Articles: brain-injuries.
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Clinical strategy to maximize effectiveness and to minimize adverse influences remains to be determined for mild hypothermia therapy for traumatic brain injury. This study was conducted to evaluate the clinical feasibility of the titration method of mild hypothermia in severely head-injured patients in whom a reduction in intracranial pressure was regarded as the target effect. ⋯ The titration method of mild hypothermia to control intracranial hypertension in severely head-injured patients is clinically feasible. However, the method failed to reduce the incidence of infectious and hematological complications.
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Ann Acad Med Singap · May 1998
Clinical TrialOutcome of patients with traumatic brain injury managed on a standardised head injury protocol.
A standardised protocol in the management of severe head injury in our hospital enables pre-determined critical care-paths and consistent treatment regimes to be instituted. In Singapore there has been no previously reported data on the outcome of severely head injured patients. Over a 6-month period, 48 consecutive patients who were enrolled in our severe head injury protocol were prospectively studied. ⋯ The use of a protocol with standardised treatment goals in the management of traumatic brain injury allows for the optimal use of limited resources and provides consistency in treatment. Good outcome is related to early aggressive resuscitation to prevent hypotension and hypoxia, prompt evacuation of surgical mass lesions and the maintenance of an adequate cerebral perfusion pressure. Our results are comparable with that reported in other established neurotrauma systems.
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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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To evaluate the effects of delayed vs early fluid resuscitation on cerebral hemodynamics after severe head injury and uncontrolled hemorrhagic shock. ⋯ Early fluid resuscitation with Ringer lactate solution following head injury and uncontrolled hemorrhagic shock worsens cerebral hemodynamics. Cerebral pressure autoregulation is sufficiently intact following head injury to maintain regional cerebral oxygen delivery without asanguineous fluid resuscitation.
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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.