Articles: brain-injuries.
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Provided herein is a summary of findings by the authors and other investigators regarding the application of evoked potential studies to the assessment of neurologic function in severely head-injured patients in the acute and subacute stages postinjury. Multimodality Evoked Potentials (MEP's) are reportedly useful in three primary areas: 1) diagnosis; 2) prognosis; and 3) monitoring recovery. In diagnosis, the abnormalities in MEP's can be associated specifically with focal sensory/motor deficits such as hemiparesis and, generally, with the severity and extent of brain dysfunction. ⋯ Their accuracy is superior to many commonly used indices and MEP results add strength to clinical indicators of prognosis. Changes in MEP results obtained within a patient over time can be used to trace recovery and assess, for an individual, the functional consequences of secondary neurologic insult or medical complication. The authors conclude that MEP studies may serve a useful function as noninvasive indices of neurologic function in the management of severely head-injured patients.
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Comparative Study
The diagnostic significance of posttraumatic sphenoid sinus effusions: correlation with head computed tomography.
In review of 1544 patients with both head computed tomography (CT) examinations and skull radiographs, 150 patients were found to have a history of acute head trauma. Twenty-nine of these patients had sphenoid sinus effusions. ⋯ Of the patients with sphenoid effusions, 31% (9/29) had intracerebral hematomas, 24% (7/29) had extracerebral hematomas, 13% (4/29) had pneumocephalus, and 13% (4/29) had cerebral edema. We conclude that the presence of posttraumatic sphenoid sinus effusion on the skull radiograph is a sensitive sign for intracranial damage and serves as an emergent indication for head CT.
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Fourteen cases of gunshot wounds of the brain, evaluated by CT scanning are presented. The results indicate that CT scanning is superior to other diagnostic tests in missile wounds of the brain. ⋯ Visualization of the missile track is of particular importance; this cannot be achieved by any other diagnostic method. It is essential for the planning of the surgical approach in these lesions.