cornerstone of hyperosmolar therapy. However, the use of hypertonic saline (HTS) has become increasingly important because of its unique advantages. Both HTS and MNT effectively reduce intracranial pressure by creating an osmotic gradient that draws fluid from brain tissue. However, unlike MNT, HTS does not induce diuresis or significantly lower blood pressure, making it more favorable for maintaining cerebral perfusion. Additionally, HTS does not cause rebound edema and carries a lower risk of renal injury than MNT. However, it is important to note that the use of HTS comes with potential risks, such as hypernatremia, hyperchloremia, and fluid overload. Due to its unique properties, HTS is a crucial agent in the management of IH, and understanding its appropriate use is essential to optimize patient outcomes.

Osteoporotic vertebral compression fractures (OVCF) significantly contribute to increased morbidity and mortality in aging populations. When adjusted for age, South Korea has the highest global prevalence of OVCF, with rates of 544 per 100,000 men and 1,575 per 100,000 women. Moreover, patients with OVCF are at a heightened risk of additional fractures, with the risk of new vertebral fractures being up to 5-fold higher. Therefore, in treating patients with OVCF, it is essential to address the current symptoms and take preventive measures against further fractures. Although pharmacological treatment is crucial, it may be insufficient for all patients with OVCF, with more severe cases often requiring physical therapy or surgical intervention. This review aimed to explore effective physical therapy methods for patients with OVCF and summarize surgical techniques for high-risk older patients with various underlying conditions.

Objective: This study investigates the feasibility of employing a pre-trained deep learning wave-to-vec model for speech-to-text analysis in individuals with speech disorders arising from Parkinson's disease (PD).

Methods: A publicly available dataset containing speech recordings including the Hoehn and Yahr (H&Y) staging, Movement Disorder Society Unified Parkinson's Disease Rating Scale (UPDRS) Part I, UPDRS Part II scores, and gender information from both healthy controls (HC) and those diagnosed with PD was utilized. Employing the Wav2Vec model, a speech-to-text analysis method was implemented on PD patient data. Tasks conducted included word letter classification, word match probability assessment, and analysis of speech waveform characteristics as provided by the model's output.

Results: For the dataset comprising 20 cases, among individuals with PD, the H&Y score averaged 2.50±0.67, the UPDRS II-part 5 score averaged 0.70±1.00, and the UPDRS III-part 18 score averaged 0.80±0.98. Additionally, the number of words derived from decoded text subsequent to speech recognition was evaluated, resulting in mean values of 299.10±16.79 and 259.80±93.39 for the HC and PD groups, respectively. Furthermore, the calculated degree of agreement for all syllables was based on the speech process. The accuracy for the reading sentences was observed to be 0.31 and 0.10, respectively.

Conclusion: This study aimed to demonstrate the effectiveness of wave-to-vec in enhancing speech-to-text analysis for patients with speech disorders. The findings could pave the way for the development of clinical tools for improved diagnosis, evaluation, and communication support for this population.

Objective: Osteoporosis is one of the most common causes of thoracolumbar compression fractures. Teriparatide is an anabolic agent used to treat osteoporosis. This study aimed to determine whether teriparatide treatment for over 6 months could be effective in patients with osteoporotic thoracolumbar compression fractures.

Methods: Between July 2012 and June 2020, we reviewed 50 patients with thoracolumbar osteoporotic compression fractures who could be followed up for more than 1 year. Patients were divided into 3 groups: 11 patients who did not receive teriparatide (Group 0), 19 patients who received teriparatide for less than 5 months (Group 1), and 20 patients who received teriparatide for over 6 months (Group 2). Demographic data, visual analog scale (VAS) scores, and medical histories were reviewed. Radiographs were reviewed to evaluate the vertebral body compression ratio and kyphotic angles.

Results: VAS scores improved in all groups at each time point after injury. Score improvements at 6 months and 1 year between Group 0 and Groups 1 or 2 were significantly different. The compression ratio in all groups increased at each time point after injury, but the differences between Groups 0, 1, and 2 were statistically significant at 3 weeks and 6 months. While the kyphotic angle significantly increased at 1 year in all groups, the differences between the groups at each time point did not reach statistical significance.

Conclusion: Over 6 months of teriparatide treatment had some effects on pain in patients with osteoporotic thoracolumbar compression fractures, but did not prevent the progression of vertebral collapse.

Although anterior cervical discectomy and fusion (ACDF) is one of the most common surgical procedures performed for the treatment of cervical disease, it is associated with a variety of postoperative complications. Esophageal perforation is a rare but very serious post-ACDF complication, and cases in which screws extrude through the mouth are even rarer. Herein, we present the case of a 61-year-old woman who visited our emergency center with oral extrusion of a screw 6 months after undergoing ACDF. Although diagnostic imaging did not confirm esophageal perforation, the oral extrusion of the screw was clear evidence of the complication. To the best of our knowledge, this is the first reported case of oral screw extrusion without confirmed esophageal injury. This case suggests that screw migration and esophageal perforation can occur depending on the patient's underlying condition, and if the symptoms are mild, conservative treatment alone may be sufficient to treat the perforation.

Effective early resuscitation and maintenance of brain oxygenation are critical for improving the outcomes of patients with severe traumatic brain injury (TBI). Red blood cell (RBC) transfusion plays a vital role in this process. Although RBC transfusion can enhance cerebral oxygenation and stabilize hemodynamics, it also poses significant risks including transfusion-related lung injury and transfusion-associated circulatory overload, highlighting the importance of meticulous transfusion management. This review explores transfusion strategies during the early resuscitation phase and the management of anemia in patients with severe TBI, focusing on appropriate treatment targets, utilizing monitoring-based personalized approaches, and summarizing recent research and current insights.

We present a unique case of a gunshot wound to the head and neck in a 51-year-old male in Korea, where such injuries are extremely rare. The case involved complex emergency procedures including neurosurgery and lingual artery ligation, complicated by worsening cerebral conditions. This report contributes to the limited Korean literature on such injuries, providing insights into their management and the importance of immediate multidisciplinary medical interventions for gunshot trauma.