1/179. A case of reflex sympathetic dystrophy (complex regional pain syndrome, type I) resolved by cerebral contusion.We present a case of refractory reflex sympathetic dystrophy (RSD) (complex regional pain syndrome, type I) whose symptoms (ongoing pain, allodynia, hyperhydrosis and temperature abnormalities) were resolved after the patient suffered a traumatic cerebral contusion in the left temporal lobe, which caused no neurological deficit. This case suggests that symptoms of some RSD patients may largely sustained by a complex network involving the brain.- - - - - - - - - - ranking = 1keywords = contusion, brain, trauma (Clic here for more details about this article) |
2/179. Sinistrad mirror writing and reading after brain concussion in a bi-systemic (oriento-occidental) polyglot.The problem of mirror writing and reading is discussed in the light of a clinical case, where this disturbance appeared after an apparently minor head injury. Mirror writing and reading in this polyglot individual affected only the sinistrad (Hebrew) writing and reading system, leaving the dextrad (Latin) system unimpaired. This disturbance appeared together with dyscalculia, left-right disorientation and slight temporal confusion, suggestive of parieto-occipital lobe pathology. The clinical picture also showed apparently "conversional" traits, such as are sometimes seen in incomplete parietal lobe syndromes. The relevant literature is reviewed and patho-physiological mechanisms of mirror reversal are discussed.- - - - - - - - - - ranking = 0.16391061746418keywords = brain, injury (Clic here for more details about this article) |
3/179. Minor traumatic brain injury: review of clinical data and appropriate evaluation and treatment.The clinical entity of minor traumatic brain injury (MTBI) is secondary to signs and symptoms encompassing neuropathological, neurochemical, neurobehavioral, neuropsychological and behavioral deficits. The patients who suffer this disorder are often given little help, medically, secondary to issues regarding the perceived reality of the disorder. A few individuals deny the existence of MTBI. Some believe the symptom complex to be strictly functional, while others believe that spontaneous recovery will occur and no treatment is necessary. When discussing traumatic brain injury the descriptors, "mild, moderate, and severe," are used to describe the severity of the acute injury. These labels do not describe the severity of the sequelae nor are they indicative of the intensity of specific treatment. A clear understanding of MTBI, its sequelae and necessary treatment is imperative to insure timely intervention. Delay or lack of early intervention appears to be responsible for "persistent sequelae" in MTBI. This paper will describe various aspects of the etiology of MTBI, with recommended evaluation and treatment guidelines. A functional assessment scale specifically for persons with MTBI is also presented. Several case histories are included for illustration purposes.- - - - - - - - - - ranking = 4.4577571504573keywords = brain injury, traumatic brain injury, traumatic brain, brain, injury, trauma (Clic here for more details about this article) |
4/179. death due to concussion and alcohol.We encountered 5 deaths following blunt trauma to the face and head in which the injuries were predominantly soft tissue in nature with absence of skull fractures, intracranial bleeding, or detectable injury to the brain. All individuals were intoxicated, with blood ethanol levels ranging from 0.22 to 0.33 g/dl. We feel that in these deaths, ethanol augmentation of the effects of concussive brain injury, with resultant posttraumatic apnea, was the mechanism of death.- - - - - - - - - - ranking = 0.39752365073126keywords = brain injury, brain, injury, trauma (Clic here for more details about this article) |
5/179. Reduplicative paramnesia: longitudinal neurobehavioral and neuroimaging analysis.Reduplicative paramnesia (RP) is a delusion in which the patient perceives familiar places, objects, or events to have been duplicated. The current case describes the development of RP in an 81-year-old male following a large right frontal lobe infarction. As the patient had been hospitalized previously with hemorrhagic contusions, neurologic, neuropsychological, and neuroimaging data were obtained both prior to and following RP onset. Psychophysiologic data were obtained following the development of the delusion. Both premorbidly and at follow-up, neuropsychological functioning was characterized by significant impairments of learning and memory and frontal-executive functions. language and visuospatial skills and motor speed were intact both before and after RP onset. The case is described within the context of preexisting theories of RP, and it is surmised that the delusion is secondary to temporal-limbic-frontal dysfunction giving rise to a distorted sense of familiarity and impaired ability to resolve the delusion via reasoning.- - - - - - - - - - ranking = 0.19212812675286keywords = contusion (Clic here for more details about this article) |
6/179. Application of a rigid endoscope to the microsurgical management of 54 cerebral aneurysms: results in 48 patients.OBJECT: To enhance visual confirmation of regional anatomy, endoscopy was introduced during microsurgery for cerebral aneurysms. The risks and benefits are analyzed in the present study. methods: The endoscopic technique was used during microsurgery for 54 aneurysms in 48 patients. Forty-three aneurysms were located in the anterior circulation and 11 were in the posterior circulation. Thirty-eight aneurysms (70.4%) had not ruptured. All ruptured aneurysms in the present series produced Hunt and Hess Grade I or II subarachnoid hemorrhage. After initial exposure achieved with the aid of a microscope, the rigid endoscope was introduced to confirm the regional anatomy, including the aneurysm neck and adjacent structures. The necks of 43 aneurysms were clipped using microscopic control or simultaneous microscopic/endoscopic control. After clipping, the positions of the clip and nearby structures were inspected using the endoscope. Use of the neuroendoscope provided useful information that further clarified the regional anatomy in 44 cases (81.5%) either before or after neck clipping. In nine cases (16.7%), these details were available only with the use of the endoscope. In five cases (9.3%), the surgeons reapplied the clip on the basis of endoscopic information obtained after the initial clipping. There were two cases in which surgical complications were possibly related to the endoscopic procedures (one patient with asymptomatic cerebral contusion and another with transient oculomotor palsy). CONCLUSIONS: It is the authors' impression that the use of the endoscope in the microsurgical management of cerebral aneurysms enhanced the safety and reliability of the surgery. However, there is a prerequisite for the surgeon to be familiar with this instrumentation and fully prepared for the risks and inconveniences of endoscopic procedures.- - - - - - - - - - ranking = 0.19212812675286keywords = contusion (Clic here for more details about this article) |
7/179. Multiple fregoli delusions after traumatic brain injury.A 61 year old man after a traumatic brain injury resulting in right frontal and left temporoparietal contusions developed florid Fregoli-type misidentifications. Extensive neuropsychological testing demonstrated significant deficits in executive and memory functions. The patient's neuropsychological profile closely resembled that seen in previously reported patients with capgras syndrome. Our findings are consistent with the hypothesis that a combination of executive and memory deficits may account for cases of delusional misidentification associated with brain lesions. However, the form which the delusion takes may be influenced by other factors including motivation.- - - - - - - - - - ranking = 3.9399684275326keywords = brain injury, traumatic brain injury, contusion, traumatic brain, brain, injury, trauma (Clic here for more details about this article) |
8/179. Successful closure of recurrent traumatic csf rhinorrhea using the free rectus abdominis muscle flap.BACKGROUND: We present two patients in whom a free rectus abdominis muscle flap was used to close recurrent traumatic CSF rhinorrhea. CASE DESCRIPTION: CT scan of both patients showed frontal lobe atrophy and porencephaly after contusional hematoma. In the first patient, because the site of CSF leakage was not identified and the patient underwent three unsuccessful attempts to close the fistula using the fascia lata, we treated the patient by unifying all paranasal sinuses and by filling them with a free rectus abdominis muscle flap. In the second patient, CSF rhinorrhea recurred 6 years after closure of the fistula using the fascia lata. The patient underwent separation of a porencephalic cyst from the paranasal sinus and a free muscle flap was placed extradurally, because the CSF pulse pressure in the enlarged left anterior horn eroded the previously repaired fascia lata, resulting in the recurrence of CSF leakage. CONCLUSION: Although duraplasty is the primary procedure for repairing dural fistulas, the vascularized free muscle flap is an alternative method when the location of the fistula is not identified or the patient with recurrent CSF rhinorrhea has severe frontal lobe atrophy and porencephaly.- - - - - - - - - - ranking = 0.19319243106342keywords = contusion, trauma (Clic here for more details about this article) |
9/179. brain stem contusion due to tentorial coup injury: case report and pathomechanical analysis from normal cadavers.This report is in two parts. First, a case report on a 20-year-old man with a localized brain stem contusion. Second, in order to elucidate the mechanism of this injury, an anatomical study was performed. Ten cadaver heads were analysed to reveal the variations of spatial anatomy around the tentorial incisura. The lateral tentorial incisura (lateral to brain stem) was situated at the level of pontomesencephalic junction and nearest to the brain stem along its course. The shortest distance between them averaged 1.0 mm (0-4 mm). Based on these findings, primary brain stem injury caused by tentorial incisura occurs at its lateral portion due to the shortest distance to the brain stem and near the level of pontomesencephalic junction. In patients with a tentorial incisura closely related to or touching the brain stem, tentorial coup injury to the brain stem may occur even with a relatively minor injury. In our case, repeated CT and MRI proved that the location of contusion was at the pontomesencephalic junction, coinciding with the level of the tentorial edge. The injury started at the surface of brain stem. The tentorial edge was close to brain stem in this case. These radiological findings support the hypothesis that the brain stem contusion was caused by a tentorial coup injury.- - - - - - - - - - ranking = 1.8096079007043keywords = contusion, brain, injury (Clic here for more details about this article) |
10/179. When instructions fail. The effects of stimulus control training on brain injury survivors' attending and reporting during hearing screenings.Bedside hearing screenings are routinely conducted by speech and language pathologists for brain injury survivors during rehabilitation. Cognitive deficits resulting from brain injury, however, may interfere with obtaining estimates of auditory thresholds. Poor comprehension or attention deficits often compromise patient abilities to follow procedural instructions. This article describes the effects of jointly applying behavioral methods and psychophysical methods to improve two severely brain-injured survivors' attending and reporting on auditory test stimuli presentation. Treatment consisted of stimulus control training that involved differentially reinforcing responding in the presence and absence of an auditory test tone. Subsequent hearing screenings were conducted with novel auditory test tones and a common titration procedure. Results showed that prior stimulus control training improved attending and reporting such that hearing screenings were conducted and estimates of auditory thresholds were obtained.- - - - - - - - - - ranking = 2.1429074713552keywords = brain injury, brain, injury (Clic here for more details about this article) |
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