Articles: brain-injuries.
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The aim of this study was to determine the functional outcome and mortality in relation to the Glasgow coma score (GCS) on presentation in patients aged over 65 years with acute head injury. 2331 patients with head injury were identified by searching the neurosurgery database (1984-1996); 191 met the inclusion criteria and systematic review of medical records was undertaken. Functional outcome on discharge from hospital and mortality were tested statistically against GCS on presentation. Mortality overall was 33. 5%. ⋯ Comparison with outcome for the 132 patients with GCS >/=11, of whom 91 had satisfactory outcomes, was highly statistically significant (P<0.001). Elderly patients with presenting GCS <11 due to acute head injury have poor functional outcomes and high mortality rates. Conservative treatment of these patients should be considered.
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Critical care medicine · Jul 2000
Early hyperthermia after traumatic brain injury in children: risk factors, influence on length of stay, and effect on short-term neurologic status.
a) To determine the risk factors for early hyperthermia after traumatic brain injury in children; b) to identify the contribution of early hyperthermia to neurologic status at pediatric intensive care unit (PICU) discharge and to PICU length of stay in head-injured children. ⋯ Early hyperthermia is independently associated with a measure of early neurologic status and resource utilization in children with traumatic brain injury serious enough to require PICU admission. These results support the prevention of hyperthermia in the management of traumatic brain injury in children. Further research is required to understand the mechanisms of this response and to identify appropriate preventive or therapeutic interventions.
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Chinese Med J Peking · Jul 2000
dl-3-n-butylphthalide reduces brain damage in mice with closed head injury.
To investigate the protective effect of dl-3-n-butylphthalide (NBP) as an anti-cerebral ischemic drug on brain damage 24 h after closed head injury in mice. ⋯ NBP provides therapeutic response in experimental closed head injury.
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Comparative Study Clinical Trial
Serum neuron-specific enolase as a predictor of intracranial lesions in children with head trauma: a pilot study.
To determine the reliability of serum neuron-specific enolase (NSE) levels in predicting intracranial lesions (ICL) in children with blunt head trauma (HT). ⋯ These results suggest that serum NSE may be a useful screening tool for predicting ICL in children with blunt head trauma. However, the NSE alone was neither sensitive nor specific in predicting all patients with ICL.
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Clinical microdialysis enables monitoring of the cerebral extracellular chemistry of neurosurgical patients. Introduction of the technique into different hospitals' neurosurgical units has resulted in variations in the method of application. There are several variables to be considered, including length of the catheter membrane, type of perfusion fluid, flow rate of perfusion fluid, and on-line compared with delayed analysis of samples. The objects of this study were as follows: 1) to determine the effects of varying catheter characteristics on substance concentration; 2) to determine the relative recovery and true extracellular concentration by varying the flow rate and extrapolating to zero flow; and 3) to compare substance concentration obtained using a bedside enzyme analyzer with that of off-line high-performance liquid chromatography (HPLC). ⋯ Two adjacent microdialysis catheters that were identical in membrane length, perfusion fluid, and flow rate showed equivalent results. Variations in perfusion fluid and freezing and thawing of samples did not result in differences in substance concentration. Catheter length had a significant impact on substance recovery. Variations in flow rate enabled the relative recovery to be calculated using a modification of the extrapolation-to-zero-flow method. The recovery was approximately 70% at 0.3 microl/minute and 30% at 1 microl/minute (10-mm membrane) for all analytes. Glutamate results obtained with the enzyme analyzer showed good correlation with those from HPLC.