Journal of neurotrauma
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Journal of neurotrauma · Nov 1996
Review Practice Guideline GuidelineThe use of mannitol in severe head injury. Brain Trauma Foundation.
Mannitol is effective in reducing ICP, and we recommend its use in the management of traumatic intracranial hypertension. Serum osmolalities greater than 320 mOSsm/L and hypovolemia should be avoided. Some data suggest that bolus administration is preferable to continuous infusion.
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Journal of neurotrauma · Nov 1996
Review Practice Guideline Comparative Study GuidelineRecommendations for intracranial pressure monitoring technology. Brain Trauma Foundation.
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Journal of neurotrauma · Aug 1996
Detection of impaired cerebral autoregulation using spectral analysis of intracranial pressure waves.
Successful resuscitation following severe traumatic brain injury (TBI) requires rapid evaluation of intracranial pressure (ICP), cerebrovascular reactivity (autoregulation), and cerebral metabolism. During impaired autoregulation, inadequate cerebral blood flow (CBF) can lead to ischemia while excessive CBF can result in elevated ICP. Without information regarding the state of autoregulation, treatment of either situation may ameliorate one problem but exacerbate the other. ⋯ This large difference in TF relative to baseline extended over a large range of BP (60 < BP < 180 mm Hg). Based on these data and previous results, it was estimated that TF can differentiate impaired autoregulation from effects solely related to elevated ICP or active vasodilation for ICP < 30-40 mm Hg. This suggests that for specific, but widely applicable physiologic conditions, spectral analysis can identify states of impaired autoregulation and, as an adjunct to traditional monitoring techniques, aid in acute resuscitation and prevention of secondary injury in TBI.
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Journal of neurotrauma · Jun 1996
Working memory deficits following traumatic brain injury in the rat.
This study was designed to examine working memory following fluid-percussion traumatic brain injury (TBI) using the Morris water maze (MWM). Rats were injured (n = 9) at a moderate level of central fluid percussion injury (2.1 atm) or were prepared for injury but did not receive a fluid pulse (sham injury) (n = 10). On days 11-15 postinjury, working memory was assessed using the MWM. ⋯ Analyses of the latency to reach the goal platform indicated that sham-injured animals performed significantly better on the second trial than on the first trial of each pair. However, injured animals did not significantly differ between first and second trial goal latencies on any day. These results indicate that injured animals have a profound and enduring deficit in spatial working memory function on days 11-15 after TBI.
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Journal of neurotrauma · Mar 1996
Diminished microtubule-associated protein 2 (MAP2) immunoreactivity following cortical impact brain injury.
This study employed Western blotting and qualitative immunohistochemistry to analyze the effects of cortical impact traumatic brain injury (TBI) on acute changes in MAP2 immunoreactivity in the rat cortex. We employed a lateral cortical impact injury device to induce severe TBI, which is associated with focal cortical contusion and neuronal death at the impact site. Three hours following TBI, Western blotting detected substantial MAP2 loss only in the cortex ipsilateral to the site of injury. ⋯ Alterations in MAP2 immunofluorescence were found both within and beyond areas of focal contusion and necrosis in the ipsilateral cortex. Thus, traumatic brain injury in rats can produce rapid and significant dendritic pathology within sites of contusion. However, immunohistochemical changes in MAP2 labeling outside of contused regions suggests that TBI-induced dendritic damage may not be exclusively associated with acute cell death.