Articles: brain-injuries.
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Zh Nevropatol Psikhiatr Im S S Korsakova · Jan 1985
[Neuropathologic syndromes in the late period of closed cranio-cerebral injuries].
Using a comprehensive psychoneurological examination including a number of paraclinical methods (EEG, REG, echoventriculometry, thromboelastography, audiography, etc.) the authors studied 160 war veterans who had sustained a closed craniocerebral injury of a mild or moderate degree during the Great Patriotic War. The following neuropathological syndromes most characteristic for its long-term period were identified: cochleo-vestibular disorders, oculomotor and optico-vestibular disorders, as well as vegetovascular, hypothalamic, Parkinsonism, dyssomnic, epileptic and hydrocephalohypertensive syndromes. The authors also describe a number of the features of these syndromes related to the type of the course of the long-term period of the injury and to the predominance in the clinical picture of the disease of posttraumatic or cerebrovascular disturbances.
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The "Krönlein" shot (evisceration of the brain) is a very rare injury of the skull caused by a high-velocity bullet. The requirement for this type of low-range shot wound is a broad opening of the skull with laceration of the dura mater. In the past, several cases of this particular injury have been reported and all led to immediate death.
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Head injury is a significant economic, social and medical problem in the United States. For this reason, prognostic factors in head injury are of major importance to all surgeons who treat severely injured patients. Outcome of severe head injury is frequently determined at the time of impact, and surgical and medical treatment is often ineffective. ⋯ Multimodality evoked responses are a noninvasive prognostic technique which predicts outcome with a high degree of certainty. For optimal accuracy, prognosis should be based upon a combination of factors, including age, Glasgow coma score, pupillary response, eye movements, presence of surgical lesion, motor posturing and multimodality evoked responses. Decisions regarding surgical and medical treatment of patients with head injury should be based upon these prognostic factors.
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Anesthesia and analgesia · Dec 1984
Cerebral and cardiopulmonary responses to high-frequency jet ventilation and conventional mechanical ventilation in a model of brain and lung injury.
The cardiopulmonary and intracranial effects of high-frequency jet ventilation (HFJV) were evaluated in four groups of 10 mongrel dogs and compared to conventional mechanical ventilation with and without positive and expiratory pressure (PEEP). Each group of animals was studied with various combinations of normal and abnormal brain and lung function. Experimental brain injury (abnormal cerebral elastance) was produced by infusion of saline into the subarachnoid space to increase intracranial pressure (ICP), while lung injury resulted from intratracheal instillation of 0.1N HCl. ⋯ ICP responses did not vary significantly with the different modes of ventilation and were not influenced by the status of lung or brain function. However, significant reductions in cerebral perfusion pressure were noted with 20 cm H2O PEEP compared to HFJV. We conclude that unless high levels of PEEP (15-20 cm H2O) are required for adequate oxygenation, the cardiovascular and cerebral effects of HFJV do not differ significantly from those of conventional mechanical ventilation.
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Zh Vopr Neirokhir Im N N Burdenko · Nov 1984
Comparative Study[Effect of osmotic diuretics and saluretics on intracranial pressure in posttraumatic brain edema].
The effect of osmotic diuretics (mannite and glimarite, 29 studies), colloid-osmotic diuretic (algurin, 22 studies), and saluretic (lasix, 58 studies) on intracranial pressure (ICP) was studied in 30 patients in the acute period of severe craniocerebral injury. It was found that the hypotensive effect of the diuretics depended on the state of the water-electrolyte homeostasis, the time of medication with the agents, the severity of the patient's condition, and the initial ICP. ⋯ Medication with osmotic diuretics and algurin in the first 2-3 days after the injury as usually attended by the "yield phenomenon"; the hypotensive effect of algurin in this period was less manifest. The effect of lasix was higher in hyperosmia caused by hypernatriemia but lower in patients who were in a terminal and extremely severe state.