ISSN:0269-9052    

DOI:10.3109/02699058909004541

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor

摘要:

This article reviews, analyses, and provides commentary on the most recent major works pertaining to frontal lobe function. Other references are included, but only as they arise within the texts themselves. The overriding intention is to provide a comprehensive yet condensed reference on the frontal lobes.

ISSN:0269-9052    

DOI:10.3109/02699058909004542

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor

摘要:

The extraction of angiogenesis factor (AGF) from the contents of chronic subdural haematomas was attempted in order to explain the angiogenesis in the capsule. AGF was extracted from eight patients using the modified Phillip's method, which has previously been used for the extraction of tumour angiogenesis factor. The thickness of the haematoma capsule was measured immediately after removal. The Hounsfield units were evaluated as the average value of three areas in the haematoma on CT scans. Chromatographic separation of the treated contents gave five fractions. The highest activity was observed in the fourth fraction on bioassay by the air sac method. The intensities of AGF activity varied from patient to patient. Although no correlation existed between the degree of AGF activity and thickness of the capsule, a positive correlation was seen between the activity and the density of the contents as indicated by Hounsfield's units on a CT scan. This may indicate the existence of a sequence of cause and effect between increase in the AGF activity and haemorrhage in the capsule of the haematoma. AGF activity increases after haemorrhage in the haematoma capsule, leading to acceleration of angiogenesis in the capsule, which promotes the haemorrhagic cause in the haematoma. Thus, a vicious circle between AGF in the haematoma, angiogenesis in the capsule and haemorrhage in the haematoma is established. It is considered that this gives rise to growth of the haematoma.

ISSN:0269-9052    

DOI:10.3109/02699058909004543

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor

摘要:

The policy of patient selection for prophylactic anticonvulsant treatment has been evaluated retrospectively in 124 head-injured patients admitted consecutively for rehabilitation after primary neurosurgical treatment. Prophylaxis had been instituted in about 60% (51/83) of high risk patients and in about 30% (12/41) of the patients who did not belong to the high risk categories. The use of existing risk data as guidelines for decisions about anticonvulsant prophylaxis is discussed.

ISSN:0269-9052    

DOI:10.3109/02699058909004544

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor

摘要:

The research reported here consisted of a series of three studies of the use of a sensory stimulation protocol and assessment scale with brain-injured patients at either Level II or Level III on the Ranchos Los Amigos Cognitive Scale. In the first study, a pilot project with six patients addressed the hypotheses that: (1) immediate changes in responsiveness occur as a result of sensory stimulation; (2) variables such as positioning and level of contact have an effect on responsiveness; and (3) these changes can be measured. The second study established acceptable concurrent validity (n= 20), test-retest (n= 20) reliability and inter-rater reliability (n= 19) values for the procedures. The third study assessed whether change in responsiveness occurs over time secondary to sensory stimulation. General Responsiveness measures for 19 patients were obtained and then remeasured after 3 months. No significant differences in mean General Responsiveness values were found using thet-test for related measures procedure. Relationships were reviewed between General Responsiveness and amount of treatment per day, frequency of family visits, pre-morbid education, age, time since injury and neurological status. No differences were found between those patients who improved and those who did not improve.

ISSN:0269-9052    

DOI:10.3109/02699058909004545

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor

摘要:

Most patients who receive anticonvulsants after traumatic brain injury are treated with the sedative anticonvulsants phenytoin and/or phenobarbital, or perhaps primidone.However, there is considerable evidence demonstrating that these medications have a deleterious effect on cognitive function. Thus, in a rehabilitation setting, alternatives should be sought. Carbamazepine has been found to be relatively free of such effects, and would be an optimum alternative if seizure control were comparable. We have studied the effects of withdrawing phenytoin, phenobarbital and primidone, and using carbamazepine as the primary anticonvulsant in 27 patients at the Greenery Rehabilitation and Skilled Nursing Center for whom ongoing anticonvulsant treatment was considered to be necessary due to previous seizures or a high risk of the occurrence of seizure.We compared a 3 month baseline period (just prior to carbamazepine introduction or sedative anticonvulsant tapering), to a 3 month post-withdrawal period immediately following sedative anticonvulsant withdrawal, when carbamazepine was the sole anticonvulsant. In 20 out of 21 patients in whom carbamazipine replaced sedative anticonvulsants seizure control was essentially similar or somewhat improved. In only one patient did the substitution with carbamazepine result in a loss of seizure control. Six patients were initially receiving carbamazepine in combination with phenytoin and/or phenobarbital. The removal of phenytoin and phenobarbital, leaving carbamazepine as sole therapy, resulted in improved seizure control in three patients and no change in the other three.

ISSN:0269-9052    

DOI:10.3109/02699058909004546

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor

摘要:

The influence of age on very late outcome was examined in 40 patients who had received very severe blunt head trauma (post-traumatic amnesia≤1 month), and who were aged 15-44 years when injured. The patients were first seen on average 4.5 months after injury and then at two follow-up examinations in their homes 2.5 and 10-15 years after the trauma. There was no significant correlation between age when injured and post-traumatic amnesia. The frequency of 13 late cognitive, behavioural, social and subjective problems was examined at the second follow-up and compared with the observations made 2.5 years after injury. A statistical analysis indicated that the younger the patient the higher the risk of late behavioural and emotional sequelae. The results have been related to information and observations obtained from the home visits.

ISSN:0269-9052    

DOI:10.3109/02699058909004547

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor

摘要:

Three young men with attentional problems after severe head injury were given microcomputer based training involving a variety of tasks designed to ameliorate attentional problems. A multiple baseline across function single case experimental design showed these procedures to be effective in producing change specifically in the targetted function.

ISSN:0269-9052    

DOI:10.3109/02699058909004548

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor

摘要:

This study examined the effects of coping strategies as moderators of long-term psychosocial and emotional adjustment following closed-head injury. Cluster analysis was used to separate 69 CHI patients into three clinically relevant groups on the basis of responses to the revised Ways of Coping questionnaire. The groups were then compared on a series of validation measures. There were no differences apparent between the three clusters in age, Glasgow Coma Scale score on admission to hospital, or in relatives' ratings of psychiatric symptomatology among the patients. However, the cluster characterized by a generally high use of a wide range of coping strategies had higher ratings of depression, as well as more psychosocial, cognitive and physical difficulties than the other groups. As with other chronic illnesses, it appears that the use of cognitive mechanisms that act as reality‘buffers’may be an important component of improved adjustment to closed-head injury.

ISSN:0269-9052    

DOI:10.3109/02699058909004549

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor

摘要:

A methodology to systematically assess the psychosexual consequences of traumatic brain injury was developed and applied to a group of 21 male patients. A majority of the sample reported negative changes in sexual behaviour, including decreased sex drive, erectile function and frequency of intercourse. Common personality changes included depression, reduced self-esteem and a perceived decline in personal sex appeal. However, despite these changes in sexual behaviour, there was evidence that the quality of their marital relationships was preserved. Furthermore, there was no evidence of a relationship between the level of affect and sexual behaviour.

ISSN:0269-9052    

DOI:10.3109/02699058909004550

出版商:Taylor&Francis    

年代:1989

数据来源: Taylor