Severe head injury

Wolf AL, Levi L, Marmarou A, Ward JD, Muizelaar PJ, Choi S, Young H, Rigamonti D, Robinson WL. Effect of THAM upon outcome in severe head injury a randomized prospective chnical trial. J Neurosurg 1993 78(1) 54—59. 

Nordstrom CH, Reinstrup P, Xu W, Gardenfors A, Ungerstedt U. 2003. Assessment of the lower limit for cerebral perfusion pressure in severe head injuries by bedside monitoring of regional energy metabolism. Anesthesiology 98(4) 809-814. 

Stahl N, Ungerstedt U, Nordstrom CH. 2001b. Brain energy metabolism during controlled reduction of cerebral perfusion pressure in severe head injuries. Intensive Care Med 27(7) 1215-1223. 

Pentobarbital (Nembutal, Others) [C-ll] [Anticonvulsant, Sedative/ Hypnotic/Barbiturate] Uses Insomnia, convulsions, induce coma following severe head injury Action Barbiturate Dose Adults. Sedative ... 

Morris G. F., Bullock R., Marshall S. B., Marmarou A., Maas A., and Marshall L. F. (1999). Failure of the competitive /V-m ethyl -1 )-aspartate antagonist selfotel (CGS 19755) in the treatment of severe head injury results of two phase III clinical trials. The Selfotel Investigators. J. Neurosurg. 91 737-743. 

HenkerR. A., Brown S. D., and Marion D. W. (1998) Comparison of brain temperature with bladder and rectal temperatures in adults with severe head injury. Neurosurgery 42,1071-1075. 

Shiozaki T., Sugimoto H., Taneda M., et al. (1993) Effect of mild hypothermia on uncontrollable intracranial hypertension after severe head injury. J. Neurosurg. 79, 363-368. 

Soukup J., Zauner A., Doppenberg E. M., et al. (2002) The importance of brain temperature in patients after severe head injury relationship to intracranial pressure, cerebral perfusion pressure, cerebral blood flow, and outcome. 7. Neurotrauma 19,559-571. 

Marion D. W., ObristW. D., CarlierP. M., Penrod L. E., and Darby J. M. (1993) The use of moderate therapeutic hypothermia for patients with severe head injuries a preliminary report. J. Neurosurg. 79, 354-362. 

Alarge multicenter trial using mildhypothermiain severe head injury was recently halted as a result of an interim analysis showing the probability of a positive outcome was unlikely (34). However, the study did... 

Hendrick E. B. (1959) The use of hypothermia in severe head injuries in childhood. 

Metz C., Holzschuh M., Bein T., et al. (1996) Moderate hypothermia in patients with severe head injury cerebral and extracerebral effects. J. Neurosurg. 85, 533-541. 

Marion D. W., Darby J., and Yonas H. (1991) Acute regional cerebral blood flow changes caused by severe head injuries. J. Neurosurg. 74,407-414. 

Muizelaar J. P., Marmarou A., Ward J. D., etal. (1991) Adverse effects of prolonged hyperventilation in patients with severe head injury a randomized clinical trial. J. Neurosurg. 75, 731-739. 

A. It is used therapeutically to relieve pain caused by severe head injury. 

High-dose methylprednisolone in severe head injury... 

Further clinical evidence of the role of free radicals in head injury has been provided by the recently published results of a phase II trial of polyethylene glycol-conjugated SOD in severe head injury (Glasgow Coma Scale = 3-8). In the SOD-treated patients, there was a significant decrease in the number of patients who had died or persisted in a vegetative state at 3 or 6 months post-injury [67]. A phase III trial is underway. 

Indometacin is used for non-invasive closure of symptomatic ductus arteriosus in the preterm infant. Intravenous administration causes an instant reduction in cerebral blood flow, increasing cerebral vascular resistance. The clinical significance for the nervous system of these hemodynamic changes is unknown (11,12), but they seem to be linked to the effects seen in the central nervous system. Advantage has been taken of this effect for reducing intracranial hypertension in patients with severe head injury (SEDA-15, 99). 

Intracranial hypertension occurred within 1 minute in a patient with a severe head injury who received phenoperidine 1 mg intravenously. It was associated with a reduction in arterial blood pressure. A similar reaction occurred when a second 1 mg bolus was given 8 hours later (SED-11,146) (1). 

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