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At least 865 records · Page 48Linked to original sources
PubMed1991

[Cerebral contusions. Study of 182 cases].

Clinical cases were selected in which cerebral contusions were the only visible lesions in CT scan on admission over the period from January 1983 and December 1985. The following characteristics were evaluated: Age, sex, conscience level (Glasgow) at admission, early post-traumatic epilepsy, focal signs, lesion mechanism, cranial fracture, as well as CT scan in which specific signs of bad prognosis were analyzed. According to the evolution of conscience level 3 groups of patients were established: Group 1 "no coma", group 2 "coma with lucid interval", group 3 "coma without lucid interval" and were correlated with the previously mentioned characteristics. The highest mean age (59.2 years) appeared in group 2. In 75% of patients in group 3 a traffic accident was the lesion mechanism. Admission CT scan showed that the severity is related to bad prognosis signs (displacement of middle line, lack of 3rd ventricle, and basal cisterns and multiple lesions). Mortality was approximately 70, 80 and 90% whether they had one, two, or three bad prognosis signs at admission CT scan.

Adult↗
PubMed1990

[Indomethacin in severe cerebral contusions with intracranial hypertension].

In five head-injured patients with cerebral contusion and oedema in whom it was not possible to control ICP by hyperventilation and barbiturate sedation, indomethacin Confortid was used as a cerebral vasoconstrictor drug. In all patients indomethacin reduced ICP below 20 mmHg for several hours. Studies of cerebral circulation and metabolism during indomethacin treatment showed a decrease in cerebral blood flow (CBF) at 2 hours. After 7 hours. ICP remained below 20 mmHg in three patients, and these still had reduced CBF. In two patients a return of ICP and CBF to pretreatment levels was observed. In all patients indomethacin treatment was followed by a fall in rectal temperature. Outcome scaling has not yet been performed, but all patients left hospital without neurological deficits. These results suggest that indomethacin is an alternative in the treatment of intracranial hypertension in head-injured patients.

Adult↗
PubMed1990

[Heart contusion].

This 40 year old patient was involved in a car accident which resulted in a thoracic trauma with fracture of the sternum and the left radius. The ECG showed a complete right bundle branch block and a left anterior fascicular block (= bifascicular block). These electrocardiographic findings and an elevated CK-MB fraction after thoracic trauma were indicative for the diagnosis of myocardial contusion. The ECG was normal after 24 hours, the CK-MB after two days. The patient left the hospital after one week. Five weeks later, a control examination showed no cardiological abnormalities.

Electrocardiography↗
PubMed1990

[Treatment of post-reno-contusive arterial hypertension by upper polar nephrectomy. Results after 10 years].

The authors report the observation of arterial hypertension occurring six years after renal trauma, secondary to the upper polar infarction of the left kidney accompanied by a hypersecretion of bilateral renin and whose cure was obtained by partial nephrectomy. According to a literature review, it seems that post-reno-contusive arterial hypertension is not rare and can be due to various lesions whose common denominator is renal ischaemia. At present, no clinical or paraclinical element enables the prediction with certainty of the reversibility of the hypertension after the surgical intervention. However, the earlier the intervention, the better the chances of recovery, thus showing the importance of the systematic screening of renal lesions after lumbo-abdominal trauma.

Child↗
PubMed1985

[Transformation to an animal. Metamorphosis or metaphor? A delusional episode following brain contusion].

Three years after a serious cerebral contusion a patient became delirious for a period of several months. During that time he pretended to turn into a cock. This theme is interpreted as a metaphorical expression rather than as a firm belief in a real metamorphosis. The feelings of strangeness considered as a matricial condition of delirious phenomenons are debated. Of first importance are the lesions of the right hemisphere upon which are often added more diffuse impairments of the frontal lobes and of the brain stem. The rarity of this phenomenon is to be emphasized whereas the references to animals seem to haunt human soul.

Brain Concussion↗
PubMed1989

Protection of rat spinal cord against contusion injury by new prostaglandin derivatives.

Two prostaglandin oligomeric compounds, an acid-form compound and an ester-form compound, were synthesized from alprostadil (prostaglandin E1). They were found to provide significant protection to the rat spinal cord against contusion injury. After laminectomy at the T-11 segment of the spinal cord, a weight drop (10 g x 5 cm) caused a "dynamic" injury. The degree of recovery was estimated by several neurologic deficit indices; the Tarlov score, inclined plane test and hot plate test. In the control group (no drug), animals were still paralyzed 4 weeks after injury (Tarlov score 1 to 2). By administering these prostaglandin oligomers, either pre-injury (30 min before injury; one dose of 6 mg/kg i.p.) or post-injury (3 doses, each of 6 mg/kg i.p. at 30 min, 6 h, and 12 h after injury), the Tarlov scores recovered to 3.5 to 4.5 by 4 weeks, and animals were able to either support body weight or to walk with a slight deficit. Although both acid- and ester-forms of the compound demonstrated efficacy, the ester-form provided greater protection to the spinal cord. Other neurologic deficit indices also supported these observations.

Animals↗
PubMed1988

The influence of piracetam on the motor activity of rabbits with contusioned spinal cord.

Rabbits were made paraplegic by spinal cord contusion. There was a good correlation between motor function and microscopic findings. The spinal lesion significantly increased creatine kinase (CKBB) isoenzyme activity in cord tissue. Significant protection from paralysis was conveyed by piracetam (a psychoactive drug with neuroprotective activity) (2 g.kg-1 i.v.) administered once per day during 9 posttraumatic days. Piracetam significantly diminished increased activity of CKBB in the severed spinal cord. The sooner the piracetam was injected after the lesion the better protective effect was seen. No side effects of piracetam were seen.

Animals↗
PubMed1988

[Use of puncture perfusion in the treatment of patients with brain contusions complicated by subarachnoid hemorrhage].

Puncture-perfusion technique has been introduced for subarachnoidal sanative treatment in patients with brain contusions complicated with subarachnoidal hemorrhages. The intervention resulted in faster reversal of general cerebral and meningeal signs, restoring to normal values the body temperature, heart rate, venous and CSF pressures. Indications and counterindications for this technique application are given.

Acute Disease↗
PubMed1987

[The value of echography in scrotal contusions. Personal experience apropos of 20 cases].

We report a serial case study of 20 patients presenting scrotal contusions and for whom an emergency scrotal ultrasonography was performed. This investigation is not a luxury. It was a useful confirmation diagnostic tool for hematocele in 1/3 of cases (7/20) as well as for the detection of associated epididymal and or testicular lesions. In 2/3 of cases (13/20) it detected lesions unsuspected by clinical examination so that a therapeutic decision was taken promptly. Scrotal echography is therefore a useful emergency tool not for major trauma where the surgical decision is evident, but for apparently benign trauma where the clinical examination is currently deficient and needs provided a trained ultrasonography operator is available.

Adult↗
PubMed1985

An assessment of acid-base balance and activity of lysosomal enzymes: mannosidase, b-galactosidase and b-glucosidase in CSF and arterial blood in early and later phases of the clinical course of cerebral contusion.

Results of the examination of the acid-base balance and the concentration of enzymes - mannosidase, b-galactosidase and b-glucosidase in 61 patients with cerebral contusion are presented. Examination was carried out on an average 11, 15 and 39 days after injury in groups of patients characterised by various clinical states. Examination showed that, in contradistinction to the acid-base balance, enzymal changes in CSF are less evident than in blood. On the base of the results presented it would appear that the level of b-glucosidase in CSF changes in accordance with the level in the blood whereas the other enzymes show a certain autonomy of the CSF in this field.

Acid-Base Equilibrium↗
PubMedDate not supplied

[Phasic character of neuroendocrine disorders in cerebral contusions].

A phase character of neuroendocrine disorders and their relationship with the neurological symptoms were established in patients with contusion of the brain. A long duration of the adrenergic-corticoid stage depending on the severity of the craniocerebral trauma was revealed. Regression of the neurological symptoms occurs in the stage of corticosteroid concentration reduction. Not all hormonal disorders disappear in the anabolic stage and the stage of restoration of the fat resources; this calls for pathogenetic correction with due consideration for the phase character of the course of the craniocerebral trauma.

11-Hydroxycorticosteroids↗
PubMed1980

Efficacy of steroids in the treatment of lung contusion.

Haemodynamic, metabolic and clinical data were recorded in patients suffering from lung contusion following blunt chest trauma. The effects of large doses of methylprednisolone (30 mg per kg b.w.) were studied in 10 patients selected at random, and compared with 10 patients receiving no steroids, but who otherwise were treated in the same way. Serious post-traumatic complications were reduced in the steroid group. The beneficial effect of the steroid treatment seemed to be associated with a significant reduction in pulmonary vascular resistance, which may lead to a better tissue perfusion and a reduction of right heart work.

Clinical Trials as Topic↗
PubMedDate not supplied

[Visual evoked potentials in cerebral contusions].

The authors carried out neurophysiological examination of 70 patients with mild and moderate degree contusion on the convex surface of the brain by the method of induced visual potentials. Changes in the amplitude-time characteristics of visual induced potentials were revealed, which is evidence of pathophysiological changes in the brain limbico-reticular structures. Study of the induced makes it possible to reveal the character and side of the injury in early periods and guide pathogenetic treatment.

Brain↗
PubMedDate not supplied

[Vascular and tissue changes in brain contusion foci in the acute period of craniocerebral trauma with varying degrees of consciousness disorder].

The author presents a comparative analysis of vascular and tissue reactions in brain contusion foci in the acute period of a craniocerebral injury involving various degrees of consciousness disorders. These reactions were found to depend on the periods elapsed since the injury and the severity of consciousness disorders.

Acute Disease↗
PubMed1994

[Successful reconstruction of a skull base fracture with frontal lobe contusion by omental transplantation for recurrent posttraumatic tension pneumocephalus: a case report].

In July 1983, 26 year-old male was admitted to our neurosurgical clinic after severe head injury caused by a car accident. Recovery of consciousness was delayed for months due to bilateral frontal lobe contusions with anterior skull base fractures on both sides. He was first discharged 6 months after surgery for ventriculo-peritoneal shunting. He was readmitted to our department due to an episode of urinary incontinence with gait disturbance 11 months after the accident. CT film of the head revealed the presence of an air shadow at the left frontal base. Utilizing lyophyllized dura mater, the first cranial surgery for closure of cerebrospinal fluid leakage was carried out in July, 1984. Pneumocephalus with meningitis recurred again five years later. Repeated conventional surgery failed including a transsphenoidal and transfrontal sinus approach to treat the recurrent pneumocephalus. In order to close the defect in the skull base, and to obliterate the dead space in the left frontal lobe, vital tissue transplantation was planned. On May 23, 1990, seven years after the accident, the skull base defect was repaired by suturing fascia taken from the temporal muscle. Then the patient's vascularized omentum was utilized as an autograft by micro-surgical technique. A superficial temporal artery and vein, and superficial sylvian vein were used to vascularize the omentum. The patient has been totally free of pneumocephalus for more than three and half years following the radical surgery. Clinical omental transplantation using microsurgical technique for vascularization of cerebral circulation as well as plastic surgery has been reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Contusion of the liver. Importance of associated lesions in polytraumatized patients].

Between January 1984 and June 1993, we treated 120 contusions of the liver in a situation of polytrauma. There were 24 patients in Stage I, 47 in Stage II, 22 in Stage III, 13 in Stage IV and 14 in Stage V according to the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma. A total of 107 patients were operated. Polytrauma related mortality was high. Besides the gravity of the liver lesion, prognosis was a function of other associated intra or extra abdominal lesions. In our series, other associated lesions were the cause fo death in 26 patients (64%) and 15 deaths (36%) were directly related to the hepatic lesion. The gravity of the Stage V lesions was related both to the state of shock of operation and the difficulties in reestablishing haemostasis. Packing decreased the effect of hypovolaemia and coagulopathy. The prognosis of supra hepatic venous lesions and hepatic resections remain disastrous. Our surgical schema has changed towards more conservative surgery and, when haemodynamic stability has been achieved, to abstention and careful monitoring. Different extra-hepatic trauma causing damage to other organs directly compromises simple hepatic lesions. The result of our series confirms the correlation between mortality and the gravity of the polytrauma as evaluated according to the Injury Severity Score proposed by Baker.

Abdominal Injuries↗