Articles: brain-injuries.
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Psychological medicine · May 1999
Psychosocial adjustment after traumatic brain injury: what are the important variables?
The common legacy of severe degrees of traumatic brain injury is varying degrees and types of impairments, which impact significantly upon the individual's resumption of pre-morbid psychosocial roles. Yet there are few data to indicate the relative contribution of these and other non-injury related variables. ⋯ These results reinforce the overriding importance of injury severity and neurological factors (both neurophysical as well as neuropsychological) in predicting psychosocial adjustment after traumatic brain injury. Support for the contribution of non-neurological factors was also found.
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In Norway, most patients with severe head injuries are transported to, and operated in, the neurosurgical unit of the regional university hospital. However, some patients are still occasionally operated on in county central hospitals by orthopedic or general surgeons who do not have neurosurgical expertise. The aim was to analyze this surgical activity outside the neurosurgical units. ⋯ The present study indicates that, in Norway and countries with a similar hospital system, it must be difficult for general and orthopedic surgeons to achieve and maintain the skills required for emergency operations in patients with acute severe head injuries. Thus, it is probably to the patients' benefit to improve the general hospitals' competency and speed in the detection of candidates for surgical decompression, and stress the importance of these patients being transferred without unnecessary delay to a neurosurgical unit.
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J. Nerv. Ment. Dis. · May 1999
Postconcussive symptoms and posttraumatic stress disorder after mild traumatic brain injury.
Postconcussive symptoms after mild traumatic brain injury (MTBI) may be exacerbated by anxiety associated with posttraumatic stress. The aim of this study was to investigate the relationship between postconcussive symptoms and posttraumatic stress disorder (PTSD) in an MTBI population. ⋯ Further, postconcussive symptoms were significantly correlated with PTSD symptoms. These findings indicate that postconcussive symptoms may be mediated by an interaction of neurological and psychological factors after MTBI.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1999
Case Reports[Ethylene glycol poisoning and brain injury--a dangerous combination].
We report on a patient after brain injury additionally showing signs of ethylene glycol intoxication. CT-scan showed a subdural hematoma, which in spite of increasing neurological deficit didn't show any enlargement. Metabolic acidosis with an increased anion gap and osmolar gap led to the diagnosis of ethylene glycol intoxication. Then intensive hemodialysis and i.v. ethanol were administered and the intoxication could be treated successfully.
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Clin. Exp. Hypertens. · May 1999
ReviewThe consequences of traumatic brain injury on cerebral blood flow and autoregulation: a review.
In this decade, the brain argueably stands as one of the most exciting and challenging organs to study. Exciting in as far as that it remains an area of research vastly unknown and challenging due to the very nature of its anatomical design: the skull provides a formidable barrier and direct observations of intraparenchymal function in vivo are impractical. ⋯ The present review will focus on alterations in the cerebrovasculature following TBI, and more specifically on changes in cerebral blood flow (CBF), mediators of CBF including local chemical mediators such as K+, pH and adenosine, endothelial mediators such as nitric oxide and neurogenic mediators such as catecholamines, as well as pressure autoregulation. It is emphasized that further research into these mechanisms may help attenuate the prevalence of secondary insults and therefore improve outcome following TBI.