Cerebral trauma

G18. Gottardis, M Nigitsch, C., Schmutzhard, E Neumann, M Putensen, C., Hackl, J. M., and Roller, W The secretion of human growth hormone stimulated by human growth hormone releasing factor following severe cranio-cerebral trauma. Intensive Care Med. 16, 163-166... 

FIGURE 13-1 Schematic illustration of the basic components of the stretch reflex. Normally, higher CNS centers control the sensitivity of this reflex by inhibiting synaptic connections within the spinal cord. Spasticity is thought to occur when this higher center influence is lost because of cerebral trauma or damage to descending pathways in the spinal cord. 

Fay T. (1943) Observations on generalized refrigeration in cases of severe cerebral trauma. Assoc. Res. Nerv. Merit. Dis. Proc. 24, 611-619. 

Contraindications include moderate to severe h)q ertension, congestive cardiac failure or a history of stroke acute or chronic alcohol intoxication, cerebral trauma, intracerebral mass or haemorrhage or other causes of raised intracranial pressure eye injury and increased intraocular pressvue psychiatric disorders such as a schizophrenia and acute psychoses. 

Hyperpyrexia has been attributed to famotidine, but the patient had pre-existing cerebral trauma as a facilitating factor (SEDA-16, 422). 

Cerebrospinal fluid 6-keto-PGF, pg/mi 120 -3600 (F) Man GC-MS normal cerebral trauma, epilepsy. 128... 

Orotic acid at high doses (3-6 g per day) was used with moderate success in adult patients with pernicious anaemia [444]. Kelley and co-workers [445] investigated the use of orotic acid in the treatment of hyperuricaemia. There was a 20-30% inhibition of purine biosynthesis and an increase in renal clearance of uric acid, but orotic acid offered no advantages over other available agents. Orotic acid in combination with vitamin was used in children with disturbed memory [446], and in combination with Kanaform in patients with cerebral trauma and vascular affections [447]. 

Erectile dysfunction is noted in patients with neurological disorders such as Parkinson s and Alzheimer s diseases, stroke, and cerebral trauma, often secondary to a decrease in libido or inability to initiate the erectile process. Spinal cord injury patients have varying degrees of erectile dysfunction largely dependent on the location and extent of the lesion. Sensory input from the genitalia is essential to achieve and maintain reflexogenic erection, and this input becomes more important as the effect of... 

Other problem exists in the case of dura mater. Injury of dura mater may result from many causes, including cranio-cerebral trauma, destruction by tumor, surgical removal, and various congenital matformations. For almost 100 years various artificial... 

Childs, C, 2008. Human brain temperature regulation, measurement and relationship with cerebral trauma part 1. Br. J. Neurosurg. 22, 486-4%. 

Dissection of the internal carotid and vertebral arteries is a common cause of stroke, particularly in young patients. Although many occur due to trauma, it is estimated that over half occur spontaneously. The mechanism of stroke following arterial dissection is either by artery-to-artery embolism, by thrombosis in situ, or by dissection-induced lumenal stenosis with secondary cerebral hypoperfusion and low-flow watershed infarction. Occasionally, dissection may lead to the formation of a pseudoaneurysm as a source of thrombus formation. Vertebrobasilar dissections that extend intracranially have a higher risk of rupture leading to subarachnoid hemorrhage (SAH). ° ... 

It has been revealed that cannabinoids exhibit neuroprotectant activities in both in vitro and in vivo models [249]. The neuroprotective effects are mainly based on regulation of transmitter release, modulation of calcium homeostasis, anti-oxidant properties and modulation of immune responses. A number of neurological disorders, including brain trauma, cerebral ischaemia, Parkinson s disease and Alzheimer s disease represent possible therapeutic areas for cannabinoids with neuroprotective properties. Cannabinoids are also suggested to have potential against glaucoma due to their neuroprotective nature and lowering of intraocular pressure [250]. 

A recent patent application from Roche [352] described a 2-amino-benzothiazole series. Roche claimed that compound (605) exhibited an IC50 value of 0.73 uM at CBi, and showed in excess of 10-fold selectivity over the CB2 receptor. The compounds were described as being of potential use in the treatment of a range of diseases, including CNS and psychiatric disorders, type-2 diabetes, gastrointestinal diseases, cardiovascular disorders, infertility disorders, inflammation, cancer, atherosclerosis, cerebral vascular incidents and cranial trauma. 

Free arachidonic acid, along with diacylglycerols and free docosahexaenoic acid, is a product of membrane lipid breakdown at the onset of cerebral ischemia, seizures and other forms of brain trauma 585... 

Under physiologic conditions, the balance of membrane lipid metabolism, particularly that of arachidonoyl and docosahexaenoyl chains, favors a very small and tightly controlled cellular pool of free arachidonic acid (AA, 20 4n-3) and docosahexaenoic acid (DHA, 22 6n-3), but levels increase very rapidly upon cell activation, cerebral ischemia, seizures and other types of brain trauma [1, 2], Other free fatty acids (FFAs) in addition to AA, released during cell activation and the initial stages of focal and global cerebral ischemia, are stearic acid (18 0), palmitic acid (16 0) and oleic acid (18 1). 

Phospholipids in synaptic membranes are an important target in seizures, head injury, neurodegenerative diseases and cerebral ischemia. Synaptic membranes are excitable membranes enriched in phospholipids esterified with the polyunsaturated fatty acids AA and DHA which form a significant proportion of the FFAs rapidly released during ischemia, seizure activity and other brain trauma. 

Free arachidonic acid, along with diacylglycerols and free docosahexaenoic acid, is a product of membrane lipid breakdown at the onset of cerebral ischemia, seizures and other forms of brain trauma. Because polyunsaturated fatty acids are the predominant FFA pool components that accumulate under these conditions, this further supports the notion that fatty acids released from the C2 position of membrane phospholipids are major contributors to the FFA pool, implicating PLA2 activation as the critical step in FFA release [1,2] (Fig. 33-6). 

HETE and acute cerebral blood flow drop after brain trauma in rats (Kehl et al.,... 

Diaz-Parejo P, Stahl N, Xu W, Reinstrup P, Ungerstedt U, et al. 2003. Cerebral energy metabolism during transient hyperglycemia in patients with severe brain trauma. Intensive Care Med 29(4) 544-550. 

Amyl nitrite Patients with glaucoma, recent head trauma, cerebral hemorrhage, and pregnancy. 

Chest pain that is not relieved by two or three tablets within 30 minutes may be due to an acute myocardial infarction. In addition, nitrate administration may result in an increase in intracranial pressure, and therefore, these drugs should be used cautiously in patients with cerebral bleeding and head trauma. 

Head trauma, meningitis, childhood fevers, brain tumors, and degenerative diseases of the cerebral circulation are conditions often associated with the appearance of recurrent seizures that may require treatment with anticonvulsant drugs. Seizures also may be a toxic manifestation of the action of central nervous system (CNS) stimulants and certain other drugs. Seizures often occur in hyperthermia (febrile seizures are very common in infants) sometimes in eclampsia, uremia, hypoglycemia, or pyridoxine deficiency and frequently as a part of the abstinence syn-... 

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