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PubMed1984

Ureteral contusion with gunshot wounds.

The entity of ureteral contusion with a gunshot wound has not been well described in the literature. The blast effect of the bullet, even one of low velocity, can cause contusion of the ureter manifested by hematuria, no extravasation on the IVP, and a normal appearing ureter or some bruising of the ureteral wall and periureteral tissues. The ureteral contusion may resolve or may progress to delayed necrosis of the ureteral wall with urine leakage. Twelve cases of ureteral contusion with gunshot wounds are reported. The ureter was found contused at exploration in two patients; one had excision of the contused area with end-to-end anastomosis and the other had a nephrostomy and ureteral splint. The ureter appeared normal in ten patients and no immediate treatment was performed to the ureter; eight had no postoperative evidence of urine leakage and two developed a urinary fistula.

Adult↗

PubMed2005

Pulmonary contusion causes impairment of macrophage and lymphocyte immune functions and increases mortality associated with a subsequent septic challenge.

OBJECTIVE AND DESIGN: Pulmonary contusion is frequently followed by acute respiratory distress syndrome, pneumonia, and sepsis. However, immunologic alterations of circulating and resident immune cell populations contributing to the posttraumatic immunosuppression are poorly understood. We therefore characterized the influence of pulmonary contusion on peripheral blood mononuclear cells, peritoneal macrophages, splenocytes, and splenic macrophages. To address the significance of the immunosuppression associated with lung contusion, we investigated how the consecutive addition of moderate or severe sepsis affected survival after blunt chest trauma. SUBJECTS: Male C3H/HeN mice (n = 10 per group) were anesthetized and subjected to chest trauma or sham procedure. MEASUREMENTS: The cytokine release of cultured peripheral blood mononuclear cells, peritoneal macrophages, splenocytes, and splenic macrophages and plasma levels of tumor necrosis factor-alpha and interleukin-6 from those animals were quantified. Sepsis was induced via cecal ligation and puncture 24 hrs after lung contusion. MAIN RESULTS: Two hours after blunt chest trauma, plasma tumor necrosis factor-alpha and interleukin-6 were markedly increased, as was peripheral blood mononuclear cell cytokine production, lung myeloperoxidase activity, and lung chemokine concentrations. At 24 hrs and, in part, already at 2 hrs, cytokine release from peritoneal macrophages, splenic macrophages, and splenocytes was significantly suppressed. Furthermore, pulmonary contusion when followed by moderate sepsis significantly diminished survival rate when compared with chest trauma or moderate sepsis alone. CONCLUSIONS: These results indicate that pulmonary contusion causes severe immunodysfunction of splenocytes, macrophages, and monocytes in different local compartments and systemically. Moreover, this immunosuppression is associated with an increased susceptibility to infectious complications, which results in a decreased survival rate if blunt chest trauma is followed by a septic insult.

Analysis of Variance↗

PubMed2005

Bilateral lavage with diluted surfactant improves lung function after unilateral lung contusion in pigs.

OBJECTIVE: This study evaluates the effects of bronchoalveolar lavage with diluted surfactant on unilateral lung contusion-induced lung dysfunction. DESIGN: Randomized prospective animal study. SETTING: An animal laboratory. SUBJECTS: Twenty adult pigs, weighing 25-35 kg. INTERVENTIONS: Animals were randomly assigned to controls and surfactant treatment. Bilateral lavage with surfactant treatment began 30 mins after unilateral lung contusion. Then 25 mg/kg of body weight diluted Curosurf (5 mg/mL) was applied in a volume of 5 mL/kg of body weight. Observation time was 8 hrs postinjury. MEASUREMENTS AND MAIN RESULTS: The Pao2/Fio2 ratio fell from 500 to 250 and then recovered gradually in controls and surfactant-treated pigs. After another 4 hrs, the Pao2/Fio2 ratio deteriorated again in controls, but not in surfactant-treated animals. Total compliance fell by 50% after injury but was completely restored by surfactant treatment. Lung contusion increased the median number of neutrophils in bronchoalveolar lavage fluid from 2% to 30% of total cells and peaked >60% at 480 mins in the contused lungs of control pigs. Surfactant-treated pigs had 40% neutrophils at 480 mins without reaching significant difference to controls. The leukocyte neutral proteinase inhibitor increased to 500 ng/mL at 30 mins postinjury in the contused lungs and increased to 2000 ng/mL after surfactant treatment. CONCLUSIONS: Bilateral bronchoalveolar lavage with diluted surfactant can effectively improve lung function after experimental unilateral lung contusion in pigs.

Animals↗

PubMed1993

Bone contusions of the knee: increased lesion detection with fast spin-echo MR imaging with spectroscopic fat saturation.

PURPOSE: To demonstrate that T2-weighted fast spin-echo (FSE) imaging with spectroscopic fat saturation (FS-FSE) increases the conspicuity between normal marrow and bone contusions in posttraumatic knees. MATERIALS AND METHODS: Seventy-six magnetic resonance (MR) studies of the knee were prospectively evaluated in 73 consecutive patients with knee pain. Conspicuity of regions of microtrabecular trauma (bone contusions) was evaluated with conventional T2-weighted imaging in the sagittal plane, T2-weighted FSE imaging in the coronal plane, T2-weighted FS-FSE imaging in the sagittal plane, and conventional T1-weighted imaging in the sagittal plane. RESULTS: Twenty-six foci of bone contusion were identified in 21 knees with the FS-FSE technique. Only 16 foci were demonstrated with conventional T2-weighted imaging. Six of the sites of bone contusion were not demonstrated with the FSE technique alone (without fat saturation). Four of the bone contusions were not seen on T1-weighted images; these sites of bone contusion were substantially more conspicuous on the FS-FSE images. In addition, FS-FSE imaging was more sensitive in demonstrating the extent of microtrabecular trauma. CONCLUSION: T2-weighted FS-FSE imaging is a sensitive and rapid method of identifying and assessing the extent of microtrabecular trauma about the knee.

Adult↗

PubMed1996

Lateral-compartment bone contusions in adolescents with intact anterior cruciate ligaments.

PURPOSE: To determine how often lateral-compartment bone contusions are seen on magnetic resonance (MR) images of knees in adolescents with intact anterior cruciate ligaments (ACLs). MATERIALS AND METHODS: MR images obtained in 53 adolescent patients (30 male, 23 female; aged 10-20 years) were reviewed to detect bone contusions in the posterolateral tibial plateau or the lateral femoral condyle. ACLs were also evaluated with accepted criteria for the diagnosis of ligamental disruption. Only patients referred for evaluation of a knee injury or mechanical symptoms were included. RESULTS: Five patients with bone contusions had an intact ACL at MR imaging. One of the five had arthroscopic confirmation. Fifteen other patients had complete ACL disruptions: 13 of these patients had typical bone contusions; the other two had no bone abnormalities but had chronic ACL tears. Thus, 28% of the 18 patients with typical bone contusions had intact ACLs. CONCLUSION: Adolescents may have the same pattern of contusions as adults but may maintain an intact ACL owing to increased ligamentous laxity.

Adolescent↗

PubMed1979

Effects of contusion and flail chest on pulmonary perfusion and oxygen exchange.

Localized pulmonary contusions were produced in the right lower lobes (RLL) of 12 anesthetized ventilated dogs, 6 of which had a flail segment in the chest wall over the RLL. Pulmonary oxygen exchange during ventilation with air and oxygen, and the lobar distribution of pulmonary perfusion by radioactive microsphere techniques were measured before and 3 h after contusion, and again after thoracotomy. These were compared to 12 noncontused dogs, 6 of which had a flail segment. Contusion produced an average decrease of 20 Torr in Pao2 during air breathing and an average increase in Qs/Qt of less than 5%, surprisingly small given the doubled weight and average 44% shunt calculated in the contused lobe after thoracotomy. No significant effect of flail or thoracotomy was found, indicating that the presence of an intact chest wall and lung-chest wall interdependence was not a major factor preventing a larger increase in intact whole-animal shunt of contused dogs. Rather, the small effect of this severe lobar injury on whole-animal shunt was due to a 30% decrease in RLL relative perfusion. This reduction was demonstrated to be localized to a smaller hemorrhagic subsection of the contused lobe.

Animals↗

PubMed1992

Altered patterns of reflex excitability subsequent to contusion injury of the rat spinal cord.

1. The present study investigated regulation of reflex excitability after experimental contusion injury of the spinal cord. 2. Four measures of H-reflex excitability were evaluated in normal rats and at 6, 28, and 60 days after contusion injury at the T8 level: 1) reflex thresholds, 2) slope of the reflex recruitment curves, 3) maximal plantar H-reflex/maximal plantar M-response (Hmax/Mmax) ratios, and 4) rate-sensitive depression (i.e., the decrease in reflex magnitude relative to repetition rate). 3. Tested as a function of the afferent volley magnitude, the thresholds for reflex initiation fell progressively subsequent to contusion injury. No change was observed at 6 days postinjury, and the decrease at 28 days was not significant. However, by 60 days postinjury, the threshold had decreased by 23% of the maximal afferent volley, and this decrease was significant, [analysis of variance (ANOVA, P < or = 0.01)]. 4. Hmax/Mmax ratios elicited in postcontusion animals at 0.3 Hz were not significantly different from those recorded in normal animals. 5. The slopes of the recruitment curves were markedly reduced subsequent to contusion injury. The decrease was greatest at 6 days postinjury. Although some recovery toward normal occurred at 28 and 60 days postinjury, the slopes of recruitment curves in postcontusion animals remained significantly decreased. 6. H-reflexes elicited at 1-5 Hz were less sensitive to rate depression in postcontusion animals than in normal animals at the same respective frequencies. The decrease was progressive in onset, becoming significant by 28 days postinjury, and of an enduring nature, i.e., still significantly different from normal in the reflexes tested 60 days postinjury. 7. Rate sensitivity of the tibial nerve monosynaptic reflex (MSR) was also compared in normal and postcontusion animals. Rate sensitivity of the tibial MSRs was significantly reduced at 28 and 60 days post-contusion, compared with normal animals. 8. These data indicate that significant changes in lumbar reflex excitability result from midthoracic contusion injury of the spinal cord. These changes include reflex threshold, slope of recruitment, and rate-sensitive depression. Although recruitment slope was most altered in the shortest postinjury interval tested, followed by some recovery, the other changes were progressive in onset and enduring in duration.

Animals↗

PubMed2006

Rotator cuff contusions of the shoulder in professional football players: epidemiology and magnetic resonance imaging findings.

BACKGROUND: No published reports have studied the epidemiology and magnetic resonance imaging findings associated with rotator cuff contusions of the shoulder in professional football players. PURPOSE: To determine a single professional football team's incidence, treatment, and magnetic resonance imaging appearance of players sustaining rotator cuff contusions of the shoulder. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: From 1999 to 2005, a North American professional football team's injury records were retrospectively reviewed for athletes who had sustained a rotator cuff contusion of the shoulder during in-season participation. Those patients who had magnetic resonance imaging of the shoulder with a 1.5-Tesla magnet were reviewed by a musculoskeletal radiologist and graded according to the appearance and severity of clinical injury. RESULTS: Twenty-six players had a rotator cuff contusion. There was an average of 5.5 rotator cuff contusions per season (47% of all shoulder injuries). The predominant mechanism of injury was a direct blow in 70.3%. Magnetic resonance imaging findings included peritendon edema at the myotendinous junction, critical zone tendon edema, and subentheseal bone bruises. Treatment consisted of a protocol involving modalities and cuff rehabilitation in all patients. Six patients had persistent pain and weakness for a minimum of 3 days and were given a subacromial corticosteroid injection. Overall, 3 patients (11.4%) required later surgical treatment on the shoulder. CONCLUSION: Rotator cuff contusions accounted for nearly half of all shoulder injuries in the football players in this study. Magnetic resonance imaging is an extremely useful tool in determining severity of injury and integrity of the rotator cuff. The majority of athletes are able to return to sports with conservative treatment; a minority of shoulders might progress to more severe injuries such as rotator cuff tears.

Adult↗

PubMed2003

Injuries in pediatric patients with seatbelt contusions.

Children restrained with lap belts may sustain severe injuries. We investigated the frequency of each type of injury associated with seatbelt contusions. The medical records of all trauma patients with ICD-9 codes for abdominal wall contusions from January 1, 1999, to December 31, 2001, were reviewed. All patients with seatbelt contusions were included in the study. Age, seat position, weight, restraint-type, sex, and mechanism of injury were noted. There were 1447 admissions for trauma over the 3-year period. Forty-six patients (ages 4-13) had a seatbelt contusion. Thirty-three wore lap belts, and 13 wore lap and shoulder harnesses. Twenty-two children required abdominal exploration. Small bowel injuries were the most common intra-abdominal injuries. Facial injuries were the most common associated injuries. Forty-eight per cent of children with seatbelt contusions in our institution required surgery. The smaller patients tend to have higher frequency of abdominal injuries. The presence of seatbelt contusion indicates the possibility of severe internal injuries.

Abdominal Injuries↗

PubMed2006

[Expression of c-fos protein after muscle contusion in experimental rats].

OBJECTIVE: To study the relationship between the expression of c-Fos protooncogene and skeleton muscle contusion of rats, and to search for a sensitive marker of timing for skeleton muscle contusion. METHODS: Fifty Sprague-Dawley rats were randomly distributed into control group and experimental groups. The expression of c-fos was microscopically observed by immunohistochemical method. RESULTS: With the time prolonged the c-fos positive intensity and area were increased. Positive expression of c-fos protein appeared at 15 min after skeleton muscle contusion, and reached to the peak at 1h after skeleton muscle contusion, then decreased gradually and returned to the normal level on 1d after skeleton muscle contusion. CONCLUSION: The detection of the expression of c-fos protein could be a sensitive marker for timing skeleton muscle contusion.

Animals↗

PubMed1984

Right ventricular contusion: experimental pathophysiology and treatment in an open-chest canine preparation.

To investigate the pathophysiology and treatment of right ventricular (RV) contusion we assessed biventricular function via volume expansion in eight open-chest, anesthetized, ventilated dogs. Measurements were obtained before and after RV contusion with a captive bolt pistol and during dobutamine infusion. RV contusion depressed both RV and left ventricular (LV) performance as assessed by classical ventricular function curves (p less than 0.05). Dobutamine reduced filling pressure (p less than 0.05) and increased cardiac output (CO) (p less than 0.01) when infused post contusion. Because, on inspection, the LV was not contused, the apparent depression in LV function is most likely due to reduced diastolic compliance secondary to ventricular interdependence. In support of this possibility, in four dogs, LV performance significantly improved (p less than 0.05) when the pericardium was opened. We conclude that RV contusion can depress the relationship between CO and filling pressures in both ventricles and that dobutamine is superior to volume in treating the resultant low cardiac output state.

Animals↗

PubMed1998

[The characteristics of the diagnosis, intensive therapy and surgical procedure in contusions of the heart].

Based on an analysis of results of treatment of 86 patients and wounded with severe combined traumas and gunshot wounds the authors have made a diagnostic scale including 8 most significant symptoms of heart contusions which determine the index MS-HC (military surgery-heart contusion). The value of this index in scores gives a reliable picture of heart contusion. Patients having not less than 15 scores are considered to be in a critical state. Lethality among them was 80%, the survivors had complications in 45% of the cases. The autopsy showed that the diagnosis of heart contusion by the score system was correct and coincided with the autopsy findings in 94.7%. A rational program of intensive therapy for heart contusions is proposed aimed at the maintenance and development of compensatory abilities in the hemodynamic system. The basic drugs are thought to be nitroglycerin, dobutrex (dophamin), neoton. The rational surgical policy for injuries of different areas of the body, terms of its realization, indications related with different degrees of the patient's state are determined. The realization of these approaches to treatment of wounds and traumas involving contusions of the heart made lethality of such patients 27% less.

Algorithms↗

PubMed2003

Edema fluid accumulation within necrotic brain tissue as a cause of the mass effect of cerebral contusion in head trauma patients.

The early massive edema caused by severe cerebral contusion results in progressive intracranial pressure (ICP) elevation and clinical deterioration within 24-72 hours post-trauma. Surgical excision of the necrotic brain tissue represents the only therapy, which can provide satisfactory control of the elevated ICP and clinical deterioration. In order to elucidate the mechanisms underlying the early massive edema, we have carried out a series of detailed clinical studies. Diffusion magnetic resonance (MR) imaging and apparent diffusion co-efficient (ADC) mapping suggest that cells in the central area of contusion undergo shrinkage, disintegration and homogenization, whereas cellular swelling is predominant in the peripheral area during the period of 24-72 hours post-trauma. The ADC values in the central and peripheral areas are maximally dissociated during this period. A large amount of edema fluid accumulates within the necrotic brain tissue of the central area beginning at approximately 24 hours post-trauma. We have found that fluid-blood interface formation within the central area does not represent an uncommon finding in various neuroimaging examinations of cerebral contusions, indicating layering of red blood cells within the necrotic brain tissue accumulating voluminous edema fluid. Intravenous slow infusion of gadolinium-DTPA and delayed MR imaging revealed that the central area of contusion can be enhanced at 24-48 hours post-trauma. implying that water supply from the blood vessels is not completely interrupted. Necrotic brain tissue sampled from the central area of contusion during surgery demonstrates a very high osmolality. It appears that the capacitance for edema fluid accumulation increases in the central area, whereas cellular swelling in the peripheral area elevates the resistance for edema fluid propagation. Combination of these circumstances may facilitate edema fluid accumulation in the central area. We also suggest that the dissociation of ADC values and high osmolality within the necrotic brain tissue may generate an osmotic potential across the central and peripheral areas and contribute to the early massive edema caused by cerebral contusion.

Body Fluids↗

PubMed2002

Secondary insults worsen blood brain barrier dysfunction assessed by MRI in cerebral contusion.

OBJECT: Understanding the cause of post-traumatic intracranial hypertension requires information about the pathophysiology of edema formation. Secondary insults are known to exacerbate edema formation following experimental contusion, however the influence of these insults on blood brain barrier (BBB) integrity is not known. This study non-invasively assesses the influence of hypoxia and hypotension on BBB permeability following experimental cortical contusion. METHODS: Sprague-Dawley rats (350-380 g) were divided into three groups. Group A: (n = 3) Sham, Group B (n = 8) focal injury (controlled cortical impact 6.0 m/sec, 3 mm depth), Group C (n = 8), focal injury with secondary insult. Cortical BBB integrity was assessed four hours post-trauma using an i.v. bolus of 0.2 mmol/kg Gd-DTPA with serial T1 MR images, over 30 minutes. Absolute tissue concentrations of Gd were measured empirically using known references. The time course of accumulation was analyzed with respect to BBB permeability. RESULTS: BBB permeability was greatest in the site of contusion, and Gd accumulation was greatly enhanced by secondary insult (p < 0.01). Regions of lowest ADC and maximal swelling correlated with regions of maximal BBB permeability (p < 0.05). CONCLUSIONS: Secondary insults enhance BBB dysfunction in contusion. Positive relationships between low ADC, tissue swelling and BBB dysfunction suggest synergy between underlying cytotoxic swelling and BBB permeability in contusion. These data also suggest that restoration of BBB integrity after injury may be an energy dependent process. These findings have important implications for the pathophysiology of ICP elevations following cerebral contusion.

Animals↗

PubMed2002

Mechanisms of the mass effect of cerebral contusion: ICP monitoring and diffusion MRI study.

OBJECTIVE: Cerebral contusion is sometimes associated with a non-hemorrhagic mass effect which progresses rapidly within 12-48 hours post-trauma. In order to determine the mechanisms underlying such a mass effect, we analyzed data obtained from ICP monitoring and diffusion MRI in a total of 38 patients with cerebral contusion. METHODS: Diffusion imaging and ADC mapping were performed employing 1.5 T echo planar MRI. ADC values were expressed as a ratio relative to the values of intact brain areas. RESULTS: In 6 patients, ICP became uncontrollable medically and surgical resection of the contused brain tissue was eventually performed. Within 24 hours post-trauma, diffusion images revealed a low intensity core and a high intensity rim in the contusion. The ADC ratio increased in the central area (1.13 +/- 0.21) and decreased in the peripheral area (0.67 +/- 0.14). A crescent-shaped zone of very high ADC ratio (1.45 +/- 0.14) was observed at the border between these two areas during the period of 24-48 hours. CONCLUSIONS: It appears that the capacitance of edema fluid accumulation is elevated by cellular disintegration in the central area, whereas the resistance to edema fluid propagation is elevated by cellular swelling in the peripheral area. We suggest that such events facilitate extracellular edema fluid accumulation within contused brain tissue and contribute, together with cellular swelling itself, to the non-hemorrhagic mass effect of cerebral contusion.

Brain Concussion↗

PubMed1997

Detection of lipid peroxidation and hydroxyl radicals in brain contusion of rats.

To examine the relationship between the free radicals and brain tissue damage, we investigated the intensity of brain hydroxyl (OH) radical generation and lipid peroxidation in the rat contusion injury model. A unilateral contusion was induced by a weight-drop method. All rats were decapitated six hours after the injury, and brain samples were taken from three portions (core, peripheral, and distal) to examine the specific gravity as an indicator of brain edema, generation of OH using an electron paramagnetic resonance spectrometer (EPR), and malondialdehyde (MDA) and 4-hydroxyalkenals production. Analysis of the specific gravity revealed cerebral edema on the ipsilateral side in the injured group. The signal intensity of EPR in the core and peripheral portions in the contusion group was significantly higher than that in the distal portion of the contusion group and that of all portions in the control animals. No significant difference was observed between the core and peripheral portions of the contusion group. The MDA and 4-hydroxyalkenals production was significantly higher in the core and peripheral portions than in the distal portion of the contusion group and that of all portions of the control group. The degree of posttraumatic brain edema was closely correlated with the increase of DMPO-OH adduct, MDA, and 4-hydroxyalkenals. These results support the current concept that free radical production following traumatic brain injury may induce lipid peroxidation and may be the direct cause of edema formation.

Animals↗

PubMed1991

Implantation of neuronal suspensions into contusive injury sites in the adult rat spinal cord.

Implants of various types of neuronal and nonneuronal tissue have shown promise for the amelioration of certain disorders of the adult mammalian brain. Implants may also have therapeutic potential for some lesions of the spinal cord. To examine the feasibility of implantation for clinically relevant spinal cord injuries, we have implanted cells into injury sites produced by a well-characterized and standardized rat model of contusive injury. To reduce the possibility of the implantation procedure itself causing damage to the spinal cord, the tissue was dissociated and a suspension of cells introduced into the cord via a small bore needle. To test the implantation procedure, dissociated adult rat dorsal root ganglia were used because of the ease with which these neurons could be distinguished after implantation. The extent to which functional deficits were produced or exacerbated by the implantation procedure was assessed by behavioral tests of groups of rats that had been implanted (implant controls), contused (injury only) or contused and implanted (injury-implant). Survival of the implanted neurons was assessed by quantitative morphological analysis of histological sections taken through the injury/implant sites at different times following injury. In addition, the histopathology of the contusive injury sites was compared for rats that had or had not received immediate or delayed implants. Results indicated that cell suspensions could be implanted into the spinal cord without causing a functional deficit in an otherwise uninjured animal or exacerbating a standardized incomplete contusive injury. Implanted neurons survived for at least 4 weeks in all contusion sites whether implantation was performed immediately following injury or after a delay of 1 week.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2005

Autoreactive antibodies against neurons and basal lamina found in serum following experimental brain contusion in rats.

BACKGROUND: Brain trauma is a risk factor for delayed CNS degeneration which may be attenuated by anti-inflammatory treatment. CNS injuries may cause anti-brain reactivity. This study was undertaken to analyze the pattern of delayed post-traumatic anti-brain immunity in experimental brain contusion. METHOD: Adult Sprague-Dawley and Lewis rats were subjected to experimental brain contusions. For B-cell investigations, serum was obtained from contused, control and naïve rats, and used for immunohistochemistry on slices of rat brains to first detect autoreactive IgG and IgM antibodies in rat serum. Secondly, anti-rat IgG and IgM antibodies were used to search for auto-antibodies already bound to the brain tissue. Double staining with rat-serum and NeuN or anti-GFAP antibody was used to detect anti-neuronal and anti-astrocytic antibodies, respectively. For T-cell reactivity, cells from brains and cervical lymph nodes of rats were used in FACS analysis and elispot with MBP and MOG stimulation. FINDINGS: Anti-vascular basal lamina IgG antibodies were detected at three months in 6/8 rats, following experimental contusion. Anti-neuronal IgG antibodies were detected 2 weeks after experimental contusion and sham surgery, while naïve controls were negative. Individual rats showed a prolonged response, or an anti-astrocytic staining. Tissue bound anti-self IgG or IgM was not detected in the brain tissue. Anti-MBP or anti-MOG T-cell responses were not detectable. CONCLUSIONS: Experimental brain trauma and to some degree even sham surgery lead to an individually variable pattern of specific anti-brain reactive B-cells, while a T-cell response did not seem to be a consequence of moderate experimental contusion. The mere presence of anti brain-antibodies may be epiphenomenal, but could also be pathogenic for delayed degeneration. It is reasonable to regard the presence of an actual anti-brain reactivity as a potential threat to brain tissue integrity.

Animals↗