Articles: brain-injuries.
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Knockout in boxing entails deliberate production of the state of unconsciousness. Acute subdural hematoma which is the most common acute brain injury in boxing, accounts for 75% of all acute brain injuries and is the leading cause of boxing fatalities. The aim of this study is to evaluate acute subdural hematoma caused by professional boxing by analyzing the content of bouts, the level of consciousness on admission, CT scan, therapy and outcome 3 months after admission. ⋯ Overall outcome was better than that published in previous reports and also than that observed in other head injuries, for example, traffic accident and fall. The reasons for this could be that the patients were younger, that there was immediate surgical treatment, and that brain injury without cerebral contusion had contributed to better outcome. Finally, the best medical management intervention seems to be to diagnose and treat the lesions as early as possible after occurrence of subdural hematoma.
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The properties of the endothelium differ between the brain and the remainder of the body. In most non-CNS tissues the size of the junctions between endothelial cells averages 65 A. Proteins do not cross these gaps, while sodium does. ⋯ However, the therapeutic approach to polytraumatized patients with small intravascular volume (4-6 ml/kg) of hypertonic solutions should not be a substitute for the usual volemic resuscitation technique. The clinical indication for these solutions should be limited to the initial resuscitation maneuvers in traumatized patients. Prolonged use of hypertonic solutions for the purpose of intravascular resuscitation would only contribute to increasing the side effects and eventually counteract the initial beneficial advantages.
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Arch Phys Med Rehabil · Sep 1996
Multicenter Study Comparative Study Clinical Trial Controlled Clinical TrialFunctional outcomes of older adults with traumatic brain injury: a prospective, multicenter analysis.
To investigate improvement rates and medical services costs in older brain injured adults relative to younger patients. ⋯ Although older persons demonstrated functional changes, the cost of change was substantially higher than for younger patients, coincident with longer lengths of stay. These higher overall charges and slower rates of change may effect changes in referral and management patterns.
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Journal of neurosurgery · Sep 1996
Ventriculostomy infections: the effect of monitoring duration and catheter exchange in 584 patients.
The investigators undertook a retrospective analysis of ventriculostomy infections to evaluate their relationship to monitoring duration and prophylactic catheter exchange. In 1984, the results of an epidemiological study of ventriculostomy-related infection were published. One of the conclusions of the paper was that the incidence of ventriculostomy-related infections rose after 5 days of monitoring. ⋯ There is a rising risk of infection over the first 10 days, but infection then becomes very unlikely despite a population that continues to be at risk. Patients in whom catheters were replaced prior to 5 days did not have a lower infection rate than those whose catheters were exchanged at more than 5-day intervals. Based on these data, it is recommended that ventriculostomy catheters for intracranial pressure monitoring be removed as quickly as possible, and in circumstances in which prolonged monitoring is required, there appears to be no benefit from catheter exchange.
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To measure the prevalence of and characterize coagulopathy in patients with blunt brain injury. ⋯ After blunt brain injury, a disseminated intravascular coagulation syndrome can lead to consumptive coagulopathy that is associated with a higher frequency of death. The syndrome develops within 1 to 4 hours after injury. Therapeutic interventions need to be implemented immediately to be effective.