Articles: brain-injuries.
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Zh Nevropatol Psikhiatr Im S S Korsakova · Jan 1992
Comparative Study[The place and significance of the autonomic dystonia syndrome in the clinico-pathophysiological structure of the late sequelae of mild closed craniocerebral trauma].
Analysis of the incidence, clinico-pathophysiological structure and dynamics of vegetovascular disorders in subjects with a history of mild closed craniocerebral injuries has demonstrated that in the majority of them, even practically healthy, functional insufficiency of vegetovascular functions is seen for many years after injury. Clinically, it manifests under the influence of diverse harmful exo- and endogenous factors, undergoes circadian changes, is altered during magnetic storms, in the course of traumatic disease and nonmedicamentous correction (by methods of adaptive bioregulation according to heart rhythm parameters, craniocerebral hypothermia, etc). It has been shown that initially transitory, reversible vegetovascular disturbances, provided they were not initially removed, transform with years to more stable vegetotrophic disorders and become risk factor of cerebrovascular diseases in the given group.
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Acta neurochirurgica · Jan 1992
Clinical outcome and cognitive impairment in patients with severe head injuries treated with barbiturate coma.
This study reports on clinical outcome in 38 patients with severe head injuries (posttraumatic coma for 6 hours or more) treated with barbiturate coma because of intracranial hypertension. Eighteen patients died, 4 patients remained in a severely disabled or a chronic vegetative state, and 16 patients reached the levels good recovery/moderate disability. ⋯ All patients except one exhibited varying degrees of cognitive dysfunction and 6 patients had signs of personality change. The quality of life for the majority of surviving patients was relatively good but the positive effects of barbiturate coma therapy in the age groups over 40 years appeared to be limited.
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A survey is given of the development and actual state of the prediction of outcome in severe head injury. Thanks to the data collection in some large databanks it has become possible, in a relatively large number of cases, to estimate reliably the chances of survival and the chance of developing an intracranial haematoma base on clinical data and CT obtained during the first 24 hours. Later during the posttraumatic course prediction is possible of the degree of remaining disability in survivors, and the chances of developing epilepsy and neuro-behavioural sequelae. Due to changing management-regimens further data collection in international databanks is necessary.
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Rev Stomatol Chir Maxillofac · Jan 1992
Case ReportsInadvertent intracranial placement of a Foley catheter. A rare iatrogenic complication of severe frontomaxillary trauma.
Severe comminuted fractures of the facial bones involving the cranial base are often accompanied by heavy bleeding into the nasopharynx. This presents considerable problems in primary care both for the anesthesiologist and the surgeon. ⋯ Skull base fractures may involve the risk of the catheter inadvertently penetrating into the brain. The authors describe a case in which a misguided Foley catheter, which was blindly inserted through the nose in an attempt to tampon the nasopharynx, resulted in fatal cerebral damage.
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Patients with an acute "brain damage" where an intracranial pressure rise can be suspected due to the pathophysiological context are an indication for intracranial pressure measurement. For registrating the reduction of the intracranial reserve space before the rise of the medium pressure, volume-loads from the side-ventricles were undertaken with 54 neurosurgical patients. A better bedside monitoring is possible though the mathematical registration of those factors which indicate the size of the functional intracranial reserve space. With the calculated parameters of the reserve space (pressure-volume-index) a theoretical pressure-volume-curve was demonstrated.