Neurosurgery clinics of North America
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If return to work is part of the expected outcome, more and more data indicate that medical care alone does not hold the key to providing success. Our modern physical treatments may seem a humane alternative to no treatment, but they have not been proven to significantly alter the natural course of back problems. Even the results of strongly indicated surgical treatment differ little from doing nothing at all after a 4-year period. ⋯ This humane approach to care has evolved from common frustrations of dealing with patients with back problems, observations in the third world, and information gained from scientific studies. Medical pain, and physical models alone are unsuccessful. To be humane and successful, we can no longer ignore the nonphysical factors that can, and do, influence patients' responses to physical treatment, especially when return to work is part of the expected outcome.
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Although head injury is a common occurrence in childhood, most of the brain injury that occurs is mild and uncomplicated. There are some differences between adults with head injuries and children with head injuries, and some of these differences are reviewed. Specific circumstances unique to childhood head injury are presented, including the importance of recognizing child abuse.
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Neurosurg. Clin. N. Am. · Apr 1991
ReviewNeurophysiologic monitoring of patients with head injuries.
Despite new technologic developments designed to analyze the brain's electrical activity, monitoring the electroencephalogram or evoked potentials has not yet provided important information with regard to acute management of patients with head injury. Measurement of cerebral blood flow as well as jugular oxygen saturation is of more practical importance. Particularly when monitored continuously, these measures can provide useful information about the use of hyperventilation and control of elevated systemic arterial pressure.
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Neurosurg. Clin. N. Am. · Apr 1991
ReviewManagement of head injury. Intracranial pressure monitoring.
The role of intracranial pressure monitoring as an adjunct to the clinical examination, CT scanning, and other diagnostic modalities has become increasingly recognized. This article presents a brief overview of the present status of this technique and touches on prospects for further developments.