Articles: brain-injuries.
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Journal of neurosurgery · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialValproate therapy for prevention of posttraumatic seizures: a randomized trial.
Seizures frequently accompany moderate to severe traumatic brain injury. Phenytoin and carbamazepine are effective in preventing early, but not late, posttraumatic seizures. In this study the authors compare the safety and effectiveness of valproate with those of short-term phenytoin for prevention of seizures following traumatic brain injury. ⋯ Valproate therapy shows no benefit over short-term phenytoin therapy for prevention of early seizures and neither treatment prevents late seizures. There was a trend toward a higher mortality rate among valproate-treated patients. The lack of additional benefit and the potentially higher mortality rate suggest that valproate should not be routinely used for the prevention of posttraumatic seizures.
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Critical care medicine · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialPrevention of secondary ischemic insults after severe head injury.
The purpose of this study was to compare the effects of two acute-care management strategies on the frequency of jugular venous desaturation and refractory intracranial hypertension and on long-term neurologic outcome in patients with severe head injury. ⋯ Secondary ischemic insults caused by systemic factors after severe head injury can be prevented with a targeted management protocol. However, potential adverse effects of this management strategy may offset these beneficial effects.
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J Head Trauma Rehabil · Oct 1999
Review Case Reports Comparative StudyThe role of fiberoptic endoscopy in dysphagia rehabilitation.
The clinical bedside swallow evaluation and videofluoroscopy routinely have been used for dysphagia management. This article explores clinical issues for dysphagia management in the population with brain injury in the acute rehabilitation setting. Citing the dysphagia, cognitive, and other relevant issues present in the population with brain injury, the use of fiberoptic endoscopy to address dysphagia assessment and intervention is presented. Factors for decision making, a retrospective review of recent studies, and relevant cases are discussed.
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Child Adolesc Psychiatr Clin N Am · Oct 1999
ReviewTraumatic brain injury in children and adolescents.
Traumatic brain injury is an insult to the brain caused by an external force that results in an impairment (transient or permanent) of cognitive, behavioral, emotional, or physical function. Traumatic brain injury encompasses shearing injury, which might be seen in a shaken infant, as well as penetrating injury from a foreign body, such as a bullet. This article addresses the recovery phase and functional sequelae following traumatic brain injury. Research and clinical experience over the past decade have led to a better understanding of the pathophysiology of head injury and, in turn, improved management.
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Journal of neurotrauma · Oct 1999
Cognitive function following traumatic brain injury: effects of injury severity and recovery period in a parasagittal fluid-percussive injury model.
Previous work in this laboratory has demonstrated that rats show substantial deficits on the cued and hidden versions of the Morris water maze, as well as an apparent time-dependent recovery over a period of months, following moderate parasagittal fluid-percussion (FP) injury. However, the longitudinal nature of those studies precluded definitive statements regarding recovery because of the possible confound of practice-dependent improvements in performance. The present experiments were undertaken to address this issue and to investigate more closely the relationship between impact severity and posttraumatic learning/memory deficits, which have not been examined thoroughly in this model. ⋯ Mildly injured animals exhibited no significant deficits on either task at either time point. The results indicate that deficits on the hidden platform task are more robust than those on the cued platform task, and that performance on both tasks is dependent on injury severity. They also indicate that the learning/memory deficits in this model are relatively enduring, suggesting that the model is a reasonable one for assessing potential treatment regimens.