Operative and nonoperative linguistic outcomes in brain injury patients.

OBJECTIVE AND BACKGROUND: Linguistic function is one of vulnerable aspects of traumatic brain injury (TBI) which may have destructive effects on patients' communicative activities and daily life, years following trauma. This paper attempts to answer the controversy whether surgery affects increase and decrease of linguistic impairment or not. MATERIALS AND METHODS: Two hundred forty-one TBI patients aged 18-65 with abnormal CT findings and at least 20 minute post-trauma amnesia (PTA), who were conscious at discharge, participated in this study. Based on operative intervention, the samples were divided into two groups: operative and nonoperative. Cognitive and aphasic deficits were inspected formally and pragmatic disorder was informally appraised at discharge. RESULTS: The groups had no significant differences in aphasia incidence and language pragmatic impairment, though they were significantly distinctive in aphasia subcategories and cognitive deficit after trauma. Fluent aphasia was more common in both groups alike. In aphasia subcategories, however, transcortical sensory aphasia (TSA) in operative and anomia in nonoperative group were the most prevalent. Several variables appeared strikingly related to higher aphasia in operative groups as follows: moderate to severe injury, 18-35 and over 50 years of age, more than 1 week PTA, intracranial surgery of multiple lesions in left or bilateral hemisphere fronto-temporal cortex plus post-trauma cognitive and pragmatic impairments, and diffuse axonal injuries. DISCUSSION: Almost certainly, meaningful drop of cognitive function post surgery roots back in significant loss of initial consciousness level. Related factors to postoperative aphasia suggest taking policies through surgery intervention. Discerning the indispensable contributions of neurosurgeons, neurolinguists, and neuroscientists, results inspire more clinical future studies.

Unintentional drowning in northern Iran: a population-based study.

The Iranian Ministry of Health documented that about 1500 people died from drowning annually in Iran between years 2000 and 2001. This study is a descriptive, retrospective, population-based analysis of 342 unintentional drowning deaths occurring to residents and tourists in Guilan and Mazandran Provinces in Iran over a 1-year period (2005-2006), using multiple data sources. The findings from this study demonstrate that the drowning rate for residents of the study population, 4.24 per 100,000, is much higher than drowning rates for populations in developed economies in Europe. Risk factors for drowning in the study populations include male gender, young age, and swimming in unsupervised areas. Drownings occurred most frequently in rivers, followed by canals and lakes. While much more remains to be done to investigate the problems associated with drowning deaths and injuries in Iran, the information obtained from this study can help point the way to targeted interventions.