摘要:

The pathophyslology of closed head injury (CHI) largely determines Its clinical natural history. The principal pathologies of CHI—focal contusion, diffuse axonal injury (DAD, and hypoxic-ischemic injury— have predictable focal and diffuse clinical effects. Focal clinical effects are linked to the localization of focal pathology; the clinical pattern following diffuse pathology is the same at different severities and includes coma, from onset, a confuslonal state, and a proportionally longer period of restoration. Severity of DAI determines the length of recovery, and duration of coma and posttraumatic amnesia are commonly used indices. Understanding clinical-pathologic relationships in CHI can help in estimating prognosis and planning appropriate Interventions.

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Historically, studies of traumatic brain Injury CTBI) have focused on metabolic, cerebral vascular, and structural pathology. However, significant recent progress has been made in understanding the biochemical features of TBI. Studies have determined that TBI can produce excessive excitation of neurons in the period immediately following impact. This excessive excitation of neurons can produce enduring pathologic changes in cell function that could result In many of the neurologic deficits characteristic of TBI. Clinically, these observations suggest that the administration of various pharmacologlc agents that can blunt excessive excitation could improve the outcome of head-injured patients, if given soon after injury.

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Studies relating neuroimaging and neuropsychology after head injury are reviewed. Computed tomography (CT) is relatively insensitive to abnormalities after head injury, and work has concentrated on the neuropsychological significance of hematoma, ventricular enlargement, and atrophy. Magnetic resonance imaging (MRI) is a more sensitive technique and reveals patterns of lesions after trauma. The complexity of the lesions found after head injury means that correspondences between abnormalities in particular locations and neuropsychological deficits have proven difficult to demonstrate. The evidence currently available stresses the importance of diffuse damage for neuropsychological outcome after head injury. Single photon emission computed tomography (SPECT) and related techniques provide information about abnormalities not given by structural techniques such as CT and MRI. The study of functional pathology after head injury is a new and fast developing area.

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In this review, a conceptual approach to the neuropsychological assessment of patients with traumatic brain injury is stressed. Two factors influencing assessment and Interpretation of results are identified. The first addresses the extent and direction of the neuropsychological assessment as related to the stage of recovery. Three temporal stages of recovery are arbitrarily defined. The second factor is the Importance of the main pathologic subtypes of head Injury, focal and diffuse brain injury. Assessment decisions related to these important factors are discussed.

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Traumatic brain Injury Is a common cause of neurologic dysfunction. There are a number of common neurologic complications that present in the outpatient or rehabilitation setting. In this article, the incidence, diagnostic Issues, and treatment options for seizures, ventricular enlargement (hydrocephalus), subdural hematoma/hygroma, behavioral problems, depression, compressive neuropathy, and spastlclty are briefly presented.

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Thirty-six cases of head injury with persistent neurologic symptoms presenting to an outpatient head injury clinic were investigated. Cases with mild injury had significantly higher prevalences of chronic pain and depression than more severely Injured cases. The “mild” group had fewer cases with good outcome than the “severe” group. This study and much of the existing literature supports the conclusion that patients with persistent postconcussive syndrome are likely to suffer from the interaction of chronic headache and depression, rather than a specific neurologic cognitive disability.

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The relationships between brain injury, functional-neural reorganization, and recovery of function are examined from historical and contemporary perspectives. Using redundancy and vicarlation theories, the history of functional reorganization Is traced through modem-day research on neural reorganization mechanisms that may mediate recovery of function following brain damage. Neuronal sparing (prevention of nerve cell death) and reorganization (denervation supersensltivlty, reactive synaptogenesis, chemical growth-survival factors, and fetal brain tissue grafts) are discussed. The potential for these neuronal sparing and reorganization mechanisms to enhance recovery of function following brain injury is considered.

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The existence of a resting electroencephalogram (EEG) marker of mild head injury (MHO has recently been demonstrated using recording and analysis techniques that arc over 20 years old. The most advanced EEGs use information from magnetic resonance imaging to produce images of superficial cortical activity with split-second resolution of neurocognitive processes such as attention and working memory, and with spatial detail approaching that of O1S positron emission tomography scans. When they become more widely available In a few years, these high-resolution EEGs may prove quite useful In detecting and characterizing the often elusive cognitive disabilities of patients with MHI.

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This article reports on the retrospective examination of 27 patients, initially nonspeaklng following traumatic brain injury, and attempts to identify prognostic indicators for functional speech by the time they were discharged from Inpatient rehabilitation. However, none did so prior to achieving The Rancho Los Amjgos Rating Scale level V or after level VI. Statistically significant differences were present between the functional and nonfunctional speaking groups for the variables of primitive oral reflexes and alternative feeding status.

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1992

数据来源: OVID