Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Jan 1998
Comparative StudyMeasurement of impaired consciousness in the neurological intensive care unit: a new test.
Neurological deterioration in alert patients with an acute CNS disorder can be subtle, but current coma scales may not clearly capture changes in level of alertness. Many coma scales include components such as eye opening and content of speech, features that are difficult to assess in intubated patients and patients with facial trauma. Two new tools have been devised by the authors. ⋯ On the first visit 49% of all tests with a maximum Glasgow coma score had a negative continuous performance test as opposed to 13% of tests with a less than maximum Glasgow coma score. For the consecutive hand position test, these numbers were respectively 25% and 2%. These tests may be a reasonable alternative to the Glasgow coma score to monitor patients, in particular when the verbal and eye response cannot be reliably tested.
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J. Neurol. Neurosurg. Psychiatr. · Jan 1998
Meta AnalysisProphylactic antiepileptic agents after head injury: a systematic review.
To determine the effectiveness and safety of prophylactic antiepileptic agents in the management of acute traumatic head injury. ⋯ Prophylactic antiepileptic drugs are effective in reducing early seizures, but there is no evidence that treatment with such drugs reduces the occurrence of late seizures, or has any effect on death and neurological disability. Insufficient evidence is available to establish the net benefit of prophylactic treatment at any time after injury.
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J. Neurol. Neurosurg. Psychiatr. · Jan 1998
Epidemiological study of Guillain-Barré syndrome in south east England.
To determine the incidence, treatment, and outcome of Guillain-Barré syndrome in south east England. ⋯ Despite the frequent use of modern immunomodulatory treatments Guillain-Barré syndrome still carries considerable morbidity and mortality.
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J. Neurol. Neurosurg. Psychiatr. · Oct 1997
Clinical TrialTiming of surgery in patients with aneurysmal subarachnoid haemorrhage: rebleeding is still the major cause of poor outcome in neurosurgical units that aim at early surgery.
To investigate prospectively the proportion of patients actually operated on early in units that aim at surgery in the acute phase of aneurysmal subarachnoid haemorrhage (SAH) and what is the main current determinant of poor outcome. ⋯ In neurosurgical units with what has been termed "modern management" including early surgery, about half of the patients are operated on early. Rebleeding is still the major cause of poor outcome.
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J. Neurol. Neurosurg. Psychiatr. · Sep 1997
Case ReportsDural puncture and activated protein C resistance: risk factors for cerebral venous sinus thrombosis.
Dural puncture is regarded a safe procedure when contraindications are carefully excluded and has so far not been recognised as a risk factor for cerebral venous sinus thrombosis (CVST). Five patients are described with CVST after dural puncture in the presence of additional risk factors. ⋯ Dural puncture may constitute an additional risk factor for CVST especially in patients with APC resistance or surgery. In such patients a thrombophilia screen is indicated.