phenylephrine-hydrochloride and Brain-Injuries

Children with cerebral injury often exhibit brief muscle contraction to a variety of stimuli. However, it remains to be determined whether or not the pattern of the reaction is stereotypical irrespective of the site stimulated. To answer this question, we studied electromyographic (EMG) responses to three types of stimuli in children.. The EMG responses of cranial and limb muscles were recorded after acoustic or somaesthetic stimulation in 6 patients and 23 control subjects.. Acoustic stimuli evoked patterned motor activity with a rostrocaudal progression. Nose-tapping stimuli elicited reflex EMG activity in the VIIth cranial muscles that was similar to the R1 component of the electrical blink reflex. Sternum-tap stimuli evoked motor activity in the sternocleidomastoid and arm muscles, and this reflex was probably mediated through the cervical cord (H-reflex). Moreover, late reflexes were evoked following these early reflexes in the patients. In particular, atypical forms of myoclonic jerks were evoked on sternum-tap stimuli.. Many types of primitive reflexes were evoked following three types of stimuli. These reflexes included startle reflex, trigeminomotor reflex, H-reflex and atypical forms of myoclonus, and they were enhanced in the patient group. There are many startle-mimicking reflexes.

Topics: Acoustic Stimulation; Blinking; Brain Injuries; Child; Child, Preschool; Electroencephalography; Electromyography; Evoked Potentials, Auditory, Brain Stem; Female; Humans; Infant; Male; Muscle, Skeletal; Nose; Physical Stimulation; Reflex, Startle; Sternum

Early complex treatment of a critical brain traumas should be aimed not only at men's life and personality saving, but also at their performance' rehabilitation. Complicity and to some degree individual nature of a critical trauma pathogenesis depend on the associative active methods of surgery interference and conservative pharmacotherapy. The article deals with well-practiced means and methods of symptomatic pharmacotherapy at the early and later stages of the brain traumas with vestibular and hearing system injures and with theoretical and clinical base for modern "quick-action adaptogens" usage in addition to psychoneurocorrectors.

Topics: Acute Disease; Adaptation, Physiological; Brain Injuries; Double-Blind Method; Drug Therapy, Combination; Ear; Humans; Military Personnel; Nose; Pharynx; Russia; Time Factors

We report the first case of a transnasal penetrating intracranial injury in Hong Kong by a chopstick. A 49-year-old man attempted suicide by inserting a wooden chopstick into his left nose and then pulled it out. The chopstick caused a transnasal penetrating brain injury, confirmed by contrast magnetic resonance imaging of the brain. He was managed conservatively. Later he developed meningitis without a brain abscess and was prescribed antibiotics for 6 weeks. He enjoyed a good neurological recovery. This case illustrates that clinician should have a high index of suspicion for penetrating intracranial injury due to a nasally inserted foreign body, even though it had already been removed. In such cases moreover, brain magnetic resonance imaging is the imaging modality of choice, as it can delineate the path of penetration far better than plain computed tomography.

Topics: Brain Abscess; Brain Injuries; Cooking and Eating Utensils; Foreign Bodies; Humans; Magnetic Resonance Imaging; Male; Meningitis; Middle Aged; Nose; Wounds, Penetrating

Transnasal intracranial penetrating injury is rare. We report a case of transnasal intracranial penetrating metallic chopstick, which was removed successfully by endoscopic approach, and management of transnasal intracranial penetrating injuries.

Topics: Brain Injuries; Endoscopy; Foreign Bodies; Humans; Male; Middle Aged; Nose; Sphenoid Sinus; Wounds, Penetrating

Topics: Accidents, Traffic; Brain Injuries; Cranial Fossa, Anterior; Craniotomy; Endoscopy; Foreign Bodies; Humans; Male; Nose; Tomography, X-Ray Computed; Wounds, Penetrating; Young Adult

Intracranial penetrating injury through the nose is uncommon. We present the case of a four-year-old girl who sustained a transnasal, intracranial penetrating injury with a sharp wooden object. We performed endoscopic removal of the foreign body and repair of the associated cerebrospinal fluid fistula.

Topics: Brain; Brain Injuries; Child, Preschool; Endoscopy; Ethmoid Bone; Female; Foreign Bodies; Humans; Magnetic Resonance Imaging; Nose; Skull Fractures; Wounds, Penetrating

A case of a 52-year-old male presented with an unusual penetrating brain injury with nasal entry. At admission he had erythema of periorbital soft tissue in the left eye and epistaxis. His neurological condition was lethargic (Glasgow Coma Scale of 13) with nonfluent aphasia. Computed tomography scan revealed intracranial contusion hematoma in the left frontal lobe and fracture of the left frontal base, which were treated surgically. At the 6-month follow-up he still showed nonfluent aphasia. Disturbances, mostly cognitive, were noted on his psychological tests. A survey of the literature reveals a few cases of this nature in penetrating brain injury with nasal entry. A penetrating brain injury with nasal entry which causes nonfluent aphasia is discussing.

Topics: Aphasia; Brain Injuries; Cerebral Hemorrhage, Traumatic; Foreign Bodies; Frontal Lobe; Head Injuries, Penetrating; Humans; Male; Memory Disorders; Middle Aged; Nose; Personality Disorders; Skull Base

Topics: Adult; Automobiles; Brain Injuries; Craniotomy; Eye Evisceration; Eye Injuries, Penetrating; Foreign Bodies; Humans; Male; Nose; Skull Fractures; South Africa; Tomography, X-Ray Computed

Topics: Adult; Blood Flow Velocity; Brain Death; Brain Injuries; Cerebral Angiography; Cerebral Infarction; Cerebrovascular Circulation; Hematoma, Epidural, Cranial; Humans; Male; Nose; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tomography, X-Ray Computed

Blast injuries involving the frontobasilar region and orbit can present difficult evaluation and treatment challenges. This article presents the surgical treatment of four patients presenting with blast-type injuries involving the central periorbital region and anterior skull base. Three of these were the result of close-range gunshot wounds, and one was caused by an avulsive penetrating tree branch injury during a motor vehicle accident. All four patients underwent frontal craniotomy for exposure to repair significant intracranial injuries. Following intracranial repair of dural and brain injuries, anterior cranial fossa reconstruction was performed. In two of these patients, elective supraorbital osteotomies were performed to allow improved access to the posterior aspect of the anterior skull base. The healing period of all four patients has been without complications relative to the anterior fossa injuries.

Topics: Adult; Blast Injuries; Bone Transplantation; Brain Injuries; Cerebrospinal Fluid Rhinorrhea; Craniotomy; Dura Mater; Eye Injuries, Penetrating; Female; Follow-Up Studies; Frontal Bone; Humans; Male; Nose; Orbital Fractures; Osteotomy; Skull Base; Skull Fractures; Surgical Flaps; Surgical Mesh; Wound Healing; Wounds, Gunshot; Wounds, Penetrating

A man with a long history of depression had recently borrowed a rifle. His body was found on its back in bed in his caravan. A rifle lay over the body with the muzzle pointing towards the head. A suicide note was found at the scene. Autopsy revealed entry via the nose with the track passing through the base of the skull to the right parietal region where the main bullet fragments were located beneath the scalp. The history, scene and autopsy findings were consistent with the gunshot wound being suicidal. We can find only one mention of a suicidal gunshot wound with nasal entry in the English-language literature, although a personal communication informed us of a similar case in the Republic of Ireland within the past two years. We report this case because of its unusual nature.

Topics: Adult; Brain Injuries; Cause of Death; Humans; Male; Nose; Parietal Bone; Postmortem Changes; Skull Fractures; Suicide; Wounds, Gunshot

The purpose of this study was to determine the intrarater and interrater reliability of measurements of three clinical features of coordination based on the performance of the "finger-to-nose" test.. Thirty-seven persons with traumatic brain injury (26 male, 11 female), aged 17 to 64 years (mean = 29.1, SD = 9.9), participated in the study.. Each subject's performance was videotaped and evaluated for the right and left upper extremities (UEs) (two trials each) with respect to the following variables: time of execution, degree of dysmetria, and degree of tremor (four-point ordinal ratings). One year later, five experienced physical therapists (including the original investigator) independently rated each patient's videotaped performance in the same manner as described above.. Intraclass correlation coefficients (ICC[3,1]) for intrarater reliability were .971 and .986 and ICCs for interrater reliability were .920 and .913 for right and left UEs, respectively, for the time of execution. A generalized Kappa statistic of .54 was calculated for the scoring of dysmetria (both UEs), and Kappa statistics calculated for the scoring of tremor were .18 and .31 for right and left UEs, respectively. Interrater reliability was lower for the scoring of these variables and varied from .36 to .40 for dysmetria and from .27 to .26 for tremor (right and left UEs, respectively).. These results indicate that physical therapists demonstrate low reliability in assessment of the presence of dysmetria and tremor using videotaped performances of the finger-to-nose test. The results suggest, however, that therapists reliably measure the time of execution of this test. If the limitations associated with therapists' capacity for objective measurement of subjective phenomena cannot be overcome (eg, by establishment of more definitive scoring criteria for the measures of dysmetria and tremor), then therapists should seek alternative methods of evaluation of UE coordination.

Topics: Adolescent; Adult; Brain Injuries; Evaluation Studies as Topic; Female; Fingers; Humans; Male; Middle Aged; Neurologic Examination; Nose; Observer Variation; Physical Therapy Modalities; Psychomotor Performance; Videotape Recording

The skull base was perforated and extensive wounds occurred in the brain during the passage of a nasogastric tube on a 48 year old woman, under general anaesthetic. The patient was treated by artificial respiration but died on the 14th day. The site of entry was the sphenoid sinus. False passage of the tube was favoured by a marked septal deviation, underdevelopment of the turbinates, and a high-grade pneumatisation of the paranasal sinus. 10 more cases of intracranial passage of a nasogastric tube were found in the literature.

Topics: Adolescent; Adult; Brain Injuries; Female; Humans; Intubation, Gastrointestinal; Male; Middle Aged; Nose

Naso-orbital trauma can cause medial orbital wall disruption and detachment of the medial canthal ligament. Damage to the nasolacrimal drainage apparatus, cerebrospinal fluid rhinorrhea and frontal sinusitis can occur. Twelve cases of naso-orbital trauma have been reviewed. There is a high incidence of associated injury to adjacent structures. Medial canthal ligament separation was missed acutely in a number of cases leading to the necessity of delayed repair. Important diagnostic and therapeutic points are stressed in the acute and delayed management, particularly medial canthal ligament separation. A wire to intranasal button technique for the delayed repair of traumatic telecanthus is presented.

Topics: Adolescent; Adult; Brain Injuries; Cerebrospinal Fluid Rhinorrhea; Child; Child, Preschool; Eye Injuries; Fractures, Bone; Humans; Ligaments; Nose; Orbit; Surgery, Plastic

Topics: Brain Injuries; Fracture Fixation; Humans; Mandibular Fractures; Maxillary Fractures; Maxillofacial Injuries; Nose; Orthopedic Fixation Devices; Tracheotomy; Zygomatic Fractures

Topics: Brain Injuries; Cerebral Hemorrhage; Craniocerebral Trauma; Fracture Fixation; Hearing Disorders; Humans; Intracranial Pressure; Nose; Skull Fractures

Topics: Brain Injuries; Hemianopsia; Humans; Nose; Occipital Lobe; Orientation; Parietal Lobe; Perceptual Disorders; Reflex; Space Perception; Temporal Bone; Visual Fields

Topics: Brain Injuries; Craniocerebral Trauma; Fractures, Bone; Humans; Maxillofacial Injuries; Nose; Rhinoplasty; Skull

Topics: Accidents, Traffic; Adult; Automobiles; Brain Injuries; Craniotomy; Diagnosis, Differential; Electroencephalography; Female; Frontal Lobe; Frontal Sinus; Glass; Hematoma; Humans; Male; Nose; Orbit; Radiography; Scalp; Skull

Topics: Adult; Brain Injuries; Diagnosis, Differential; Electroencephalography; Female; Fractures, Bone; Humans; Nose

Topics: Adaptation, Biological; Birth Injuries; Brain Injuries; Extraembryonic Membranes; Female; Fetal Death; Fetus; Hearing Disorders; Humans; Infant, Newborn; Infant, Premature, Diseases; Labor, Obstetric; Nose; Otitis Media; Pregnancy; Respiration; Respiratory Distress Syndrome, Newborn; Respiratory Tract Infections

Topics: Animals; Brain Injuries; Dog Diseases; Dogs; Foreign Bodies; Nose

Topics: Brain; Brain Injuries; Humans; Iatrogenic Disease; Nose; Nose Diseases

Topics: Brain; Brain Injuries; Cranial Fossa, Anterior; Humans; Nose; Paranasal Sinuses; Skull; Wounds and Injuries

Topics: Brain; Brain Injuries; Facial Injuries; Humans; Nose; Orbit; Paranasal Sinuses; Skull

Topics: Brain; Brain Injuries; Craniocerebral Trauma; Humans; Nose; Skull; Spinal Cord Injuries; Wounds, Penetrating

Topics: Brain; Brain Injuries; Frontal Sinus; Humans; Nose; Paranasal Sinuses