Articles: brain-injuries.
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J Head Trauma Rehabil · Dec 1999
Interaction of posttraumatic stress disorder and chronic pain following traumatic brain injury.
To investigate the association between posttraumatic stress disorder (PTSD) and chronic pain in patients who had sustained a severe traumatic brain injury (TBI). ⋯ Effective rehabilitation of persons with chronic pain following severe TBI should recognize the role of posttraumatic stress in the maintenance of dysfunctional reactions. Specific interventions that address adaptive coping mechanisms to reduce PTSD may enhance rehabilitation for persons with TBI who suffer chronic pain.
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J Head Trauma Rehabil · Dec 1999
Traumatic brain injury in the United States: A public health perspective.
Traumatic brain injury (TBI) is a leading cause of death and disability among persons in the United States. Each year, an estimated 1.5 million Americans sustain a TBI. As a result of these injuries, 50,000 people die, 230,000 people are hospitalized and survive, and an estimated 80,000-90,000 people experience the onset of long-term disability. ⋯ State surveillance systems can provide reliable data on injury causes and risk factors, identify trends in TBI incidence, enable the development of cause-specific prevention strategies focused on populations at greatest risk, and monitor the effectiveness of such programs. State follow-up registries, built on surveillance systems, can provide more information regarding the frequency and nature of disabilities associated with TBI. This information can help states and communities to design, implement, and evaluate cost-effective programs for people living with TBI and for their families, addressing acute care, rehabilitation, and vocational, school, and community support.
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J Head Trauma Rehabil · Dec 1999
Functional outcome of individuals with traumatic brain injury and lower extremity deep venous thrombosis.
To determine the impact of acute lower extremity (LE) deep venous thrombosis (DVT) on functional outcome after traumatic brain injury (TBI). ⋯ Lower extremity DVT does not appear to interfere with functional outcome after TBI. The data suggest that this patient population is appropriate for admission or continued participation in acute inpatient rehabilitation, despite the presence of LE DVT.
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Journal of neurotrauma · Dec 1999
Interrelations of laser doppler flowmetry and brain tissue oxygen pressure during ischemia and reperfusion induced by an experimental mass lesion.
The objective of this study was to assess interrelations between bilateral changes of cortical laser doppler flowmetry and intraparenchymal, subcortical partial tissue oxygen tension in the course of an experimental trauma. Ten animals served as a sham group, 8 Sprague-Dawley rats received an unilateral, focal parietal mass lesion. The bilateral course of cortical blood flow measured by laser doppler flowmetry (LDF) was correlated with subcortical, intraparenchymal partial tissue oxygen tension [p(ti)O2]. ⋯ Both parameters showed a significant but rather weak correlation (r = 0.56; p < 0.001). Based upon these findings, we conclude that intraparenchymal, subcortical p(ti)O2 measurements supplemented on-line cortical CBF monitoring and score out discontinuous alternative measurement techniques in detecting hemodynamically relevant events. The small spatial resolution of LDF and p(ti)O2 probes, however, which in the small animal model may be of negligible influence, does raise the question whether the values obtained represent the microcirculatory situation of the human brain.
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Critical care medicine · Dec 1999
Effect of endotracheal suctioning on cerebral oxygenation in traumatic brain-injured patients.
In patients with severe head injuries, brain damage occurs not only from the primary trauma but also secondarily from a reduction in cerebral oxygenation as a result of brain swelling, ischemia, and elevated intracranial pressure (ICP). However, routine interventions designed to maintain oxygenation, such as endotracheal suctioning (ETS), also may negatively affect the cerebrovascular status by increasing the ICP. The purpose of this study was to determine whether ETS influences cerebral oxygenation in patients with traumatic brain injury. ⋯ The increase in jugular venous oxygen tension associated with increases in middle cerebral artery velocity and mean arterial pressure suggests that cerebral oxygen delivery was maintained during ETS. Cerebral changes associated with ETS using the described protocol are consistent with the preservation of cerebral oxygenation.