Articles: brain-injuries.
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The present study examined the role of endogenous opioid peptides in the pathophysiological sequelae of fluid percussion head injury in the cat. Two hours following injury, tissue concentrations of dynorphin-like immunoreactive material (ir-Dyn) were significantly elevated in specific brain regions where injury, as evidenced by histological examination, was most severe. Changes in ir-Dyn but not beta-endorphin-like immunoreactive material (ir-End) were significantly correlated with a fall in regional cerebral blood flow (CBF) that occurred 2 h following injury. Administration of the opiate antagonist WIN44,441-3 (with enhanced activity at kappa-receptors) stereospecifically increased cerebral blood flow to the injured regions.
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Historical Article
Wounded by bayonet, ball, and bacteria: medicine and neurosurgery in the American Civil War.
The American Civil War was a holocaust that illustrated the mid-19th century's unpreparedness for the delivery of medical care to the mass casualties due to both wounds and disease. Several major considerations are offered to explain the soldiers' morbidity. Incomplete understanding of pathophysiology and its management is exemplified by the treatment of the battlefield head injury. Accepting these concepts and the extent of the knowledge of the time, that higher mortality did not occur is in part testimony to the admirable care that was rendered and human resilience in an effort to survive.
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Acta Neurol. Scand. · Nov 1985
The use of evoked potentials in the management of patients with severe cerebral trauma.
Evoked potentials (SEP and BAEP) were measured daily in 18 patients who had suffered severe craniocerebral trauma, but could not be examined neurologically due to a barbiturate coma or neuromuscular blockade. The BAEP had only limited value as an indicator of the prognosis for these patients. ⋯ In some patients serial measurement of the EPs also gave an indication of the presence of late posttraumatic intracranial mass lesions. EPs are useful for the monitoring of cerebral functions in patients who have suffered a contusion of the brain and can no longer be assessed clinically.
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Zh Vopr Neirokhir Im N N Burdenko · Nov 1985
[External drainage of the ventricular system of the brain in a complex of intensive therapy of severe craniocerebral injuries].
Indications for draining the ventricular system of the brain in patients with severe craniocerebral injury are given, based on analysis of the clinical neurological signs and the quantitative estimations. The most frequent situations in which drainage is necessary are described. Ventricular drainage should be the final stage of the principal operative intervention, namely, trephination of the skull and removal of intracranial hematomas and foci of brain crushing.
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Journal of neurosurgery · Oct 1985
Clinical evaluation of two methods of subdural pressure monitoring.
Recordings from two different types of subdural pressure monitor with simultaneous intraventricular pressure (IVP) tracings are compared in 20 head-injured patients. In the first 10 patients a fluid-filled catheter was placed subdurally and connected to an external transducer, and in the second 10 the Gaeltec model ICT/b solid state miniature transducer was used. The latter system has the advantage that both zero and calibration checks can be carried out after insertion. ⋯ With the Gaeltec transducer, 72% of subdural pressure readings corresponded with IVP, while only 9% were lower and 19% were higher than IVP. The differences may have been due to technical causes or to true pressure differentials. The subdural catheter appears too unreliable for routine clinical use, but the Gaeltec transducer may be a satisfactory alternative to ventricular pressure monitoring.