Brain Concussion: New Classifications and Current Physiopathological Knowledge of the Disease

The present review paper aims to update the definition and classification of cerebral concussion, highlighting its pathophysiological mechanisms. The high prevalence of cerebral concussion in emergency rooms around the world makes it necessary to know its proper management to avoid its late sequelae, which traditionally compromise cognitive aspects of behavior. New evidence on potential neuroprotective treatments is being investigated.

Forensic application of brainstem auditory evoked potential in patients with brain concussion / 法医学杂志

OBJECTIVE@#To investigate changes of brainstem auditory evoked potential (BAEP) in patients with brain concussion.@*METHODS@#Nineteen patients with brain concussion were studied with BAEP examination. The data was compared to the healthy persons reported in literatures.@*RESULTS@#The abnormal rate of BAEP for patients with brain concussion was 89.5%. There was a statistically significant difference between the abnormal rate of patients and that of healthy persons (P<0.05). The abnormal rate of BAEP in the brainstem pathway for patients with brain concussion was 73.7%, indicating dysfunction of the brainstem in those patients.@*CONCLUSION@#BAEP might be helpful in forensic diagnosis of brain concussion.

Labor de enfermería en el traumatismo craneoencefálico infantil / Nursing work in the intensive infantile cranioencephalic traumatism 1998

Se realizó un estudio descriptivo prospectivo de un universo de 117 enfermos que sufrieron accidentes por varias causas, tomamos como muestras 26 pacientes que sufrieron traumatismo craneoencefálico y que ingresaron en la Unidad de Cuidados Intensivos del Hospital Pediátrico Universitario "José Luis Miranda" de Villa Clara durante el año 1998. Se confeccionó un modelo donde se reflejaron las variables de interés para el estudio, tomadas de las historias clínicas: edad, sexo modo de ingreso en cuidados intensivos, estadía, formas fisiopatológicas del trauma, ventilación mecánica, diagnóstico, acciones de enfermería y evaluación de la atención de enfermería. Los resultados se presentaron en cuadros mediante el método porcentual, realizados al efecto en microcomputadoras en un programa estadístico, EPINFO del módulo "Análisis", así como la evaluación del proceso de atención de enfermería, según escala de Glasgow. El 61,5 (por ciento) de los pacientes estaban en edades comprendidas entre 5 y 10 años, en su mayoría del sexo masculino. El 92,3 (por ciento) de los pacientes ingresaron en cuidados intensivos procedentes de servicios de urgencias, el 92,30 (por ciento) de los pacientes evolucionaron favorablemente. La conmoción cerebral y la contusión cerebral son las formas fisiopatológicas más frecuentes del traumatismo craneoencefálico, mayormente en la edad preescolar. Constituyó el servicio de urgencia el primer eslabón de la atención. La ventilación mecánica es importante para el tratamiento de la hipoxia severa, pero no constituye el tratamiento de elección de esos niños. El proceso de atención de enfermería como método científico permitió brindar cuidados específicos, con alto grado de calidad a estos pacientes(AU)

He/she was carried out a prospective descriptive study of an universe of 117 sick persons that you/they suffered accidents for several causes, we take like samples 26 patients that suffered traumatism craneoencefálico and that they entered in the Unit of Intensive Cares of the University Pediatric Hospital José Luis Miranda of Villa Clara during the year 1998. A model was made where they were reflected the variables of interest for the study, taken of the clinical histories: age, sex entrance way in intensive cares, demurrage, forms fisiopatológicas of the trauma, ventilation mechanics, diagnosis, infirmary actions and evaluation of the infirmary attention. The results were presented in squares by means of the percentage method, carried out to the effect in microcomputers in a statistical program, EPINFO of the module " Analysis ", as well as the evaluation of the process of infirmary attention, according to scale of Glasgow. The 61,5 (percent) of the patients they were in ages understood between 5 and 10 years, in their majority of the masculine sex. The 92,3 (percent) of the patients they entered in intensive cares coming from services of urgencies, the 92,30 (percent) of the patients they evolved favorably. The cerebral shock and the cerebral bruise are the forms more frequent fisiopatológicas of the traumatism craneoencefálico, mostly in the age preescolar. It constituted the service of urgency the first link of the attention. The ventilation mechanics is important for the treatment of the severe hipoxia, but it doesn't constitute the treatment of those children's election. The process of infirmary attention like scientific method allowed to offer specific cares, with high degree of quality to these patients(AU)

Manejo del TEC / Management head trauma

The treatment in the acute phase of a patient with a severe head injury and coma require inmediate neurologic attention and, often resuscitation. There is often pupillary enlargement or asymmetry. Persistent unresponsiveness is a grave sign. After the patient is cadiorrespiratory stabilized, atention is given to life-threatening noncranial injuries, followed by a survey neurologic examination

Lesäo axonal difusa: aspectos fisiopatológicos / Diffuse axonal injury: physiopathological aspects

É realizada uma revisäo da literatura sobre a lesäo axonal difusa, enfocando especialmente a sua biomecâmica. Com base nos trabalhos da literatura e dos autores é proposta uma explicaçäo mecânica, baseada na açäo das forças inerciais sobre a conformaçäo característica do encéfalo, para a localizaçäo mais freqüente e lateralizada da lesäo axonal difusa nas formaçöes inter-hemisféricas e na porçäo rostral do tronco encefálico.