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Kuo-Sheng Hung MD Phd Chung-Ling Liang MD Cheng-Haung Wang MD Hsueh-Wen Chang PhD Naeun Park MS Suh-Hang Hank Juo MD PhD 《Journal of clinical neuroscience》2004,11(8):849-853
Frontal intracerebral haemorrhage (ICH) is a common result of cranial trauma. Outcome differences between bilateral and unilateral frontal ICH are not well studied but would be valuable to predict prognosis in clinical practice. Two aims are proposed in this study: first to compare the risk of developing delayed ICH after bilateral or unilateral frontal ICH, and second to determine the variables helpful to predict outcome according to the Glasgow Outcome Scale (GOS). Between January 1993 and December 1997, 694 consecutive patients with traumatic ICH were admitted to the Chang Gung Medical Center within 24 h of the trauma. Patients with ICH in sites other than the frontal lobes were excluded. A total of 161 cases (mean age 46.3+/-20.3 years), including 57 bilateral (mean age 52.5+/-18.7 years) and 104 unilateral (mean age 42.9+/-20.5 years) traumatic frontal ICH were studied. Twenty-eight of 57 patients (49%) with bifrontal ICH versus 17 of 104 patients (16%) with unilateral frontal ICH had a further, delayed ICH. In 42 of 45 patients (93%) with delayed ICH, this occurred within 5 days of the initial trauma. Multivariate logistic regression was used to select significant predictors of outcome. We found that delayed ICH (p<0.001), age (p=0.004) and mechanism of injury (p=0.001) explained the worse outcome in patients with bifrontal ICH. The best-fitting logistic regression model included three variables: delayed ICH (p=0.011), initial GCS (p=0.023), and a sum score of clinical and radiological variables (p=0.003). Bifrontal ICH tended to occur in older patients after a fall and was associated with a higher risk of developing delayed ICH or brain stem compression compared to unilateral ICH damage. Using these three variables - delayed ICH, initial GCS, and the sum score - in a logistical regression model is useful to predict outcome in patients with traumatic frontal ICH and may aid patient management. 相似文献
3.
Summary 115 traumatic extradural haematoma cases who were treated surgically at Cerrahpasa Medical Faculty Neurosurgery Department between 1987 and 1992 are evaluated.When factors affecting the outcome were examined, a strong correlation was found between the result andGlasgow coma scale (GCS) (p<0.00001). The existence of a fracture, the interval between onset of haematoma symptoms and intervention and the existence of an intracerebral haematoma together with contusion accompanying intradural haematoma, affect the outcome in a negative direction. There was no statistical correlation between the outcome and the age of patient, localization of the haematoma and aetiology. 相似文献
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5.
孙迎香 《安徽卫生职业技术学院学报》2005,4(4):14-14
目的:探讨老年糖尿病低血糖昏迷特点.方法:对12例老年低血糖昏迷患者回顾性分析.结果:本组患者均以昏迷为首发症状,且应用降糖药物不规范.结论:老年低血糖患者症状多不典型,很快进入昏迷状态,易误诊而延误治疗. 相似文献
6.
本文报告50例肝硬化患者SCG含量的临床意义.结果表明,SCG测定诊断肝硬化的阳性率为92%,明显高于SGPT(53%)及ADA(78.6%)的阳性率.Child-pugh肝功能分级中A、B、C级SCG值分别为10.14±6.03,23.55±11.27和54.66±24.47μmol/L(P<0.01).相关分析表明,SCG与血清白蛋白含量呈负相关(r=-0.5018.P<0.01),与胆红素含量呈正相关(r=0.6964,P<0.01).并发肝性脑病和原发性肝癌者及死亡病例,其SCG升高更为明显.我们认为肝硬化患者SCG值大于40μmol/L预示病情危重,预后不良. 相似文献
7.
Prognostic value of somatosensory- and motor-evoked potentials in patients with a non-traumatic coma
Josef Zentner Alois Ebner 《European archives of psychiatry and clinical neuroscience》1988,237(3):184-187
Summary A total of 28 patients with non-traumatic coma were studied both with somatosensory- and motor-evoked potentials. While somatosensory-evoked potentials (SEP) have proved to be useful in predicting the outcome in patients with severe brain damage, the aim of this study was to find out whether the additional evaluation of motor-evoked potentials (MEP) could contribute to a better prediction of the outcome than SEP alone. Our results clearly indicate that in terms of prognostic value, SEP are superior to MEP. Nine patients with bilaterally preserved MEP died, while all of the patients with bilaterally preserved SEP and a central conduction time 6.5 ms survived, with a Glasgow outcome score of 1 to 3. Therefore, we cannot recommend the inclusion of MEP in the prognostic evaluation of patients with non-traumatic coma. 相似文献
8.
A case of somatostatin-producing pancreatic tumor associated with severe insulindependent diabetes mellitus and ketoacidotic
coma is reported. The tumor, a 10-cm expansile mass arising from the pancreatic tail of a 70-yr-old woman, was first detected
by ultrasonography, performed because of abdominal pain, and subsequently confirmed by computed tomography and fine-needle
tumor aspiration. Pathologic investigation showed a predominatly solid-trabecular structure with scattered microacini and
psammomatous bodies. A large proportion of tumor cells expressed somatostatin and/or calcitonin. Following resection of the
primary tumor and three peripancreatic lymph nodes with metastases, the patient recovered rapidly from her diabetic syndrome
and remained in substantially good health during a subsequent 8-yr follow-up period, without evidence of tumor recurrence. 相似文献
9.
Use of post-mortem human synaptosomes for studies of metabolism and transmitter amino acid release 总被引:2,自引:0,他引:2
J A Hardy P R Dodd A E Oakley A M Kidd R H Perry J A Edwardson 《Neuroscience letters》1982,33(3):317-322
Synaptosomes have been prepared from human brain obtained at autopsies carried out up to 24 h postmortem (p.m.). They showed generally good retention of morphology, as well as accumulation of tissue potassium and linear rates of oxygen uptake. In response to veratrine depolarization they showed increased respiration rate, decreased tissue potassium content and the specific release of transmitter amino acids. Regression analysis indicated that metabolically and functionally active preparations may be obtained up to ca. 25 h p.m. Preparations obtained from patients dying with brain injury were inactive. 相似文献
10.
Dr. H. Hörtnagl H. Lochs G. Kleinberger J. M. Hackl A. F. Hammerle H. Binder F. Wewalka 《Journal of molecular medicine (Berlin, Germany)》1981,59(20):1159-1164
Summary Plasma levels of adrenaline, noradrenaline and octopamine were estimated by a radioenzymatic method in nine cirrhotic outpatients with encephalopathy and in ten patients with hepatic coma (coma grade III–IV). In the cirrhotic outpatients normal as well as elevated plasma levels of noradrenaline were found. Octopamine could not be detected in the plasma of these patients as well as of ten healthy volunteers. Elevated noradrenaline levels were present in all patients with hepatic coma. Plasma noradrenaline remained elevated or even further increased during the course of hepatic coma, whereas adrenaline was elevated less frequently. In eight of the ten patients with hepatic coma octopamine was again not detectable in plasma. Only in two patients high levels of octopamine up to 59.5 ng/ml could be found in addition to increased noradrenaline concentrations. The infusion of the branched chain amino acid L-valine had no influence on the plasma level of either noradrenaline or octopamine.The data indicate that the sympathetic nervous system is activated during the course of hepatic coma. An accumulation of octopamine is not a common finding in chronic liver disease and hepatic coma. Since in the two patients with elevated octopamine levels the rise in octopamine occured concomitantly with a rise in noradrenaline, a displacement of noradrenaline by the false neurotransmitter octopamine in the noradrenergic neuron of the peripheral sympathetic nervous system seems unlikely. The results indicate that the development of hypotension in the course of liver cirrhosis and hepatic coma cannot be related to a deficiency of noradrenaline.Deeply moved we have to inform the readers about the sudden death of our colleague and teacher Professor Dr. F. Wewalka 相似文献