Articles: brain-injuries.
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J Am Acad Child Adolesc Psychiatry · Jan 1997
Traumatic brain injury in children and adolescents: psychiatric disorders in the first three months.
To assess predictive factors of psychiatric outcome in the first 3 months after traumatic brain injury (TBI) in children and adolescents. ⋯ These data suggest that there are children, identifiable through clinical assessment, at increased risk for development of psychiatric disorders in the first 3 months after TBI.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Measuring epidural intracranial pressure in patients with severe craniocerebral trauma].
In 30 patients with severe head injury (SHI), intracranial pressure (ICP) was monitored using epidural transducers. In 22 patients, the measurements were reliable, with average values of 19.4 mmHg in the survivors and 64.6 mmHg in those who died. It is concluded that epidural measurement of ICP provides a helpful method for the management of SHI and to control the indication for CT scans.
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Acta Neurochir. Suppl. · Jan 1997
Clinical TrialNear infrared spectroscopy (NIRS) in patients with severe brain injury and elevated intracranial pressure. A pilot study.
Near infrared spectroscopy (NIRS) was used to asses changes in regional cerebral oxygen saturation (rSO2) in 8 head injured patients with an intracranial pressure (ICP) higher or lower than 25 mmHg (n = 4 for each group). NIRS values in the high ICP group (> 25 mmHg) were significantly lower than in the low ICP group (< 25 mmHg). In contrast, arterial pO2, pCO2, peripheral oxygen saturation and transcranial Doppler sonography (TCD) values were similar in both groups. ⋯ However, rSO2 values in patients with an ICP > 25 mmHg were significant lower than in patients with an ICP < 25 mmHg after the hyperoxygenation period. In addition, patients with an ICP < 25 mmHg revealed a significant increase in rSO2 values at the end of the hyperoxygenation period, not detectable in patients with an ICP > 25 mmHg. Our results suggest that NIRS may be an additional diagnostic tool in the non-invasive evaluation of impaired cerebral microcirculation in patients with increased intracranial pressure.
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In the past several years, improvements in technology have advanced the monitoring capabilities for patients with TBI. The primary goal of monitoring the patient with TBI is to prevent secondary insults to the brain, primarily cerebral ischemia. Cerebral ischemia may occur early and without clinical correlation and portends a poor outcome. ⋯ Similarly, microdialysis is in its infancy but has demonstrated great promise for metabolic monitoring. EEG and SEP are excellent adjuncts to the monitoring arsenal and provide immediate information on current brain function. With improvements in electronic telemetry, functional monitoring by EEG or SEP may become an important part of routine monitoring in TBI.