Management of head injury involves thorough assessment using the Glasgow Coma Scale and imaging like CT scan to determine severity and guide treatment. Minor injuries may only require observation, while moderate and severe injuries require interventions to prevent complications like raised intracranial pressure. Treatments aim to maintain oxygenation, ventilation, blood pressure and avoid seizures, fever and coagulopathy which can worsen outcomes. Surgical evacuation is considered for certain skull fractures and hemorrhages based on size, mass effect and neurological status. Long term risks include seizures, cranial nerve injuries and syndrome of inappropriate antidiuretic hormone.
70% of RTA patients have head injury(HI).
One of the most important public health problems of today.
70% of deaths in RTA are due to HI.
At Risk population
Males 15-24
Infants
Young Children
Elderly
70% of RTA patients have head injury(HI).
One of the most important public health problems of today.
70% of deaths in RTA are due to HI.
At Risk population
Males 15-24
Infants
Young Children
Elderly
neurosurgery is a very important topic for pg entrance.....so all about it has been discussed in detail as required for pg entrance....do make use of it...
neurosurgery is a very important topic for pg entrance.....so all about it has been discussed in detail as required for pg entrance....do make use of it...
Cholelithiasis (calculi or gallstones) usually form in the gallbladder from the solid constituents of bile and vary greatly in size, shape and composition.
Dr. Guy Nicastri, Associate Professor of Surgery and Family Medicine at the Warren Alpert School of Medicine at Brown University takes us through some of the pearls of the Acute Abdomen Examination in the Adult
Thyrotoxicosis- complete review of anatomy, physiology, types and clinical fe...Surjeet Acharya
this presentation covers extensive pictures for clear explanation. this includes the anatomy & physiology of thyroid gland, a case review, types, clinical features and treatment of thyrotoxicosis. and the most intersting part it, it also includes Recent Advances in field of thyrotoxicosis
"Trouma" is not a term or concept that I am familiar with. It's possible that you might be referring to something specific or using a term from a different context. Could you please provide more information or clarify your question?
Children at very low risk of brain injuriesSun Yai-Cheng
Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study
Lancet 2009; 374: 1160–70
Head injuries top the list of trauma patienrts coming to the casualty. The condition has to be immediately assessed and investigated. Depending upon the findings prompt medical or neurosurgical treatment has to be administered.
Similar to 4. management of head injury 6th aug 14 (20)
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
3. Introduction
►Head injury is a frequent cause of
emergency department attendance,
accounting for approximately 3.4% of all
presentations1.
►It is the most common cause of death in
young adults (age 15–24 years) and is more
common in males than females.
4. Introduction
►Road traffic accidents (RTAs) are the most
common cause of head injury , followed by
falls and assaults1.
►Although the majority of injuries are mild,
around 10.9% are classified as moderate or
severe and many patients are left with
significant disability2.
5. Assessment
►Assessment should be done under these
three headings1.
Mechanism of injury:
►Blunt Vs Penetrating
Glassgow Coma Scale:
►minor head injury: GCS 15 with no loss of
consciousness (LOC);
►mild head injury: GCS 14 or 15 with LOC;
►moderate head injury: GCS 9–13;
►severe head injury: GCS 3–8.
6. Assessment
Morphology:
►Scalp: laceration, hematomas
►Skull: Vault (linear, depressed or
communited) or basilar fractures
►Intracranial: hematomas (epi/subdural,
subarachnoid or parenchymal) , contusions
and diffuse axonal injury.
7. Investigations
►CT Scan:
Recent guidelines suggest CT in all head injury
with GCS ≤14.
NICE guidelines for computerised tomography
in head injury
►Glasgow Coma Score (GCS) <13 at any point
►GCS 13 or 14 at 2 hours
►Focal neurological deficit
►Suspected open, depressed or basal skull fracture
►Seizure
►Vomiting > one episode
8. Investigations
CT Scan should also be considered if
►Age > 65
►Coagulopathy (e.g. on warfarin)
►Dangerous mechanism of injury (CT within 8 hours)
►Antegrade amnesia > 30 min (CT within 8 hours)
►Electrolytes: Na/K
►Random blood sugar
►X-ray C-spine:
9. Investigations
As per NEXUS (National Emergency X-radiography
Utilisation Group) criteria, C-spine injury can be
clinically ruled out if:
► Normal level of alertness i.e. GCS 15
► No evidence of intoxication.
► No C-spine tenderness.
► No focal neurological deficits.
► No distracting injuries (esp long bone fractures)
10. Treatment
►Minor/mild head injury1:
Examination and a period of observation of 24
hours especially if CT is not available.
The following criteria must be met before
discharge: the patient must have a GCS of
15/15 with no focal neurological deficit; the
patient must be accompanied by a responsible
adult and should not be under the influence of
alcohol or other drugs.
11. Treatment
► Advice must be given to return to the emergency
department if persistent or worsening headache
despite analgesia, persistent vomiting, drowsiness,
visual disturbance such as double or blurred
vision, and development of weakness or
numbness in the limbs.
12. Treatment
►Moderate/severe head injury:
►ABCDE as per primary trauma care.
►Cervical immobilization is required until
clearance obtained.
►Severe head injury also requires
intubation and is best managed in neuro-
intensive care settings even if
neurosurgical intervention is not
performed1.
13. Treatment
►Treatment should aim to avoid hypoxia
and hypotension2.
Maintain SaO2 >97, Maintain a PaCO2 value of 4.5–
5.0 kPa.
Maintain MAP >80 (BTF)-90 (AAGBI) mm Hg3-5.
Replace intravascular volume, avoid hypotonic and
glucose-containing solutions.
►Glucose management : Hyperglycemia
is associated with worsened outcome in a
variety of neurologic conditions including
severe TBI.6-8
14. Treatment
►Temperature management — Fever
worsens outcome after stroke and
probably severe head injury, presumably
by aggravating secondary brain injury
10.Hence, current approaches emphasize
maintaining normothermia.
15. Treatment
Medical management of raised
intracranial pressure > 20-25 mm Hg
10 :
►Position head up 30º
►Avoid obstruction of venous drainage
from head keeping head in midline and
cervical immobilisation collar should not
obstruct venous return from the head.
►Sedation +/– muscle relaxant
16. Treatment
► Normocapnia 4.5–5.0 kPa
► Diuretics like furosemide, mannitol (0.5-1 g/kg
bd- tds) to reduce cerebral swelling.
► Seizure control: Seizures increase the brain
metabolic rate and should be controlled.
Prophylactic use of anticonvulsants reduce
seizures in the first week is recommended11-12.
► Normothermia
18. Treatment
► Sodium balance: Severely brain-injured
patients are susceptible to disturbances of
sodium haemostasis such as diabetes insipidus
and syndrome of inappropriate antidiuretic
hormone (SIADH).
► Barbiturates
► Steroids in severe head injury are
associated with increased mortality and
should not be used13.
► Further steps are aimed at specific
morphological injuries.
20. Treatment
Skull:
► Open fractures should be considered for
debridement and subsequent closure if possible.
► But operative intervention is considered if 3,14
skull fractures depressed greater than the thickness
of the cranium
dural penetration
Associated with significant intracranial hematoma
frontal sinus involvement
wound infection or contamination
pneumocephalus
21.
22. Treatment
► Depressed fractures — Patients with depressed
skull fractures are at increased risk of infection
and seizures, and prophylactic measures are
recommended 15:
tetanus prophylaxis given as appropriate.
prophylactic antibiotics be given for five to
seven days to prevent the risk of subsequent
CNS infection.
anticonvulsants are often given to reduce the
risk of seizures.
23. Treatment
Cerebrospinal fluid leaks:
► The majority of CSF leaks resolve spontaneously
within one week of injury and without CNS
complications 16,17.
► The incidence of bacterial meningitis rises
substantially if the leak persists past seven days
prophylactic antibiotics should be given in such
cases 18.
24. Treatment
When to intervene??19
► Persistent for 7-10 days.
► Ceased leak that recurs after 7-10 days.
► Clinical evidence of large defect like herniation
of brain tissue through nostrils.
► Meningitis or brain abscess.
25.
26. Treatment
Intracranial hematomas:
► Consider in cases of depressed skull fractures,
focal neurological deficits including cranial nerve
palsies, ipsilateral pupillary dilatation and
contralateral paralysis, ataxia (esp in elderlies).
► Epidural hematoma —Surgical guidelines
recommend evacuation of an epidural
hematoma (EDH) if20:
larger than 30 mL
coma (GCS score ≤8) who have pupillary
abnormalities (anisocoria).
27.
28. Treatment
Subdural hematoma — Surgical
evacuation if21:
► acute SDH >10 mm in thickness
► midline shift >5 mm on CT
► GCS ≤8
► Decrease in GCS by ≥2 points from the time of
injury to hospital admission
► asymmetric or fixed and dilated pupils
► intracranial pressure measurements are
consistently >20 mmHg.
29.
30. Treatment
Subarachnoid haemorrhage:
►Trauma is the most common cause of
SAH followed by rupture of aneurysm.
Treated with:
Triple H therapy: Hypervolemia,
hemodilution & hypertension.
Nimodipine
Statins 22.
31. Treatment
►Intracerebral hemorrhage —
Surgical evacuation of a traumatic
intracerebral hemorrhage (ICH) in the
posterior fossa is recommended if:
significant mass effect (distortion,
dislocation, obliteration of the fourth
ventricle, compression of the basal
cisterns, or obstructive hydrocephalus) 23.
32. Treatment
►For traumatic ICH involving the cerebral
hemispheres, consensus surgical guidelines
recommend craniotomy with evacuation if24:
the hemorrhage exceeds 50 cm3 in volume
GCS score <8 with a frontal or temporal
hemorrhage greater than 20 cm3 with midline
shift of at least 5 mm and/or cisternal
compression on CT scan.
33. Other complications in head injury
►Cranial nerve injuries:
Occurs in 1/3rd of patients with moderate to
severe head injury. Recovery is more likely with
injury of CN III, IV & VI and less with CN VII &
VIII19.
34. Other complications in head injury
►Post traumatic seizures:
About one-half of early post-traumatic seizures
occur during the first 24 hours, and one-quarter
occur within the first hour 25.
Early seizures occurring within one week are
acute symptomatic events and are more
common with intracranial hematoma, depressed
skull fracture, severe injury, and in young
children.
35. Other complications in head injury
In patients who have not had but appear to be
at risk for early seizures, AED treatment reduces
the incidence of early seizures and may be used
because of similar concerns for secondary
complications 26,27.
Between 17 to 33 percent of patients with early
seizures will develop epilepsy.
36. Other complications in head injury
Recurrence of seizures without treatment is
likely, as high as 86 percent in the first two
years 28.As a result, long-term anticonvulsant
treatment is recommended for patients after an
initial late seizure.
37. Other complications in head injury
►Coagulopathy:
Approximately one-third of patients with severe
head injury develop a coagulopathy, which is
associated with an increased risk of hemorrhage
enlargement, poor neurologic outcomes and
death 29-33.
Severe head injury produce a coagulopathy
through the systemic release of tissue factor
and brain phospholipids into the circulation
leading to inappropriate intravascular
coagulation and a consumptive coagulopathy 34.
38. Other complications in head injury
►Coagulation parameters should be
measured in the emergency department in
all patients with severe head injury and
efforts to correct any identified
coagulopathy should begin immediately.
39. Other complications in head injury
►SIADH:
Fluid restriction, salt administration, and
vasopressin receptor antagonists.
Fluid restriction is a mainstay of therapy in most
patients with SIADH, with a suggested goal
intake of less than 800 mL/day 35.
Use of hypertonic saline:
►An effective initial regimen is 100 mL of 3 percent
saline given as an intravenous bolus, which should
raise the serum sodium concentration by
40. Other complications in head injury
►approximately 1.5 meq/L in men and 2.0
meq/L in women, thereby reducing the
degree of cerebral edema. If neurologic
symptoms persist or worsen, a 100 mL bolus
of 3 percent saline can be repeated one or
two more times at ten minute intervals.
41. Other complications in head injury
►Cerebral Salt wasting
characterized by hyponatremia and extracellular
fluid depletion due to inappropriate sodium
wasting in the urine.
Volume repletion with isotonic saline is the
recommended therapy in CSW.
43. References
1. Hamilton Bailey ; Macneil Love. (2008). Short Practice of Surgery.
London NW1 3BH: Edward Arnold (Publishers) Ltd.
2. Dinsmore, J. (2013). Traumatic brain injury: an evidence-based
review of management. Continuing Education in Anaesthesia, Critical
Care & Pain j .
3. Brain Trauma Foundation. Management and prognosis of severe
traumatic brain injury. J Neurotrauma 2007; 24: S1–106
4. Mass AI, Dearden M, Teasdale GM et al. EBIC-guidelines for
management of severe head injury in adults. European Brain Injury
Consortium. Acta Neurochir (Wein) 1997; 139: 286–94
5. The Association of Anaesthetists of Great Britain and Ireland.
Recommendations for the Safe Transfer of Patients with Brain Injury.
London: The Association of Anaesthetists of Great Britain and
Ireland, 2006
44. References
6. Rovlias A, Kotsou S. The influence of hyperglycemia on neurological
outcome in patients with severe head injury. Neurosurgery 2000;
46:335.
7. Jeremitsky E, Omert LA, Dunham CM, et al. The impact of
hyperglycemia on patients with severe brain injury. J Trauma 2005;
58:47.
8. Lam AM, Winn HR, Cullen BF, Sundling N. Hyperglycemia and
neurological outcome in patients with head injury. J Neurosurg 1991;
75:545.
9. Andrews PJ, Sleeman DH, Statham PF, et al. Predicting recovery in
patients suffering from traumatic brain injury by using admission
variables and physiological data: a comparison between decision tree
analysis and logistic regression. J Neurosurg 2002; 97:326.
10. Brain Trauma Foundation. Management and prognosis of severe
traumatic brain injury. J Neurotrauma 2007; 24: S1–106
45. References
11. Chang BS, Lowenstein DH, Quality Standards Subcommittee of the
American Academy of Neurology. Practice parameter: antiepileptic
drug prophylaxis in severe traumatic brain injury: report of the Quality
Standards Subcommittee of the American Academy of Neurology.
Neurology 2003; 60:10.
12. Schierhout G, Roberts I. Anti-epileptic drugs for preventing seizures
following acute traumatic brain injury. Cochrane Database Syst Rev
2001; :CD000173.
13. Roberts I, Yates D, Sandercock P, et al. Effect of intravenous
corticosteroids on death within 14 days in 10008 adults with clinically
significant head injury (MRC CRASH trial): randomised placebo-
controlled trial. Lancet 2004; 364:1321.
14. Qureshi NH, Harsh GR. Skull fractures. eMEDICINE, 2001.
file://emedicine.medscape.com/article/248108-overview (Accessed on
June 24, 2009).
15. Al-Haddad SA, Kirollos R. A 5-year study of the outcome of surgically
46. References
16. Ratilal BO, Costa J, Sampaio C, Pappamikail L. Antibiotic prophylaxis
for preventing meningitis in patients with basilar skull fractures.
Cochrane Database Syst Rev 2011; :CD004884.
17. Santos SF, Rodrigues F, Dias A, et al. [Post-traumatic meningitis in
children: eleven years' analysis]. Acta Med Port 2011; 24:391.
18. Brodie HA, Thompson TC. Management of complications from 820
temporal bone fractures. Am J Otol 1997; 18:188.
19. Oxford Textbook of Surgery. (2000). Oxford Press.
20. Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of acute
epidural hematomas. Neurosurgery 2006; 58:S7
47. References
21. Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of acute
subdural hematomas. Neurosurgery 2006; 58:S16.
22. Sillberg VA, Wells GA, Perry JJ. Do statins improve outcomes and
reduce the incidence of vasospasm after aneurysmal subarachnoid
hemorrhage: a meta-analysis. Stroke 2008; 39:2622.
23. Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of
posterior fossa mass lesions. Neurosurgery 2006; 58:S47.
24. Bullock MR, Chesnut R, Ghajar J, et al. Surgical management of
traumatic parenchymal lesions. Neurosurgery 2006; 58:S25.
25. Pagni CA. Posttraumatic epilepsy. Incidence and prophylaxis. Acta
Neurochir Suppl (Wien) 1990; 50:38.
48. References
26. Chang BS, Lowenstein DH, Quality Standards Subcommittee of the
American Academy of Neurology. Practice parameter: antiepileptic
drug prophylaxis in severe traumatic brain injury: report of the Quality
Standards Subcommittee of the American Academy of Neurology.
Neurology 2003; 60:10.
27. Schierhout G, Roberts I. Anti-epileptic drugs for preventing seizures
following acute traumatic brain injury. Cochrane Database Syst Rev
2001; :CD000173.
28. Haltiner AM, Temkin NR, Dikmen SS. Risk of seizure recurrence after
the first late posttraumatic seizure. Arch Phys Med Rehabil 1997;
78:835.
29. Harhangi BS, Kompanje EJ, Leebeek FW, Maas AI. Coagulation
disorders after traumatic brain injury. Acta Neurochir (Wien) 2008;
150:165.
30. Allard CB, Scarpelini S, Rhind SG, et al. Abnormal coagulation tests
are associated with progression of traumatic intracranial hemorrhage.
49. References
31. Wafaisade A, Lefering R, Tjardes T, et al. Acute coagulopathy in
isolated blunt traumatic brain injury. Neurocrit Care 2010; 12:211.
32. Stein SC, Young GS, Talucci RC, et al. Delayed brain injury after head
trauma: significance of coagulopathy. Neurosurgery 1992; 30:160.
33. Murray GD, Butcher I, McHugh GS, et al. Multivariable prognostic
analysis in traumatic brain injury: results from the IMPACT study. J
Neurotrauma 2007; 24:329.
34. Zehtabchi S, Soghoian S, Liu Y, et al. The association of coagulopathy
and traumatic brain injury in patients with isolated head injury.
Resuscitation 2008; 76:52.
35. Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med 2000; 342:1581.