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10,789 results for

Management of Severe Head Injury

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10701. Brain metabolic and hemodynamic effects of cyclosporin A after human severe traumatic brain injury: a microdialysis study. (Abstract)

the effect of CsA on brain energy metabolism, as measured by cerebral microdialysis, and on cerebral hemodynamics, in a group of severely head injured patients.Fifty adult patients with a severe head injury were enrolled in this randomized, double-blind, placebo-controlled study. Patients received 5 mg/kg of CsA over 24 h, or placebo, within 12 h of the injury. A microdialysis probe was placed in all patients, who were managed according to standard protocols for the treatment of severe head injury.The (...) Brain metabolic and hemodynamic effects of cyclosporin A after human severe traumatic brain injury: a microdialysis study. Mitochondrial dysfunction is a major limiting factor in neuronal recovery following traumatic brain injury. Cyclosporin A (CsA) has been recently proposed for use in the early phase after severe head injury, for its ability to preserve mitochondrial bioenergetic state, potentially exerting a neuroprotective effect. The aim of this study was, therefore, to evaluate

2008 Acta neurochirurgica Controlled trial quality: uncertain

10702. Gender differences in outcome in patients with hypotension and severe traumatic brain injury. (Abstract)

adults (151 males), aged >17 years, with severe blunt head trauma, initial GCS <9 and hypotension, recruited into a randomised controlled trial of pre-hospital hypertonic saline resuscitation versus conventional fluid management. Outcome was measured by survival and Glasgow Outcome Scale-Extended version (GOS-E) scores at 6 months post-injury.Females recruited into the study had a higher mean age. Females were more likely to be injured as passengers and pedestrians and males as drivers (...) Gender differences in outcome in patients with hypotension and severe traumatic brain injury. Animal studies have identified hormonal influences on responses to injury and recovery, creating a potential gender effect on outcome. Progesterone and oestrogen are thought to afford protection in the immediate post-injury period, suggesting females have an advantage, although there has been limited evidence of this in human outcome studies.This study examined the influence of gender on outcome in 229

2008 Injury Controlled trial quality: uncertain

10703. Early modifiable factors associated with fatal outcome in patients with severe traumatic brain injury: a case control study. (Abstract)

, Glasgow Coma Scale score, Abbreviated Injury Scale: Head (AISHEAD), Revised Trauma Score, and Injury Severity Score with survivors. Potentially modifiable contributors to secondary brain injury were examined and compared in both groups.A level I trauma center in Melbourne, Australia.Patients with traumatic brain injury caused by blunt trauma with an AISHEAD >or=4 were identified from a prospective intensive care database.None.Between January 1, 1999, and July 30, 2000, 74 patients, including 37 (...) unit admission tended to be initiated later in nonsurvivors, potentially delaying recognition and management of inadequate cerebral perfusion pressure. In nonsurvivors, hypothermia did not normalize during the first 24 hrs after injury.In patients with severe traumatic brain injury, lower blood pressure in the first 4 hrs after admission was associated with mortality and may have increased the rate of secondary brain injury. Outcomes of patients with severe traumatic brain injury may potentially

2007 Critical Care Medicine

10704. Transcranial doppler ultrasonography as an early outcome forecaster following severe brain injury. (Abstract)

Transcranial doppler ultrasonography as an early outcome forecaster following severe brain injury. Knowledge of post-traumatic cerebral haemodynamic disturbances might be beneficial for predicting the management outcome when measuring the basal cerebral arteries blood flow velocity by ultrasonic transcranial Doppler device immediately after severe head injury. Thirty patients who sustained severe brain injury underwent an early blood velocity measuring by transcranial Doppler ultrasonography (...) as a possible predictor of severe head injury management outcome. This non-invasive and simple procedure could be engaged in the daily management of severely brain-injured patients.

2006 British Journal of Neurosurgery

10705. Temporal changes in cerebral tissue oxygenation with cerebrovascular pressure reactivity in severe traumatic brain injury. Full Text available with Trip Pro

derangement correlates with increasing cerebrovascular dysautoregulation in patients succumbing to severe head injury, supporting the utility of PRx as a monitoring variable and the rationale for a target-driven approach to head injury management. (...) Temporal changes in cerebral tissue oxygenation with cerebrovascular pressure reactivity in severe traumatic brain injury. To investigate the temporal relationship between cerebrovascular pressure reactivity and brain tissue oxygenation in patients with severe head injury.In 40 patients, brain tissue oxygenation and intracranial pressure were monitored. Time-averaged values for intracranial pressure (ICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP) and brain tissue

2007 Neurosurgery and Psychiatry

10706. Value of radiological diagnosis of skull fracture in the management of mild head injury: meta-analysis

Value of radiological diagnosis of skull fracture in the management of mild head injury: meta-analysis Value of radiological diagnosis of skull fracture in the management of mild head injury: meta-analysis Value of radiological diagnosis of skull fracture in the management of mild head injury: meta-analysis Hofman P A, Nelemans P, Kemerink G J, Wilmink J T Authors' objectives To assess the value of the diagnosis of skull fracture by plain radiograph in the diagnosis of intracranial haemorrhage (...) : The authors did not state any implications for research. Bibliographic details Hofman P A, Nelemans P, Kemerink G J, Wilmink J T. Value of radiological diagnosis of skull fracture in the management of mild head injury: meta-analysis. Journal of Neurology, Neurosurgery and Psychiatry 2000; 68(4): 416-422 Original Paper URL Other publications of related interest Moses LE, Shapiro D, Littenberg B. Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some

2000 DARE.

10707. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Full Text available with Trip Pro

Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," published in 2004.Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based (...) risk for death (2B except 2C for postoperative patients). In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients

2008 Critical Care Medicine

10708. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Full Text available with Trip Pro

Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock," published in 2004.Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based (...) ). In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients unless contraindicated (1B); avoiding routine use of pulmonary artery

2007 Intensive Care Medicine

10709. A Study to Evaluate the Efficacy of Somatropin in Adults With Growth Hormone Deficiency Caused by Trauma and/or Head Injury

A Study to Evaluate the Efficacy of Somatropin in Adults With Growth Hormone Deficiency Caused by Trauma and/or Head Injury A Study to Evaluate the Efficacy of Somatropin in Adults With Growth Hormone Deficiency Caused by Trauma and/or Head Injury - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached (...) . Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years and older (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Documented GHD Documented mild, moderate, and severe head injury (e.g

2008 Clinical Trials

10710. Head Injury Retrieval Trial

Party): Alan Garner, CareFlight Study Details Study Description Go to Brief Summary: The study hypothesis is that advanced interventions as provided by a physician at an accident scene will decrease the death rate and the rate of severe disability in survivors of severe head injury. Extended interventions by advanced level prehospital providers may include rapid sequence intubation (RSI) airway management, blood transfusions, surgical procedures, etc. Condition or disease Intervention/treatment (...) Phase Head Injuries, Closed Procedure: Extended interventions by advanced level prehospital providers Not Applicable Detailed Description: A randomised, controlled trial examining prehospital management of persons with severe blunt head injury, in the Sydney region. Treatments examined will be the current system consisting principally of paramedic management (standard care) compared with management by a retrieval team lead by a consultant anaesthetist, emergency physician or intensive care

2005 Clinical Trials

10711. Warfighter Head Injury Study

Warfighter Head Injury Study Warfighter Head Injury Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Warfighter Head Injury Study The safety and scientific validity of this study is the responsibility (...) and the published results of those studies have changed the management and evaluation of head-injured warfighters, and contributed to knowledge of brain function and the long-term effects of head injury. Furthermore, based on the knowledge acquired in our previous research with Vietnam warfighters and our current interests in the functions of the human PFC, cognitive neuroplasticity in the young brain, posttraumatic stress disorder (PTSD), posttraumatic epilepsy (PTE), caregiver stress, and genetic-plasticity

2008 Clinical Trials

10712. Vietnam Head Injury Study

Vietnam Head Injury Study Vietnam Head Injury Study - Phase III - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Vietnam Head Injury Study - Phase III The safety and scientific validity of this study (...) heart dysfunction, etc...) A history of severe head injury, stroke, loss of consciousness, or other significant neurological, psychiatric or medical condition that would render the subject unsuitable for the VHIS testing battery. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov

2005 Clinical Trials

10713. Immunemodulation in Patients With Minor Head Injury

Immunemodulation in Patients With Minor Head Injury Immunemodulation in Patients With Minor Head Injury - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Immunemodulation in Patients With Minor Head Injury (...) Population Patients from daily practice Criteria Inclusion Criteria: minor head injury Exclusion Criteria: severe head injury Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00622778 Locations Layout table for location information Austria Medical

2008 Clinical Trials

10714. Observational Endothelin and Markers of Cellular Apoptosis In CSF Head Injury

Observational Endothelin and Markers of Cellular Apoptosis In CSF Head Injury Observational Endothelin and Markers of Cellular Apoptosis In CSF Head Injury - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more (...) Neurohormones Cellular Apoptosis Endothelin System Detailed Description: Severe traumatic brain injury (TBI) remains a critical problem in the United States and throughout the world. Advances in critical care of the TBI patient has resulted in improved outcome. However, despite these efforts, half of the patients with severe brain injury die or are left with severe disability. Thus, the need for a pharmaceutical agent to blunt the cascade of neurotoxins released with mechanical head trauma and improve

2007 Clinical Trials

10715. Transcranial Doppler Measurement and Prognosis in Moderate Head Injury

Transcranial Doppler Measurement and Prognosis in Moderate Head Injury Transcranial Doppler Measurement and Prognosis in Moderate Head Injury - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Transcranial (...) which could produce ischemia. The measurement of CPP generally is gotten by invasión with ICP determination. In severe head injury has been demonstrated correlation between ICP and PI, strongest for CPP and PI. Other parameters are oligaemia and vasospasm in the first 24 hours correlate poor outcome. Because of the non invasive characteristic and good correlation with physiologic and prognosis, we think it is important evaluate if there are a kind of correlation between amnesia and orientation

2006 Clinical Trials

10716. Missile injuries in head — neck and maxillo-facial region — an experience in eastern nepal Full Text available with Trip Pro

Missile injuries in head — neck and maxillo-facial region — an experience in eastern nepal Ballistic injuries to head-neck and maxillofacial region is quite common problem nowadays. Most of the time the injuries seem to be dreadful but the mechanism of the injuries caused by ballistics and the anatomical conditions of maxillofacial and head-neck region mitigate the severity of the injuries. Proper primary management followed by reconstruction and management of associated injuries decreases (...) the mortality and morbidity of missile injuries in head-neck and maxillofacial region. Eleven cases of missile injuries in head-neck and maxillofacial region are included in the present study. The mechanism of the injury and the ideal management strategy for the ballistics injuries in the region has been discussed in the article.

2008 Indian Journal of Otolaryngology and Head & Neck Surgery

10717. Hypothermia pediatric head injury trial: the value of a pretrial clinical evaluation phase. (Abstract)

Hypothermia pediatric head injury trial: the value of a pretrial clinical evaluation phase. The utility of a pretrial clinical evaluation or run-in phase prior to conducting trials of complex interventions such as hypothermia therapy following severe traumatic brain injury in children and adolescents has not been established.The primary objective of this study was to prospectively evaluate the ability of investigators to adhere to the clinical protocols of care including the cooling (...) and rewarming procedures as well as management guidelines in patients with severe traumatic brain injury (Glasgow Coma Scale

2006 Developmental neuroscience Controlled trial quality: uncertain

10718. Critical thresholds of intracranial pressure and cerebral perfusion pressure related to age in paediatric head injury. Full Text available with Trip Pro

Critical thresholds of intracranial pressure and cerebral perfusion pressure related to age in paediatric head injury. The principal strategy for managing head injury is to reduce the frequency and severity of secondary brain insults from intracranial pressure (ICP) and cerebral perfusion pressure (CPP), and hence improve outcome. Precise critical threshold levels have not been determined in head injured children.To create a novel pressure-time index (PTI) measuring both duration and amplitude (...) thresholds generated are identical to age related physiological values. Management guidelines for paediatric head injuries should take account of these CPP thresholds to titrate appropriate pressor therapy.

2006 Neurosurgery and Psychiatry

10719. An epidemiological study of head injuries in a UK population attending an emergency department. Full Text available with Trip Pro

An epidemiological study of head injuries in a UK population attending an emergency department. We aimed to identify the attendance rate for all head injuries, and for moderate to severe head injury (MSHI), in an emergency department (ED), and related risk factors for MSHI, including age, sex, area of residence, and socioeconomic status (SES). This was a retrospective descriptive epidemiological study of an ED database of head injury attendances over 6 years, carried out in an ED that serves (...) both urban and mixed rural and urban areas, with a wide socioeconomic range, and a total population of 344,600. The main outcome measure was rates of attendance for head injury. Head injury presentations accounted for 3.4% of all attendances per year. An overall rate of 453 per 100,000 was found for all head injuries, of which 40 per 100,000 were moderate to severe (10.9%). Urban residents had significantly greater risk of presenting with MSHI compared with residents of mixed/rural areas. Males

2006 Neurosurgery and Psychiatry

10720. Internal decapitation: survival after head to neck dissociation injuries. Full Text available with Trip Pro

patients had upper neck and head dissociation injuries. The pattern of injury in all of these cases included a distraction type mechanism. All cases demonstrated soft tissue disruption in the zone of injury, which was consistent and apparent on all imaging studies. In these patients, the extent and severity of injury was more apparent on magnetic resonance imaging (MRI) than on radiograph or computed tomography scan. Management of these injuries included immobilization followed by surgery (...) Internal decapitation: survival after head to neck dissociation injuries. Case series.To describe survival and outcomes after occipitocervical dissociation injuries.Historically, occipitocervical dissociation injuries have a high rate of associated neurologic deficit with a relatively high incidence of mortality.Six patients with occipitocervical dissociation injuries are reported and their management and imaging findings reviewed. Possible contributory factors for survival are discussed.All

2008 Spine

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