摘要:

Traumatic head-injuries have been described as a national‘silent epidemic’(Wall Street Journal [1]) and within the medical rehabilitation field it is becoming increasingly recognized that the care and service needs for this population significantly surpass the typical scope of acute rehabilitation services. From the literature, it is suggested that long-term recovery is contingent upon the person remaining within a structured, therapeutic environment. Cognitive retraining is one such area of therapeutic- service. The major goal of an educational retraining programme for traumatically head-injured students is to maximize each individual's potential for independent functioning, which is promoted through improvement in cognitive functioning, social and emotional adjustments and transitional living experiences. The pre- and post-tests results for this were analysed collectively utilizing standard T-test comparison procedures for groups with correlated means (SPSS 1983). The results of each student were then analysed individually utilizing the procedure described for subjects measured with the LNNB by Knight and Godfrey (1983).

ISSN:0269-9052    

DOI:10.3109/02699058709034447

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

This study presents a new device for producing experimental, concussive head injury together with a detailed description of biomechanical features of fluid percussion brain injury in the cat. Anaesthetized cats were subjected to multiple (N=3) or single injuries (N=87). The variables studied in repeated injury experiments included the volume of fluid injected intracranially, rate of fluid flow, and the associated pressure transients recorded extracranially in the injury device and intracranially at supratentorial and infratentorial sites. Peak fluid flow increased with increasing volumes of fluid loaded intracranially. Extracranial pressure peaks and durations increased when volume loading was increased. Extracranial and intracranial pressure transients were similar at all recording sites. The form of pressure transients recorded in single injury experiments was similar to that recorded in multiple injury experiments. In single injury experiments, the extracranial pressure peaks and durations also increased with increased intracranial fluid volume loading. The slopes describing the relationships between intracranial volume loading and extracranial pressure transients were significantly different in single and multiple injury experiments. Details of the design and use of the head injury device are also discussed.

ISSN:0269-9052    

DOI:10.3109/02699058709034448

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

This study examined physiological and histopathological changes in the cat produced by a new experimental fluid injury device. Spontaneously breathing (N=14) and artificially ventilated (N=45) cats were subjected to systematically varied magnitudes of fluid percussion brain injury. Within certain injury ranges, increasing magnitudes of fluid percussion injury produced increasing durations of apnea, as well as greater transient increases in mean arterial blood pressure, intracranial pressure and cerebral perfusion pressure. Acute increases in intracranial pressure may have been related to cerebral vasodilatation produced by the systemic hypertension following brain injury.Injuries associated with pressure transients greater than 10atm ms produced concussive responses, including irreversible apnea in spontaneously breathing cats and temporary pupillary dilatation, increases in heart rate and mean arterial blood pressure in artificially ventilated cats. Injuries greater than 39atm ms frequently produced histopathological and physiological indices of significant irreversible brain damage, including fixed and dilated pupils, systemic cardiovascular hypotension and deteriorating blood gases. Injury magnitudes less than 20atm ms did not produce macroscopic evidence of histopathology, intermediate injury ranges produced increasing evidence of subarachnoid and petechial hemorrhage while injury levels greater than 40 atm ms frequently produced significant histopathology including massive hematomas. Injury greater than 10atm ms resulted in opening of the blood-brain barrier, as assessed by extravasation of horseradish peroxidase. Injury greater than 19 atm ms produced suppression of EEG amplitudes which did not recover for up to 40 minutes after injury. These data provide detailed information on the physiological and histopathological consequences of fluid percussion injury in the cat and indicate that this modified fluid percussion apparatus can produce graded levels of brain injury similar to those previously reported for fluid percussion injury.

ISSN:0269-9052    

DOI:10.3109/02699058709034449

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

This article provides a broad overview of the consequences of head injury and approaches to its rehabilitation. Of necessity, no specific area is covered in depth. Sufficient references are provided, however, for the reader who desires further information in any of the areas discussed. It is hoped that, by providing this broad overview, the reader will develop a generalized picture of head injury rehabilitation. Furthermore, the article is designed for‘novices’in the field of head injury rehabilitation such as (1) the family/significant others of the injured persons—so they may begin to know what to expect and to plan for appropriate services; (2) the rehabilitation student—so he or she may be introduced to this emerging specialization and thereby make more informed career choices; and (3) perhaps most important, the newly hired, novice head injury practitioner. This article could form the nucleus of an orientation or in-service training programme for new employees who are not sufficiently knowledgeable in this specialization. In-service programmes are often a necessity for new employees (even on the graduate level) because of the recent, large increase in the number of facilities and programmes specializing in head injury rehabilitation, and because of the lack of available head injury rehabilitation education and training programmes.

ISSN:0269-9052    

DOI:10.3109/02699058709034450

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor