Articles: brain-injuries.
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Case Reports Historical Article
The history of the Glasgow Coma Scale: implications for practice.
The Glasgow Coma Scale (GCS) has been the gold standard of neurologic assessment for trauma patients since its development by Jennett and Teasdale in the early 1970s. The GCS was found to be a simple tool to use. ⋯ Although the scale has been shown to be effective, many authors have cited weaknesses in the scale including the inability to predict outcome, variation in inter-rater reliability, and the inconsistent use by caregivers in the prehospital and hospital settings. This article outlines the components of the GCS and how practitioners can best use the scale, particularly in patients whose injuries and treatments make them difficult to assess.
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Brain injury : [BI] · Feb 2001
Clinical TrialMethotrimeprazine in the treatment of agitation in acquired brain injury patients.
Medical management of the agitation associated with acquired brain injury (ABI) has been proble matic. At least 12 distinct drugs are currently recommended in the medical literature. In recent years, on the ABI in-patient rehabilitation unit, methotrimeprazine (MTZ) has come to be the preferred drug and is used routinely for effective treatment of agitation. ⋯ Agitation was controlled in most cases. In only two cases were significant side effects noted. While MTZ has been used as a safe and effective neuroleptic in psychiatry for over 40 years, this is the first report of its use in treating agitation in ABI.
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J. Nerv. Ment. Dis. · Feb 2001
Posttraumatic stress disorder and psychosocial functioning after severe traumatic brain injury.
The aim of this study was to investigate the influence of posttraumatic stress disorder (PTSD) on rehabilitation after severe traumatic brain injury (TBI). Ninety-six patients with severe TBI patients were assessed 6 months after hospital discharge with the Posttraumatic Stress Disorder Interview, the Functional Assessment Measure (FAM), the Community Integration Questionnaire (CIQ), the Overt Aggression Scale (OAS), the General Health Questionnaire (GHQ), the Beck Depression Inventory (BDI), and the Satisfaction with Life Scale (SWL). ⋯ Patients with PTSD reported higher scores on the GHQ and BDI, and lower scores on the FAM, CIQ, OAS, and SWLS than those without PTSD. Effective rehabilitation after severe TBI may be enhanced by management of PTSD.
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Journal of neurotrauma · Feb 2001
Age-dependency of 45calcium accumulation following lateral fluid percussion: acute and delayed patterns.
This study was designed to determine the regional and temporal profile of 45calcium (45Ca2+) accumulation following mild lateral fluid percussion (LFP) injury and how this profile differs when traumatic brain injury occurs early in life. Thirty-six postnatal day (P) 17, thirty-four P28, and 17 adult rats were subjected to a mild (approximately 2.75 atm) LFP or sham injury and processed for 45Ca2+ autoradiography immediately, 6 h, and 1, 2, 4, 7, and 14 days after injury. Optical densities were measured bilaterally within 16 regions of interest. 45Ca2+ accumulation was evident diffusely within the ipsilateral cerebral cortex immediately after injury (18-64% increase) in all ages, returning to sham levels by 2-4 days in P17s, 1 day in P28s, and 4 days in adults. ⋯ Histological analysis of cresyl violet-stained, fresh frozen tissue indicated little evidence of neuronal loss acutely (in all ages), but considerable delayed cell death in the ipsilateral thalamus of the P28 and adult animals. These data suggest that two temporal patterns of 45Ca2+ accumulation exist following LFP: acute, diffuse calcium flux associated with the injury-induced ionic cascade and blood brain barrier breakdown and delayed, focal calcium accumulation associated with secondary cell death. The age-dependency of posttraumatic 45Ca2+ accumulation may be attributed to differential biomechanical consequences of the LFP injury and/or the presence or lack of secondary cell death.
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To evaluate the forensic determination of post cerebral traumatic epilepsy. ⋯ The forensic determination of post traumatic epilepsy must be on the basis of traumatic and previous history combined with EEG, CT and MRI analysis.