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Arthur M. Lam, H. Richard Winn, Bruce F. Cullen, and Nancy Sundling

a stress response and reflects the extent of brain injury 27, 31 and, as such, has prognostic significance. 20, 24, 31 On the other hand, it may have a direct impact on neurological outcome since hyperglycemia has been shown in both experimental and clinical studies to exacerbate the severity of brain injury during ischemic conditions. 2, 3, 7, 16, 18, 25 The etiology of the increased neuronal injury caused by hyperglycemia is likely related to continuing anaerobic metabolism leading to intracellular acidosis and accumulation of lactate, 14, 19 particularly

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Narendra Nathoo, Pradeep K. Narotam, Devendra K. Agrawal, Catherine A. Connolly, James R. van Dellen, Gene H. Barnett, and Runjan Chetty

and to determine the role of these proteins in and their relationships, if any, to neurological outcome. Clinical Material and Methods Patient Population and Specimens Approval for this study was obtained from the University of Natal's institutional review board. Thirty-four surgical samples were harvested from the PIZ in patients with CT-confirmed traumatic, supratentorial cerebral contusions who had been selected for an ongoing, randomized, prospective controlled trial to study treatment paradigms for traumatic cerebral contusions. The size of the

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Zaitun Zakaria, Chandrasekaran Kaliaperumal, Darach Crimmins, and John Caird

S pontaneous intracranial hematoma is an unusual complication of primary and secondary coagulation diatheses in children. 7 , 22 Management of these cases is a challenge when the patients present with acute neurological deterioration. However, with prompt diagnosis and an appropriate hematological treatment plan, a good neurological outcome may be achieved. A combined approach is necessary for 1) rapid access to neuroimaging for prompt radiological diagnosis, 2) correction of any coagulation abnormalities (including perioperative correction), and 3) immediate

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Andreas Gruber, Andrea Reinprecht, Harald Görzer, Peter Fridrich, Thomas Czech, Udo M. Illievich, and Bernd Richling

the direct effects of SAH, repeated SAH, or chronic arterial spasm. 32 Pulmonary dysfunction was responsible for 50% of all deaths resulting from medical complications in the aforementioned study. 32 In view of these findings, the purpose of this observational study was to examine the relationship between a patient's neurological condition and pulmonary function and the influence of pulmonary function on neurological outcome. Clinical Material and Methods Since February 1992, 380 patients have been treated for cerebral aneurysms at the General Hospital of

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Kevin James Tierney, Natasha V. Nayak, Charles J. Prestigiacomo, and Ziad C. Sifri

of antiplatelet or anticoagulant, was collected. The number, date, time, and findings of the initial and all subsequent cranial CT scans were recorded from radiographic reports by staff radiologists. Operative reports on the NSI were reviewed for timing and type of operation performed. Outcome variables were reviewed. Primary outcome variables were the GOS score and mortality rate. A good neurological outcome was defined as a GOS score of 4 (mild disability) or 5 (good recovery), whereas a poor neurological outcome was defined as a GOS score of 3 (severe

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Joshua Wayne Gatson, Victoria Warren, Kareem Abdelfattah, Steven Wolf, Linda S. Hynan, Carol Moore, Ramon Diaz-Arrastia, Joseph P. Minei, Christopher Madden, and Jane G. Wigginton

resected after severe TBI, diffuse plaques were observed throughout the cortex in specimens resected as early as 2 hours postinjury. This was observed in 33% of the patients in this study (age range of this subgroup 35–62 years). 19 These findings suggest that following injury to the brain, there is a great increase in the expression of amyloid precursor protein, which may lead to the production of chronic β-amyloid plaques. Also, it has been determined that CSF levels of Aβ42 in patients with TBI may help predict neurological outcome, since patients with good

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Stephen P. Kingwell, Armin Curt, and Marcel F. Dvorak

most common spinal column injuries resulting in CMI or CEI are burst fractures and fracture dislocations. Flexion-distraction injuries may also lead to neurological deficits at these levels, although they are less common and have less risk of an associated neurological lesion. 18 , 23 , 38 Combining the assessment of spinal stability, neurological status, and unique patient factors, the surgeon is now able to develop an appropriate management plan. Management Factors Affecting Neurological Outcome Canal Encroachment In a small retrospective study

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Zeev Feldman, Boris Gurevitch, Alan A. Artru, Arieh Oppenheim, Esther Shohami, Eli Reichenthal, and Yoram Shapira

release in brain tissue has been reported in association with brain injury in rats. 7, 24, 25, 33 The noncompetitive agent phencyclidine attenuated long-term behavioral deficits after traumatic brain injury (TBI) in the rat. 18, 57 Ketamine and dextrorphan blocked NMDA excitation, improving the neurological outcome after TBI in rats and reducing the increase in brain tissue Ca ++ and the decrease in brain tissue Mg ++ . 9, 44, 48 Shapira, et al. , 49 reported that the beneficial effects of ketamine administration following TBI were dose and time related. Ketamine

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Franklin C. Wagner Jr. and Bahram Chehrazi

I t is uncertain what effect compression of the cervical spinal cord which persists after a closed injury has on neurological outcome. In contrast, the results of an untreated fracture-dislocation of the cervical spine are better known. In the latter situation, it is generally agreed that if a fracture-dislocation persists bone healing is likely to be retarded, and that if angulation occurs a delayed neurological loss may result. 1, 4, 7, 20 Consequently, immobilization and reduction of fracture-dislocations with skeletal traction are well accepted measures

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Christopher J. Stapleton, Brian P. Walcott, William E. Butler, and Christopher S. Ogilvy

event is lower with coil embolization, the consequences of this complication are more profound in this setting. Several retrospective studies and meta-analyses have examined risk factors for aneurysm rerupture during endovascular coiling, techniques for IPR management, and radiographic and neurological outcomes following IPR. 2 , 13 , 14 , 17 , 21 , 24 No study, however, has reported comparative rates of vasospasm or need for CSF diversion in patients who suffer IPR versus those who do not. The purpose of this study was to evaluate the effect of IPR during