Articles: brain-injuries.
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Preventive medicine · Sep 1994
Prevention of secondary disabilities after brain injury and spinal cord injury: implications for future research.
Over the past decade there has been increased emphasis upon prevention of disability. Although it is obvious that preventing a disability is the most desirable approach, disabilities will nonetheless occur. When they do, we must treat them and prevent additional disabilities from following the original ones. Indeed, this separation of disabilities has led to a clearer understanding of their prevention, namely primary, secondary, and tertiary prevention.
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Comparative Study
[Surgical outcome after severe craniocerebral trauma in childhood and adulthood. A comparative study].
During a period of 15 years 1123 patients were operated on for severe head injury in our Department of Neurosurgery. We evaluated 936 patients (83%) on the basis of the Glasgow coma scale and the Glasgow outcome scale and allocated them into four groups by diagnosis and also grouped them by age. The 170 patients in the groups of children and adolescents (15%) were compared with the adults, and the features characterizing the causes of the accidents and the prognosis were analysed. ⋯ The postoperative results after severe head injuries in children and adults were the same as in the group with an initial rating of 3-5 points and 9-15 points on the Glasgow coma scale. Only the group of children with 6-8 points on the Glasgow coma scale on admission had better results than the adults. The reason for this might be the greater plasticity of the brain in childhood.
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Neurobehavioral outcome after craniocerebral gunshot wounds was evaluated in a prospective, 3-year, longitudinal follow-up of a consecutive case series of 13 children and adolescents. The younger group was composed of seven children, ages 1.5 to 4 years, and the older group contained six children, ages 5 to 14. Outcome measures included the Glasgow Outcome Scale and neuropsychological assessment of intelligence, language, motor, memory, attention, academic achievement, and adaptive behavior. ⋯ Disabilities appear to be at least as severe in our sample after cerebral gunshot wounds as in our studies of severe pediatric closed-head injury. At the time of follow-up, younger children sustaining gunshot wounds had slightly lower intelligence quotient scores and similar receptive language, expressive language, and gross motor scores compared with children with severe closed-head injury. The older gunshot wound patients were significantly more impaired than patients with severe closed-head injuries on measures of adaptive behavior and attention.(ABSTRACT TRUNCATED AT 250 WORDS)
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Journal of neurotrauma · Aug 1994
Regional levels of free fatty acids and Evans blue extravasation after experimental brain injury.
The recently developed controlled cortical-impact (CCI) model of brain injury in rats serves as an excellent tool to understand some of the neurochemical mechanisms mediating the pathophysiology of traumatic brain injury. In this study, rats were subjected to lateral CCI brain injury of low-grade severity. Their brains were frozen in situ at various times after injury to measure regional levels of free fatty acids. ⋯ Extravasation of Evans blue was found to be significantly increased in the ipsilateral cortex of injured animals at 30 min and 10 h after brain injury. These results indicate the degradation of membrane phospholipids and blood-brain barrier breakdown in the ipsilateral cortex after lateral CCI brain injury. These results also suggest that arachidonic acid and its metabolites may play a role as a mediator in the blood-brain barrier breakdown associated with cortical impact brain injury in rats.
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Dystonia is a rare consequence of head trauma. We describe 10 such cases and review 19 similar patients reported in the literature. Twenty-two of the 29 patients suffered head injury during the first or second decade of life. ⋯ Two cases remained as focal dystonias, but the others developed segmental, hemi-, multifocal, or generalized dystonia. On brain imaging studies (CT or MRI), the most frequent lesion site was in the contralateral basal ganglia or thalamus, but two cases had normal brain scans. Dysfunction of the lenticulothalamic neuronal circuit seems to be related to the development of dystonia following head trauma.