PubMed · 11299637
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J R Lodi. 2001-03-26. When a coma isn't one.. https://pubmed.ncbi.nlm.nih.gov/11299637/
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We make fast, "saccadic" eye movements to view our surroundings, "voluntary" saccades when saccade targets are deliberately selected, and "stimulus-driven" saccades when a target suddenly appears. Saccades of patients with spatial neglect have been studied to identify the coordinate systems guiding such behavior. However, previous reports disagree on whether neglect involves an eye-centered deficit of (delayed and hypometric) saccades specifically when performed in the direction opposite the brain lesion or not. We show that this inconsistency is due to independent mechanisms underlying voluntary and stimulus-driven saccades. We used a new experimental procedure comparing identical saccades performed either during an exploratory search task or a stimulus-driven task, both of which required similar cognitive functions (Figure 1). Only the patients' stimulus-driven saccades showed the eye-centered deficit. The same saccades were intact when voluntarily performed. However, here the patients showed a head-centered deficit; their saccades ignored the left part of space. In none of our control subjects with or without brain lesions did the neglect patients' pattern of deficits occur. The results argue that the brain flexibly uses a system of distinct but interrelated neural circuits for visual orienting to optimally encode its sensorimotor functions in multiple behavioral situations.
Experimenting upon a synthetic, non-biological Skull-Brain Model, our goal was to document and study the bullet-body interaction of grazing (glancing, tangential) gunshots. Thanks to the high-speed study of the dynamic bullet-body interaction it was possible to document the glancing behavior of projectiles with a resolution of 50 million pictures per second. It was possible to demonstrate the differing deformation and fragmentation patterns between the 9mm Luger full metal jacketed projectile and the 38 Smith & Wesson (S & W) lead round nose projectile. In a true-to-life manner the morphologic fracture systems could be documented by utilization of the model in dependence of the projectile's behavior, deformation, and fragmentation. Based on these experimental studies with body models, conclusions could be drawn for surgical and reconstructive forensic questions in real cases. In summary, model substitutes offer a suitable basis for the study of the bullet-body interaction because the experiments are reproducible, totally independent of the biological variances of corpse and animal experiments, and are harmless from the ethical perspective.
PURPOSE: The aim of the present manuscript is to review current methods for classifying initial severity and final outcome in traumatic brain injury (TBI) and to suggest a direction and form of further research. METHOD: The literature on valid and reliable measurements used in TBI-research for classifying initial severity and final outcome was reviewed. RESULTS: Classifying initial severity in patients with head injury according to clinical condition or CT-parameters is valid. Classifying outcome according to measurement tools of disability showed adequate validity and reliability. CONCLUSIONS: Future research in TBI outcome, particularly in rehabilitation medicine, should focus on determinants of outcome, identifying those patients who will have the greatest chance of benefiting from intensive rehabilitation programmes. More research is needed to determine the long-term functional outcome in TBI, the long-term socio-economic costs, and the influence of behavioural problems on family cohesion. Finally, validation of outcome measures is required in the TBI-population; the relative value of various outcome measures needs to be determined, and the usefulness and applicability of measures for health related quality of life in TBI should be established.