Articles: brain-injuries.
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Zh Vopr Neirokhir Im N N Burdenko · Nov 1984
Comparative Study[Effect of osmotic diuretics and saluretics on intracranial pressure in posttraumatic brain edema].
The effect of osmotic diuretics (mannite and glimarite, 29 studies), colloid-osmotic diuretic (algurin, 22 studies), and saluretic (lasix, 58 studies) on intracranial pressure (ICP) was studied in 30 patients in the acute period of severe craniocerebral injury. It was found that the hypotensive effect of the diuretics depended on the state of the water-electrolyte homeostasis, the time of medication with the agents, the severity of the patient's condition, and the initial ICP. ⋯ Medication with osmotic diuretics and algurin in the first 2-3 days after the injury as usually attended by the "yield phenomenon"; the hypotensive effect of algurin in this period was less manifest. The effect of lasix was higher in hyperosmia caused by hypernatriemia but lower in patients who were in a terminal and extremely severe state.
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Journal of neurosurgery · Oct 1984
Effect of mannitol on ICP and CBF and correlation with pressure autoregulation in severely head-injured patients.
In a previous paper, the authors showed that mannitol causes cerebral vasoconstriction in response to blood viscosity decreases in cats. The present paper describes the changes in intracranial pressure (ICP) and cerebral blood flow (CBF) after mannitol administration in a group of severely head-injured patients with intact or defective autoregulation. The xenon-133 inhalation method was used to measure CBF. ⋯ When autoregulation is not intact there is no vasoconstriction in response to increased oxygen availability; thus, CBF increases with decreased viscosity. With the lack of vasoconstriction, the effect on ICP through dehydration is not enhanced, so that the resulting decrease in ICP is much smaller. Such a mechanism explains why osmotic agents do not change CBF but decrease ICP in normal animals or patients with intact vasoconstriction, but do (temporarily) increase CBF in the absence of major ICP changes after stroke.
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Journal of neurosurgery · Sep 1984
Predicting outcome from closed head injury by early assessment of trauma severity.
The relationship between severity of head injury and outcome was studied in 96 patients. Severity was assessed based on the level of coma and presence of mass lesion, hemiparesis, skull fracture, and pupil abnormality. Outcome was assessed using the Wechsler Adult Intelligence Scale, the Halstead-Reitan neuropsychological battery, and the Glasgow Outcome Scale. ⋯ Coma grade and pupil abnormality predicted the Glasgow Outcome Scale. Low to moderate relationships were found between the predictor variables and the measurement of IQ and the Glasgow Outcome Scale; multiple regression coefficients were 0.63 and 0.61, respectively. The relationship between measurement of trauma severity and the Halstead Impairment Index was also low (R = 0.37).
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Zh Vopr Neirokhir Im N N Burdenko · Sep 1984
[Relation between criteria for the outcome of craniocerebral trauma and the severity of consciousness disorders in the acute phase].
Prognostic criteria of outcomes after severe craniocerebral traumas observed in 66 patients have been presented with the account of the degree of consciousness disorders in the acute phase. Favourable outcomes were confirmed in subjects whose level of consciousness impairments was not below 20 points according to coma quantity classification accepted at the N. N. Burdenko Institute of Neurosurgery.