Articles: brain-injuries.
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Study of a number of routine nursing care activities has suggested a relationship between activities and intracranial pressure (ICP). The purpose of this study was to focus on the relationship between nursing care activities and variations in ICP. A case study method was used to study ICP in five brain-injured patients with a Glasgow Coma Scale (GCS) score of 4 or more. ⋯ During the bathing procedures only two baths elicited an ICP greater than 20 mm Hg. All other bathing procedures elicited minimal increases in ICP. These findings further support the need for nurses to be aware of the patient's ICP prior to turning and suctioning.
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Cerebral blood flow (CBF) varies unpredictably in patients after head injury and hemorrhagic shock. Proper treatment requires knowledge of ischemic versus hyperemic flow. The degree to which the size or severity of the injury may contribute to CBF abnormalities is unknown. ⋯ In the small lesion group traumatic brain injury, followed by shock and resuscitation, produced a significant and sustained elevation in bihemispheric regional CBF and cerebral oxygen delivery that was significantly greater than that observed in either the large lesion group or the controls (p < 0.05). There were no significant differences between the experimental groups in volume of hemorrhage, intracranial pressure, cerebral perfusion pressure, arterial oxygen content, or PaCO2. These data suggest that the volume of injured tissue may determine post-resuscitation CBF, and that interventions to reduce cerebral blood volume (i.e., hyperventilation) may not be universally applicable in all head injured patients.
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The neuropathological changes produced by a captive bolt pistol are described. The primary wound track in the brain was similar to that inflicted by a weapon such as a .22 calibre rifle. However neural and vascular damage at a distance from the primary wound canal was much less severe and widespread after penetration of the low velocity captive bolt projectile due to the formation of a smaller temporary wound cavity by radial forces imparted to the parenchyma. These findings suggest that the use of a captive bolt pistol for euthanasia should be immediately followed by further actions to ensure that an animal is rendered permanently unconscious.
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Randomized Controlled Trial Comparative Study Clinical Trial
Desflurane and isoflurane have similar effects on cerebral blood flow in patients with intracranial mass lesions.
Before desflurane is advocated for patients undergoing neurosurgical procedures, it is necessary to determine the effect of desflurane on cerebral blood flow (CBF). In this study, CBF values are compared between desflurane and isoflurane at two doses. In addition, CBF reactivity to CO2 and the effect of prolonged exposure were compared between the two agents. ⋯ Desflurane and isoflurane are similar in terms of absolute CBF, the response to increasing doses, and the preservation of CO2 reactivity.