1/15. 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 = 1keywords = physical (Clic here for more details about this article) |
2/15. Concussive convulsions: emergency department assessment and management of a frequently misunderstood entity.Immediate concussive convulsions are an unusual but dramatic sequela to head injuries. Previously believed to be an epileptic phenomenon, they are now thought to be a brief traumatic functional decerebration that results from loss of cortical inhibition. With concussive convulsions generally occurring within seconds of head impact and lasting up to several minutes, patients are initially in a tonic phase, followed by a clonic convulsion. A postictal phase is generally brief if it occurs at all with these episodes. patients with isolated concussive convulsions have no evidence of structural brain injury as assessed with neuroimaging studies or physical examination. Neuropsychological testing often demonstrates transient cortical dysfunction consistent with the concussive episode. The long-term outcome for patients with isolated concussive convulsion is universally good, with no long-term neurologic sequelae and no increased incidence of early or late posttraumatic epilepsy. Emergency department management should focus on evaluation of the associated concussive injury. The concussive convulsion requires no specific therapy, and antiepileptic medication is not indicated.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/15. Radiographical investigations of organic lesions of the hypothalamus in patients suffering from neurogenic pulmonary edema due to serious intracranial diseases: relationship between radiographical findings and outcome of patients suffering from neurogenic pulmonary edema.Radiographical investigations of the hypothalamus by computerized tomography (CT) have rarely been performed despite the fact that the damage to the hypothalamus owing to serious intracranial organic diseases may cause neurogenic pulmonary edema (NPE). We presented 22 consecutive cases of patients suffering from NPE caused by serious intracranial organic diseases and investigated the relationship between NPE and abnormal radiographical findings of the hypothalamus. In 11 cases, organic lesions were noted in the hypothalami and 10 of these patients died of NPE (91.0%). In contrast, of the remaining 11 cases without significant radiographical findings of organic lesions in the hypothalami, only 2 patients were lost (18.2%). In general, various factors including systemic ones are considered to contribute to the prognosis of the patients suffering NPEs caused by serious intracranial diseases. It was concluded that hypothalamic damage was not always found by radiograph in patients with NPE due to critical intracranial diseases, but once abnormal findings in their hypothalamus of these patients were noted, their prognosis would become significantly poor (p < 0.05).- - - - - - - - - - ranking = 13.066765755206keywords = suffering (Clic here for more details about this article) |
4/15. A unique collaboration of female medical providers within the united states Armed Forces: rehabilitation of a marine with post-concussive vestibulopathy.Uncle Sam's loyal nieces have come a long way from the days of world war i. The development of occupational and physical therapy was heavily influenced by an early relationship with medical specialists during the First World War. This relationship can be considered largely responsible for the eventual acceptance (by the Armed Forces) of women working in this area. Over the past decade active duty women have seen many changes in opportunities to serve and are now stationed aboard aircraft carriers, performing roles previously considered for male personnel. We report a case study of the medical care provided by both military and civilian women working for the united states Armed Forces. Initial assessment was conducted in a battalion aid station of a united states Marine Corp base and the subject was then referred to a military medical center with highly technical vestibular assessment and rehabilitation services. The subject's case represents a unique collaboration of women therapists, enabling a Marines' access to timely and accurate assessment, treatment and ultimately, successful return to active duty. This case study is one of many examples of the acceptance and successful integration of women as providers of medical care within the Military's medical framework.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/15. Effectiveness of cerebral hemispherotomy for improving behavioral disorders associated with intractable post-traumatic seizures.A 25-year-old man presented with intractable post-traumatic seizures after suffering cerebral contusion in a traffic accident at age 5 years. Cerebral hemispherotomy was performed to transect the neuronal fibers to interrupt connections between seizure foci in wide areas of the brain, and to minimize the resected brain parenchyma. His seizures resolved and behavioral disorders improved, which had been impaired since age 8 years. Increased glucose metabolism in the normal frontal lobe detected by interictal fluorodeoxyglucose-positron emission tomography was correlated with the improvements in behavioral disorders. These findings suggest that the effects of seizures may be reversible in brain areas connected with, but remote from, the epileptogenic cortex.- - - - - - - - - - ranking = 1.3066765755206keywords = suffering (Clic here for more details about this article) |
6/15. carbamazepine hypersensitivity reaction.carbamazepine is an anticonvulsant that is being used more frequently in the treatment of various psychiatric disorders. The drug has been associated with serious adverse reactions that appear to have an immunological pathogenesis. A case report describing a patient suffering an adverse reaction to carbamazepine is presented, to illustrate the various body systems typically affected in the apparent hypersensitivity reaction. The importance of laboratory and patient monitoring during the initial 3 months of carbamazepine therapy is reinforced.- - - - - - - - - - ranking = 1.3066765755206keywords = suffering (Clic here for more details about this article) |
7/15. Acute subdural haematoma successfully treated by percutaneous subdural tapping in an elderly patient.An elderly patient suffering acute subdural haematoma associated with cerebral contusion was treated by percutaneous subdural tapping while preparing for craniotomy. Most of the subdural haematoma, though of high density on computed tomography scanning, proved to be semiliquid. drainage of the haematoma yielded resolution of the mass effect, and was followed by a rapid improvement of consciousness. This observation suggests the significance of trial subdural tapping for the treatment of acute traumatic subdural haematoma prior to craniotomy.- - - - - - - - - - ranking = 1.3066765755206keywords = suffering (Clic here for more details about this article) |
8/15. fever of unknown origin following traumatic brain injury.Fever is a common complication of a traumatic brain injury, occurring during both the acute-care phase and the rehabilitation phase of recovery. The aetiology of fever in this population may remain obscure because of the presence of cognitive confusion associated with post-traumatic amnesia interfering with history taking and the difficult physical examination. We present a case where recovery from a traumatic brain injury was complicated by a fever of unknown origin that proved to be secondary to lateral sinus thrombophlebitis. This case emphasises the importance of a thorough knowledge of the differential diagnosis for fever that is unique to the traumatic brain injury population.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/15. A case of chronic subdural hematoma with anxiety states and concomitant regression-like symptoms.The authors described an epileptic suffering from head trauma in whom anxiety states and concomitant regression-like symptoms masked the diagnosis of chronic subdural hematoma. Along with the occurrence of chronic subdural hematoma, psychic symptoms were manifested including the anxiety and regression of personality. However, after the chronic subdural hematoma was neurosurgically evacuated, these psychic symptoms gradually disappeared. In the study of organic and symptomatic psychosis, Mackenzie and Popkin (1983) have proposed the concept of an organic anxiety syndrome on the ground that DSM-III provides no organic equivalent for anxiety disorders. Therefore, we presented a case of chronic subdural hematoma in which the direct effect on CNS of this pathological condition was considered to bring about the above-mentioned anxiety disorders with regression-like symptoms.- - - - - - - - - - ranking = 1.3066765755206keywords = suffering (Clic here for more details about this article) |
10/15. Supported employment and compensatory strategies for enhancing vocational outcome following traumatic brain injury.Epidemiological research clearly indicates that traumatic head injury has reached epidemic proportions. incidence rates for head injury are greater than those for cerebral palsy, multiple sclerosis, and spinal cord injury combined. Many victims suffer from long-term impairments in functional, neurological, medical, neuropsychological and linguistic status. Emotional and behavioural problems are common as well. Additionally, family problems often ensue as a consequence of the victim's dependency and concomitant emotional changes. Investigations of post-injury vocational status indicate that unemployment rates within the first 7 years post-injury range as high as 70% for those with moderate and severe injuries. Researchers have demonstrated that the emotional and neuropsychological changes arising from injury are the greatest contributors to reduced employability. Relatively high unemployment rates strongly suggest that traditional approaches to physical and vocational rehabilitation have been entirely inadequate. To complement existing services and enhance employment outcome, two approaches have been developed and refined for use with victims of head injury. Supported employment is a unique approach which assists the client to select, obtain and maintain suitable employment on the basis of his/her interests and abilities. Compensatory strategies have been developed to help the individual offset intellectual problems which would otherwise interfere with learning job skills and maintaining production levels. Often, compensatory strategies are used in the context of a comprehensive supported employment programme. The greater use of supported employment and compensatory strategies is likely to enhance employment outcomes for those with traumatic head injury. Nevertheless, additional research is needed to more clearly identify the types of techniques which work best for each unique set of problems.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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