Articles: brain-injuries.
-
Journal of neurosurgery · May 1994
Randomized Controlled Trial Multicenter Study Clinical TrialA multicenter trial of the efficacy of nimodipine on outcome after severe head injury. The European Study Group on Nimodipine in Severe Head Injury.
Between January 1, 1989, and June 30, 1991, 852 severely head-injured patients were entered into a prospective placebo-controlled trial of the efficacy of nimodipine administration. The patients could not obey commands at the time of entry into the trial, which was within 12 hours after the start of the inability to obey commands and within 24 hours of injury. The main hypothesis that nimodipine would increase the percentage of patients with a favorable outcome (moderate disability or good recovery) from 50% to 60% was rejected. ⋯ The effect was statistically significant in those patients who complied with all protocol requirements. This finding is consistent with the effect of nimodipine on secondary ischemia following spontaneous SAH. The results of the study warrant a clinical trial of the efficacy of nimodipine in severely head-injured patients who show traumatic SAH on the initial CT scan.
-
Reliable Assessment of the probability that a head injury patient harbors a surgical intracranial lesion is critical to both triage and treatment. The authors analyzed data from 608 patients with severe head injuries (Glasgow Coma Scale score, < or = 8) in the Traumatic Coma Data Bank to assess the reliability of pupillary asymmetry in predicting the presence and location of an intracranial mass lesion. Of 210 patients with pupillary asymmetry of > or = 1 mm, 63 (30%) had intracranial mass lesions, 52 (25%) of which were extra-axial in location, 38 (73%) of these located ipsilateral to the larger pupil. ⋯ For both asymmetry categories, strong interactions were found with age and mechanism of injury, the highest incidence of extra-axial lesions occurring in older patients injured other than as occupants of motor vehicles. The authors developed regression equations that provide a graphic means to predict the presence of an intracranial hematoma using data on pupillary asymmetry, age, and mechanism of injury. This predictive model, interpreted in a hospital- and patient-specific fashion, should be of significant use in directing triage, activating diagnostic and therapeutic resources, and evaluating the utility of exploratory trephination.
-
Journal of neurotrauma · Apr 1994
The rotarod test: an evaluation of its effectiveness in assessing motor deficits following traumatic brain injury.
The purpose of the present experiment was to examine the effectiveness of a modified rotarod test in detecting motor deficits following mild and moderate central fluid percussion brain injury. In addition, this investigation compared the performance of the rotarod task with two other commonly used measures of motor function after brain injury (beam-balance and beam-walking latencies). Rats were either injured with a mild (n = 14) or moderate (n = 8) level of fluid percussion injury or were surgically prepared but not injured (n = 8). ⋯ Performance on the rotarod, beam-walk, and beam-balance tasks were compared and evaluated by a multivariate stepdown analysis (multiple analysis of variance followed by univariate analyses of covariance). This analysis indicated that the rotarod task measures aspects of motor impairment that are not assessed by either the beam-balance or beam-walking latency. These findings suggest that compared to the beam-balance and beam-walking tasks, the rotarod task is a more sensitive and efficient index for assessing motor impairment produced by brain injury.