Articles: brain-injuries.
-
Zh Vopr Neirokhir Im N N Burdenko · Mar 1990
Comparative Study[The combined therapy of patients with severe craniocerebral injury].
The hemostasis system was studied in 423 patients. Coagulation occurred in a definite sequence: its expressiveness and duration were determined by the severity and form of brain damage. In the period of hypercoagulative changes (from 2 to 15 days and longer), thrombotic processes were revealed in 16% of the cases. Anticoagulative treatment including heparin, indirect anticoagulants, des- and antiaggregates, as well as fibrinolytics were applied in 27% of the cases, which reduced mortality by 12%.
-
Ideal resuscitation would simultaneously replete intravascular volume and minimize cerebral edema. We assessed the effects of hypertonic saline (HS) shock resuscitation on cerebral edema after head injury. Rats were subjected to hemorrhagic shock (40 mm Hg for 1 hour) in the presence or absence of mechanical brain injury, followed by 1 hour of resuscitation with either hypertonic saline (6.5%) or lactated Ringer's (LR). After resuscitation, animals were sacrificed and brain water contents determined. ⋯ HS resuscitation of hemorrhagic shock decreases brain water content in uninjured but not injured brain. HS may be useful in resuscitation of combined hemorrhagic shock and head injury.
-
EEG and multimodal evoked potentials are currently the most frequently used methods of brain functioning monitoring in severely acute primary or secondary brain damage. Development or regression of brain function disturbances can be reliably assessed in this way. The methods are suitable for early diagnosis of intracranial complications and contribute to diagnosis of irreversible loss of cerebral function. ⋯ EEG and evoked potentials can be monitored at the bed-site. If there are no technical facilities for long-term EEG monitoring, repeated conventional single tracings are of value in these cases. When both the acoustic evoked brain stem potentials and the early somatosensory potentials are to be examined, the possibility exists to differentiate between hemispheric and brain stem damage and to use these results for prognosis assessment.
-
Journal of neurotrauma · Jan 1990
Characterization of axonal injury produced by controlled cortical impact.
Axonal injury and behavioral changes were evaluated 3-7 days after traumatic brain injury. Previous research from this laboratory demonstrated that clinical central nervous pathology is produced by dynamic brain compression using a stroke-constrained impactor. We wanted to determine if the technique also would produce diffuse axonal injury after recovery from the procedure. ⋯ Axonal injury also was evident in the white matter of the cerebellar folia and the region of the deep cerebellar nuclei. Behavioral assessment showed functional coma lasting up to 36 h following 8.0 m/sec impacts, with impaired movement and control of the extremities over the duration of the postinjury monitoring time. These experiments confirm that the cortical impact model of traumatic brain injury mimics all aspects of traumatic brain injury in humans and can be used to investigate mechanisms of axonal damage and prolonged behavioral suppression.
-
Stereotact Funct Neurosurg · Jan 1990
Electrophrenic respiration in patients with craniocervical trauma.
We implanted electrophrenic respiration (EPR) units in 15 apneic quadriplegic patients with brain stem or high cervical cord injury. 11 of the patients achieved full-time respiration with EPR and another 2 achieved half-time respiration. Despite the loss of patients due to unrelated problems, 7 now use EPR continuously, 1 for 18 years. The factors involved in the significant success rate with EPR are discussed from the point of view of a neurosurgeon.