Articles: brain-injuries.
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Assessment of the level of cerebral function or of functional deficits, respectively, as in patients with acute cerebral lesions in coma, is the main purpose of cerebral monitoring. Although the clinical-neurological exploration of the patient with employment of scoring systems, such as the Glasgow Coma Scale, is the most comprehensive approach, it is of limited quantitative nature. ⋯ Recording of the intracranial pressure in comatose patients with severe head injury continues to play a central role in early recognition of fatal complications threatening the brain, such as an intracranial mass. Besides, assessment of the intracranial pressure is indispensable for selection of appropriate methods of treatment and adjustment of its necessary dose.
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Study of a number of routine nursing care activities has suggested a relationship between activities and intracranial pressure (ICP). The purpose of this study was to focus on the relationship between nursing care activities and variations in ICP. A case study method was used to study ICP in five brain-injured patients with a Glasgow Coma Scale (GCS) score of 4 or more. ⋯ During the bathing procedures only two baths elicited an ICP greater than 20 mm Hg. All other bathing procedures elicited minimal increases in ICP. These findings further support the need for nurses to be aware of the patient's ICP prior to turning and suctioning.
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The neuropathological changes produced by a captive bolt pistol are described. The primary wound track in the brain was similar to that inflicted by a weapon such as a .22 calibre rifle. However neural and vascular damage at a distance from the primary wound canal was much less severe and widespread after penetration of the low velocity captive bolt projectile due to the formation of a smaller temporary wound cavity by radial forces imparted to the parenchyma. These findings suggest that the use of a captive bolt pistol for euthanasia should be immediately followed by further actions to ensure that an animal is rendered permanently unconscious.
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J. Cereb. Blood Flow Metab. · Sep 1993
Comparative StudyHypothermia attenuates the loss of hippocampal microtubule-associated protein 2 (MAP2) following traumatic brain injury.
Traumatic brain injury (TBI) produces a tissue-specific decrease in protein levels of microtubule-associated protein 2 (MAP2), an important cross-linking component of the neuronal cytoskeleton. Because moderate brain hypothermia (30 degrees C) reduces certain neurobehavioral deficits produced by TBI, we examined the efficacy of moderate hypothermia (30 degrees C) in reversing the TBI-induced loss of MAP2 protein. Naive, sham-injured, and moderate (2.1 atm) fluid percussion-injured rats were assessed for MAP2 protein content 3 h post injury using quantitative immunoreactivity measurements. ⋯ Fluid percussion injury dramatically reduced MAP2 levels in the normothermic group (44.3 +/- 5.9%; p < 0.0005) compared with normothermic sham-injured controls. No significant reduction of MAP2 was seen in the hypothermic injured group (95.2 +/- 4.6%; compared with hypothermic sham-injured controls, p > 0.20). Although it is premature to infer any causal link, the data suggest that the attenuation of injury-induced MAP2 loss by hypothermia may contribute to its overall neuroprotective action.
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Randomized Controlled Trial Comparative Study Clinical Trial
Desflurane and isoflurane have similar effects on cerebral blood flow in patients with intracranial mass lesions.
Before desflurane is advocated for patients undergoing neurosurgical procedures, it is necessary to determine the effect of desflurane on cerebral blood flow (CBF). In this study, CBF values are compared between desflurane and isoflurane at two doses. In addition, CBF reactivity to CO2 and the effect of prolonged exposure were compared between the two agents. ⋯ Desflurane and isoflurane are similar in terms of absolute CBF, the response to increasing doses, and the preservation of CO2 reactivity.