Articles: brain-injuries.
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Recent evidence has shown that a variety of prostaglandins and leukotrienes can be produced in brain tissue after injury in animals. It has also been speculated that increases in brain prostaglandins occur in humans following injury. Ventricular cerebrospinal fluid (CSF) samples have been obtained from children with static lesions (controls) as well as children with acute brain injury and eicosanoids measured by immunologic techniques. ⋯ Elevated levels of hydroxyeicosatetraenoic acids (HETEs) were observed in those samples stored frozen, but these metabolites were most probably due to autooxidation of arachidonic acid in CSF. Arachidonic acid concentration in CSF was typically found to be in the range of 10-200 ng/ml, but was found to be 5-10 fold higher in one severely injured patient. Thus, elevated free arachidonic acid and various oxygenated metabolites were observed in CSF following brain injury.
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EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb · Dec 1987
[Early prognostic assessment using evoked potentials in severe craniocerebral trauma].
103 patients in acute posttraumatic coma were assessed during 72 hours following severe head injury by clinical examinations (documented with a modified Glasgow-Coma-Score and a brain-stem-score and brainstem auditory evoked potentials (BAEP) as well as short latency somatosensory evoked potentials (SEP). Patient outcomes were classified at 6 months or more, according to the following categories: good recovery, severely disabled or vegetative, and brain dead. Patients who had died by systemic complications were excluded from the study. ⋯ The brainstemscore and the BAEPs were reliable predictors of an unfavorable but not a favorable outcome. SEP data however, performed well as a prognostic indicant in predicting an unfavorable as well as a favorable outcome. Using the BAEP, the amplitude ratio Wave V/Wave I is more sensitive to detect a lesion than the interpeak-latency Wave I-Wave V, and--using the SEP--the amplitude ratio N20/N13b (over C2) is more sensitive than the central conduction time (N13a (over C7)--N20).
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Delayed injury following trauma to the central nervous system (CNS) may be due to the release or activation of endogenous factors. Endogenous opioid peptides have been proposed as one such class of injury factors, based on pharmacological studies demonstrating a therapeutic effect of naloxone and other opiate receptor antagonists following CNS injury. However, changes in brain opioid concentrations following injury have not been evaluated. ⋯ In the anterior pituitary, a significant increase in ir-End and a significant decrease in ir-Dyn was observed at 2 h following both levels of injury. Pathological damage to brain tissue after injury was most pronounced in those regions showing significant increases in ir-Dyn but not other opioids. In the medulla, the increase in ir-Dyn but not ir-End or ir-Enk was also significantly correlated with a fall in systemic mean arterial pressure (MAP) at 2 h following high- but not low-level injury.(ABSTRACT TRUNCATED AT 250 WORDS)