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The development of neuronal responses to gamma-aminobutyric acid (GABA) was examined using intracellular recording techniques in area CA1 of rabbit hippocampal slices maintained in vitro. Microapplication of GABA (via pressure ejection) in stratum pyramidale in slices from mature rabbits (age 1 month) evoked a hyperpolarization of CA1 pyramidal neurons. The(More)
Reliable Assessment of the probability that a head injury patient harbors a surgical intracranial lesion is critical to both triage and treatment. The authors analyzed data from 608 patients with severe head injuries (Glasgow Coma Scale score, < or = 8) in the Traumatic Coma Data Bank to assess the reliability of pupillary asymmetry in predicting the(More)
We evaluated evidence for the effectiveness of cognitive rehabilitation methods to improve outcomes for persons with traumatic brain injury (TBI). A search of MEDLINE, HealthSTAR, CINAHL, PsycINFO, and the Cochrane Library produced 600 potential references. Thirty-two studies met predetermined inclusion criteria and were abstracted; data from 24 were placed(More)
Widely-varying published and presented analyses of the Benchmark Evidence From South American Trials: Treatment of Intracranial Pressure (BEST TRIP) randomized controlled trial of intracranial pressure (ICP) monitoring have suggested denying trial generalizability, questioning the need for ICP monitoring in severe traumatic brain injury (sTBI), re-assessing(More)
In order to define the role of intracranial and extracranial complications in determining outcome from severe head injury, 734 patients from the Traumatic Coma Data Bank were analyzed. Nine classes of intracranial and 13 classes of extracranial complications occurring within the first 14 days after admission were analyzed, while controlling for age,(More)
P ractice guidelines for physicians who treat children with brain trauma are long overdue. A significant barrier to producing guidelines has been the lack of data from well-designed, controlled studies that address each specific juncture of the acute treatment phase. Our goal with this document was to assimilate the scarce data that exist and present it(More)
Myogenic motor-evoked responses to transcranial magnetic stimulation of the motor cortex (tcmag-MERs) may become clinically useful for the noninvasive assessment of motor pathway conduction during surgery. However, application is hindered because most anesthetic regimens result in severe depression of tcmag-MER amplitudes. As part of our systematic attempts(More)
Monitoring of ICP from the subarachnoid, intraparenchymal, or ventricular spaces can be accomplished easily and reliably. The risks and benefits of each approach should be considered when choosing the monitoring technique. The goal of ICP management is to prevent herniation and to optimize cerebral perfusion. Even transient episodes of post-traumatic(More)
The outcome from severe head injury (GCS < or = 8 mmHg) was prospectively studied in patients from the Traumatic Coma Data Bank. We investigated the impact on outcome of hypotension (SBP < 90 mmHg) occurring from injury through resuscitation (early hypotension; N = 717) or in the Intensive Care Unit [ICU] (late hypotension; N = 493). Early hypotension(More)
STUDY DESIGN The authors analyzed motor-evoked potentials using transcranial electrical cortical stimulation during spinal surgery in 40 patients under conditions of partial neuromuscular blockade. OBJECTIVES The results were used to investigate the utility of motor-evoked potential monitoring to prevent neurologic injury in spinal surgery. SUMMARY OF(More)