書誌事項
- タイトル別名
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- Analysis of talk & deteriorate patients : Report of our own cases and review of literature
- Talk & deteriorate ショウレイ ノ ケントウ : ジケンレイ ノ ホウコク ト ブンケンテキ コウサツ
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説明
<p>Introduction: We retrospectively analyzed surgically treated “talk and deteriorate (T&D)” patients at our institution to find an appropriate management of this potentially preventable poor outcome head injury.</p><p>Materials and Methods: From January 1996 to November 2014, a total of 468 patients with mild head injuries (GCS≧13) were admitted to our institution. Among these, 16 patients were identified as T&D. We defined T&D as a patient who utters comprehensible speech at some time after head injury and then deteriorates to a severe state (GCS score 8 or less) within 24 hours after injury. Clinical characteristics of these patients were analyzed.</p><p>Results: Of the 16 T&D patients, 10 were men, and 6 were women, aged 16–89 years (mean ± standard deviation (SD) = 65 ± 19). Thirteen patients were injured in non high energy trauma. All deterioration was due to intra-cranial hematomas, mostly acute subdural hematoma. Time interval from accident to deterioration was 1–15 hours (mean ± SD ＝ 4.4 ± 4.0). All patients underwent craniotomy, two of these craniectoy and 5 indwelled intracranial pressure monitoring. Two died and 6 were left in moderate disability or severe disability status. The remaining 8 patients had good outcome.</p><p>Conclusion: The most important factors in saving these patients are rapid diagnosis and immediate surgical decompression before irreversible brain damage sets in.</p>
収録刊行物
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- 神経外傷
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神経外傷 39 (1), 27-31, 2016-08-10
一般社団法人 日本脳神経外傷学会