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At least 19 recordsLinked to original sources

Association of perinatal events, epilepsy, and central nervous system trauma with juvenile delinquency.

The association of perinatal events, childhood epilepsy, and central nervous system trauma with juvenile delinquency was studied prospectively in a geographically defined population of 5966 males in northern Finland. Those who had obtained a criminal record up to the age of 22 years, totalling 355, or 6.0%, were defined as delinquents. The incidence of delinquency was not increased in males with a birth weight less than 2500 g or greater than 4000 g, preterm births < 37 weeks' gestation, or those with perinatal brain damage or having epileptic seizures before 14 years of age. The incidence was increased by 6.8% in the group of males with birth weights less than 3500 g, but not significantly increased after standardisation for a number of social and demographic background variables. The incidence was increased by 10.3% among the males who had had a central nervous system trauma by the age of 14 years, however, and this factor remained significant when social and demographic factors were standardised by regression analysis, with an odds ratio of 1.9 for all males with a criminal record and an odds ratio of 3.15 for those who had committed a violent crime. Previous central nervous system trauma may be a cause of delinquency, or another possibility is that the type of behaviour pursued by males who are likely to commit a violent crime will expose them more often to accidents which can result in central nervous system trauma.

Adolescent

An injury severity scale for comprehensive management of central nervous system trauma.

The Glasgow Coma Scale (GCS) is used in central Virginia by emergency medical technicians (EMT's), emergency department personnel and neurosurgical staff to evaluate patients with central nervous system (CNS) trauma. In a series of 406 patients admitted to the neurosurgical services at the University of Virgina Hospital between October 1977 and February 1978, a GCS score was recorded by the neurosurgeon, nurse, and EMT. All 250 data points, including clinical diagnosis and incidence of associated injuries were entered into our information system analysis. The scale can be easily mastered by all members of the emergency medical team giving reproducible results. It also appears to be a valid predictor of the ultimate outcomes of head injury. The GCS has substantial clinical value in the management of the nuerotrauma patient. It is presently being employed in all phases of the emergency medical system to monitor the progression of the neurologic injury. Ultimately, this injury severity scoring system will be used to standardize patient populations in well controlled clinical studies in which different treatment parameters will be assessed.

Adolescent

Dimethyl sulfoxide in central nervous system trauma.

Dimethyl sulfoxide has been tested in various experimental injuries of the central nervous system in relation to other therapies. It appears to be a useful drug in acute extradural mass-forming lesions, middle cerebral artery occlusion, respiratory anoxia, and spinal cord injuries, in rhesus and squirrel monkeys, dogs, and rats. The data from these studies suggest that in the experimental models used, DMSO is clearly superior to no treatment, and appears to be more generally effective than other comparable treatments. No satisfactory answer has yet been found to explain the beneficial effects of DMSO, but several hypothetical suggestions are offered; their validation hinges primarily on further confirmatory evidence. Further experiments with our present models and alternative research lines are discussed.

Animals

The neurologic examination in patients with central nervous system trauma.

The neurological assessment of the head injured patient must be integrated into the emergency management and daily care of the patient. Neurosurgical nurses are in the best position to perform serial neurologic examinations and assess changes in the patient's clinical picture. If this added responsibility is assumed, neurosurgical nurses must take an active role in improving assessment skills. The improved assessment of the head injured patient will result in early intervention in the patient's course to avert potential problems, thus resulting in improved morbidity and eventual outcome. As neurosurgical nurses expand their roles in nursing, improved patient assessments are mandatory to deliver optimal patient care.

Humans

Ethanol potentiation of central nervous system trauma.

Two models have been used to study the effects of ethanol on injuries of the central nervous system. The spinal cords of cats were injured by delivering a 200 gm-cm impact to the exposed dura mater. A second group of animals received a similar injury to the exposed dura mater overlying the cerebral hemispheres. The animals were divided into two groups, those that received an infusion of ethanol before injury, and control animals that received no ethanol. The parameters of injury used in this model produced small and insignificant lesions in those animals that received no ethanol; however, when the animals were pretreated with ethanol, a considerable increase in the extent of the injury was noted. These include alterations in membranes-bound enzymes and clotting mechanisms, and alteration of cell membranes through abnormal free radical reactions.

Animals

2-(Aminomethyl)chromans that inhibit iron-dependent lipid peroxidation and protect against central nervous system trauma and ischemia.

A series of 2-(aminomethyl)chromans was developed as potent inhibitors of iron-dependent lipid peroxidation. Compounds within this class are extremely effective at inhibiting lipid peroxidation with IC50's as low as 0.2 microM. Selected members were found to enhance early neurological recovery and survival in a mouse head injury model. In this assay, improvement in the 1-h post-head-injury neurological status (grip test score) by as much as 230% of control was observed. One of the most efficacious compounds (35) was evaluated in two models of cerebral ischemia where significant neuroprotection was observed. These results provide further support for the importance of cerebroprotective antioxidants for the treatment of traumatic and ischemic injury as well as additional evidence for the role of oxygen radicals in postischemic brain damage.

Animals

Injuries to the nervous system and spine in downhill skiing.

The authors describe injuries to the nervous system and spine from downhill skiing accidents through a review of the charts of downhill skiers admitted over 5 years to the three teaching hospitals of the University of Calgary. The office of the chief medical examiner provided details about accidental deaths from downhill skiing in which nervous system trauma occurred. During the study period, 145 downhill skiers suffered injury to the nervous system or spine. There were five deaths from nervous system trauma. The mean age of the injured skiers was 23.8 years, and these injuries were three times more common in men than in women. Eighty-eight skiers sustained a head injury, 25 had spinal fractures alone, 20 had spinal cord or nerve root injury and 12 had peripheral nerve injury. A simple fall on the hill was the commonest method of injury, followed in frequency by collision with a tree, which caused the most severe injuries. Reckless skiing, design of ski runs and man-made snow were contributing factors. The serious nature and number of these injuries must be recognized, and further study is needed on causal factors and preventive measures.

Adolescent

[Reorganization of the nervous system during regeneration in Dugesia tigrina].

The normal structure of the nervous system in Dugesia tigrina Girard and the total morphodynamics of the nervous system during regeneration have been studied by means of choline esterase assay. The nervous system reacts to local damages of the planarian body; accumulations of nervous elements form in the wound region. Following the transverse cut of a planarian, the regeneration of the nervous system is not reduced to the completion of lacking parts. In this case (as well as in that of asexual reproduction) the nervous system manifests a considerable morphological lability and undergoes morphological rearrangements accompanied by the appearance of additional, frequently unpaired, nerve trunks. The data obtained are to be taken into account in neurobiological studies on planarians.

Animals

Alcohol exacerbates behavioral and neurochemical effects of rat spinal cord trauma.

Acute alcohol intoxication may exacerbate the consequences of central nervous system trauma, although the mechanism is uncertain. Effects of acute ethanol administration on behavioral and neurochemical changes were examined in rats after traumatic spinal cord injury. Survival rates were reduced and posttraumatic neurologic function worsened in ethanol-treated as compared with saline-treated controls. Ethanol-treated rats had significantly lower tissue levels of excitatory amino acids and higher levels of free fatty acids, thromboxane, and lactic acid than did controls. Tissue magnesium concentration was significantly reduced by trauma and recovered more slowly in ethanol-treated rats. Enhanced phospholipid hydrolysis with free fatty acid and thromboxane accumulation, increased release of excitatory amino acids, and decreased tissue magnesium levels may each serve to worsen secondary tissue damage and diminish neurologic recovery after spinal cord injury associated with acute alcohol intoxication.

Amino Acids

Development of pain mechanisms.

Interest in the neural development of pain pathways and of the perception and treatment of pain in newborn infants has increased markedly in the last few years. The tremendous improvement in the survival of premature infants, particularly those weighing less than 1000 gm at birth, means that there are now a significant number of infants, many of whom require surgery, undergoing necessarily extensive traumatic procedures in intensive care units. At the same time it is becoming clear that the traditional belief of paediatricians and anaesthetists that newborn infants do not feel or remember pain and therefore need no anaesthesia or analgesia is rooted in a mixture of misconception and fear.

Acute Disease

[The structural bases of the compensatory potentials of the central nervous system in closed craniocerebral trauma].

The article analyses 160 cases of fatal craniocerebral trauma encountered in the practice of the Burdenko Research Institute, AMS USSR, in 1980-1989. The results of the author's personal research and the literature data bear evidence of the different means of restoration of the functions of the central nervous system in localized and diffuse axonal brain damage. Reparative processes in the neurons of the pericontusion zone may provide compensatory changes. Compensation of disturbed functions of the central nervous system in diffuse axonal trauma is determined to a certain extent by the regenerative possibilities of partly damaged axons.

Adaptation, Physiological

Trauma of the central nervous system in children.

In summary, the care of the patient with head trauma is not dissimilar to any other acutely ill individuals. Careful, systematic observation and recording of changing factors and physical signs is necessary. Proper application and appropriate treatment in response to dynamic changes will provide a satisfactory result as in any other form of illness or trauma. The patient with multiple injuries may call for compromise in treatment, however with the exception of gross hemorrhage, the head injury should take precedence in the early period following injury for there are other factors that may prove fatal. Do not accept unnecessary delay in the treatment of other injuries on the grounds that the patient has had a head injury. The orthopedic surgeon can treat the fractured femur, the plastic surgeon-the face, and the general surgeon-the abdomen, without jeopardizing brain recovery. The treatment of the patient with head trauma, as treatment of any other individual in present day medical practice, has become more of a team effort, not only involving the neurosurgeon, but the pediatrician, the specialist in pulmonary physiology, and other expert groups.

Brain Edema