Articles: brain-injuries.
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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.
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The purpose of this study was to examine the relationship of the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) scores in pediatric and adult patients having surgical entry into the cranium for diagnostic or therapeutic purposes after brain insult. In this retrospective record review, the predictor variable was the coma-associated GCS score (GCS score 3-8) obtained 24 hours after surgery. The outcome variable was the combined Glasgow Outcome category: recovery/moderate disability; severe disability/vegetative state; and death; ascertained 14 days postoperatively. ⋯ Considering the GCS components, the eye scores significantly discriminated one outcome, the motor scores two outcomes, and the verbal scores two outcomes (p < .001 to .005). The unweighted GCS scores in adults significantly discriminated all three outcomes and in children two outcomes; the weighted GCS scores in both children and adults significantly discriminated all three outcomes. The approximately 25% misclassification rate for outcomes, however, would preclude using the scales in a predictive or prescriptive manner.