RESUMO
The electroencephalogram (EEG) is a physiologic measure of cerebral function that has been used by some to assess coma and prognosticate survival and global outcome after traumatic brain injury (TBI). Surface recordings of the brain's electrical activity reveal distinct patterns that indicate injury severity, depth of unconsciousness, and patient survival. The data produced with traditional qualitative studies, however, does not allow resolution and quantification of the wave frequency spectrum present in the brain. As a result, conventional EEG typically has only been used for gross and qualitative analyses and is not practical for use in long-term patient monitoring or as a sophisticated prognostic tool. One area of investigation that is working to address the limitations of conventional EEG has been the development and implementation of Fourier Transform (FT) EEG which resolves and quantifies frequency bands present in the brain. When FT analysis is applied to EEG, it provides concurrent and continuous monitoring, resolution, and quantification of all frequencies emitted. This review discusses the history and significance of conventional EEG and provides a review of how FT-EEG, commonly referred to as Quantitative EEG (QEEG), is being used in the clinical setting. The specific applications and significance of QEEG methods regarding treatment of patients with TBI are discussed in detail. The advantages, disadvantages, and future directions of QEEG in TBI are also discussed.
Assuntos
Lesões Encefálicas/diagnóstico , Eletroencefalografia/métodos , Lesões Encefálicas/fisiopatologia , Eletroencefalografia/história , Análise de Fourier , História do Século XX , Humanos , Deficiências da Aprendizagem/diagnóstico , Transtornos Mentais/diagnósticoRESUMO
Survivors of traumatic brain injury frequently develop respiratory complications that require specialized knowledge and management skills in both acute and postacute environments. This article discusses the pathophysiology of and treatment options for ventilatory failure, neurogenic pulmonary edema, and aspiration. Management of tracheostomies is also discussed, with particular attention paid to decision making regarding the removal of a tracheal appliance. Long-term tracheal complications are also outlined.
Assuntos
Lesões Encefálicas/complicações , Doenças Respiratórias/etiologia , Lesões Encefálicas/fisiopatologia , Tórax Fundido/etiologia , Hemotórax/etiologia , Humanos , Pneumotórax/etiologia , Doenças Respiratórias/fisiopatologia , Doenças da Traqueia/etiologia , TraqueostomiaRESUMO
Neuroscientists have been transplanting neurological tissue into humans and animals for more than a century. Recently, a number of animal studies have demonstrated a degree of central nervous system protection after brain injury using transplanted tissue. This article reviews the history of neural tissue transplantation. Clinical efficacy in Huntington's disease, Parkinson's disease, and spinal cord injury is discussed. In addition, possible implications for the treatment of traumatic brain injury are reviewed. Ethical issues in the use of fetal tissue are also discussed.
Assuntos
Doenças dos Gânglios da Base/cirurgia , Lesões Encefálicas/cirurgia , Tecido Nervoso/transplante , Animais , Ética Médica , Transplante de Tecido Fetal , Humanos , Doença de Huntington/cirurgia , Doença de Parkinson/cirurgia , Traumatismos da Medula Espinal/cirurgiaRESUMO
The purpose of this section of the Self-Directed Physiatric Education Program Study Guide on rehabilitation in diseases affecting nerve and muscle is to assist practitioners and trainees in physical medicine and rehabilitation by providing an overview of the evaluation, treatment, and rehabilitative care of patients with inherited and acquired neuropathies. Both diffuse and focal processes are discussed. Current research is briefly reviewed, and the utility and limitations of electrodiagnostic studies are discussed.