Articles: brain-injuries.
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Journal of neurosurgery · Oct 1999
Comparative StudySomatosensory evoked potentials in severe traumatic brain injury: a blinded study.
Beginning in 1979, the results of somatosensory evoked potential (SSEP) monitoring have been used to predict outcome in patients who have suffered severe brain trauma. The data indicate that if the cortical components of the SSEPs were bilaterally absent, the outcome was always death or a vegetative state, but previous studies have not been blinded. The aims of this study were to correlate the results of SSEP recordings with the outcome in a prospectively blinded manner and to assess whether monitoring of SSEPs was a useful adjunct to clinical judgment in the prediction of outcome. ⋯ Of 51 patients with a bilaterally normal CCT, 29 (57%) had a good outcome (GOS Score 5). Any delay in CCT was associated with a decreased incidence of good outcome (30%). Unilateral absence of the cortical component of the SSEP was usually associated with a poor outcome (death or severe disability), and bilateral absence was always associated with a poor outcome. The authors conclude that SSEPs correlate well with outcome and that this is not the result of investigator bias.
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J Neurosurg Anesthesiol · Oct 1999
Monitoring brain PO2, PCO2, and pH during graded levels of hypoxemia in rabbits.
Brain ischemia and hypoxia are of concern when they occur following traumatic brain injury because they frequently result in potentially preventable secondary brain damage. In this study, we examined the ability of an implantable catheter (Paratrend 7; Diametrics Medical, St. Paul, MN) to continuously measure brain tissue pH, PCO2, and PO2 during graded levels of hypoxia. ⋯ As expected, there was a good correlation between the changes in pH, PCO2, and PO2 in brain tissue and sagittal sinus blood. Brain tissue PO2 was numerically lower than sagittal sinus blood at all inspired levels of oxygen. These data suggest that the Paratrend 7 may be useful in monitoring brain tissue oxygen tension in patients at risk for regional cerebral ischemia and hypoxia.
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Journal of neurosurgery · Oct 1999
Exacerbation of cortical and hippocampal CA1 damage due to posttraumatic hypoxia following moderate fluid-percussion brain injury in rats.
Patients with head injuries often experience respiratory distress that results in a secondary hypoxic insult. The present experiment was designed to assess the histopathological consequences of a secondary hypoxic insult by using an established rodent model of traumatic brain injury (TBI). ⋯ The results of this study demonstrate that a secondary hypoxic insult following parasagittal FPI exacerbates contusion and neuronal pathological conditions. These findings emphasize the need to control for secondary hypoxic insults after experimental and human head injury.
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Neuroscience letters · Sep 1999
The effect of riluzole and mannitol on cerebral oedema after cryogenic injury in the mouse.
A cryogenic lesion was produced under halothane anaesthesia in the mouse by placing a cotton swab soaked in liquid nitrogen onto the surface of the cranium. This provoked an oedematous lesion which developed within the hour after the insult and evolved over the following week. ⋯ Repeated doses (2 x 16 mg/kg, i.p.) of riluzole were also able to reduce oedema significantly (24%, P < 0.05) at 24 h post lesion. Riluzole, in four repeated doses of 8 mg/kg i.p. was also able to reduce lesion surface size by 16% (P < 0.05) 48 h after lesion.