ABSTRACT
Among 1142 patients with head injuries hospitalized in the Neurosurgery Department of Gazi University Medical School during the period between 1979 and 1992, 583 had initial CT scans. A retrospective analysis of these initial CT images revealed intracranial air on admission in only 21 cases. These were classified as acute traumatic intracranial pneumocephalus: a potentially serious complication of head injury. CT scans were re-evaluated so as to reveal whether air was situated in the epidural, subdural, or subarachnoid spaces or intracerebrally; whether associated space-occupying lesions were present and whether the air bubbles were single or multiple. Clinical data such as the presence of persistent rhinorrhea and/or otorrhea, tension pneumocephalus, severity and type of trauma, and outcome were were also assessed to determine the significance of this rare finding.
Subject(s)
Brain Injuries/physiopathology , Pneumocephalus/physiopathology , Adolescent , Adult , Brain Injuries/diagnostic imaging , Child , Child, Preschool , Craniocerebral Trauma/complications , Craniocerebral Trauma/diagnostic imaging , Female , Humans , Infant , Male , Middle Aged , Pneumocephalus/classification , Pneumocephalus/diagnostic imaging , Survival Analysis , Tomography, X-Ray ComputedABSTRACT
Patients defined as having a moderate head injury on the basis of Glasgow Coma Scale scores within the ranges of 9 to 13 after acute nonsurgical procedures were selected. Almost 1600 cases were hospitalized in the Neurosurgery Department. The cases were admitted through the Emergency Unit of Gaz University Medical School, Ankara, Turkey during the period between 1979 and 1992. The group studied consisted of 231 selected patients assessed separately in paediatric, adult and elderly age groups. Possible risk factors such as: GCS score, anisocoria, unilateral or bilateral fixed pupils, impaired oculocephalic reflexes, presence of multiple systemic injuries, aetiology of head trauma, presence of linear or depressed skull fractures, space occupying mass on CT or operation was also assessed. Subarachnoid haemorrhage turned out to be the only independent significant risk factor in predicting mortality. The data about the patients who have "talked and deteriorated" were also reported so as to assisst physicians charged with the care of trauma victims.
Subject(s)
Aphasia/mortality , Brain Damage, Chronic/mortality , Head Injuries, Closed/mortality , Adolescent , Adult , Aged , Aphasia/diagnosis , Brain Damage, Chronic/diagnosis , Cause of Death , Child , Child, Preschool , Cross-Sectional Studies , Female , Follow-Up Studies , Glasgow Coma Scale , Head Injuries, Closed/diagnosis , Humans , Incidence , Infant , Male , Middle Aged , Neurologic Examination , Subarachnoid Hemorrhage/diagnosis , Subarachnoid Hemorrhage/mortalityABSTRACT
Sister chromatid exchange (SCE) frequencies were studied in lymphocytes from 45 patients with malignant lymphoma. Fifteen patients were untreated when studied. The mean SCE frequency for these patients was 8.70 +/- 0.99 per mitosis. The mean score for 35 controls was 4.37 +/- 1.19. SCE mean scores were significantly higher in the untreated patients than in the controls (p < 0.001). Nine patients were treated with radiotherapy alone. The mean SCE frequency (6.80 +/- 0.87) they demonstrated was significantly lower (p < 0.01) than that found in untreated patients. Twelve patients received cyclophosphamide 1 month before the study was started. They demonstrated a mean SCE frequency (12.00 +/- 1.31) significantly higher (p < 0.05) than that found in patients who had received regimens that did not contain cyclophosphamide (9.72 +/- 1.32). From these findings we suggest that untreated patients with malignant lymphoma have elevated SCE frequencies, which may be further increased by chemotherapeutic agents.
