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J D Born

Publications and source records attributed to J D Born.

At least 19 recordsLinked to original sources
PubMed1991

Magnetic stimulation of the motor cortex in cervical spondylosis.

We report a new technique of transcranial magnetic stimulation of the motor cortex to measure conduction within central motor pathways of 67 patients with cervical spondylosis or disk herniation. There were upper motor neuron signs in 34 patients (51%) and x-ray evidence of cervical cord compression in 44 (66%). Muscle action potentials (MAPs) to cortical stimulation were abnormal in 84% of patients with, and 22% of those without, radiologic signs of cervical cord compression. Median nerve somatosensory evoked potentials were altered in only 25% of patients. The frequency of MAP alterations correlated with upper motor neuron signs. In 5 (11%) of the 44 patients with x-ray evidence of cervical cord compression, subclinical cord compression was disclosed by cortical stimulation. In 10 patients restudied 3 months after surgical decompression, normalization of central motor conduction time did not occur, indicating permanent damage to the cervical cord.

Action Potentials↗
PubMed1991

Continuous measurement of jugular venous bulb oxygen saturation in neurosurgical patients.

Monitoring cerebral oxygen availability and utilization is of the utmost importance for patients with brain insults or potentially at risk of brain oxygen deprivation. The availability of the continuous measurement of oxygen saturation in the jugular bulb questions the value of this parameter as an indicator of brain oxygenation. This article reviews the theoretical background and the practical aspects of this monitoring. It describes its possible applications to neurosurgical patients in the operating theater as well as in the intensive therapy unit. Finally, it comments on its main limitations which could impede an extensive utilization in clinical practice.

Brain↗
PubMed1988

[Brain death].

Explore the source record for details and available documents.

Brain Death↗
PubMed1988

The Glasgow-Liège Scale. Prognostic value and evolution of motor response and brain stem reflexes after severe head injury.

In 1982, we developed a new coma scale, the Glasgow-Liège Scale (GLS), which combines the Glasgow coma scale (GCS) with the quantified analysis of five brain stem reflexes. After severe head injury, the two most important parameters for determining the degree of encephalic disturbances are motor responses (M) and brain stem reflexes (R). The object of this study was to further evaluate the prognosis ability of M and R on admission and during the first month after injury. The study is based on 141 patients. The highest score, during the first day, was less than or equal to 7 on the GCS and 12 on the GLS. Using a multiple group logistic discriminant analysis, we confirmed that, in the first 24 hours, the study of brain stem reflexes appears to be the one factor with the best prognostic ability. We also showed that the prognostic value of certain signs is optimal for a limited period. If, within the two variables M and R, recovery follows an identical pattern whatever the final outcome may be, the restructing speed differs for each outcome. M follows an exponential curve spread over a long period explaining its importance in the course of time. On the other hand, R follows a linear model with straight lines more or less parallel for each outcome. R evolves over a short period of time. These clinical findings give us the opportunity to discuss the physio-pathology of head injury.

Adolescent↗
PubMed1988

Clinical and radiological aspects of dysplastic gangliocytoma (Lhermitte-Duclos disease): a report of two cases with review of the literature.

Two cases of Lhermitte-Duclos disease confirmed by biopsy are reported. Review of the 58 published cases shows that the disease can manifest itself only by signs of increased intracranial pressure. Cerebellar symptoms are not constant. Computed tomographic (CT) scans suggest the diagnosis by showing a posterior fossa lesion, iso- and hypodense, partially calcified, and not enhanced by contrast medium. Magnetic resonance imaging (MRI) seems to define limits of the lesion better than CT scanning and could improve the surgical approach. Surgical excision of the lesion is the only satisfactory treatment. The postoperative prognosis is usually favorable.

Adult↗
PubMed1987

Interobserver agreement in assessment of motor response and brain stem reflexes.

In 1982, we developed a new coma scale, the Glasgow-Liège scale, which combines the quantified analysis of five brain stem reflexes with the Glasgow methodology. The present study was undertaken to determine to what extent agreement exists among different raters assessing brain stem reflexes (Parameter R) and to compare the results with those observed from motor responses (Parameter M). We show the good agreement achieved by different examiners in the evaluation of brain stem reflexes. Brain stem reflexes offer a slightly higher agreement (kappa = 0.69) than that of the study of motor response (kappa = 0.65). Within Parameters M and R, we observed less agreement in the evaluation of flexion responses and in the interpretation of oculocephalic reactions. The reliability of the evaluation of M and R parameters justifies the use of the Glasgow-Liège scale as a means for evaluating disturbances of consciousness.

Blinking↗
PubMed1987

"Extrapolated" creatine kinase-BB isoenzyme activity in assessment of initial brain damage after severe head injury.

The severity of initial brain damage is an important risk factor in determining the prognosis of head trauma. It can be assessed by assigning neurological scores or by determining the cerebrospinal fluid (CSF) activity of the isoenzyme creatine kinase-BB (CK-BB). In 10 severely head-injured patients serial CSF samples were obtained during the first 24 hours after trauma, and exponential decay of CK-BB activity with an average half-life of 4.5 hours was demonstrated. This finding led the authors to propose an "extrapolated" CK-BB activity, which theoretically occurs immediately after injury and is calculated from a single CK-BB recording, as a new index for assessing the degree of initial brain damage. In 50 patients with severe head injury, the prognostic ability of "observed" and "extrapolated" CK-BB activity was compared with two clinical scoring systems that evaluate severity of head trauma (the Glasgow and the Glasgow-Liège Coma Scales). "Extrapolated" CK-BB activity proved to be the best prognostic factor. With a CK-BB cutoff point of 330 U/liter, a true-positive rate of 79% and a true-negative rate of 73% were obtained. These results suggest the usefulness of measuring CK-BB activity in CSF as soon as possible after hospital admission for head injury.

Adolescent↗
PubMed1987

[Cervico-arthrotic myelopathies. Treatment and prognosis].

The authors present 50 cases of cervical spondylotic myelopathy treated by anterior or posterior approach. To assess the severity of the pre- and postoperative neurological symptoms, they define an original ten-point classification scale taking into account gait and urinary disturbance, ability to manipulate objects and pain. With C2-C7 laminectomy, 60% of the patients are improved, essentially for walk. A few cases only (14%) are upgraded for upper limbs function. The authors conclude that this surgical treatment should be applied only when there is a multi-level narrowed canal and predominant lower limbs deficits. The efficacy of the anterior approach depends on complete removal of osteophytes. In cases with complete osteophytectomy, this surgical treatment can improve both the upper and lower limbs function and 77.8% good results are obtained. In a few cases it may be necessary to use both approach successively. Discriminant analysis applied to 12 factors shows that pre-operative scores of upper and lower limbs and sagittal diameter of spinal canal are the most important factors for neurological prognosis.

Adult↗
PubMed1987

Predicting recovery from head injury.

Outcome prediction after severe head injury remains an important issue. We investigated this problem by recording seven risk factors in 40 patients with severe head injury. By applying multivariate statistical analysis to the patients' data we selected the factors of prognostic significance: degree of initial neurological damage, severely raised intracranial pressure, and age. We compared clinical and biochemical parameters for evaluating the severity of brain lesion and proposed various simple prognostic indices allowing for correct prediction in more than 85% of patients.

Adolescent↗
PubMed1986

[Skull injury. Arteriovenous shunt. Limitations of cerebral x-ray computed tomography].

The authors report the case of a patient suffering from a head trauma after dizziness followed by a loss of consciousness. In the hours following the admission, he developed drowsiness and a left hemiparesis. CT scanner showed an intracerebral haematoma. Due to the dizziness a carotid angiography has been realized and has demonstrated an intracerebral avascular mass, an arteriovenous shunt and an epidural haematoma at the vertex. Two aspects of the case seem to be important: the first one is the limit of CT scanner; the second one is the relationship between the three lesions.

Adult↗