Trans-Cranial Doppler as a Screening Test to Exclude Intracranial Hypertension in Brain Injured Patients: The IMPRESSIT-2 Prospective Multicenter International Study

2021 ◽  
Author(s):  
Frank Anthony Rasulo ◽  
Stefano Calza ◽  
Chiara Robba ◽  
Fabio Silvio Taccone ◽  
Daniele G. Biasucci ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Screening Test ◽  
International Study ◽  
Brain Injured ◽  
Injured Patients ◽  
Trans Cranial Doppler

The outcome with aggressive treatment in severe head injuries

1979 ◽  
Vol 50 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Lawrence F. Marshall ◽  
Randall W. Smith ◽  
Harvey M. Shapiro
Keyword(s):  
Intracranial Hypertension ◽  
Head Injuries ◽  
High Rate ◽  
High Dose ◽  
Content Type ◽  
Diffuse Brain Injury ◽  
High Dose Dexamethasone ◽  
Brain Injured ◽  
Injured Patients ◽  
Fine Print

✓ In a series of 100 consecutive patients with severe head injuries, uncontrolled intracranial hypertension, which was defined as occurring when intracranial pressure (ICP) exceeded 40 mm Hg for 15 minutes or more, occurred in 25 patients. This was despite high-dose dexamethasone, hyperventilation, mannitol, normothermia, appropriate surgical evacuation, and cerebrospinal fluid drainage when possible. Persistently elevated ICP occurred in 19 patients with diffuse brain injury, and in six patients uncontrolled intracranial hypertension followed evacuation of a surgical mass. All of these patients received intravenous barbiturates to control the ICP. At the time of initial barbiturate administration, 11 of the 25 had bilaterally unreactive pupils and 12 were decerebrate. The initial pentobarbital loading dose (3 to 5 mg/kg) effectively reduced the ICP in 76% of the patients. Prolonged pentobarbital treatment with blood barbiturate levels from 2.5 to 3.5 mg% was associated with normalization of the ICP (ICP less than 15 mm Hg) in 13 patients. In those patients responding to barbiturates, the daily mannitol requirement was reduced from 4.5 to 0.5 gm/kg/day (p < 0.01). In six nonresponders to barbiturates, mannitol requirements increased to 5.9 gm/kg/day; five of these died and one remains vegetative. Ten of the 19 barbiturate responders have returned to a productive life, two remain moderately disabled, two are severely disabled, one is vegetative, and four are dead. The high rate of good quality survival in this series of severely brain-injured patients indicates that barbiturates are useful in the treatment of uncontrolled intracranial hypertension and that a broader investigation of the clinical application of barbiturates is indicated.

The Use of Bispectral Index to Monitor Barbiturate Coma in Severely Brain-Injured Patients with Refractory Intracranial Hypertension

2008 ◽  
Vol 107 (5) ◽  
pp. 1676-1682 ◽  
Author(s):  
Vincent Cottenceau ◽  
Laurent Petit ◽  
Françoise Masson ◽  
Dominique Guehl ◽  
Julien Asselineau ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Bispectral Index ◽  
Barbiturate Coma ◽  
Brain Injured ◽  
Injured Patients

Specific Computerized Attention Training in Stroke and Traumatic Brain-Injured Patients

2003 ◽  
Vol 14 (4) ◽  
pp. 283-292 ◽  
Author(s):  
W. Sturm ◽  
B. Fimm ◽  
A. Cantagallo ◽  
N. Cremel ◽  
P. North ◽  
...  
Keyword(s):  
Divided Attention ◽  
Single Case ◽  
Baseline Period ◽  
Specific Training ◽  
Attention Task ◽  
Baseline Phase ◽  
Computerized Training ◽  
Brain Injured ◽  
Divided Attention Task ◽  
Injured Patients

Abstract: In a multicenter European approach, the efficacy of the AIXTENT computerized training programs for intensity aspects (alertness and vigilance) and selectivity aspects (selective and divided attention) of attention was studied in 33 patients with brain damage of vascular and traumatic etiology. Each patient received training in one of two most impaired of the four attention domains. Control tests were performed by means of a standardized computerized attention test battery (TAP) comprising tests for the four attention functions. Assessment was carried out at the beginning and at the end of a four week baseline period and after the training period of 14 one-hour sessions. At the end of the baseline phase, there was only slight but significant improvement for the most complex attention function, divided attention (number of omissions). After the training, there were significant specific training effects for both intensity aspects (alertness and vigilance) and also for the number of omissions in the divided attention task. The application of inferential single case procedures revealed a high number of significant improvements in individual cases after specific training of alertness and vigilance problems. On the other hand, a non specific training addressing selectivity aspects of attention lead either to improvement or deterioration of alertness and vigilance performance. The results corroborate the findings of former studies with the same training instrument but in patients with different lesion etiologies.

How to manage fever in brain-injured patients

2020 ◽  
Vol 86 (1) ◽  
Author(s):  
Edoardo Picetti ◽  
Francesco Minardi ◽  
Sandra Rossi
Keyword(s):  
Brain Injured ◽  
Injured Patients

Convergence insufficiency in brain-injured patients

Brain Injury ◽  
1989 ◽  
Vol 3 (2) ◽  
pp. 187-191 ◽  
Author(s):  
M. Cohen ◽  
Z. Groswasser ◽  
R. Barchadski ◽  
A. Appel
Keyword(s):  
Convergence Insufficiency ◽  
Brain Injured ◽  
Injured Patients
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