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Biomedical subjects

L J Horn

Publications and source records attributed to L J Horn.

8 recordsLinked to original sources
PubMed1999

Clinical assessment of posttraumatic headaches.

The evaluation of the person with posttraumatic headache remains a difficult clinical task. The rehabilitation clinician seeing the person with posttraumatic headache may encounter a large spectrum of potential etiologies for cephalgia. We believe an ordered approach to the history, physical, and laboratory examination may lead to a more accurate and focused diagnosis in some cases. In an attempt to provide a directed approach to posttraumatic headaches, this discussion is divided into extracranial and intracranial sources. A brief table guide to the etiology of pain by site is presented, and the key eight steps of examination are reviewed.

Craniocerebral Trauma↗
PubMed1991

Rehabilitation in brain disorders. 1. Basic sciences.

This learning module highlights the basic sciences of brain disorders and their relevance to the rehabilitation process. It is part of the chapter on rehabilitation in brain disorders for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. The chapter is composed of four articles, and each builds on principles established in the others. This article contains essential information on the hierarchy and integration of cerebral neural processes, functional anatomy, and neurochemistry. It also highlights newer advances in brain plasticity and response to injury, at a cellular level and with reference to acute and secondary processes, which will likely be at the forefront of medical management and functional "damage control" in the near future. The learner is directed to articles 2, 3, and 4 in this chapter for supporting information.

Brain Diseases↗
PubMed1991

Rehabilitation in brain disorders. 3. Intervention strategies.

This self-directed learning module highlights advances in the principles of management of brain disorders. It is part of the chapter on rehabilitation in brain disorders for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. The chapter is composed of four articles, and each builds on principles established in the others. This article covers rehabilitation philosophy, management of cognitive remediation, and behavioral management, with attention to communication disorders, social factors, vocational/educational/avocational issues, treatment of motor deficits, dysphagia, sensory dysfunction, sexual dysfunction, and substance abuse. Advances that are covered in this section include pharmacologic and rehabilitative interventions for acute, chronic, and progressive brain injuries and diseases. The learner is directed to articles 1, 2, and 4 in this chapter for supporting information.

Brain Diseases↗
PubMed1991

Rehabilitation in brain disorders. 4. Specific disorders.

This self-directed learning module highlights important aspects of medical rehabilitation of patients with brain disorders. The specific disorders reviewed in this module are traumatic brain injury, stroke, multiple sclerosis, Parkinson's disease, and other degenerative disorders. This module is a section of the chapter on rehabilitation of brain disorders for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. The chapter is composed of four articles, and each builds on principles established in the others. Emphasis is given in this section on key elements of current medical practice, including epidemiology, pathophysiology, prognosis, and outcome. Neurologic assessment and management is highlighted for coma, amnesia, cranial nerve and late intracranial complications, postacute management, and postconcussive syndromes. The learner is directed to articles 1, 2, and 3 in this chapter for supporting information.

Brain Diseases↗
PubMed1986

Hypertension after brain injury: case report.

Hypertension after brain injury requires comprehensive evaluation and management. Focal brain injury to centers of blood pressure regulation, high levels of circulating catecholamines from generalized trauma or intracranial lesions, increased intracranial pressure, pheochromocytomas unmasked after trauma, and occult spinal cord injury with hyperreflexia represent possible causes of hypertension after brain injury. This case of a brain-injured patient who had episodes of hypertension and diaphoresis with catecholamine elevations in plasma and urine, and evidence of hypothalamic-pituitary dysfunction, demonstrates the importance of a thorough neuroendocrine evaluation in brain-injured patients with hypertension. When high levels of catecholamines are found, without further evidence of a pheochromocytoma, treatment with a beta blocker is appropriate.

Adolescent↗
PubMedDate not supplied

Botulinum toxin treatment of lumbrical spasticity: a brief report.

Botulinum toxin A has been used to treat wrist and finger spasticity mainly through injection of the forearm flexor muscles. This case study describes its first reported use in managing spastic lumbricals of the hand. A 19-year-old male had significant flexion deformity and hypertonicity of the left wrist and hand, particularly the second through fifth metacarpophalangeal joints, after traumatic brain injury. By using the 0-4 Ashworth scale, spasticity of the lumbricals across the second to fourth metacarpophalangeal joints was rated 2, with persistent clonus of the finger flexors as confirmed by electromyography to the middle and ring fingers, even after botulinum toxin A injection of the flexor digitorum sublimis and profundus muscles. By using the electromyography-guided technique, botulinum toxin A was injected into the first lumbrical of the index finger (12 units), second and third lumbricals of the middle and ring fingers, respectively (15 units each), and fourth lumbrical of the little finger (10 units). At follow-up, clinical and electromyographic examination revealed a significant reduction in tone and clonus of the injected lumbricals. Ashworth scores of the lumbricals from the index to little finger improved to 1. Botulinum toxin A injection of the lumbricals can be beneficial in managing spasticity of these muscles. It is well tolerated and effective at doses of 10 to 15 units. Lumbrical injection of botulinum toxin A is a useful adjunct in our percutaneous armamentarium for managing the spastic hand.

Adult↗
PubMedDate not supplied

Hypertension in traumatic brain injury.

The incidence and natural history of hypertension associated with traumatic brain injury were studied using a cohort of 80 patients discharged from a brain-injury rehabilitation centre. Although a significant incidence (15%) of hypertension is documented in traumatic brain-injured patients, the problem appears transient for most patients. Nonetheless, hypertension after brain injury merits treatment while it is an ongoing process for the anticipated few patients in whom it might persist.

Adult↗