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J. M. Allcock

have survived for up to 1 year, and another 17 are still alive after varying periods of 1 to 5 years. The remaining 6 were first seen over 5 years ago. Clinical Outcome The patients were graded into four categories according to their eventual outcome. Under the heading of “Good” were put all those who made a complete recovery or were left with a disability so minor that it did not prove a handicap. Those who had some residual disability that was rather more marked, but who it was thought should be able to lead a reasonably normal and effective life in

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John Mealey Jr., Andrievs J. Dzenitis and Arthur A. Hockey

–1957 1958–1967 Total Operation Total Operation Competitive 7 7 7 7 Defective 4 3 8 8 Dead 21 11 7 4 Total 32 21 22 19 * Case whose occipital lesion resolved spontaneously and who is normal is excluded. The Time of Surgical Intervention For occipital encephalocele, the timing of operation had no clearly discernible influence on the ultimate clinical outcome ( Fig. 2 ). Of the five infants operated on within 24 hours of birth, one premature infant did not survive the

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Anthony J. Raimondi and G. H. Samuelson

clinical outcome of each particular case. Our series is not large enough to form any conclusions concerning these factors, but they may well be worth considering in more extensive studies of this type. Table 4 is a tabular representation of many of these parameters as observed in our series. TABLE 4 Summary of clinical and ballistic factors related to deaths Ballistic Data Total Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Total Deaths Total Operations Operative Deaths Basilar Fracture Linear Fracture

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Stephen H. Martin and James R. Bloedel

irreversibly disappeared (Groups C and D), the gliosis and central cystic degeneration was severe. Very little of the normal cord was preserved ( Fig. 3 ). Similar lesions were found by Assenmacher and Ducker 3 in all of their chronic animals with irreversible lesions. Discussion These results imply that changes in the cortical responses evoked by peripheral stimulation may indeed be useful in determining the clinical outcome of animals with “closed” spinal cord injuries. In every animal studied, ability to walk returned only if the response never disappeared or

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Cerebral circulation after head injury

Part 1: Cerebral blood flow and its regulation after closed head injury with emphasis on clinical correlations

Jørn Overgaard and William A. Tweed

are clearly significant. The very acute period after injury was characterized by normal or low flow values, but was quickly succeeded by a period of relative hyperemia which persisted into the second or third week from injury. Despite the slight bias of patient selection, the inter-group variations must be due chiefly either to the natural history of the disease, the results of treatment, or to both. A poor clinical outcome was observed when patients had either ischemia or hyperemia in the acute stage of injury. All five of the patients with an acute phase CBF

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Spinal arachnoid cysts

Report of six cases

Jacques J. Palmer

evacuated, and nothing further was done pending observation of the clinical outcome from this decompression. The patient made a remarkable recovery. When examined 1 month later he had resumed normal play and except for slight spasticity of the legs and equivocal plantar responses he was neurologically intact. On February 21, 1970, he started to wake up at night complaining of severe neck pain which was followed by decerebrate posturing and variable periods of flaccidity of both arms. There was no weakness of the legs or sphincter disturbance. He seemed unresponsive

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Cerebral circulation after head injury

Part 2: The effects of traumatic brain edema

Jørn Overgaard and William A. Tweed

clinical evidence of recovery. Fig . 1. Clinical outcome in patients related to presence or absence of traumatic brain edema (BE). The statistical significance of differences was tested by the chi-square test. No significant difference in clinical outcome could be attributed to BE, although there is obviously a marked difference in clinical mortality (vegetative or dead) among the three neurological classes. White area = recovery; hatched area = severe deficits; black area = vegetative or dead. Treatment It is, of course, impossible to investigate the

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Patrick J. Kelly, Ralph J. Gorten, Robert G. Grossman and Howard M. Eisenberg

relationship of the adequacy of cerebral perfusion to the outcome in a group of patients with ruptured intracranial aneurysms by using radionuclide cerebral perfusion scintigraphy (dynamic brain scanning) 4 as an index of the adequacy of cerebral perfusion. In the following retrospective study, the findings of dynamic brain scanning and the presence or absence of arteriographic spasm are correlated with the clinical outcome in patients with ruptured intracranial aneurysms. Clinical Material and Methods Dynamic brain scans were performed on 44 patients admitted to the

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Evaluation of brain function in severe human head trauma with multimodality evoked potentials

Part 2: Localization of brain dysfunction and correlation with posttraumatic neurological conditions

Richard P. Greenberg, Donald P. Becker, J. Douglas Miller and David J. Mayer

, as well as clinical outcome. The scheme shown in Fig. 8 outlines our goal. Persisting focal deficits difficult to diagnose acutely by clinical neurological examination in unresponsive patients, such as deafness, visual dysfunction, and hemiparesis, were also evaluated electrophysiologically. Fig. 8. Scheme showing the relationship of evoked potentials and prognosis in patients with brain injury. Dysfunction of Specific Neural Systems The evaluation of dysfunction in specific neural systems with evoked potentials proved to be extremely valuable

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Thomas W. Langfitt

very little information in the literature on clinical outcome, and then more recently a resurgence of interest in not only measuring outcome but also predicting the end result as soon as possible following admission. In 1909, Phelps 12 reported a mortality rate of 59% among 542 patients who were unconscious after head injury, and the following year Ransohoff 13 reported a mortality rate of 70% among 98 patients in “deep coma.” In a report by Carter, 4 in 1926, the mortality rate was 66.3% among patients who were “unconscious on admission and remained so for