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- Shahsavari, Sima, 1976, et al.
(författare)
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A comparison between the transfer function of ABP to ICP and compensatory reserve index in TBI
- 2008
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Ingår i: Acta Neurochirurgica, Supplement. - Vienna : Springer Vienna. - 0065-1419. - 9783211855775 ; 102:102, s. 9-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The transfer functions which map the arterial blood pressure to the intracranial pressure and the compensatory reserve index have been investigated by various groups to evaluate the brain compliance of patients with traumatic brain injury. The focus of this study has been to assess the capability of both the above mentioned methods to monitor the intracranial compliance in patients suffering from brain swelling. MATERIALS AND METHODS: Clinical data was collected from sixteen traumatic brain injury patients and split into 4 min segments. For each segment, both the magnitude of the empirical transfer function at the fundamental cardiac frequency and the compensatory reserve index were extracted. FINDINGS: The mean values of the compensatory reserve index and the magnitude of the transfer function which scored higher than 0.7 and 0.1 respectively were recorded for all patients suffering from brain swelling. By comparing the histogram of the magnitude of the transfer function at the fundamental cardiac frequency with the histogram of the compensatory reserve index for all patients, a positive correlation between the mean values and a negative correlation among their variances were observed. The linear correlation between the mean values was estimated at r = 0.82 (p
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- Skoglund, Thomas, 1969, et al.
(författare)
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Aspects on decompressive craniectomy in patients with traumatic head injuries
- 2006
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Ingår i: J Neurotrauma. - 0897-7151. ; 23:10, s. 1502-9
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Tidskriftsartikel (refereegranskat)abstract
- In patients with traumatic brain injury (TBI), intracranial hypertension secondary to cerebral edema is a major problem. A last-tier treatment in these cases is decompressive craniectomy. The aim of the present retrospective investigation was to (1) study the long-time outcome in patients with traumatic head injuries with intracranial hypertension treated with decompressive craniectomy; (2) examine the effects on intracranial pressure (ICP) by the craniectomy; and (3) investigate the possible relationship between the size of the removed bone-flap and the effects on ICP. Among the about 150 patients with severe TBI treated at our neurointensive care unit during 1997-2002, 19 patients were treated with decompressive craniectomy. All patients were young (mean 22 +/- 11 years, range 7-46 years), and 68% were male. The mean ICP was reduced from 29.2 +/- 3.5 before to 11.1 +/- 6.0 mm Hg immediately after the craniectomy; at 24 h after the craniectomy, the mean ICP was 13.9 +/- 9.7 mm Hg. Paired-samples t-test revealed a statistically significant decrease, both when comparing the preoperative values to the values immediately postoperative as well as to the values after 24 h (p < 0.01). A significant correlation between the size of the craniectomy and the decrease in ICP was found using Pearson regression analysis. The outcome of all patients could be assessed. The survival rate was 89%. Two patients died (both day 4 after the trauma); 68% of the patients had a favorable outcome (Glasgow Outcome Scale [GOS] score of 4 or 5); 16% were severely disabled (GOS score of 3); and one patient (5%) was left in a vegetative state.
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- Skoglund, Thomas, 1969, et al.
(författare)
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Long-Term Follow-up of a Patient with Traumatic Brain Injury Using Diffusion Tensor Imaging
- 2007
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Ingår i: Acta Radiol. - 0284-1851. ; , s. 1-3
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Tidskriftsartikel (refereegranskat)abstract
- This case report describes a patient who sustained severe head trauma with diffuse axonal injury (DAI). Examination with magnetic resonance diffusion tensor imaging (MR-DTI), 6 days post-injury, showed a severe reduction in fractional anisotropy (FA) in the rostral pons containing the corticospinal tract, which correlated to the patient's severe hemiparesis. By 18 months post-accident, the patient had recovered completely and conventional MRI showed no pathology. However, although her FA values in the rostral pons had increased, they were still not normalized. It seems that a complete normalization of the FA values is not required to achieve clinical recovery, and that MR-DTI seems to be more sensitive to DAI compared to conventional MRI.
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- Skoglund, Thomas, 1969, et al.
(författare)
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Long-time outcome after transient transtentorial herniation in patients with traumatic brain injury
- 2005
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Ingår i: Acta Anaesthesiol Scand. - 0001-5172. ; 49:3, s. 337-40
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study investigates mortality and morbidity in patients with traumatic brain injury (TBI) who developed episode(s) of transtentorial herniation. The transtentorial herniation was defined as a deterioration of consciousness accompanied by uni- or bilateral pupil dilatation. METHODS: The medical records of all patients with traumatic brain injury admitted during 1999 to the Neuro- or General Intensive Care Units at Sahlgrenska University Hospital were analyzed, and patients with at least one episode of transtentoryal herniation were included. Information regarding patient age, gender, type of trauma, initial GCS, precipitating reason for herniation, uni-/bilateral pupil dilatation, treatment(s) and outcome after at least 6 months, assessed with the Glasgow Outcome Scale (GOS), was collected from medical records. RESULTS: The study included 27 patients, average age 44 years (range 6-81), with a male proportion of 81%. The majority of the patients were victims of traffic accidents and falls. The results demonstrated that 16/27(59%) of the patients had a favorable outcome (GOS 4/5), 4/27(15%) were severely disabled (GOS 3), none was vegetative (GOS 2) and 7/27(26%) died (GOS 1). When analyzing patient subgroups, best outcome was found in children where 3/4 (75%) had a GOS 4/5. CONCLUSION: Transtentorial herniation is a serious consequence of supratentorial edema/mass lesions in patients with TBI. However, with aggressive neurointensive care and neurosurgical treatments we found a 59% patient incidence of a favorable outcome.
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- Skoglund, Thomas, 1969, et al.
(författare)
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Tumor of the conus medullaris treated with antituberculous therapy
- 2007
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Ingår i: Clin Neurol Neurosurg. - : Elsevier BV. - 0303-8467. ; 109:2, s. 192-4
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Tidskriftsartikel (refereegranskat)abstract
- This case report concerns a 21-year-old man developing left leg paresis. Evaluation with magnetic resonance imaging (MRI) showed an intramedullary tumor in the conus region. He was planned for surgery but preoperative investigation indicated he had tuberculosis and the tumor was presumed to be a tuberculoma. Antituberculous therapy was started and the patient improved neurologically. The patient was followed clinically and with consecutive MRI during 2 years and the last MRI showed that the lesion had disappeared completely. Intramedullary tuberculomas are rare but important differential diagnosis in patients with spinal cord mass lesions. The role of medical and surgical treatment of intramedullary tuberculomas is discussed.
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