Articles: brain-injuries.
-
To determine the prevalence of abnormal computed tomography (CT) scans and define high-risk clinical variables in patients with mild head injury. ⋯ Abnormalities on CT scans in patients with mild head trauma are fairly common, although the need for neurosurgical intervention is rare. Clinical decision rules can be used to identify those patients with more serious intracranial pathology. Such strategies should be validated prospectively in various ED settings.
-
To devise a practical technique for high-resolution evaluation of the anterior optic apparatus using a phased-array surface coil system, and to evaluate this system in patients with suspected optic pathway abnormalities. ⋯ Phased-array surface coils allow rapid, thin-section imaging of the entire anterior optic pathway, with improved signal-to-noise ratio. This may improve evaluation of optic pathway lesions over conventional techniques.
-
Tidsskr. Nor. Laegeforen. · May 1995
[Surgical treatment of acute head injuries, especially epidural hematomas. Current and future practice in Norway].
A survey among the 13 general county hospitals and the five regional neurosurgical units in Norway showed that 263 patients were operated on for acute head injuries in 1993. More than 80% of these operations took place in a neurosurgical unit, and most county hospitals had only 1-2 such surgical procedures each year. Most county hospitals also limited their surgical activities to extradural conditions. ⋯ One patient died. It is concluded that these good results probably reflect the standard of handling, diagnostic work and transport of the patient prior to surgery, rather than the surgery itself. It seems unreasonable to continue the infrequent practice of treating these conditions surgically in local hospitals.
-
Tidsskr. Nor. Laegeforen. · May 1995
[Minor head injuries. May early CT-scanning replace in-hospital observation?].
A one-year prospective study was undertaken to judge whether in-hospital observation after minor head injury could be partly replaced by early computerized tomography (CT), and if such a practice would save hospital resources. All 146 patients had a Glasgow Coma Score (GCS) > or = 14 and no neurological deficits. 128 had suffered loss of consciousness. CT of 97 (67%) patients revealed intracranial lesions in eight (contusions six, oedema one and epidural haematoma in one). ⋯ We observed no complications to the head injury in patients with normal CT. There is no need for hospitalization after minor head injury in patients with GCS > or = 14 with no neurological deficits and normal CT. We advocated wide use of early CT in cases of minor head injury, to allow early detection of intracranial haematomas, diagnoses of brain contusions and avoidance of unnecessary hospitalization.
-
The occurrence of severe head injury, isolated or in connection with polytrauma, is a challenge for all physicians working in emergency care at the scene of an accident or afterwards in hospital care. It is an advantage to have a basic knowledge of neurological assessment. The Glasgow Coma Scale is widely used in this context; we refer to mild, moderate, and severe injuries. ⋯ It has not yet been possible to show that using corticosteroids is definitely beneficial in human brain trauma; there may be a positive effect in connection with spinal trauma. New therapies are being investigated, such as increasing CPP, administering AMPA/NMDA-antagonists, 21-aminosteroids, or hypertonic-hyperoncotic solutions. However, they have not as yet been proven effective for general clinical use or clinical use et al.