Articles: brain-injuries.
-
The increased popularity of contact sports worldwide exposes a large number of participants to both acute and chronic traumatic brain injury. Chronic traumatic brain injury (CTBI) represents the cumulative, long-term neurological consequences of repetitive concussive and subconcussive blows to the brain. ⋯ Minimizing the frequency and severity of acute brain injury in sport will be instrumental in accomplishing this goal. The prevention of CTBI will need to be sport specific and will undoubtedly rely on limiting the exposure of high-risk athletes, utilizing of protective equipment, enforcing strict rule adherence, training and supervising athletes, and increasing medical surveillance.
-
Intensive care medicine · Jul 2001
Brain energy metabolism during controlled reduction of cerebral perfusion pressure in severe head injuries.
To study cerebral biochemical markers with intracerebral microdialysis and bedside analysis in patients with severe head injuries treated with a controlled reduction of cerebral perfusion pressure (CPP). ⋯ The study shows that pharmacological decrease in CPP according to the "Lund concept" is associated with a normalisation of cerebral metabolism. The study also indicates that intracerebral microdialysis can be used for evaluation of new treatment strategies.
-
J Neurosurg Anesthesiol · Jul 2001
Comparative StudyCould heart rate variability predict outcome in patients with severe head injury? A pilot study.
Despite major improvements in the resuscitation of patients with head injury, the outcome of patients with head trauma often remains poor and difficult to establish. Heart rate variability (HRV) analysis is a noninvasive tool used to measure autonomic nervous system (ANS) activity. The aim of this prospective study was to investigate whether HRV analysis might be a useful adjunct for predicting outcome in patients with severe head injury. ⋯ Referring to the area under the rMSSD ROC curve, HRV might provide useful information in predicting early evolution of patients with severe head trauma. During the awakening period, global HRV and the parasympathetic tone were significantly lower in the worsened neurologic state group. In conclusion, HRV could be helpful as a predictor of imminent brain death and a useful adjunct for predicting the outcome of patients with severe head injury.
-
Journal of neurotrauma · Jul 2001
Case ReportsDelayed hemispheric neuronal loss in severely head-injured patients.
Recent experimental studies have revealed that traumatic brain injury as well as ischemic brain injury can cause chronic progressive neuronal damage. In the present study, we demonstrate previously unreported delayed cerebral atrophy on computerized tomography (CT) scans in severely head-injured patients. Seventeen severely head-injured patients who required mild hypothermia to control intracranial hypertension after the failure of conventional therapies were retrospectively analyzed. ⋯ Six of these eight patients with DNL achieved functional recovery despite progressive atrophic changes demonstrated on CT scans. On CT scans, DNL was characterized by (1) the sudden appearance at several months postinjury of a low-density area in the hemisphere ipsilateral to the injury; (2) the preservation of essential cortical structure although related white matter structures showed severe atrophic changes; and (3) no spread of the low-density area to the contiguous territory of the other main cerebral artery. It is concluded that focal primary injury to underlying brain, if severe enough, can result in delayed hemispheric atrophy.
-
To determine the epidemiology of pediatric traumatic brain injury (TBI) in a midwestern state and to examine differences between metropolitan and nonmetropolitan residents. ⋯ This study reports the lowest incidence of pediatric TBI that results in death or hospitalization to date. One half of severely injured patients suffered poor outcomes. A greater proportion of nonmetropolitan than metropolitan residents suffered severe TBI and had higher mortality and case-fatality rates.