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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The present study investigates whether whole-body or local (chest) exposure to blast overpressure can induce ultrastructural, biochemical, and cognitive impairments in the brain. ⋯ These results confirm that exposure to blast overpressure induces ultrastructural and biochemical impairments in the brain hippocampus, with associated development of cognitive deficits.
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Pediatric neurosurgery · Mar 2001
The influence of hemocoagulative disorders on the outcome of children with head injury.
Although disseminated intravascular coagulation (DIC) and other hemocoagulative abnormalities are severe complications of head injury, their effect on clinical outcome remains unclear, particularly among children. ⋯ In addition to GCS, type of trauma, type of brain lesion and certain coagulation abnormalities are predictors of GOS.
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The majority of severely head injured children will not require neurosurgery. For the pediatrician, the central question must be whether medical interventions are effective in limiting morbidity and treating the problem of cerebral oedema. However, in order to address this issue we need to give some thought to the system of care in which we practice, how we assess the severity of brain injury and whether, in regard to pathophysiology, responses in children are significantly different from those seen in adults. In this regard, this review highlights some of the recent pediatric neurocritical care literature and provides, for the clinician, a framework on which to base ones medical management of severe traumatic brain injury occurring in childhood.
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Determine variables in the acute care period associated with survival and pediatric intensive care unit (PICU) length of stay (LOS) for children with severe traumatic brain injury. ⋯ Patients with higher 6-hr Glasgow Coma Scale scores were more likely to survive. Adjusting for severity of injury, survival was associated with maximum systolic blood pressure >or=135 mm Hg, suggesting that supranormal blood pressures are associated with improved outcome. Mannitol administration was associated with prolonged LOS, yet conferred no survival advantage. We suggest reevaluation of blood pressure targets and mannitol use in children with severe traumatic brain injury.