Preface

**Chapter 9 153**

**Chapter 10 173**

**Chapter 11 185**

*by Sabrina Araujo de França, Wagner M. Tavares, Wellingson S. Paiva* 

Demographic, Clinical, and Radiographic Characteristics of Cerebral

Neurobehavioral, Cognitive, and Paroxysmal Disorders in the Long-Term

Benefits of Early Tracheostomy in TBI Patients

Aneurysms in Tuberous Sclerosis Complex *by Mehdi Chihi, Ulrich Sure and Ramazan Jabbarli*

Period of Pediatric Traumatic Brain Injury

*by Nikolay Zavadenko, Yuriy Nesterovskiy, Alexey Kholin* 

*and Manoel J. Teixeira*

*and Irina Vorobyeva*

**II**

The brain is an interesting and fascinating organ. It is commonly viewed as an organ with complex anatomy and physiology. Lately, however, some scientists do not regard the brain as an organ! This is mainly because of their belief that the brain cannot be transplanted. The scientific reason for that is probably related to the quantum concept of the brain. From the perspective of quantum physics, the atom can exist in either particles or waves. This is the dual existence of an atom. Thus, besides the anatomical brain, the brain can also be viewed as whole waves, which interact meaningfully with the cosmological waves, forming a part of the cosmological quantum field (onefield). This concept highlights the importance of the brain for optimal human body function, which encompasses the whole of the universe. Any injury to the brain may give rise to nonoptimal or dysfunctional human body function. As a result, a brain injury is a real concern to a person who suffers from it and is commonly associated with an intrauterine, traumatic, ischemic, or hemorrhagic type of injury. The new information and understanding in traumatic brain injury gathered in this book from various field scientists may provide important insights into the pathophysiology, treatment, and ultimate advancement of brain injury knowledge.

Chapter 1 covers the historical aspect of intracranial pressure, waveforms, and compliance. The authors have touched upon the various waveforms for the ICP and the importance of each.

Chapter 2 is a superb review of the peripheral immune response following a traumatic brain injury. The detailed review also covers prevalence, pathology, and current methods in studying traumatic brain injury. Chapter 3 discusses brain injury and neuroinflammation of the gut-brain axis in individuals with cerebral palsy. Brain–gut or spinal cord–gut axis is currently a hot topic in neuroinflammation. Various diseases are related to this, including the current Covid-19 pandemic, which is rightly discussed by the authors. Chapter 4 comprehensively reviews the pathogenesis and prevention of fetal and neonatal brain injury with an emphasis on pathogenesis, prevention, management, and treatment. Chapter 5 presents the interesting topic of traumatic brain injury in children, which is uncommonly discussed in detail. Chapter 6 details noninvasive monitoring and diagnostic methods by using the transcranial Doppler, optic nerve sheath diameter, and intracranial pressure waveform. The various indexes used in these methods are well depicted in the tabulated forms. Chapter 7 concerns hyperbaric oxygenation in the treatment of traumatic brain injury. The chapter covers the mechanisms of head injury and potential positive mechanisms of hyperbaric oxygen therapy. The neuroprotective effects are stated clearly by the authors–increasing tissue oxygenation, reducing inflammation, decreasing apoptosis, reducing ICP, and promoting neurogenesis and angiogenesis. Based on these pathophysiological understandings, the authors went further in discussing the scientific studies that have been completed, including some with conflicting results. The added values of this chapter are the economic argument and a discussion of the chronic sequelae of head injury. Chapter 8 is an excellent review of the engineering aspect of head injury. It gives additional understanding to the clinician on the pathophysiology for "diffuse" head injury. As correctly stated at the conclusion, this chapter provides alternative insights in

understanding the correlation between a vehicle's interior padding, various types of head form models, materials modeling, and output parameters such as acceleration, strain, and pressure that can be correlated to TBI resulting from a vehicle crash. Chapter 9 contains a systematic review of the benefits of early tracheostomy with details on the epidemiology and pathophysiology and added emphasis on oxygen management. Chapter 10 details the demographic, clinical, and radiographic characteristics of cerebral aneurysms in the tuberous sclerosis complex. It is a chapter that focuses on the hemorrhagic aspect of brain injury and the distinct characteristics of these aneurysms. The final chapter in this book outlines the neurobehavioral, cognitive, and paroxysmal disorders in the long-term period of pediatric traumatic brain injury. The subject is rarely studied by scientists or clinicians; thus, it is not commonly presented. Therefore, this chapter is a gift to all scientists and clinicians hoping to better understand the pathogenesis of pediatric traumatic brain injury and related cognitive and neurobehavioral sequelae.

This book is the result of vigorous work and invaluable contributions by many researchers. Thus, I gratefully acknowledge their efforts and also the assistance provided by the InTech editorial team, with specific thanks to Ms. Sandra Maljavac and Ms. Marijana Francetic.

> **Dr. Zamzuri Idris** Professor, Head, Neurosurgeon and Senior Lecturer, Department of Neurosciences and Brain and Behaviour Cluster (BBC), School of Medical Sciences, Universiti Sains Malaysia (USM), Kelantan, Malaysia

> > **1**

**Chapter 1**

**Abstract**

under study.

**1. Introduction**

expanded.

critically ill patients.

Intracranial Pressure Waveform:

Intracranial pressure (ICP) can be analyzed for its absolute value, usually in mmHg or cmH2O, its tendency over time and the waveform of its pulse. This chapter will focus on the waveform of the ICP pulse (ICPwf), already observed since 1881, and for a long time not understood. Studies conducted in recent decades show the correlation between the ICPwf and intracranial compliance (ICC), another important clinical parameter added to the practice in the second half of the last century. ICC allows physicians early analyzing patients' neurological conditions related to disorders resulting from variations in cerebrospinal fluid (CSF), blood and intracranial tissue volumes. This chapter is an invitation to dive into the history and development of ICPwf analysis, clinical uses already adopted and others still

**Keywords:** intracranial pressure waveform, intracranial compliance, ICP

Technological development has brought the opportunity for significant advances in the health area. As new sensors have been developed, tools for image acquisition and treatment are improved and analytical methods using modern algorithms and artificial intelligence are developing, the set of tools available to assist in the diagnosis and monitoring of patients has been

ICP is a good example of how technological advancement has led to clinical understanding. Initially, only the number corresponding to the mean ICP was used to guide clinical procedures. Until then, there was only one number, and the

Advancing in understanding disclosed the value of having available real time information on early stages of intracranial hypertension (ICH), thus, techniques that show the pressure trend curve proved to be remarkable for the follow-up of

information was punctual, it was as if we looked at a photo.

History, Fundamentals and

*Gustavo Frigieri, Cintya Yukie Hayashi,* 

*Nicollas Nunes Rabelo and Sérgio Brasil*

Applications in Brain Injuries
