The diagnostic value of high resolution computerized tomography in post-traumatic head pain patients.
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Adolescent↗
Biomedical subjects
M A Guidice
Publications and source records attributed to M A Guidice.
Visual evoked response in head trauma: pattern-shift stimulus.
Studies of visual evoked potentials in head injuries have all utilized the flash stimulus. We studied the efficacy of monocular pattern-shift visual evoked potentials (PSVEPs) in eliciting residual dysfunction of the visual pathways in 33 patients 6 to 24 months after head injury. Those with ocular trauma or ocular pathology were not included. Abnormal PSVEPs were seen in one-third of 33 head-injured patients. Only 1 (11%) of 9 patients with mild cognitive impairment had abnormal PSVEPs compared with 7 (39%) of 18 with moderate and 3 (50%) of 6 with severe cognitive impairment.
Adolescent↗
Airway complications in patients with closed-head injuries.
The neurologic deficits in the closed-head injury population present special problems when managing the airway. Many of these closed-head injury patients require long-term intubation with endotracheal tube or tracheostomy to treat their central respiratory problems and control oral and pulmonary secretions. Four hundred sixty-seven closed-head injury patients were seen over a five-year period. Seventy-two of these patients required long-term endotracheal intubation, tracheostomy, or both. A prospective study by direct endoscopic examination prior to decannulation showed 23 of these 72 patients (32%) had important laryngeal or tracheal findings. The principal abnormalities observed were vocal cord paralysis, tracheal stenosis, subglottic stenosis, glottic stenosis, and tracheomalacia. This study suggests also that severely mentally impaired patients (cognitive function II and III) should retain their tracheostomy because of the high morbidity and mortality among these patients (31%) when they are decannulated. This mortality was directly related to poor pulmonary toilet, with pneumonia and sepsis being the major causes of death. This study did not show that the use of steroids or ventilators in the initial management adversely effected airway complications.
Adolescent↗
Post-traumatic epilepsy following head injury.
The occurrence of post-traumatic epilepsy (PTE) was studied in 164 consecutive closed head injury patients, each of whom had been unconscious and amnestic for at least one hour. The overall incidence of PTE was found to be 25%, significantly higher than previously reported. Analysis of data revealed PTE was not related to the presence or absence of a hematoma, but rather to the duration of the coma. The incidence of PTE was found to be 35% among patients comatose for three weeks or more.
Adult↗