[Comparative efficiency of nootropic drugs in complex treatment of patients with remote consequences of closed craniocereberal trauma].

PubMed

Hliebova, O S; Tkachenko, O V

2008-01-01

Main data of the research were data obtained after a complex treatment of 120 persons with late consequences of closed craniocereberal trauma (CCRCT). The treatment included administration of one of nootropic agents (noophen, aminolon or entropil), magnesium sulfate, group B vitamins. All patients have passed a complex examination: specially developed questionnaire, anamnesis gathering, neurologic status, neuropsychological status with the use of multiple-aspect scales and questionnaires, examination of fundus of eye, rheoencephalography, echoencephalography, brain MRT. Results of a complex examination proved positive effect of the use of nootropic agents, in particular noophen, entropil and aminolon in complex treatment of late consequences of closed craniocereberal trauma. For optimisation of the use of nootropic agents in the treatment of late consequences of closed craniocereberal trauma it is recommended to consider features of influence of nootropic agents on certain clinical aspects of the disease.

Transdural doppler ultrasonography monitors cerebral blood flow changes in relation to motor tasks.

PubMed

Hatanaka, Nobuhiko; Tokuno, Hironobu; Nambu, Atsushi; Takada, Masahiko

2009-04-01

Monitoring changes in cerebral blood flow in association with neuronal activity has widely been used to evaluate various brain functions. However, current techniques do not directly measure blood flow changes in specified blood vessels. The present study identified arterioles within the cerebral cortex by echoencephalography and color Doppler imaging, and then measured blood flow velocity (BFV) changes in pulsed-wave Doppler mode. We applied this "transdural Doppler ultrasonography (TDD)" to examine BFV changes in the cortical motor-related areas of monkeys during the performance of unimanual (right or left) and bimanual key-press tasks. BFV in the primary motor cortex (MI) was increased in response to contralateral movement. In each of the unimanual and bimanual tasks, bimodal BFV increases related to both the instruction signal and the movement were observed in the supplementary motor area (SMA). Such BFV changes in the SMA were prominent during the early stage of task training and gradually decreased with improvements in task performance, leaving those in the MI unchanged. Moreover, BFV changes in the SMA depended on task difficulty. The present results indicate that TDD is useful for evaluating regional brain functions.

Progress in legal definition of brain death and consent to remove cadaver organs.

PubMed

Stuart, F P

1977-01-01

The availability of cadaver kidneys for transplantation falls far short of the needs of a rapidly expanding population of patients on chronic hemodialysis. Kidneys with the least ischemic injury come from donors with fatal head injury or stroke; such kidneys can be removed from a "beating-heart" cadaver after declaring death on the basis of brain death. To clarify the legal status of brain death and to encourage salvage of transplantable kidneys with minimal ischemic injury, 12 states already have codified the concept of brain death. Although the first few laws were lengthy and included medical terms, six of the last seven laws have used one or two models proposed by the American Bar Association (ABA) and the Institute of Society, Ethics and Life Sciences, Hastings-on-Hudson, N. Y. The ABA proposal is the simpler of the two models and should provide the basis for future state laws. In addition, the National Conference of Commissioners on Uniform State Laws plans to present a model law to define death and the liabilities of a physician who declares death on the basis of brain death by mid 1977. While state legislatures have written laws that establish the legality of the concept of brain death, medical groups have sought to define the medical criteria for its determination. The most recent list of criteria comes from a National Institutes of Health-supported Collaborative Study on Cerebral Survival, as follows: (1) unresponsivity, (2) apnea, (3) dilated pupils and absent cephalic reflexes, (4) electrocerebral silence, (5) a confirmatory test of absent cerebral blood flow (angiography, isotope bolus curve, retinoscopy, or echoencephalography).