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Biomedical subjects

G F Gade

Publications and source records attributed to G F Gade.

9 recordsLinked to original sources
PubMed2000

Low back pain.

The communication between radiologists and their surgical colleagues is particularly important in the setting of back pain. This common disorder often does not have a definable cause, even when the imaging findings are abnormal. A shared understanding of the various causes of back pain, the appropriate terminology, and the needs of the surgeon is vital to proper patient treatment. Unfortunately, little standardization in the terminology for and management of back pain syndromes exists. This article elucidates the approaches to problems of back pain used in one clinical setting.

Humans↗
PubMed1989

Craniotomy improves outcome in subdural empyema.

Renewed uncertainty regarding the best technique of surgical therapy (burr holes versus craniotomy) for subdural empyema prompted a review of the experience with this disease entity at UCLA. Based on data obtained from this review and from studies previously published in the literature, the keys to optimal outcome are rapid diagnosis, craniotomy with total removal of pus, and appropriate antibiotic therapy. The clinical syndrome of subdural empyema can overlap that of other intracranial infections; infants and young children present with a different syndrome than older children and adults. Computed tomography scanning is nearly always diagnostic but may be equivocal or normal; magnetic resonance imaging may become the diagnostic study of choice. Multiple organisms are often cultured, which requires multiple drug therapy.

Adolescent↗
PubMed1988

Value of skull radiography, head computed tomographic scanning, and admission for observation in cases of minor head injury.

A retrospective review of 373 adult patients admitted to Harbor General Hospital between 1980 and 1984 for minor closed head injury (Glasgow coma scale 13-15) was performed to determine the benefits of skull radiography, computed tomographic (CT) scanning of the head, and admission for observation. Variables reviewed were mental status, neurological examination, presence or absence of loss of consciousness, clinical evidence of basilar skull fracture, and fracture on skull radiography. The neurological examination (including mental status and Glasgow coma scale) in the emergency room was the best predictor of subsequent deterioration or the presence of an operative hematoma. The only patients with Glasgow coma scale scores of 15 who required surgical evacuation of an extraaxial hematoma had focal neurological deficits referable to hemispheric compression, with or without an abnormal mental status. A Glasgow coma scale score of 13 or 14 places the patient at risk either of having a hematoma requiring surgery or of deteriorating. We recommend that a head CT scan be obtained on all patients with Glasgow coma scale scores of less than 15, abnormal mental status, or hemispheric neurological deficits. If no operative lesion is found on the CT scan, the patient should be admitted for observation because there is still a risk of deterioration. Those with a Glasgow coma scale score of 15, a normal mental status, and no hemispheric neurological deficit may be discharged to be observed at home by a competent observer despite basilar or calvarial skull fracture, loss of consciousness, or cranial nerve deficit. No benefit was gained from skull radiography in any group.

Adolescent↗
PubMed1988

Intraoperative development of contralateral epidural hematoma during evacuation of traumatic extraaxial hematoma.

Intraoperative development of an epidural hematoma contralateral to a craniotomy for acute traumatic extraaxial hematoma has been previously reported. This entity, however, has never been distinctly defined and differentiated from either the delayed or the bilateral acute epidural hematoma. We present 3 new cases of intraoperative contralateral acute epidural hematoma and review the 14 previously reported cases. The typical clinical presentation is a severe head injury with an acute extraaxial hematoma and severe ipsilateral brain displacement during craniotomy. If brain displacement is not noted at craniotomy, then the contralateral hematoma is manifested by immediate postoperative neurological deterioration or intractable elevated intracranial pressure. The presence of any of these signs makes an immediate postoperative CT scan or burr holes contralateral to the original craniotomy mandatory for early diagnosis. In addition to defining "intraoperative contralateral epidural hematoma," stricter definitions of the terms "delayed epidural hematoma" (no hematoma present on the initial CT scan but one present on a later scan) and "bilateral epidural hematomas" (present on the initial scan) are proposed.

Adolescent↗
PubMed1988

Stress-induced malignant hyperthermia in a head-injured patient. Case report.

Susceptibility to malignant hyperthermia is a rare inherited myopathy. Hypermetabolic crises accompanied by a rise in body temperature to as high as 44 degrees C are the hallmark of malignant hyperthermia episodes. These are triggered by inhalational anesthetic agents or depolarizing muscle-relaxant drugs. A similar condition exists in pigs; however, in addition to drug-induced attacks, episodes of malignant hyperthermia occur in these animals as a result of stress. It has been proposed that stress-induced malignant hyperthermia occurs in man. The present paper presents a case of stress-induced malignant hyperthermia in a 21-year-old man in whom the inciting stress was a head injury.

Adult↗
PubMed1984

Minor head injury.

The evaluation and treatment of minor head injuries are reviewed, with particular emphasis on those problems of head injury commonly seen by family physicians. Clinical history, physical examination, and radiologic studies that are of value in diagnosing minor head injuries are highlighted.

Adult↗