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Early Insults to the Injured Brain
Abstract
Of 100 consecutive patients with severe head injury who arrived at a major trauma center, half of whom came direct from the accident site and half from another hospital, potentially serious systemic insults to the brain were present in 44 cases. Arterial hypotension (13 cases), anemia (12 cases), and hypercarbia (4 cases) were almost exclusively associated with multiple injuries, which were present in 57 patients and were caused usually by vehicular accidents. Hypoxia was seen in 30 patients, including several with brain injury alone. These systemic insults to the already injured brain were associated with an increase in mortality and morbidity. We believe that direct transfer to a trauma center that has full-time neurosurgical facilities for victims of automobile accidents and patients who have been rendered unconscious by a fall or blow on the head will increase survival. Care for the patient with head injuries should start at the roadside.
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Citations
Cited by
Acute secondary adrenal insufficiency after traumatic brain injury: a prospective study
Cohan, P., Wang, C., McArthur, D. L., Cook, S. W., Dusick, J. R., Armin, B., Swerdloff, R., Vespa, P., Muizelaar, J. P., Cryer, H. G., et al. (2005) · Critical Care Medicine · doi:10.1097/01.ccm.0000181735.51183.a7 · Cited by 282
Spaite, D. W., Hu, C., Bobrow, B. J., Chikani, V., Barnhart, B., Gaither, J. B., Denninghoff, K. R., Adelson, P. D., Keim, S. M., Viscusi, C., et al. (2017) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2016.08.007 · Cited by 187
Kelly, D. F., McArthur, D. L., Levin, H., Swimmer, S., Dusick, J. R., Cohan, P., Wang, C., & Swerdloff, R. (2006) · Journal of Neurotrauma · doi:10.1089/neu.2006.23.928 · Cited by 158
CHRONIC HYPOPITUITARISM AFTER TRAUMATIC BRAIN INJURY: RISK ASSESSMENT AND RELATIONSHIP TO OUTCOME
Bavisetty, S., McArthur, D. L., Dusick, J. R., Wang, C., Cohan, P., Boscardin, W. J., Swerdloff, R., Levin, H., Chang, D. J., Muizelaar, J. P., et al. (2008) · Neurosurgery · doi:10.1227/01.neu.0000325870.60129.6a · Cited by 126
Metadata
- Authors
- Miller, J. D.
- Venue
- JAMA: The Journal of the American Medical Association
- Publisher
- American Medical Association (AMA)
- Published
- 1978-08-04
- Volume
- 240
- Issue
- 5
- Pages
- 439
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2115577166
- Cited by
- 467
- References
- 0
- FWCI
- 8.83
- Type
- journal article
- Language
- en
- Open access
- closed
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- Miller, J. D. (1978). Early Insults to the Injured Brain. JAMA: The Journal of the American Medical Association. https://doi.org/10.1001/jama.1978.03290050029011
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
