Articles: brain-injuries.
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The scientific evidence that bicycle helmets protect against head, brain and facial injuries has been well established by 5 well designed case-control studies. Additional evidence of helmet effectiveness has been provided from time series studies in Australia and the US. Bicycle helmets of all types that meet various national and international standards provide substantial protection for cyclists of all ages who are involved in a bicycle crash. ⋯ Helmet use reduces the risk of head injury by 85%, brain injury by 88% and severe brain injury by at least 75%. Helmets should be worn by all riders whether the cyclist is a recreational rider or a serious competitor engaged in training or race competition. The International Cycling Federation (ICF) should make the use of helmets compulsory in all sanctioned races.
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Case Reports
Acute spinal cord and head injury: case report and discussion of cardiac, respiratory and endocrine abnormalities.
We report a male patient who after a fall suffered high cervical spinal cord and head (cerebral) injuries. These injuries led to spinal shock, marked sinus bradycardia and asystolic cardiac and respiratory arrests, recalcitrant central traumatic diabetes insipidus, and death within approximately seven weeks. Temporary transvenous cardiac pacing proved useful in the management of this patient.
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Anesthesia and analgesia · Apr 1998
The relationship of soluble adhesion molecule concentrations in systemic and jugular venous serum to injury severity and outcome after traumatic brain injury.
Adhesion molecules control the migration of leukocytes into tissue after injury. This may result in further cellular damage. We hypothesized that altered serum concentrations of soluble intercellular adhesion molecule (sICAM)-1 and soluble L-selectin (sL-selectin) after traumatic brain injury would correlate with injury severity and neurological outcome. We investigated serum concentrations of sICAM-1 and sL-selectin in 22 patients with traumatic brain injury admitted to the intensive care unit. The Glasgow Coma Scale (GCS) score and Injury Severity Score were recorded. Paired arterial and jugular venous blood samples were taken on admission and 24, 48, and 96 h after injury. Mean systemic and jugular venous concentrations of sICAM-1 were normal on admission but became significantly increased by 96 h (P = 0.018). sL-selectin concentrations of injured patients were markedly below those of controls at all time points (P < 0.001). There were no significant differences between jugular venous and arterial concentrations of either sICAM-1 or sL-selectin. Serum sICAM-1 was significantly related to neurological outcome (P < 0.001) and to the GCS score (P < 0.001). These changes in adhesion molecule expression after acute brain injury may be important in the pathophysiology of secondary injury. The highly significant relationship between serum sICAM-1 and neurological outcome suggests that the inflammatory response to injury may be detrimental. Drugs that antagonize the actions of the adhesion molecules may have a role in therapy after traumatic brain injury. ⋯ This observational study shows that there is a strong association between soluble intercellular adhesion molecule-1 in serum and poor neurological outcome after traumatic brain injury. This suggests that inflammation after brain injury may worsen the prognosis and that therapies directed against this inflammation may prove useful.
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Zh Vopr Neirokhir Im N N Burdenko · Apr 1998
Comparative Study[Ultrasonic scanning of the brain in the postoperative period in patients with an acute neurosurgical pathology].
Authors present the results of ultrasound scanning in 130 adult patients with CNS trauma, brain tumors and hemorrhagic stroke. Forty three variants of ultrasound pictures were described. There was a discrepancy between ultrasound and CT-based diagnoses in 44% of cases. The method is recommended for routine use in neurosurgical clinics, especially in those unequipped with CT scans.