Vasogenic oedema and brain trauma.
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Biomedical subjects
Publications and source records attributed to F Murillo-Cabezas.
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The present study was designed to determine how traumatic brain injury affect executive functioning, to know whether different treatments in the acute phase improve this functioning, and to check whether the severity of the neurocognitive impairment is detected by the Glasgow Outcome Scale (GOS). Ability for problem solving and executive functioning within 2 years after Traumatic Brain Injury (TBI) was examined in 35 conscious survivors. Two groups were formed. One group consisted of 13 patients who needed neurosurgery. The other group was made up of 22 patients without neurosurgical treatment. All were treated in the Neurosurgical Intensive Care Unit and in the Rehabilitation Service. The following variables were registered: Secondary Lesions, Glasgow Coma Scale (GCS), CT, subacute CT, and Glasgow Outcome Scale. Neuropsychological tests administered were Wisconsin Card Sorting Test (WCST) and the Tower of Hanoi/Sevilla. Comparing both groups' test performance (man Whitney U) we found that a severe traumatic brain injury, whatever the treatment applied in the acute phase, impairs the executive functioning of the patients; this impairment is related to acute pathophysiological events. The neurosurgical intervention does not improve the executive functioning. The Glasgow Outcome Scale does not detect more than 25% of the patients with severe impairment. It is suggested that the Tower of Hanoi/Sevilla could be a good tool to evaluate the executive functioning routinely in TBI patients as outcome. It also suggested that mild TBI patients must be referred for a complete neuropsychological examination.
INTRODUCTION: Epilepsy is one of the most common neurological disorders, affecting about one percent of the world population. Pharmacological treatment fails in one-third of these patients. Surgical intervention has become an accepted treatment option for those patients with seizure disorders that are refractory to conventional therapies. Cortical resection and callosotomy are the most widely accepted methods of surgical intervention. A prerequisite for success in this type of surgical intervention is the preoperative clinical assessment of the epilepsy surgery candidate. DEVELOPMENT: This paper examines the current uses of neuropsychological assessment in an epilepsy surgery program. Several areas are addressed for discussion with respect to the contributions of neuropsychological assessment: the preoperative evaluation of the epilepsy surgery candidates, including the clinical examination of language and memory functions during the Wada test; the neuropsychological changes that result from surgery and the predictive role of neuropsychology in these areas, and prediction for seizure control following surgery. CONCLUSION: Assessment of cognitive functions is an important component of the preoperative evaluation of the epilepsy surgery candidate, and is needed in order to obtain complete diagnostic information.
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The aim of these studies was the analysis of the psychological repercussions on the closest members of families of 76 gravely traumatised patients admitted into the Intensive Care Unit (ICU) of the Hospital Universitario de Rehabilitación y Traumatología "Virgen del Rocio", Sevilla (Spain). An investigation based on social information and the Clinical Analysis Questionnaire was used. The sample of family members was composed of 42 women and 34 men, with an average age of 41.3 years (SD +/- 12.8). Results showed that (a) more than 50% of the family members of gravely traumatised patients admitted into an ICU showed symptoms of depression, (b) the women scored more points in hypochondria, suicidal depression, anxious depression, low-energy depression, guilt-resentment, apathy-withdrawal, paranoia, schizophrenia, psychasthenia and psychological disadjustment, and (c) in general terms, the psychological characteristics of the families were far from the norm of the control group.
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