Brain long-term outcomes

Brain metastases are among the most feared complications of cancer and generally carry a poor prognosis. One serious consequence of brain metastases is elevated intracranial pressure, which can rapidly lead to fatal intracranial herniation and death. Rapid identification of the signs and symptoms of brain metastases is critical to improve long-term outcome and avoid mortality. 

Silverman, D. H., Small, G. W., Chang, C. Y. et al. Positron emission tomography in evaluation of dementia regional brain metabolism and long-term outcome. JAMA 286 2120-2127, 2001. 

Richelson E, Nelson A Antagonism by neuroleptics of neurotransmitter receptors of normal brain in vitro. Eur J Pharmacol 103 197-204, 1984 Rickels K, Schweizer E The treatment of generalized anxiety disorder in patients with depressive symptomatology. J Clin Psychiatry 54 [suppl) 20-23, 1993 Rickels K, Weisman K, Norstad N, et al Buspirone and diazepam in anxiety a controlled study. J Chn Psychiatry 43(12 pt 2) 81-86, 1982 Rickels K, Feighner JP, Smith WT Alprazolam, amitriptyline, doxepin, and placebo in the treatment of depression. Arch Gen Psychiatry 42 134-141, 1985 Rickels K, Schweizer E, Weiss S, et al Maintenance drug treatment for panic disorder, 11 short- and long-term outcome after drug taper. Arch Gen Psychiatry 50 61-68, 1993... 

In 138 Japanese patients with West syndrome treated with low-dose tetracosactide, the initial effects on seizures and long-term outcome were not related to dose (daily dose 0.005-0.032 mg/kg, 0.2-1.28 IU/kg total dose 0.1-0.87 mg/kg, 4—35 IU/kg) (7). There were moderate or severe adverse effects in 30% of the patients. There was slight loss of brain volume on CT/MRI scans in 64% of the patients, moderate loss in 23%, and severe loss in 4%. The severity of adverse effects correlated with the total dose of corticotropin, and the severity of brain volume loss due to corticotropin correlated well with the daily and total doses. The authors recommended a reduction in the dose of corticotropin in order to avoid serious adverse effects. 

Hankey GJ (1991). Isolated angiitis/angiopathy of the central nervous system. Cerebrovascular Diseases 1 2-15 Hankey GJ (2003). Long term outcome after ischaemic stroke/transient ischaemic attack. Cerebrovascular Diseases 16(Suppl 1) 14-19 Hankey GJ, Warlow CP (1994). Major Problems in Neurology, Vol. 27 Transient Ischaemic Attacks of the Brain and Eye. London Saunders... 

Kafritsa Y, Fell J, Long S, Bynevelt M, Taylor W, MiUa P. Long-term outcome of brain manganese deposition in patients on home parenteral nutrition. Arch Dis Child 1998 79 263-5. 

Smith DF Lithium attenuates clonidine-induced hypoactivity further studies in in-bred mouse strains. Psychopharmacology 94 428-430, 1988 Smith DF, Amdisen A Lithium distribution in rat brain after long-term central administration by minipump. J Pharm Pharmacol 33 805-806, 1981 Smith J, Williams K, Birkett S, et al Neuroendocrine and clinical effects of electroconvulsive therapy and their relationship to treatment outcome. Psychol Med 24 547-555, 1994... 

Based on experimental and clinical data, cerebral hypothermia appears to be a potent therapeutic approach to treating brain trauma. However, recent results from the Multicenter National Brain Injury Study Hypothermia (NABIS H) clinical trial appear to be disappointing, and more refinement of the clinical application of hypothermia is required (73). Additional clinical trials are now required to evaluate systematically the beneficial effects of clinical hypothermia in different populations of brain-injured patients. In addition, experimental data regarding the beneficial effects of combination therapy are required to evaluate whether hypothermia plus pharmacotherapy may provide a better outcome. Forexample, mildpostischemichypothermia(33-39°C) combined with the antiinflammatory cytokine IL-10 has recently been reported to produce long-term protection of the C Al hippocampus after transient global ischemia (74). Hypothermia or IL-10 treatment alone did not protect chronically. In contrast, Kline etal. (75) showed that acute systemic administration of IL-10 suppressed the beneficial effects of... 

Benesch, M., Lackner, H., Moser, A., Kerhl, R., Schwinger, W., Oberbauer, R. Eder, H.G., Mayer, R., Wiegele, K., Urban, C. (2001). Outcome and long-term side effects after synchronous radiochemotherapy for childhood brain stem gliomas. Pediatr. Neurosurg. 35 173-80. 

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