[Intrathecal air insufflation in patients with concussion of the brain accompanied by subarachnoidal hemorrhage and signs of increased intracranial pressure].
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Adult↗
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Results for “Brain Concussion”
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[Concussion of the brain and its treatment in organically changed capillary vessels with hexanitol].
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Aged↗
A look back: concussion of the brain.
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Brain Concussion↗
[The epidemiology of brain injury and the organization of health care to victims in Aden (Yemen)].
All medical information sources available in Aden (Yemen) over 1998-2000 showed that there were 862 victims with brain injury. The prevalence of brain injury was 2.19 cases per 1,000; that being 1.6 cases in adults and 4.8 in children per 1000 of the pediatric population. The main causes of brain injury were domestic and road traffic accident in 54.7 and 40% of cases, respectively. Mild brain injury (mild brain concussion and contusions) was equally stated with severe one (moderate-to-severe brain contusions, as well as cerebral compression). Closed brain injuries predominated (in 732 (84.9%) 732 victims) over open ones (in 130 (15.1%)). The findings will make it possible to implement a number of organizational measures to improve medical service of this group of seriously ill patients and to reduce disability and mortality.
Accidents, Traffic↗
[Computerized tomographic findings in brain contusions (author's transl)].
Over a 1 1/2 year period computerized tomographical examinations were performed on 104 patients suffering from brain concussions. The evaluation of findings resulted in the following classification: Type 1: severe generalized brain oedema without visible contusional foci, Type IIa: typical contusion with solitary or multiple contusional foci, Type IIb: typical contusion with severe, locally pronounced oedema, Type IIIa: contusion with flat subdural contusional bleeding, Type IIIb: contusion with minor intracerebral contusional bleeding, Type IIIc: contusion with intraventricular bleeding. Space-occupying haemorrhages were excluded. The comparison of computerized tomographic findings with the clinical course justifies such a classification. There are significant correlation between CT findings and the clinical picture, especially with the degree of clouding of consciousness as well as with further prognosis.
Brain↗
[The characteristics of the clinical course of closed craniocerebral trauma in diabetics].
Analysis of 210 cases of brain concussion and contusion showed that the general cerebral and focal symptoms of trauma of the brain are pronounced much more markedly and persist longer in combination of craniocerebral trauma (CCT) and diabetes mellitus than in CCT and normal blood sugar content. Inclusion of vasoactive agents Cavinton and Complamin into the scheme of complex therapy accelerates regression of the neurological symptomatology. The clinical course of diabetes mellitus may be aggravated by the CCT, which shows that additional correction of antidiabetic therapy is necessary.
Acute Disease↗
[Circulating immune complexes in acute concussion of the brain].
The aim of the study was to study the count of circulating immune complexes (CIC) in the blood of children with acute concussion of the brain. The fact that CIC at high concentrations that can penetrate into the brain through the blood-brain barrier and cause complications as vasculitis, microangiopathy, proliferative processes in the meninges, enlarged ventricles of the brain, and atrophy of its tissue was borne in mind. The studies revealed a significant progressive CIC increase within 3 weeks. For correction of blood CIC levels, laser exposure was applied to the carotid and vertebral arteries and acupuncture points. For comparison, thymaline in age-specific doses was used. Laser radiation showed a significant fall of CIC at days 19-21, particular when applied to the acupuncture points. Thymaline did not affect blood CIC levels. Laser application to the acupuncture points in children with acute brain concussion should reduce the incidence of complications of brain injury disease.
Acupuncture Therapy↗
Vasomotor and permeability effects of bradykinin in the cerebral microcirculation.
All components of an intracerebral kallikrein-kinin system have been described. Thus, bradykinin (BK) acting from the parenchymal site as well as from the blood site may influence cerebral microcirculation. BK is a potent dilator of extra- and intraparenchymal cerebral arteries when acting from the perivascular site. The vasomotor effect of BK is mediated by B2 receptors which appear to be located at the abluminal membrane of the endothelial cell. The effect of BK is mediated by NO. prostanoids, free radicals, H2O2 or leukotrienes depending on the animal species and on the location of the artery. Selective opening of the blood-brain barrier for small tracers (Na(+)-fluorescein; MW, 376) has been found in cats during cortical superfusion or intraarterial application of BK. This leakage is mediated by B2 receptors located at the luminal and abluminal membrane of the endothelial cells. Formation of brain edema has been found after ventriculo-cisternal perfusion or interstitial infusion of BK. This can be explained by increase of vascular permeability and cerebral blood flow due to arterial dilation thus enhancing driving forces for the extravasation. An increase of the BK concentration in the interstitial space of the brain up to concentrations which induce extravasation, dilatation and oedema formation has been found under several pathological conditions. Thus, BK may be involved in oedema formation after cold lesion, concussive brain injury, traumatic spinal cord and ischemic brain injury. The mediator role of BK in brain edema is further supported by therapeutic results. Brain swelling due to cold lesion or ischemia could be diminished by treatment with kallikrein-inhibitors. Similarly, dilatation of cerebral arterioles after concussive brain injury was reduced by blockade of B2 receptors. Thus, all criteria favour BK as one mediator of vasogenic oedema.
Angiotensin-Converting Enzyme Inhibitors↗
[Perimetric diagnosis of chiasmal injury after contusion of skull and brain (author's transl)].
After a discussion of the pathomechanism of skull trauma by a blow leading to chiasmal lesion, frontobasal injuries of the skull are considered; it is shown that typical defects of the visual field resulting from chiasmal damage can be revealed not only in cases of serious industrial or traffic accidents with brain concussion and skull base fracture, but also following minor injuries without unconsciousness and radiologically visible bone fractures.
Adolescent↗
[Expert assessment of craniocerebral trauma].
The officially appointed external expert needs a precise documentation of the initial clinical findings and the findings at follow-up of the patient with craniocerebral trauma. The next step in preparation of the expert report consists in a pathophysiological and a neurological examination, including CT scan and EEG repeated at intervals; a stable condition can be expected after 1-2 years. In the case of reversible closed head syndrome (brain concussion) the expert should certify a disability for about 6 months; a degree of 20% for over 3 months should not be certified unless there are massive vegetative signs and symptoms. Persisting damage should only be recognized if a substantial brain lesion is present. In cases of cerebral compression or open skull fracture with manifest damage to the substance of the brain the duration of unconsciousness must be taken into account. For children and young people up to 10 days' unconsciousness is not taken to imply later disability; after 10-20 days' unconsciousness such young people are considered fit for work or school to a qualified extent; a persistent defect must be expected to follow unconsciousness lasting over 20 days. Adults who are unconscious for up to 5 days can be expected to make a complete recovery, while a longer duration of coma and more advanced age are associated with a worse outcome. The degree of functional impairment is thus important in the expert's decision on the level of disability. A flow chart is presented for guidance in the preparation of expert reports.(ABSTRACT TRUNCATED AT 250 WORDS)
Brain Concussion↗
Serum activities of hydroxybutyrate dehydrogenase (HBD) and the isoenzymes of lactate dehydrogenase (LD) as an index of traumatic brain injury.
The lactate dehydrogenase (LD), the hydroxybutyrate dehydrogenase (HBD), and the LD isoenzyme activities in serum were followed in the posttraumatic period in 113 patients with cranio-cerebral injury, 70 of whom had verified brain contusion--laceration. In patients with brain contusion the HBD activity, known to be exerted mainly by the anodal LD isoenzyme fractions dominating in brain tissue, was significantly raised in 91% of the blood samples taken within four hours, and in 92% of the samples taken between 12 and 24 hours after trauma, while it was within normal limits in all the samples taken within four hours in patients with brain concussion, and increased in only 17% of the concussion patients 12-24 hours after trauma. The LD1 and the LD1+2 activities were of less diagnostic importance in blood samples taken during the first 24 hours. However, after 24 hours the LD1 activity was as informative as the HBD activity. The LD1 activity was normal in all concussion patients from the third day after trauma, while 78% of the contusion patients still showed raised LD1 activity then. The determination of HBD activity in serum in the immediate post-traumatic period is recommended as an appropriate method for screening parenchymatous brain injury. A complete LD isoenzyme separation may later add some further information in doubtful cases.
Adolescent↗
[Early post-traumatic epilepsy in childhood: significance and short term prognosis (author's transl)].
In the last five years, 244 children with head trauma were observed. An early post-traumatic epilepsy was present in 11% of the patients. This complication was more frequent in children less than six years of age or presenting a previous neurological history. Early posttraumatic epilepsy was rarely associated with brain concussion and frequently with cerebral contusion. An intracranial haematoma was not encountered in the absence of the classical signs of expanding space occupying lesion.
Adolescent↗
[Value of vestibular symptomatology in the differential diagnosis of slight closed injury to the skull and brain].
The authors performed otoneurological studies in 1118 cases, where in 152 such examinations were done repeatedly (on the 2, 7, 14 and 20 day following the brain trauma). One of the methods was a calorization of the labyrinth with a registration of the nystagm. A modified method (after A. A. Serdtseva) was used to study the optokinetic nystagm (the nystagm registration was done before and after labyrinth calorization). This method permitted to detect larvated disorders of the optokinetic nystagm, making it possible to differentiate the signs of mild brain concussion and contusion. These symptoms are not discernible neurologically and may facilitate the determination of the side of the heaviest damage during contusion.
Brain Concussion↗
Epilepsy and complication after craniocerebral traumas.
Three hundred and seventy-two patients aged from 24-80 years were examined 10-15 years after past craniocerebral trauma. Of that number 355 subjects had concussion and 17 subjects brain contusion. Posttraumatic epilepsy was diagnosed by 8 cases (2.15%) only. It affected 4 females, aged from 40-60 years, and 3 males aged 30-48 years after the brain concussion, as well as 1 man, 30 years old, after the brain contusion. That first epileptic attack in 4 cases occurred after the lapse of 1-2 years, in 3 persons after the lapse of 6-10 months, and 1 patient having had brain contusion after 4 months. All posttraumatic patients were treated prophylactically with phenobarbital 0.1 twice a day for a period of several weeks.
Adult↗
Head trauma and exposure to prolactin-elevating drugs as risk factors for male breast cancer.
On the basis of information obtained from a population-based cancer registry in Sweden, male patients with breast cancer (n = 95) were found to have experienced significantly more brain concussions and skull fractures than male patients with lung cancer (n = 383) or malignant lymphoma (n = 69). Other risk factors significantly associated with breast cancer among men were drug treatment associated with prolactin elevations, radiation treatment, family history of breast cancer among first-degree relatives, a history of gynecomastia, gonadal injury, and treatment for inguinal hernias. The results confirm some previously described risk factors for male breast cancer and suggest that events elevating plasma prolactin (e.g., drugs, brain concussions, and skull fractures) and events predisposing for inguinal hernias may be new risk factors for the disease. Using hospital charts is likely to underestimate exposure for different risk factors; therefore, the results need to be confirmed in studies that directly retrieve information. However, such studies are difficult or impossible to undertake in most countries because the disease is so rare.
Adult↗
[Immunologic component in the pathogenesis of a progressive course following closed cranio-cerebral trauma].
Overall 393 patients with different types of closed brain injury (CBI) were examined for the immunological blood parameters in the acute and late periods. The decrease of immunological defence of the organism and possibilities of inflammatory complications in the lungs were established. CBI was found to run a progredient course in 27.7% of patients who suffered brain concussions++, in 54.5% of cases after repeated mild CBI, and in 73.7% of patients after severe CBI and CBI of medium gravity. Some immunological criteria and an approximate scale of a probability of the progredient course of CBI were proposed.
Adolescent↗
Head injury in athletes.
HEAD INJURIES INCURRED during athletic endeavors have been recorded since games were first held. During the last century, our level of understanding of the types of cerebral insults, their causes, and their treatment has advanced significantly. Because of the extreme popularity of sports in the United States and worldwide, the implications of athletic head injury are enormous. This is especially true considering the current realization that mild traumatic brain injury (MTBI) or concussion represents a major health consideration with more long-ranging effects than previously thought. When considering athletic injuries, people who engage in organized sports, as well as the large number of people who engage in recreational activities, should be considered. There are 200 million international soccer players, a group increasingly recognized to be at risk for MTBI. The participation in contact sports of a large number of the population, especially youth, requires a careful and detailed analysis of injury trends and recommended treatment. There are numerous characteristics of this patient population that make management difficult, especially their implicit request to once again be subjected to potential MTBI by participating in contact sports. Recent research has better defined the epidemiological issues related to sports injuries involving the central nervous system and has also led to classification and management paradigms that help guide decisions regarding athletes' return to play. We currently have methods at our disposal that greatly assist us in managing this group of patients, including improved recognition of the clinical syndromes of MTBI, new testing such as neuropsychological assessment, radiographic evaluations, and a greater appreciation of the pathophysiology of concussive brain injury. The potential for long-term consequences of repetitive MTBI has been recognized, and we no longer consider the "dinged" states of athletic concussions to have the benign connotations they had in the past. We review the historical developments in the recognition and care of athletes with head injuries, the current theory of the pathophysiology and biomechanics of these insults, and the recommended management strategy, including return-to-play criteria.
Athletic Injuries↗
[Experience with the use of posterior pituitary hormones in memory disorders of different etiology].
Results of using vasopressin and pituitrin in 20 patients with memory disturbances of various genesis (due to circulatory disturbances in the vertebrobasilar system, cerebral atherosclerosis, neurasthenia, brain concussion, epilepsy) are reviewed. The therapeutic efficacy of the hormones was evaluated with the use of a complex of psychophysiological methods. Objective changes in the patients' neurological status and subjective state were taken into account. A high therapeutic efficacy of the hormones in the treatment of amnestic syndromes is demonstrated.
Adult↗