Articles: brain-injuries.
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Journal of neurotrauma · Oct 2001
Effects of binge ethanol administration on the behavioral outcome of rats after lateral fluid percussion brain injury.
This study examined the effects of 4 weeks of binge ethanol administration (BEAn) on the behavioral outcome in rats after lateral fluid percussion (FP) brain injury. Rats were intragastrically given 7.5 mL/kg of either 40% ethanol in 5% glucose solution (3 g ethanol/kg; binge ethanol group), or 5% glucose solution (vehicle group), twice on Thursday and Friday of 3 consecutive weeks. Then rats from both groups were subjected to either lateral FP brain injury of moderate severity (1.8 atm) or to sham operation. ⋯ Histologic analysis of injured animals from both injured ethanol and vehicle groups revealed similar extents of ipsilateral cortical and observable hippocampal damage. These results suggest that 4 weeks of binge ethanol treatment followed by ethanol intoxication at the time of injury worsens some aspects of the spatial learning ability of rats. This worsening is probably caused by subtle, undetectable morphologic damage by binge ethanol administration.
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Fever above 38 degrees C that occurs in patients with acute neurosurgical diseases appears to worsen secondary brain injury and ultimate neurologic outcomes. Laboratory investigations are quite clear regarding the adverse effects of fever in terms not only of functional outcomes, but also histologic and neurochemical injury. ⋯ The ability to eliminate fever in most of these patients during the first five to seven days after their injury would seem desirable. Based on a phase-I trial, it appears that intravascular cooling is a promising new method for avoiding fever in the neurosurgical ICU.
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Journal of neurotrauma · Oct 2001
Traumatic brain injury-induced changes in gene expression and functional activity of mitochondrial cytochrome C oxidase.
Traumatic brain injury (TBI) is documented to have detrimental effects on CNS metabolism, including alterations in glucose utilization and the depression of mitochondrial oxidative phosphorylation. Studies on mitochondrial metabolism have also provided evidence for reduced activity of the cytochrome oxidase complex of the electron transport chain (complex IV) after TBI and an immediate (lhr) reduction in mitochondrial state 3 respiratory rate, which can persist for up to 14 days postinjury. Using differential display methods to screen for differences in gene expression, we have found that cytochrome c oxidase II (COII), a mitochondrial encoded subunit of complex IV, is upregulated following TBI. ⋯ These differences in cytochrome c oxidase activity were supported by in vitro assay of complex IV using cerebral cortical and hippocampal tissues. Our present results support the hypothesis that COII is selectively vulnerable to TBI and that COII differences may indicate the degree of metabolic dysfunction induced by different pathologies. Taken together, such data will better define the role of metabolic function in long-term recovery after TBI.
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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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Comparative Study Clinical Trial
Prospective comparison of admission computed tomographic scan and plain films of the upper cervical spine in trauma patients with altered mental status.
The accurate evaluation of patients with multiple injuries is logistically complex and time sensitive, and must be cost-effective. We hypothesize that computed tomographic (CT) scan of the upper cervical spine (occiput to C3 [Co-C3]) would add little to the initial evaluation of patients with multiple injuries who have altered mental status. ⋯ CT scan of Co-C3 was superior to plain films in the early identification of upper cervical spine injury. Plain films failed to identify 45% of upper cervical spine injuries; four of these missed injuries resulted in motor deficits. Our study supports the practice guidelines developed by the Eastern Association for the Surgery of Trauma for clearance of the upper cervical spine in patients with altered mental status, as all patients with injuries were identified using these guidelines.