Pituitary apoplexy following closed head trauma

✓ The authors report a case of chiasmal compression resulting from hemorrhage into a pituitary adenoma following minor head trauma. The adenoma was still confined to the pituitary fossa and only in retrospect had caused any endocrine effects prior to the accident. The diagnosis in this case was established by computerized tomography, angiography, subsequent surgery, and pathological examination of the specimen. There was significant but partial recovery of vision following surgery.

Download Full-text

Neuroprotective effects of NPS 846, a novel N-methyl-d-aspartate receptor antagonist, after closed head trauma in rats

Journal of Neurosurgery ◽

10.3171/jns.1998.88.6.1066 ◽

1998 ◽

Vol 88 (6) ◽

pp. 1066-1074 ◽

Cited By ~ 12

Author(s):

Boris Gurevich ◽

Alan A. Artru ◽

Arthur M. Lam ◽

Alan L. Mueller ◽

Vladimir Merkind ◽

...

Keyword(s):

Specific Gravity ◽

Receptor Antagonist ◽

Head Trauma ◽

Content Type ◽

Aspartate Receptor ◽

Hemorrhagic Necrosis ◽

Ischemic Tissue ◽

Closed Head ◽

Closed Head Trauma ◽

Fine Print

Object. The authors sought to determine whether 3,3-bis (3-fluorophenyl) propylamine (NPS 846), a novel noncompetitive N-methyl-d-aspartate receptor antagonist, alters outcome after closed head trauma in rats. Methods. The experimental variables were: presence or absence of closed head trauma, treatment with NPS 846 or no treatment, and time at which the rats were killed (24 or 48 hours). The NPS 846 (1 mg/kg) was administered intraperitoneally at 1 and 3 hours after closed head trauma or sham operation. Outcome measures were the neurological severity score (NSS), ischemic tissue volume, hemorrhagic necrosis volume, and specific gravity, water content, and concentrations of calcium, sodium, potassium, and magnesium in brain tissue. The following closed head trauma—induced changes in the injured hemisphere (expressed as the mean ± the standard deviation) were reversed by NPS 846: decreased specific gravity of 1.035 ± 0.006 at 24 hours was increased to 1.042 ± 0.004; the decreased potassium level of 0.583 ± 0.231 mg/L at 48 hours and at 24 hours was increased to 2.442 ± 0.860 mg/L; the increased water content of 84.7 ± 2.6% at 24 hours was decreased to 79.8 ± 2%; the increased calcium level of 0.592 ± 0.210 mg/L at 24 hours was decreased to 0.048 ± 0.029 mg/L; and the increased sodium level of 2.035 ± 0.649 mg/L was decreased to 0.631 ± 0.102 mg/L. Administration of NPS 846 also lowered the NSS (improved neurological status) at 48 hours (7 ± 3) and caused no significant changes in ischemic tissue or hemorrhagic necrosis volumes in the injured hemisphere at 24 or 48 hours. Conclusions. In this model of closed head trauma, NPS 846 improved neurological outcome, delayed the onset of brain edema, and improved brain tissue ion homeostasis.

Download Full-text

Long-term follow-up review of 31 children with severe closed head trauma

Journal of Neurosurgery ◽

10.3171/jns.1990.73.5.0684 ◽

1990 ◽

Vol 73 (5) ◽

pp. 684-687 ◽

Cited By ~ 43

Author(s):

Hanan Costeff ◽

Zeev Groswasser ◽

Ruth Goldstein

Keyword(s):

Head Trauma ◽

Vegetative State ◽

Persistent Vegetative State ◽

Acute Stage ◽

Ct Scans ◽

Permanent Disability ◽

Content Type ◽

Closed Head ◽

Closed Head Trauma ◽

Fine Print

✓ Thirty-one children aged 3 to 15 years were followed for 5 to 11 years after suffering severe closed head trauma which caused coma for 1 week or more (median duration of coma 3 weeks). One patient remained in a persistent vegetative state until his death 9 years later. The other 30 recovered consciousness and were discharged. All suffered diminution of their abilities, and 24 of them had major permanent disability. The most common motor disabilities were pure spastic hemiparesis (seven cases), basal ganglia syndromes (four cases), ataxia (three cases), and a combination of hemiparesis and ataxia (five cases). Of the 30 patients, 26 regained independent ambulation, seven were epileptic, and 14 were dysarthric in various degrees. Only 10 had the cognitive ability to profit from the normal educational system, and none had attempted postsecondary education. Social problems were common. The worst outcomes were associated with intracranial bleeding and/or brain contusion seen on computerized tomography (CT) scans at the acute stage; the best were associated with normal CT scans. The degree of residual disability in these children seems no less than that of adults with trauma of similar severity.

Download Full-text

Bilateral trigeminal and abducens neuropathies following low-velocity, crushing head injury

Journal of Neurosurgery ◽

10.3171/jns.1979.50.4.0508 ◽

1979 ◽

Vol 50 (4) ◽

pp. 508-511 ◽

Cited By ~ 27

Author(s):

C. Gail Summers ◽

Jonathan D. Wirtschafter

Keyword(s):

Head Injury ◽

Head Trauma ◽

Head Injuries ◽

Large Diameter ◽

Low Velocity ◽

Content Type ◽

Diameter Pipe ◽

Closed Head ◽

Closed Head Trauma ◽

Fine Print

✓ A case is presented of bilateral injury to the trigeminal and abducens nerves following closed head trauma in which the patient survived crushing of the head by a heavy, large-diameter pipe. Bilateral trigeminal and unilateral abducens neuropathies persisted for more than 1 year. These unusual findings are discussed in regard to localization and possible mechanisms of injury. The effects of this type of low-velocity, crushing head injury are compared and contrasted with those of acceleration-deceleration head injuries.

Download Full-text