Articles: brain-injuries.
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Experimental neurology · Apr 2001
Therapeutic effects of environmental enrichment on cognitive function and tissue integrity following severe traumatic brain injury in rats.
Postinjury environmental enrichment (EE) has been shown to alter functional and anatomical outcomes in a number of injury paradigms, including traumatic brain injury (TBI). The question of whether EE alters functional outcome following TBI in a model which produces overt histopathological consequences has not been addressed. We investigated this question using the severe, parasagittal fluid percussion injury (FPI) model. ⋯ At 14 days post-TBI, enriched animals had approximately twofold smaller lesion areas in regions of the cerebral cortex posterior to the injury epicenter (-4.5, -5.8, -6.8 mm relative to bregma; P < 0.05) compared to injured/standard animals. In addition, overall lesion volume for the entire injured cortical hemisphere was significantly smaller in animals recovering in the enriched environment. These results indicate that noninvasive environmental stimulation is beneficial in attenuating cognitive deficits and preserving tissue integrity in a TBI model which causes cerebral contusion and cell death.
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A report of a case of a patient with severe head trauma with pneumonia and cerebral infarction transported by helicopter. An eighty-year-old male was referred to our hospital because of dyspnea after a fall during sightseeing at Hiroshima. He was lucid at first, but, after two days presented restlessness due to brain contusional hemorrhage and edema. ⋯ The patient was carried to a waiting ambulance and transported to the hospital. Total transport time was only two hours and thirty minutes. This is a case showing a helicopter could safely transport a patient with severe brain damage over a long distance in a short time.
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To evaluate the agreement between end-tidal carbon dioxide (PETCO2) and arterial CO2 (PaCO2) in patients with traumatic brain injury and to document the course of the (PaCO2-PETCO2) gradient over time. ⋯ In this selected population of patients with severe traumatic brain injury, measurements of PETCO2 and PaCO2 are not interchangeable. Further the PoCO2-PETCO2 gradient is not stable over time and cannot predict variations of PaCO2. The use of PETCO2 instead of PaCO2 could be deleterious in patients in whom strict control of PaCO2 values is required.
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Arch Phys Med Rehabil · Mar 2001
Assessing traumatic brain injury outcome measures for long-term follow-up of community-based individuals.
To determine which outcome measures are best and least suited for assessing long-term functional outcome of individuals with traumatic brain injury (TBI) in the community. ⋯ Measures that appeared to contribute little to assessing functional status of a TBI sample years postinjury were the FIM, FIM+FAM, SRS, GOS, and LCFS. Measures that showed a range of deficits across participants were DRS employability, the NFI, PCRS, and the R-CHART cognition subscale.
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Neurological research · Mar 2001
ReviewUse of sedative and analgesic agents in neurotrauma patients: effects on cerebral physiology.
Sedation and analgesia is used primarily in the intensive care unit (ICU) to limit the stress response to critical illness, provide anxiolysis, improve ventilatory support, and facilitate adequate ICU care. However, in the neurotrauma ICU there are many other reasons for the use of these agents. The primary aim is to prevent secondary cerebral damage by maintaining adequate cerebral perfusion pressures. ⋯ Concerns surrounding the use of these agents include time to awakening after discontinuation, effect on the cerebrovasculature, and the effect on patient outcome. There are many different pharmacological agents available, each with their distinct advantages and disadvantages. The purpose of this review is to evaluate the pharmacokinetic and pharmacological effects of each of these agents when used in neurotrauma patients.