Brain injury : [BI]
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Brain injury : [BI] · Dec 1996
Patients with traumatic brain injury referred to a rehabilitation and re-employment programme: social and professional outcome for 508 Finnish patients 5 or more years after injury.
We studied influence of age and educational level before injury on the social and vocational outcome among a group of traumatic brain injury (TBI) patients with post-injury problems in their education and employment. Patients with TBI, followed up for at least 5 years, and who were admitted to a rehabilitation and re-employment programme, were selected for evaluation of long-term outcome. We used the Glasgow Coma Scale (GCS) scores at the time of emergency admission to the hospital to measure brain injury severity. ⋯ Our patients were selected from the TBI population as survivors with problems in education and re-employment. Those with severe injury sustained early in life (childhood and early teens) coupled with poor educational attainment had relatively worse social and vocational outcome; better outcomes were enjoyed by those severely injured individuals whose injuries were sustained later (late teens or early adulthood). In the groups of patients with moderate and mild brain injuries such a relationship was not found between age or pre-injury education and outcome.
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What should clinical neuropsychologists look out for when asked to assess someone with hypoxic brain damage? To determine whether there are typical cognitive profiles of hypoxic patients, all referrals for a neuropsychological assessment made to the author over a period of 16 years were scanned to identify those with a primary diagnosis of cerebral hypoxia as recorded in the hospital notes. From a total sample of 567 patients, 18 (3.17%) had sustained primary cerebral hypoxia from a variety of causes including carbon monoxide poisoning, cardiac arrest, anaesthetic accident, respiratory failure following a pulmonary embolus, hanging and drowning. ⋯ Three presented with an amnesic syndrome; two with memory, executive and visuospatial deficits; and three with visuospatial or visuoperceptual problems without severe memory impairments. The remaining four patients were very severely impaired intellectually (VSI), with widespread cognitive deficits precluding the use of neuropsychological assessment procedures designed for adults.
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Brain injury : [BI] · May 1996
Comparative StudyMicrovascular leakage in mouse pial venules induced by bradykinin.
The actions of bradykinin on pial venule leaky site formation were measured intra-vitally in two inbred strains of mice (BALB/c and SJL/J). Pial venules were visualized using an open cranial window microscopy technique and the microvascular leaky site formation was assessed visually using a fluorescein-dextran (70 kDa) INDICATOR. The SJL/J strain was found to be very sensitive to bradykinin-induced microvascular leakage. ⋯ In contrast, the BALB/c strain was found to be refractory to bradykinin-induced leakage. Pial arterioles were dilated in response to bradykinin in both strains of mice. These results support the concept that genetically controlled differences in vascular sensitivity and localization of inflammatory peptides play important roles in the generation of vasogenic oedema and inflammation in CNS trauma and disease.
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Brain injury : [BI] · Mar 1996
Traumatic brain injury, alcohol and quantitative neuroimaging: preliminary findings.
Magnetic resonance (MR) quantitative neuroimaging analysis was undertaken with a large group of normal (n = 197) and traumatically brain injured (TBI, n = 99) adults. Of the TBI subjects 18 patients were identified with a history of substance-related abuse (TBI/Abuse group). Both the TBI/ Abuse group and the remaining sample of TBI patients (n = 81, TBI/Non-abuse group) without a history of substance-related abuse differed significantly from the control group on most quantitative MR imaging analyses. ⋯ However, the TBI/Abuse group had a significantly lower Glasgow Coma Scale (GCS) score, ostensibly suggesting that those with substance-related abuse suffered more severe brain injury than non-abuse TBI patients. When a subset (n = 18) of the TBI/Non-abuse group was matched by GCS, gender and age to the TBI/Abuse group, both groups differed significantly from the control group on most morphometric measures, but did not differ from one another. Results are discussed in terms of the potential adverse role that substance-related abuse, particularly alcohol, plays in the individual who sustains traumatic injury to the brain.
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Brain injury : [BI] · May 1995
ReviewClassification of the spectrum of mild traumatic brain injury.
Mild traumatic brain injury (TBI) is a very common injury, resulting in immediate and possible long-term symptoms. The accurate and consistent definition of mild TBI is important in the initial and rehabilitation management of the injury, and in research concerning mild TBI. ⋯ Within the spectrum of injury severity in mild TBI there are several classification systems, primarily used in management of acute mild TBI, that breakdown mild TBI into grades of injury severity. These are based upon the presence or absence of mental status changes, amnesia, loss of consciousness, anatomical lesion or neurological deficit.