RESUMEN
The present work examined the relationship between the appearance of periarticular new bone formation (PNBF) and the presence of local sensorimotor disability, and the relationship between PNBF and the severity of the motor disability. The study population consisted of 18 patients with spinal cord lesions and 18 patients with traumatic brain injury. The confinement of PNBF below the level of neurological deficit in patients with spinal cord lesions, and mainly to paralysed or paretic limbs in brain injured patients, indicates a possible causal relationship between the presence of sensorimotor disability and PNBF. On the other hand, the high incidence of bilateral PNBF in patients with incomplete spinal lesions and the appearance of PNBF in some nonplegic and even paretic limbs in the brain injured patients, demonstrates the lack of connection between the severity of the motor deficit and the risk of PNBF. It is suggested that local factors which are related to sensorimotor disability are probably involved in PNBF induction, but additional elements may also play a role in the induction of PNBF and in its propagation.
Asunto(s)
Lesiones Encefálicas/fisiopatología , Articulaciones/fisiopatología , Osteogénesis , Enfermedades de la Médula Espinal/fisiopatología , Adolescente , Adulto , Anciano , Lesiones Encefálicas/complicaciones , Extremidades , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Movimiento/etiología , Trastornos del Movimiento/fisiopatología , Enfermedades de la Médula Espinal/complicacionesRESUMEN
Sleep complaints were obtained from 22 hospitalised patients with traumatic brain injury of recent onset (median 3.5 months after injury) and were compared with those of 77 discharged patients who had sustained brain injury about two to three years (median 29.5 months) previously. A high incidence of sleep complaints was noted in both groups (72.7% and 51.9% respectively). Disorders in initiating and maintaining sleep (DIMS) were the most common complaints among hospitalised patients (81.2%), whereas disorders of excessive somnolence (DOES) were common in discharged patients (72.5%). This difference in the nature of the complaints was apparently due to differences between the two groups in the time elapsed since injury, duration of coma, and immediate environmental conditions. In discharged patients with sleep complaints, neurobehavioural impairments and a poorer occupational outcome were more common than in those discharged patients without sleep complaints. It is suggested that early evaluation and treatment of sleep disturbances must be considered an integral part of the rehabilitation process.
Asunto(s)
Daño Encefálico Crónico/etiología , Lesiones Encefálicas/complicaciones , Trastornos Neurocognitivos/etiología , Trastornos del Sueño-Vigilia/etiología , Adulto , Daño Encefálico Crónico/rehabilitación , Lesiones Encefálicas/rehabilitación , Femenino , Estudios de Seguimiento , Humanos , Masculino , Trastornos Neurocognitivos/rehabilitación , Pruebas Neuropsicológicas , Trastornos del Sueño-Vigilia/rehabilitaciónRESUMEN
Repeated cystometry was performed in 17 patients after a cerebrovascular accident. Cranial computerised tomography (CT) was performed in all patients. In this series, urinary continence showed a significant correlation both with cystometric bladder tone and with the CT brain findings. The most favourable prognostic factors for urinary continence were a non-hypertonic bladder and absence of extensive brain lesions.