Articles: brain-injuries.
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Curr. Opin. Pediatr. · Jun 1999
ReviewHypoxic-ischemic brain injury: advancements in the understanding of mechanisms and potential avenues for therapy.
Hypoxic-ischemic brain injury occurs frequently in infancy and childhood. Events such as perinatal asphyxia, near drowning, respiratory arrest, and near sudden infant death syndrome cause significant mortality and morbidity. Despite current critical care practices, the outcomes from such injuries may be life-long neurologic deficits. ⋯ The development of new therapies for hypoxic-ischemic brain injury depends on such understanding. To date, the results of preclinical therapeutic trials have not demonstrated a "magic bullet." Nevertheless, the understanding of injury mechanisms has uncovered potential avenues for new therapies, particularly combination therapies or single interventions that have multiple effects. Clinical trials, using these strategies, are planned or have been recently begun and offer hope for advancements in treatment.
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J Clin Child Psychol · Jun 1999
Posttraumatic stress symptoms in children following orthopedic or traumatic brain injury.
Examined posttraumatic stress (PTS) symptoms in children following pediatric traumatic brain injury (TBI). Children (ages 6-12) with TBI (n = 81) and orthopedic injury (OI; n = 59) were assessed 6 and 12 months postinjury. Parents of children with severe TBI reported higher levels of child PTS symptoms than did parents of children with moderate TBI or OI at the 6- and 12-month follow-ups. ⋯ The group differences in parent and child reports were significant even after taking ethnicity, social disadvantage, and age at injury into account. Parent and child reports of child PTS symptoms were related to family socioeconomic status. Implications for clinical intervention with children and families following pediatric TBI are discussed.
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Tidsskr. Nor. Laegeforen. · May 1999
Comparative Study[Management of minor head injuries in Norwegian hospitals--can the quality be improved?].
Management protocols for minor head injury should include strategies for early detection of intracranial haematomas. This study focuses on the management of minor head injury in 63 Norwegian hospitals. We report considerable inter-hospital variation. ⋯ Emergency room evaluation included routine radiological evaluation, usually skull radiography, in 18 (29%) hospitals, and assessment according to the Glasgow Coma Scale (GCS) in 27 (43%). GCS was used during in-hospital observation in 32 (51%) hospitals. 33 (52%) discharged selected minor head injury patients without in-hospital observation. We conclude that the quality of care for minor head injury patients in Norwegian hospitals can be improved through extended use of routine early CT and consistent evaluation according to GCS.
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Journal of neurotrauma · May 1999
Behavioral responses of C57BL/6, FVB/N, and 129/SvEMS mouse strains to traumatic brain injury: implications for gene targeting approaches to neurotrauma.
Recent studies have suggested that mouse models of traumatic brain injury may be useful for evaluating the role of single gene products in brain trauma. In the present study, we report that three background strains (C57BL/6, FVB/N, and 129/SvEMS), commonly used in genetically altered mice, exhibit significantly different behavioral responses when subjected to sham surgery (n = 9 per group) or moderate controlled cortical impact (CCI) injury (n = 12 per group). Injured animals from all three strains showed delayed recovery of pedal withdrawal and righting reflexes compared to sham-operated controls. ⋯ Significant impairment of place learning in the Morris water maze and Barnes circular maze was observed at 7-10 days and 21-24 days after injury, respectively, in C57BL/6 mice when compared with sham controls. Sham-operated FVB/N and 129/SvEMS mice were unable to learn either task, and performance did not differ significantly from respective CCI injured animals. Our results suggest that background strain should be carefully considered with experiments involving genetically altered mice, especially when planning behavioral outcome measures after CNS injury.