Brain activation during working memory 1 month after mild traumatic brain injury: a functional MRI study.

OBJECTIVE: To assess patterns of regional brain activation in response to varying working memory loads shortly after mild traumatic brain injury (MTBI). BACKGROUND: Many individuals complain of memory difficulty shortly after MTBI. Memory performance in these individuals can be normal despite these complaints. METHODS: Brain activation patterns in response to a working memory task (auditory n-back) were assessed with functional MRI in 12 MTBI patients within 1 month of their injury and in 11 healthy control subjects. RESULTS: Brain activation patterns differed between MTBI patients and control subjects in response to increasing working memory processing loads. Maximum intensity projections of statistical parametric maps in control subjects showed bifrontal and biparietal activation in response to a low processing load, with little additional increase in activation associated with the high load task. MTBI patients showed some activation during the low processing load task but significantly increased activation during the high load condition, particularly in the right parietal and right dorsolateral frontal regions. Task performance did not differ significantly between groups. CONCLUSION: MTBI patients differed from control subjects in activation pattern of working memory circuitry in response to different processing loads, despite similar task performance. This suggests that injury-related changes in ability to activate or to modulate working memory processing resources may underlie some of the memory complaints after MTBI.

Successful donation and transplantation of multiple organs after fatal poisoning with brodifacoum, a long-acting anticoagulant rodenticide: case report.

BACKGROUND: Successful organ donation has been reported after death from poisonings with cyanide, carbon monoxide, methanol, benzodiazepines, and tricyclic antidepressants. In this report, we describe a case of multiple organ donation from a previously healthy individual who died from poisoning with the long-acting anticoagulant rodenticide, brodifacoum. METHODS: Case report and review of the literature. RESULTS: All organs procured from the poisoned donor functioned adequately, and there were no hemorrhagic complications in any of the recipients. CONCLUSION: This case demonstrates that brodifacoum poisoning is not an absolute contraindication to organ donation from brain-dead patients who have sustained a fatal ingestion.

Acute short-term memory loss from trimethyltin exposure.

We report a case of organic tin exposure in a graduate chemistry student. The inhalational and transcutaneous exposure occurred following a laboratory explosion. The patient initially presented with first and second degree burns of the face and chest, and developed an acute loss of short-term memory 72 hours after exposure. The memory loss gradually improved over the course of several months.

Visits to the college health service for alcohol-related injuries.

A study of alcohol-related injuries presenting to the local emergency room and the campus health service indicated an annualized rate of 25.16 injuries per thousand students. Twenty-four percent of injuries presenting to the emergency room were assessed as alcohol-related; another 6% were listed as being "suspected." Less than 4% of the injuries presenting to the campus health service were assessed as alcohol-related, and a similar number were listed as "suspected." Males had a significantly higher rate of alcohol-related injuries than females, and undergraduates had a higher rate than graduate students. Differences among the undergraduate classes were not significant. An investigation of the time of presentation indicated that most alcohol-related injuries occurred after hours and on weekends.

The acute painful eye.

A number of ocular and nonocular conditions may produce an acutely painful eye or orbit. A careful history and physical examination with special attention to the cornea, sclera, fundus, and cranial nerves will usually delineate the etiology of the pain. In particular, certain life- or vision-threatening conditions such as leaking internal carotid aneurysm, cavernous sinus thrombosis, orbital cellulitis, acute narrow-angle glaucoma, and temporal arteritis must be kept in mind.

Upper extremity burns from woodstoves.

Twenty-one woodstove-related burns of the hand and forearm in preschool-aged children were reviewed concerning nature and mechanism of injury, treatment, and clinical course. Two distinct patterns of injury were seen: with infants less than 14 months of age, burns occurred almost exclusively when the child touched the stove intentionally, unable to distinguish it from another piece of furniture; in older children burns were always "accidental." Most burns epithelialized spontaneously with surgical intervention and without functional disability. Protective devices are available and could prevent childhood burns from woodstoves.