Articles: brain-injuries.
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Randomized Controlled Trial Clinical Trial
Does intensive rehabilitation improve the functional outcome of patients with traumatic brain injury? Interim result of a randomized controlled trial.
To evaluate the effects of intensive rehabilitation on the functional outcome in patients with traumatic brain injury (TBI), we carried out a randomized controlled assessor-blind trial, comparing two groups of patients receiving different intensities of rehabilitation treatment (2 versus 4 h per day). Patients with moderate and severe TBI, aged from 12 to 65 years, were included. ⋯ Intensive rehabilitation may improve the early functional outcome of TBI patients. The interim results indicate that the study should be continued.
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Chin. J. Traumatol. · Nov 2001
Randomized Controlled Trial Clinical TrialGlasgow Coma Scale, brain electric activity mapping and Glasgow Outcome Scale after hyperbaric oxygen treatment of severe brain injury.
To study the effect of hyperbaric oxy gen (HBO) treatment of severe brain injury. ⋯ Hyperbaric oxygen treatment could improve obviously GCS, BEAM and GOS of severe brain injury patients, and effectively reduce the mortality and morbidity. It is an effective method to treat severe brain injury.
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Brain injury : [BI] · Oct 2001
Randomized Controlled Trial Clinical TrialPilot study of electrical stimulation on median nerve in comatose severe brain injured patients: 3-month outcome.
To determine if electrical stimulation (ES) benefits (waking time, 3-month outcomes) treated coma patients. ⋯ These data show an interesting trend, although statistical power was limited in this small pilot study, suggesting the need for a larger trial.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Lack of effect of induction of hypothermia after acute brain injury.
Induction of hypothermia in patients with brain injury was shown to improve outcomes in small clinical studies, but the results were not definitive. To study this issue, we conducted a multicenter trial comparing the effects of hypothermia with those of normothermia in patients with acute brain injury. ⋯ Treatment with hypothermia, with the body temperature reaching 33 degrees C within eight hours after injury, is not effective in improving outcomes in patients with severe brain injury.
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Randomized Controlled Trial Clinical Trial
A randomized trial of very early decompressive craniectomy in children with traumatic brain injury and sustained intracranial hypertension.
The object of our study was to determine, in children with traumatic brain injury and sustained intracranial hypertension, whether very early decompressive craniectomy improves control of intracranial hypertension and longterm function and quality of life. ⋯ All children were managed from admission onward according to a standardized protocol for head injury management. Children with raised intracranial pressure (ICP) were randomized to standardized management alone or standardized management plus cerebral decompression. A decompressive bitemporal craniectomy was performed at a median of 19.2 h (range 7.3-29.3 h) from the time of injury. ICP was recorded hourly via an intraventricular catheter. Compared with the ICP before randomization, the mean ICP was 3.69 mmHg lower in the 48 h after randomization in the control group, and 8.98 mmHg lower in the 48 hours after craniectomy in the decompression group (P=0.057). Outcome was assessed 6 months after injury using a modification of the Glasgow Outcome Score (GOS) and the Health State Utility Index (Mark 1). Two (14%) of the 14 children in the control group were normal or had a mild disability after 6 months, compared with 7 (54%) of the 13 children in the decompression group. Our conclusion was that when children with traumatic brain injury and sustained intracranial hypertension are treated with a combination of very early decompressive craniectomy and conventional medical management, it is more likely that ICP will be reduced, fewer episodes of intracranial hypertension will occur, and functional outcome and quality of life may be better than in children treated with medical management alone (P=0.046; owing to multiple significance testing P <0.0221 is required for statistical significance). This pilot study suggests that very early decompressive craniectomy may be indicated in the treatment of traumatic brain injury.