Articles: brain-injuries.
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Crit Care Nurs Clin North Am · Dec 2000
ReviewKeeping the brain in the zone. Applying the severe head injury guidelines to practice.
Providing care to the TBI patient population with severe injuries requires an integrated multidisciplinary approach. The team in clinical practice must be willing to examine its own practice, seek out the latest information on TBI, and critically analyze the information. Members must be open to changing their own practice when the data presented support change. ⋯ The standardization of these interventions into protocols facilitates team communication and coordination. Measuring outcomes is imperative for evaluating the effectiveness of current treatment algorithms. Changes in treatment practice should be based on the measured outcomes and advances in the scientific literature.
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Crit Care Nurs Clin North Am · Dec 2000
ReviewIntracranial pressure monitoring and assessing intracranial compliance in brain injury.
Caring for the patient with a brain injury is a dynamic process with the goal of providing therapy to prevent secondary injury. Until practitioners have a better understanding of the pathophysiology of ischemia and the response of therapies for treating increased ICP, they must use the tools that exist. ICP monitoring gives a rough index of the relationships and the response of the intracranial contents to changes in volume that may produce increases in pressure and further damage. Understanding the information supplied by ICP monitoring is imperative to successful management of increased ICP.
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Acta neurologica Belgica · Dec 2000
ReviewThe usefulness of EEG, exogenous evoked potentials, and cognitive evoked potentials in the acute stage of post-anoxic and post-traumatic coma.
Three-modality evoked potentials (TMEPs) have been used for several years in association with the EEG as a diagnostic and prognostic tool in acute anoxic or traumatic coma. Cognitive EPs have been recently introduced. EEG and cognitive EPs provide functional assessment of the cerebral cortex. ⋯ Thus, cognitive EPs can usefully complement exogenous EPs as a prognostic tool in coma. Indeed, even if the absence of cognitive EPs in comatose patients does not have any prognostic value, their presence implies a very high (more than 90%) probability of consciousness recovery. The major technical challenge for the future will be the development of reliable tools for continuous EEG and TMEP monitoring.
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Journal of neurotrauma · Dec 2000
Comparative StudyIsoflurane improves long-term neurologic outcome versus fentanyl after traumatic brain injury in rats.
Despite routine use of fentanyl in patients after traumatic brain injury (TBI), it is unclear if it is the optimal sedative/analgesic agent. Isoflurane is commonly used in experimental TBI. We hypothesized that isoflurane would be neuroprotective versus fentanyl after TBI. ⋯ Alternatively, fentanyl may be detrimental. Isoflurane may mask beneficial effects of novel agents tested in TBI models. Additionally, fentanyl may not be optimal early after TBI in humans.
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Journal of neurotrauma · Dec 2000
Riluzole reduces brain swelling and contusion volume in rats following controlled cortical impact injury.
Modulation of the glutamatergic and excitotoxic pathway may attenuate secondary damage following traumatic brain injury by reducing presynaptic glutamate release and blocking sodium channels in their inactivated state. The aim of the present study was to investigate the neuroprotective potential of riluzole in traumatic brain-injured rats. A left temporoparietal contusion was induced in 70 male Sprague-Dawley rats (controlled cortical impact injury). ⋯ Following trauma, CSF glutamate, taurine, and hypoxanthine levels were significantly increased compared to nontraumatized rats (p < 0.001). However, these neurochemical parameters as measured in cisternal CSF failed to reflect trauma-dependent increases in severity of tissue damage and did not reveal riluzole-mediated neuroprotection. Under the present study design, riluzole significantly reduced brain edema formation and contusion volume in rats subjected to a mild focal cortical contusion.