Articles: brain-injuries.
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Brain-type creatine kinase (CK) isoenzyme (CK-BB) was found in the ventricular cerebrospinal fluid (CSF) and the serum in a series of 35 patients within 13 hours following severe head injury. There was a good correlation between total CK and CK-BB activities in CSF only. The values found in the CSF appear to be a quantitative index of brain dysfunction at admission, and did not correlate with intracranial pressure activity. High levels of CK-BB in the CSF correlated with a poor outcome, and thus offer a reliable criterion for the assessment of the severity of head injury.
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A case of delayed intracerebral haematoma following closed head injury in a young male is reported. The patient was treated surgically with a satisfactory result. The problem of the unsuspected delayed traumatic intracerebral haematoma is highlighted.
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CT scan demonstrates the invaluable information about the parenchymal lesions of head injuries. The parenchymal lesions were classified into 6 categories; 1) isodensity without mass effect: I(-), 2) isodensity with mass effect: I(+), 3)high density: H, 4) high-low density complex: H-L, 5) low density: L, 6) diffuse cerebral swelling: DCS. Glasgow coma scale (GCS) and outcome scale (GOS) were international practical scales for the evaluation of severity and prognosis of severe head injuries. ⋯ In the patients, whose prognoses were poor despite of favorable GCS, H and H-L were common findings. SAH and IVH were also common. The poor prognosis was induced by secondary systemic complications, such as pneumonia and meningitis, etc.