Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2006
Monitoring and interpretation of intracranial pressure after head injury.
To investigate the relationships between long-term computer-assisted monitoring of intracranial pressure (ICP) and indices derived from its waveform versus outcome, age, and sex. ⋯ High ICP and low PRx are strongly associated with fatal outcome. There is a considerable heterogeneity amongst patients; optimization of care depends upon observing the time-trends for the individual patient.
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Acta Neurochir. Suppl. · Jan 2006
Case ReportsPositive selective brain cooling method: a novel, simple, and selective nasopharyngeal brain cooling method.
Brain damage is worsened by hyperthermia and prevented by hypothermia. Conventional hypothermia is a non-selective brain cooling method that employs cooling blankets to achieve surface cooling. This complicated method sometimes induces unfavorable systemic complications. ⋯ The chilled air was exhaled through the oral cavity. In most patients, PSBC maintained normal brain temperature. This new technique provides quick induction of brain temperature control and does not require special facilities.
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Acta Neurochir. Suppl. · Jan 2006
Long term follow-up results of dorsal root entry zone lesions for intractable pain after brachial plexus avulsion injuries.
Brachial plexus avulsion injury is one of the major complications after traffic, especially motorcycle accidents and machine injuries. Intractable pain and paralysis of the affected limbs are the major neurological deficits. During the past 18 years, we have encountered and treated more than 500 cases with brachial plexus avulsion injuries. ⋯ The pain relief rate dropped to 60% in 5 year follow-up period and only 9 cases (50%) had excellent or good result in 10 year follow-up. Reconstructive procedures were performed in almost all patients in the last 10 years. Dorsal root entry zone lesion is an effective procedure for pain control after brachial plexus avulsion injuries.
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Acta Neurochir. Suppl. · Jan 2006
Clinical TrialImportance of cerebral perfusion pressure management using cerebrospinal drainage in severe traumatic brain injury.
To evaluate hemodynamics in patients with severe traumatic brain injury (TBI) after cerebral perfusion pressure (CPP) management using cerebrospinal fluid (CSF) drainage. ⋯ CPP management using CSF drainage decreases the total infusion volume of crystalloid and may reduce the risk of aggravated brain edema after excess fluid resuscitation.
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Acta Neurochir. Suppl. · Jan 2006
Clinical TrialOrgan dysfunction assessment score for severe head injury patients during brain hypothermia.
The purpose of this study was to evaluate the utility of a novel organ dysfunction assessment score developed for patients with severe traumatic brain injury during therapeutic brain hypothermia. The Brain Hypothermia Organ Dysfunction Assessment (BHODA) score is calculated through the combined assessment of 6 indices: central nervous system (CNS) function, respiratory function, cardiovascular function, hepatosplanchnic circulation, coagulation, and metabolism. The CNS, hepatosplanchnic circulation, and metabolic indices were based on measurements of cerebral perfusion pressure, gastric tonometry, and blood glucose, respectively. ⋯ A total maximum BHODA score of more than 13 points corresponded to a mortality of 70%. In a multivariate model, the total maximum BHODA score was independently associated with neurological outcome (odds ratio for unfavorable neurological outcome, 2.590: 95% confidence interval, 1.260, 5.327). In conclusion, the BHODA score can help assess multiple organ dysfunction/failure during therapeutic hypothermia and may be useful for predicting outcome.