Articles: brain-injuries.
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Multicenter Study Clinical Trial
The Canadian CT Head Rule for patients with minor head injury.
There is much controversy about the use of computed tomography (CT) for patients with minor head injury. We aimed to develop a highly sensitive clinical decision rule for use of CT in patients with minor head injuries. ⋯ We have developed the Canadian CT Head Rule, a highly sensitive decision rule for use of CT. This rule has the potential to significantly standardise and improve the emergency management of patients with minor head injury.
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Multicenter Study Comparative Study
International study of emergency department care for pediatric traumatic brain injury and the role of CT scanning.
Our objective was to investigate the use of CT and its relationship to head injury severity and age. ⋯ The majority of children did not need significant medical intervention. Physicians ordered X-ray investigations more frequently than CT scanning. The use of X-ray to decide whether or not CT is necessary is not warranted. The implications of positive CTs in mild or moderate injuries were most noteworthy, as were age-related interactions with positive CT findings.
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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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J Head Trauma Rehabil · Jun 2000
Multicenter StudyPsychological distress and family satisfaction following traumatic brain injury: injured individuals and their primary, secondary, and tertiary carers.
To assess family psychosocial outcome following traumatic brain injury (TBI) in all family members, including relatives more peripheral to the person with the injury. ⋯ Male relatives (the majority of whom were secondary or tertiary carers) may report their distress in terms of anger and fatigue, rather than as depression and anxiety. Future research could develop TBI-specific measures of anger and fatigue as screening instruments to identify peripheral family members requiring assistance in adapting to TBI. Many families-despite their initial traumatic experience-eventually cope well, encouraging researchers and clinicians to focus future research efforts on those families who have made good adjustments to TBI.
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Journal of neurotrauma · Jun 1999
Randomized Controlled Trial Multicenter Study Clinical TrialEffects of the bradykinin antagonist Bradycor (deltibant, CP-1027) in severe traumatic brain injury: results of a multi-center, randomized, placebo-controlled trial. American Brain Injury Consortium Study Group.
A phase II prospective, randomized, double blind clinical trial of Bradycor, a bradykinin antagonist, was conducted at 31 centers within North America in severely brain injured patients. Patients of Glasgow Coma Score (GCS) 3-8 (n = 139) with at least one reactive pupil were randomized to receive either Bradycor, 3 microg/kg/min or placebo as a continuous intravenous infusion for 5 days, with the infusion beginning within 12 h of the injury. The primary objective was to assess the efficacy of a continuous infusion of Bradycor (3.0 mc/kg/min) in preventing elevation of intracranial pressure (ICP). ⋯ There were fewer deaths in the Bradycor group, which had a 28-day all cause mortality of 20% versus 27% on placebo. Patients treated with Bradycor showed a 10.3% improvement in favorable outcome at 3 months and a 12% improvement in dichotomized GOS at 6 months (p = 0.26). The consistent positive trends seen in ICP, TIL, neuropsychological tests, and, most importantly, 3- and 6-month GOS provide supportive evidence that a bradykinin antagonist may play a neuroprotective role in severe brain injury.