1/147. Traumatic aphasia in children: a case study.Traumatic aphasia in children has been recognized as a distinct clinical pathology, differing from adult aphasia in symptomatology and course of recovery. The upper limit for complete recovery has been identified as age 10. However, there is a paucity of literature documenting recovery of children with traumatic aphasia. It is apparent that definitive statements of the upper age limit for complete recovery from traumatic aphasia in children cannot be made at this time. This article reviews the literature concerning traumatic aphasia and presents case information of a 10-year-old traumatic aphasic girl seen at the North texas State University speech and hearing Center. The design, execution, and assessment of therapeutic interaction and the observed language abilities of the client are reported.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/147. Non-heart-beating donors: a case study in procurement.To help meet the increasing need for transplantable organs, especially kidneys, organ procurement organizations are recovering organs from non-heart-beating patients. This article outlines the successful recovery and transplantation of kidneys from such a donor. Consent issues and historical background are also discussed.- - - - - - - - - - ranking = 0.31296295178359keywords = back (Clic here for more details about this article) |
3/147. Frozen in time: life in the face of chronic care cutbacks.Kathy Cook won the $750 first prize in CMAJ's 7th Annual Amy Chouinard Memorial Essay Contest. The deadline for entries to the contest, which is designed to stimulate interest in medical writing among journalism students, is June 1. Entries should be forwarded to the news and features editor. In her winning essay, Cook explores the frustrations and quality-of-life issues that arise in a chronic care institution that is trying to operate in the midst of serious funding cuts.- - - - - - - - - - ranking = 1.2518518071344keywords = back (Clic here for more details about this article) |
4/147. Citicoline for traumatic brain injury: report of two cases, including my own.Citicoline is an investigational new drug in this country that was provided on a compassionate use basis in two cases of traumatic brain injury after horseback riding accidents. While this report is primarily anecdotal, the behavioral observations in both cases suggested atypical patterns of improvement and perhaps greater recovery than might otherwise have been predicted. The side effect profile of this drug is negligible and previous experimental research has yielded positive findings for treatment after stroke and head trauma, as well as memory loss in aging. Consequently, Citicoline may potentially be very helpful for patients suffering traumatic brain injuries and should, in our opinion, be made available and studied further in this clinical population.- - - - - - - - - - ranking = 0.31296295178359keywords = back (Clic here for more details about this article) |
5/147. Self awareness: effects of feedback and review on verbal self reports and remembering following brain injury.Brain injury may produce impairments in self awareness. The magnitude of impairment is often determined by comparing patient self reports with self reports of others (report-report) or with patient performance (report-performance). This paper presents data on the pattern of a self-awareness deficit in memory functioning exhibited by a brain injury survivor 5 years post-injury. The effects of practice and feedback on reporting-recall differences was examined using single case methodology. Several prospective and retrospective self reports were obtained, to allow an examination of reporting about past or future recall. Results showed that recall improved and the magnitude of report-recall differences were reduced with practice and feedback.- - - - - - - - - - ranking = 1.8777777107015keywords = back (Clic here for more details about this article) |
6/147. Real-time continuous visual biofeedback in the treatment of speech breathing disorders following childhood traumatic brain injury: report of one case.The efficacy of traditional and physiological biofeedback methods for modifying abnormal speech breathing patterns was investigated in a child with persistent dysarthria following severe traumatic brain injury (TBI). An A-B-A-B single-subject experimental research design was utilized to provide the subject with two exclusive periods of therapy for speech breathing, based on traditional therapy techniques and physiological biofeedback methods, respectively. Traditional therapy techniques included establishing optimal posture for speech breathing, explanation of the movement of the respiratory muscles, and a hierarchy of non-speech and speech tasks focusing on establishing an appropriate level of sub-glottal air pressure, and improving the subject's control of inhalation and exhalation. The biofeedback phase of therapy utilized variable inductance plethysmography (or Respitrace) to provide real-time, continuous visual biofeedback of ribcage circumference during breathing. As in traditional therapy, a hierarchy of non-speech and speech tasks were devised to improve the subject's control of his respiratory pattern. Throughout the project, the subject's respiratory support for speech was assessed both instrumentally and perceptually. Instrumental assessment included kinematic and spirometric measures, and perceptual assessment included the Frenchay dysarthria Assessment, Assessment of Intelligibility of Dysarthric speech, and analysis of a speech sample. The results of the study demonstrated that real-time continuous visual biofeedback techniques for modifying speech breathing patterns were not only effective, but superior to the traditional therapy techniques for modifying abnormal speech breathing patterns in a child with persistent dysarthria following severe TBI. These results show that physiological biofeedback techniques are potentially useful clinical tools for the remediation of speech breathing impairment in the paediatric dysarthric population.- - - - - - - - - - ranking = 391.17935983784keywords = breathing, back (Clic here for more details about this article) |
7/147. Relations between traumatic brain injury and the environment: feedback reduces maladaptive behaviour exhibited by three persons with traumatic brain injury.feedback is a commonly used technique in neurorehabilitation. It functions to strengthen or weaken select relations between individuals' behaviour and their environment. The study of behaviour-environment relations is a focus of operant psychology, commonly referred to as behaviour analysis. Central to behaviour analysis is the analysis of interrelations among stimuli, behaviour, and consequences. The focus on behaviour-environment relations may have considerable benefits for designing clinical treatments and accounting for successful and unsuccessful treatments, especially psychological interventions for maladaptive behaviour. In the present investigation, three persons with traumatic brain injuries, diagnosed with depression and presenting mild cognitive impairments, received feedback about their maladaptive behaviour. Weekly feedback resulted in general reductions in the variability and frequency of maladaptive behaviour. The results support the utility of giving equal consideration to relations between persons with traumatic brain injury and their environment, despite existing psychological or cognitive impairments. Future research on variables that influence the development and maintenance of behaviour-environment relations, and more generally operant behaviour, may provide a unique perspective on the effects of traumatic brain injury.- - - - - - - - - - ranking = 2.1907406624851keywords = back (Clic here for more details about this article) |
8/147. Air-puff-induced facilitation of motor cortical excitability studied in patients with discrete brain lesions.Air-puff stimulation applied to a fingertip is known to exert a location-specific facilitatory effect on the size of the motor evoked potentials elicited in hand muscles by transcranial magnetic stimulation. In order to clarify its nature and the pathway responsible for its generation, we studied 27 patients with discrete lesions in the brain (16, 9 and 2 patients with lesions in the cerebral cortex, thalamus and brainstem, respectively). Facilitation was absent in patients with lesions affecting the primary sensorimotor area, whereas it was preserved in patients with cortical lesions that spared this area. Facilitation was abolished with thalamic lesions that totally destroyed the nucleus ventralis posterolateralis (VPL), but was preserved with lesions that at least partly spared it. Lesions of the spinothalamic tract did not impair facilitation. The size of the N20-P25 component of the somatosensory evoked potential showed a mild correlation with the amount of facilitation. The facilitation is mainly mediated by sensory inputs that ascend the dorsal column and reach the cortex through VPL. These are fed into the primary motor area via the primary sensory area, especially its anterior portion, corresponding to Brodmann areas 3 and 1 (possibly also area 2), without involving other cortical regions. The spinothalamic tract and direct thalamic inputs into the motor cortex do not contribute much to this effect. Some patients could generate voluntary movements despite the absence of the facilitatory effect. The present method will enable us to investigate in humans the function of one of the somatotopically organized sensory feedback input pathways into the motor cortex, and will be useful in monitoring ongoing finger movements during object manipulation.- - - - - - - - - - ranking = 0.31296295178359keywords = back (Clic here for more details about this article) |
9/147. The relation of phoneme discrimination, lexical access, and short-term memory: A case study and interactive activation account.A brain-damaged patient (AP) is reported who had a strong tendency to identify nonwords as words on auditory lexical decision and to lexicalize nonwords in repetition, yet who showed a normal ability to perceive individual phonemes. It was initially hypothesized that these findings could be accounted for in terms of disrupted lexical phonological representations. This hypothesis was rejected on the basis of an interactive activation model of word recognition which revealed that modifications at the lexical level did not mimic the patient's pattern of results. Instead, it was found that increasing the rate of decay of activation at the phoneme level produced output that was consistent with the phoneme discrimination, lexical decision, and repetition results. This hypothesis of increased phoneme level decay led to the prediction that speech discrimination would decline with increased interstimulus interval and that short-term memory performance would be impaired. Both predictions were confirmed. The results of this study provide support for an interactive activation model of word recognition with feedback from the lexical to the phonemic level and for a close connection between the processes involved in word recognition and short-term memory.- - - - - - - - - - ranking = 0.31296295178359keywords = back (Clic here for more details about this article) |
10/147. The shaking trauma in infants - kinetic chains.The findings in three children who died as a consequence of shaking and those in another child who survived are presented. In the three fatal cases, a combination of anatomical lesions were identified at autopsy which appear to indicate the sites where kinetic energy related to the shaking episodes had been applied thus enabling the sequence of events resulting in the fatal head injury to be elucidated. Such patterns of injuries involved the upper limb, the shoulder, the brachial nerve plexus and the muscles close to the scapula; hemorrhages were present at the insertions of the sternocleidomastoid muscles due to hyperextension trauma (the so-called periosteal sign) and in the transition zone between the cervical and thoracic spine and extradural hematomas. Characteristic lesions due to traction were also found in the legs. All three children with lethal shaking trauma died from a subdural hematoma only a few hours after the event. The surviving child had persistant hypoxic damage of the brain following on massive cerebral edema. All the children showed a discrepancy between the lack of identifiable external lesions and severe internal ones.- - - - - - - - - - ranking = 0.5keywords = upper (Clic here for more details about this article) |
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