Articles: brain-injuries.
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Fortschr Neurol Psychiatr · Jul 1987
[Clinical aspects and prognosis following severe craniocerebral trauma].
The practical employment of diagnostic and therapeutic management in the early stage of head-injured patients depends on the precise assessment of the clinical course. In a retrospective study of 39 patients with severe head injury the prognostic value of clinical and methodical (instrument) parameters was analysed and compared with results of 28 international studies. ⋯ The duration of post-traumatic coma was not appropriate to give an early view of the development of disease. The high value of neurological state in combination with neuroradiological and neurophysiological investigations in the early posttraumatic period of severe head injury is emphasised.
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The authors report 3 cases of infants presenting with cerebral lesions related to violent head shaking. They emphasize the diagnostic difficulties when the classical signs of the battered child (marks of blows, fractures) are lacking. ⋯ The value of skull CT-scan is major, showing intracranial lesions which could not be found before. Because of the observed lesions, evolution is often severe.
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Propofol (Disoprivan) is a rapid and effective hypnotic comparable with etomidate. Up to now, the effects on intracranial pressure (ICP) have only rarely been investigated, especially in cases with pre-existing increased ICP [4, 18]. The aim of this study was the evaluation of ICP after i.v. propofol administration in comparison with thiopental. ⋯ Conclusions. The data now available permit the conclusion that both propofol and thiopental can be used in patients with possibly elevated ICP. The marked cardiovascular side effects of propofol must be taken into consideration.