Articles: brain-injuries.
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Lethargy, hyperpyrexia, tremor, and rigidity associated with leukocytosis and elevation of the creatine kinase level occurred in a patient with a closed head injury who was being treated with haloperidol for control of agitation. This constellation of symptoms, known as the neuroleptic malignant syndrome (NMS), partially improved when the neuroleptic medication was stopped, but complete resolution of the syndrome did not occur until the patient was treated with bromocriptine. ⋯ The NMS is caused by neuroleptic medications and may initially present with unexplained hyperpyrexia, leukocytosis, and elevated creatine kinase levels. Halting the neuroleptic, supportive care, and the use of dantrolene sodium and bromocriptine are the treatment modalities of choice for this syndrome, which has a mortality rate of 20 to 30% and may be linked to malignant hyperthermia.
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Zentralbl. Neurochir. · Jan 1986
[Can mortality in severe traumatic brain damage be generally reduced?].
A total of 272 cases with fatal traumatic brain injuries were retrospectively analysed. 68% of the cases were outside of any form of therapy. Only the third of these fatal cases are ever seen by a neurosurgeon. In 12% of these fatal cases the outcome might have been improved by an optimum diagnosis and therapy. Prevention of these severe head injuries seems to be the only potential therapy.
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The present study examined the role of endogenous opioid peptides in the pathophysiological sequelae of fluid percussion head injury in the cat. Two hours following injury, tissue concentrations of dynorphin-like immunoreactive material (ir-Dyn) were significantly elevated in specific brain regions where injury, as evidenced by histological examination, was most severe. Changes in ir-Dyn but not beta-endorphin-like immunoreactive material (ir-End) were significantly correlated with a fall in regional cerebral blood flow (CBF) that occurred 2 h following injury. Administration of the opiate antagonist WIN44,441-3 (with enhanced activity at kappa-receptors) stereospecifically increased cerebral blood flow to the injured regions.
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A case of interhemispheric subdural hematoma following head injury is presented and discussed, and the literature reviewed. Clinical and neuroradiological features are described together with the surgical treatment and results.