Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · May 1997
Impact on clinical outcome of secondary brain insults during the neurointensive care of patients with subarachnoid haemorrhage: a pilot study.
To analyse the occurrence and influence on outcome of secondary brain insults during neurointensive care of patients with subarachnoid haemorrhage. ⋯ The clinical outcome after subarachnoid haemorrhage is at least partly determined by the number of secondary insults. Therefore, vigorous attempts should be made to avoid all events that may potentially increase the risk of secondary cerebral ischaemia. Prospective studies must be initiated to define the role of "priming" of the brain and the impact of specific individual secondary insults in patients with subarachnoid haemorrhage.
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J. Neurol. Neurosurg. Psychiatr. · May 1997
Assessment of autonomic dysreflexia in patients with spinal cord injury.
To assess the impairment of supraspinal control over spinal sympathetic centres and the occurrence of autonomic dysreflexia in patients with spinal cord injury. Autonomic dysreflexia is caused by the disconnection of spinal sympathetic centres from supraspinal control and is characterised by paroxysmal hypertensive episodes caused by non-specific stimuli below the level of the lesion. Therefore, patients with spinal cord injury were examined clinically and by different techniques to assess the occurrence of autonomic dysreflexia and to relate disturbances of the sympathetic nervous system to episodes of autonomic dysreflexia. ⋯ The urodynamic examination was more sensitive in indicating signs of autonomic dysreflexia in patients with spinal cord injury, whereas SSR allowed the assessment of the degree of disconnection of the sympathetic spinal centres from supraspinal control. Using ABPM recordings the occurrence of episodes of autonomic dysreflexia over 24 hours and the effectiveness of therapeutical treatment can be assessed.