Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Oct 1995
ReviewThe radiologic evaluation of craniocerebral missile injuries.
A brief overview of the imaging findings in craniocerebral missile injury is presented here. CT scanning has established itself as the primary imaging modality for the complex injuries seen in CMI as well as its acute and delayed complications. ⋯ With regard to outcome prediction, imaging has also proved to be of some, albeit limited, usefulness, primarily as adjuncts to clinical criteria such as the GCS. Future research with CT as well as magnetic resonance imaging will likely expand the clinical role of these modalities, particularly in the realm of outcome analysis.
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Neurosurg. Clin. N. Am. · Oct 1995
ReviewCharacteristics of cerebral gunshot injuries in the rural setting.
The rural CGW population has not yet undergone the metamorphosis experienced by its urban counterparts. Reminiscent of a past era, suicides far outweight homicides. Although many rural firearm injuries involve hunting accidents, these comprise only a small fraction of CGW at best. ⋯ Although prophylactic antibiotics were not used in all cases, the authors encountered no deep or superficial infections in surviving patients. The prevalence of seizures in the authors' series despite prophylactic AED is unusually high. This feature merits further study.
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Neurosurg. Clin. N. Am. · Oct 1995
ReviewMultivariate analysis and prediction of outcome following penetrating head injury.
Schemes for predicting outcome in craniocerebral missile injury have ranged from Cushing's analysis that was based on the physical characteristics of the injury to complex logistic analyses that incorporate radiographic, laboratory, and clinical data. Generation of predictive scales is discussed, focusing on the utility of the Glasgow Coma Scale (GCS) score at presentation, presence or absence of coagulopathy, and radiographic evidence of the volume and type of tissue damage.
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Neurosurg. Clin. N. Am. · Oct 1995
ReviewPenetrating injuries in the Vietnam war. Traumatic unconsciousness, epilepsy, and psychosocial outcome.
The WF Caveness Vietnam Head Injury Study includes over a thousand men who survived penetrating head injuries during the Vietnam War and on whom detailed medical and follow-up data are available. This population offers unique opportunities for the study of recovery from brain injury and of brain structure-function relationships. The authors briefly review long-term outcome in this cohort with respect to traumatic unconsciousness, post-traumatic epilepsy, and elements of psychologic and psychosocial function, including returning to work.
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Neurosurg. Clin. N. Am. · Oct 1995
ReviewThe prehospital and emergency department management of penetrating head injuries.
The prehospital and emergency department management of the patient with a penetrating cranial injury can be summarized by the following tenets: 1. Assume any alteration in level of consciousness to be a result of the brain injury and not from alcohol or illicit drug intoxication. 2. Have a low threshold to protect the patient's airway with endotracheal intubation and chemical paralysis if a surgical lesion is suspected, there is seizure activity, or the patient is too combative to obtain the necessary studies. 3. ⋯ Remember, first do no harm. The primary brain injury has already been done. The clinician maximizes preservation of viable brain tissue by preventing secondary injury.