Articles: brain-injuries.
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Intensive care medicine · Jan 2001
Comparative Study Clinical TrialComparison of the cerebral effects of dopamine and norepinephrine in severely head-injured patients.
To compare the cerebral effects of dopamine and norepinephrine after severe head injury. ⋯ For the same MAP, ICP was significantly higher with dopamine than norepinephrine with no argument supporting an increase of cerebral blood flow.
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There is growing evidence to suggest that growth hormone plays a role in the growth and development of the CNS. Specifically, growth hormone has been implicated in promoting brain growth, myelination, neuronal arborisation, glial differentiation and cognitive function. Here we investigate if growth hormone has a role in the recovery from an unilateral hypoxic-ischaemic brain injury. ⋯ In summary, we have found that a growth hormone-like factor increased in the brain in the days after injury. In addition, treatment with growth hormone soon after an hypoxic-ischaemic injury reduced the extent of neuronal loss. These results further suggest that a neural growth hormone axis is activated during recovery from injury and that this may act to restrict the extent of neuronal death.
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NeuroRehabilitation · Jan 2001
ReviewLimitations of neuropsychological testing to predict the cognitive and behavioral functioning of persons with brain injury in real-world settings.
While neuropsychological tests have been designed to identify cognitive impairments stemming from a brain insult and their severity, the vast majority of these tests were never designed to predict how these patients were likely to function in real-world settings, live independently, return to work, or maintain competitive employment. No one specific neuropsychological test or measure can accurately predict how an individual who has sustained a brain insult will function in everyday or vocational settings. Predictions based on neuropsychological test data tend to be more accurate if the particular tasks utilized during testing closely match or simulate the individual's everyday and vocational demands. Predicting an individual's vocational potential also requires a careful assessment of his or her work and medical history, injury characteristics, emotional and behavioral functioning, motivation to return to work, and family circumstances.
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In western countries, injuries remain the leading cause of death in young adults (Jennett B. Epidemiology of head injury. J Neurol Neurosurg Psychiatry 1996; 60: 362-369). ⋯ In: Cooper PR, Ed. Head Injury, 3rd ed. Baltimore, MD: William Wilkins, 1993), and in addition to causing death often causes severe and long-lasting functional impairment in survivors.
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J. Neurol. Neurosurg. Psychiatr. · Jan 2001
Increased jugular bulb saturation is associated with poor outcome in traumatic brain injury.
The objective was to compare secondary insults, particularly decreases in jugular bulb oxyhaemoglobin saturation (SjO(2)), during intensive care in patients with "poor" and "good" outcomes 12 months after traumatic brain injury. A prospective observational study of patients' physiological data collected each minute from multimodality monitoring was carried out. Patients had duration of physiological insults quantified as a percentage of their validated monitoring time (once invalid data due to technical reasons were removed). ⋯ There was no difference between the groups for ICP, injury severity score, peripheral pulse saturation, and pyrexia. This study confirms that secondary insults, including an increased SjO(2), occur significantly more in patients with poor outcomes. More research into strategies to reduce the impact of secondary insults, including management of increased SjO(2), is required.