Articles: brain-injuries.
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Acta Neurochir. Suppl. · Jan 1999
Theory and practice of microdialysis--prospect for future clinical use.
The application of microdialysis for neurochemical monitoring in neurosurgery and neurointensive care is rapidly expanding in a number of clinical centers around the world. In order for microdialysis to become a future routine method in these clinical settings a number of problems, outlined in this communication, must be solved by the clinical researchers and the commercial companies. Regardless of the future success as a routine method, it is already obvious that microdialysis will be an important clinical research tool for years to come, providing new important insights into the pathophysiology of acute human brain injury.
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Clinical Trial
[Clinical observations concerning piracetam treatment of patients after craniocerebral injury].
Piracetam (Nootropil) is a cytoprotective to brain tissue and improving cerebral blood flow medicine. In the Department of Neurotraumatology we investigated results of piracetam treatment in a group of 100 succeeding patients admitted between 1995-96 due to craniocerebral injury. High doses (24-30 g per day) of this medicine have a positive effect on final result of treatment, when treatment is initiated immediately after the injury and described conditions are abided. We also showed usefulness of piracetam treatment in posthospital management.
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Secondary brain injury is associated with a reduction in cerebral blood flow, oxygenation and perfusion related to hypotension, hypoxemia and raised intracranial pressure. This has been confirmed on autopsy and is associated with a higher mortality rate, as supported by many studies. The primary goal of nursing management in severe head trauma is to maintain adequate cerebral perfusion and improve cerebral blood flow in order to prevent cerebral ischaemia and secondary injury to the brain. ⋯ The majority of the evidence was derived from class II and class III classifications, which provide guidelines and options for practice. Nursing and medical management were found to overlap, with the focus for the nurse being an integrated balance of scientific, technical and humanistic management. The nurse's role is extremely important because the expert nurse cognitively manipulates many variables over a continuum of care and, if such tasks are skillfully and successfully performed, the incidence of secondary brain injury is reduced.
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Journal of neurosurgery · Dec 1998
Increase in extracellular glutamate caused by reduced cerebral perfusion pressure and seizures after human traumatic brain injury: a microdialysis study.
To determine the extent and duration of change in extracellular glutamate levels after human traumatic brain injury (TBI), 17 severely brain injured adults underwent implantation of a cerebral microdialysis probe and systematic sampling was conducted for 1 to 9 days postinjury. ⋯ Extracellular neurochemical measurements of excitatory amino acids may provide a marker for secondary insults that can compound human TBI.
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This review focuses on neuro-ophthalmic disorders caused by trauma. Most articles discussed were published after 1995. ⋯ The topics are the oculomotor nerves and the facial nerve, the cavernous sinus, the orbit, the optic nerve, and the brain. Treatment options are discussed, including strabismus surgery, orbital reconstruction, and medical as well as surgical treatment of traumatic optic neuropathy.