Das Schädel-Hirn-Trauma

  • H.-G. Imhof


Schädel-Hirn-Traumen (SHT) sind nicht nur die häufigste Todesursache in der Altersgruppe der unter 45 jährigen, sondern sind auch für die meisten der unfallbedingten invalidisierenden Behinderungen verantwortlich. Die häufigste Ursache sind mit über 50% Unfälle im Straßenverkehr, gefolgt von Stürzen, die rund ein Drittel der Schädel-Hirn-Verletzungen verursachen; Manner sind um ein Mehrfaches häufiger betroffen als Frauen.


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  1. Adams JH, Doyle D, Ford I, Gennarelli TA, Graham DI, McLellan DR (1989) Diffuse axonal injury in head injury: Definition, diagnosis and grading. Histopathology 15: 49–59PubMedCrossRefGoogle Scholar
  2. Alberico AM, Ward JD, Choi SC, Marmarou A, Young HF (1987) Outcome after severe head injury. Relationship to mass lesions, diffuse injury, and ICP course in pediatric and adult patients. J Neurosurg 67: 648–656PubMedCrossRefGoogle Scholar
  3. Aldrich EF, Eisenberg HM, Saydjari C et al. (1992) Predictors of mortality in severely head-injured patients with civilian gun-shot wounds: a report from the NIH Traumatic Coma Data Bank. Surg Neurol 38: 418–423PubMedCrossRefGoogle Scholar
  4. Andrews BT, Pitts LH, Lovely MP, Bartkowski H (1986) Is computed tomographic scanning necessary in patients with tentorial herniation? Results of immediate surgical exploration without computed tomography in 100 patients. Neurosurgery 19: 408–414PubMedCrossRefGoogle Scholar
  5. Andrews BT, Chiles BW, Olsen WL, Pitts LH (1988) The effect of intracerebral hematoma location on the risk of brain-stem compression and on clinical outcome. J Neurosurg 69: 518–522PubMedCrossRefGoogle Scholar
  6. Andrews BT, Mampalam TJ, Omsberg E, Pitts LH (1990) Intraoperative ultrasound imaging of the entire brain through unilateral exploratory burr holes after severe head injury: Technical note. Surg Neurol 33: 291–294PubMedCrossRefGoogle Scholar
  7. Borovich B, Braun J, Guilburd JN et al.(i985) Delayed onset of traumatic extradural hematoma. J Neurosurg 63: 30–34Google Scholar
  8. Borzone M, Rivano C, Altomonte M, Baldini M (1995) Acute traumatic posterior fossa subdural haematomas. Acta Neurochir (Wien) 135: 32–37CrossRefGoogle Scholar
  9. Bratton SL, Davis RL (1997) Acute lung injury in isolated traumatic brain injury. Neurosurgery 40: 707–712PubMedCrossRefGoogle Scholar
  10. Bricolo AP, Pasut LM (1984) Extradural hematoma: toward zero mortality. A prospective study. Neurosurgery 14: 8–12PubMedCrossRefGoogle Scholar
  11. Bullock R, Smith RM, van-Dellen JR (1985) Nonoperative management of extradural hematoma. Neurosurgery 16: 602–606PubMedCrossRefGoogle Scholar
  12. Bullock R, Golek J, Blake G (1989) Traumatic intracerebral hematoma which patients should undergo surgical evacuation? CT scan features and ICP monitoring as a basis for decision making. Surg Neurol 32: 181–187PubMedCrossRefGoogle Scholar
  13. Bullock R, Hanemann CO, Murray L, Teasdale GM (1990) Recurrent hematomas following craniotomy for traumatic intracranial mass. J Neurosurg 72: 9–14PubMedCrossRefGoogle Scholar
  14. Bullock R, Chesnut RM, Clifton G et al. (1996) Guidelines for the management of severe head injury. Brain Trauma Foundation. Guidelines for the management of severe head injury. Brain Trauma Foundation. Eur J Emerg Med 3: 109–127PubMedCrossRefGoogle Scholar
  15. Chesnut RM, Marshall SB, Piek J, Blunt BA, Klauber MR, Marshall LF (1993a) Early and late systemic hypotension as a frequent and fundamental source of cerebral ischemia following severe brain injury in the Traumatic Coma Data Bank. Acta Neurochir (Suppl) Wien 59: 121–125Google Scholar
  16. Chesnut RM, Marshall LF, Klauber MR et al. (1993b) The role of secondary brain injury in determining outcome from severe head injury. J Trauma 34: 216–222PubMedCrossRefGoogle Scholar
  17. Chesnut RM, Gautille T, Blunt BA, Klauber MR, Marshall LE (1994) The localizing value of asymmetry in pupillary size in severe head injury: relation to lesion type and location. Neurosurgery 34: 840–845PubMedCrossRefGoogle Scholar
  18. Choi SC, Muizelaar JP, Barnes TY, Marmarou A, Brooks DM, Young HF (1991) Prediction tree for severely head-injured patients. J Neurosurg 75: 251–255; Comment in: J Neurosurg 1992, 76: 561-562PubMedCrossRefGoogle Scholar
  19. Choi SC, Barnes TY, Bullock R, Germanson TA, Marmarou A, Young HF (1994) Temporal profile of outcomes in severe head injury. J Neurosurg 81: 169–173PubMedCrossRefGoogle Scholar
  20. Clark WC, Muhlbauer MS, Lowrey R, Hartman M, Ray MW, Watridge CB (1989) Complications of intracranial pressure monitoring in trauma patients. Neurosurgery 25: 20–24PubMedCrossRefGoogle Scholar
  21. Clifton GL (1995) Systemic hypothermia in treatment of severe brain injury: a review and update. J Neurotrauma 12: 923–927PubMedCrossRefGoogle Scholar
  22. Colohan AR, Alves WM, Gross CR, Torner JC, Mehta VS, Tandon PN, Jane JA (1989) Head injury mortality in two centers with different emergency medical services and intensive care. J Neurosurg 71: 202–207PubMedCrossRefGoogle Scholar
  23. Dacey RG Jr, Alves WM, Rimel RW, Winn HR, Jane JA (1986) Neurosurgical complications after apparently minor head injury. Assessment of risk in a series of 610 patients. J Neurosurg 65: 203–210PubMedCrossRefGoogle Scholar
  24. Dunn LT, Foy PM (1994) Anticonvulsant and antibiotic prophylaxis in head injury. Ann R Coll Surg Engl 76: 147–149PubMedGoogle Scholar
  25. Eisenberg HM, Frankowski RF, Contant CF, Marshall LF, Walker MD (1988) High-dose barbiturate control of elevated intracranial pressure in patients with severe head injury. J Neurosurg 69: 15–23PubMedCrossRefGoogle Scholar
  26. Eisenberg HM, Gary HE, Aldrich EF et al. (1990) Initial CT findings in 753 patients with severe head injury. A report from the NIH Traumatic Coma Data Bank. J Neurosurg 73: 688–698PubMedCrossRefGoogle Scholar
  27. Ernestus RI, Beldzinski P, Lanfermann H, Klug N (1997) Chronic subdural hematoma: surgical treatment and outcome in 104 patients. Surg Neurol 48: 220–225PubMedCrossRefGoogle Scholar
  28. Fackler ML, Lindsey D (1996) Civilian cases of tangential gunshot wounds to the head. J Trauma 41: 573; Comment on: Stone JL, Lichtor T, Fitzgerald LF, Gandhi YN (1996) Civilian cases of tangential gunshot wounds to the head. J Trauma 40: 57-60Google Scholar
  29. Fukamachi A, Nagaseki Y, Kohno K, Wakao T (1985) The incidence and developmental process of delayed traumatic intracerebral haematomas. Acta Neurochir (Wien) 74: 35–39CrossRefGoogle Scholar
  30. Gennarelli TA (1993) Mechanisms of brain injury. J Emerg Med 11: 5–11PubMedGoogle Scholar
  31. Gennarelli TA, Champion HR, Sacco WJ, Copes WS, Alves WM (1989) Mortality of patients with head injury and extracranial injury treated in trauma centers. J Trauma 29: 1193–1201PubMedCrossRefGoogle Scholar
  32. Gennarelli TA, Champion HR, Copes WS, Sacco WJ (1994) Comparison of mortality, morbidity, and severity of 59,713 head injured patients with 114,447 patients with extracranial injuries. J Trauma 37: 962–968PubMedCrossRefGoogle Scholar
  33. Gentleman D, Nath F, Macpherson P (1989) Diagnosis and management of delayed traumatic intracerebral haematomas. Br J Neurosurg 3: 367–372PubMedCrossRefGoogle Scholar
  34. Ghajar JB (1993) Significant lateralisation of supratentorial ICP after blunt head trauma [letter; comment]. Acta Neurochir (Wien) 120: 98–99; Comment on: Mindermann Th, Reinhardt H. Gratzl O (1992) Significant lateralisation of supratentorial ICP after blunt head trauma. Acta Neurochir (Wien) 116: 60-61CrossRefGoogle Scholar
  35. Graham DI, Adams JH, Doyle D (1978) Ischaemic brain damage in fatal non-missile head injuries. J Neurol Sci 39: 213–234PubMedCrossRefGoogle Scholar
  36. Graham DI, Adams JH, Gennarelli TA (1988) Mechanisms of nonpenetrating head injury. Prog Clin Biol Res 264: 159–168PubMedGoogle Scholar
  37. Grant PT, Shrouder S (1997) Initial assessment and outcome of head injured patients transferred to a regional neurosurgical service: what do we miss? J Accid Emerg Med 14: 10–12PubMedGoogle Scholar
  38. Greene KA, Jacobowitz R, Marciano FF, Johnson BA, Spetzler RF, Harrington TR (1996) Impact of traumatic subarachnoid hemorrhage on outcome in nonpenetrating head injury. Part II: Relationship to clinical course and outcome variables during acute hospitalization. J Trauma 41: 964–971PubMedCrossRefGoogle Scholar
  39. Gruss JS, Pollock RA, Phillips JH, Antonyshyn O (1989) Combined injuries of the cranium and face. Br J Plast Surg 42: 385–398PubMedCrossRefGoogle Scholar
  40. Gutman MB, Moulton RJ, Sullivan I, Hotz G, Tucker WS, Muller PJ (1992) Risk factors predicting operable intracranial hematomas in head injury. J Neurosurg 77: 9–14PubMedCrossRefGoogle Scholar
  41. Haines SJ (1989) Efficacy of antibiotic prophylaxis in clean neurosurgical operations. Neurosurgery 24: 401–405PubMedCrossRefGoogle Scholar
  42. Heinzelmann M, Platz A, Imhof HG (1996) Outcome after acute extradural haematoma, influence of additional injuries and neurological complications in the ICU. Injury 27: 345–349PubMedCrossRefGoogle Scholar
  43. Helling TS, Evans LL, Fowler DL, Hays LV, Kennedy FR (1988) Infectious complications in patients with severe head injury. J Trauma 28: 1575–1577PubMedCrossRefGoogle Scholar
  44. Helling TS, McNabney WK, Whittaker CK, Schultz CC, Watkins M (1992) The role of early surgical intervention in civilian gunshot wounds to the head. J Trauma 32: 398–400PubMedCrossRefGoogle Scholar
  45. Holloway KL, Barnes T, Choi S et al. (1996) Ventriculostomy infections: the effect of monitoring duration and catheter exchange in 584 patients. J Neurosurg 85: 419–424PubMedCrossRefGoogle Scholar
  46. Holmes B, Harbaugh RE (1993) Traumatic intracranial aneurysms: a contemporary review. J Trauma 35: 855–860PubMedCrossRefGoogle Scholar
  47. Holzschuh M, Schuknecht B (1989) Traumatic epidural haematomas of the posterior fossa: 20 new cases and a review of the literature since 1961. Br J Neurosurg 3: 171–180PubMedCrossRefGoogle Scholar
  48. Hsiang JK, Chesnut RM, Crisp CB, Klauber MR, Blunt BA, Marshall LF (1994) Early, routine paralysis for intracranial pressure control in severe head injury: is it necessary? Crit Care Med 22: 1471–1476PubMedCrossRefGoogle Scholar
  49. Ishiwata Y, Fujitsu K, Sekino T, Fujino H, Kubokura T, Tsubone K, Kuwabara T (1988) Subdural tension pneumocephalus following surgery for chronic subdural hematoma. J Neurosurg 68: 58–61PubMedCrossRefGoogle Scholar
  50. Iwabuchi T, Sobata E, Ebina K, Tsubakisaka H, Takiguchi M (1986) Dural sinus pressure: various aspects in human brain surgery in children and adults. Am J Physiol 250: 389–396Google Scholar
  51. Jagger J, Jane JA, Rimel R (1983) The Glasgow coma scale: to sum or not to sum? Lancet Jul 9/2 (8341): 97CrossRefGoogle Scholar
  52. Jagger J, Fife D, Vernberg K, Jane JA (1984) Effect of alcohol intoxication on the diagnosis and apparent severity of brain injury. Neurosurgery 15: 303–306PubMedCrossRefGoogle Scholar
  53. Jeret JS (1993) Management of mild head injury. J Trauma 35: 490–491PubMedCrossRefGoogle Scholar
  54. Jinkins JR, Dadsetan MR, Sener RN, Desai S, Williams RG (1992) Value of acute-phase angiography in the detection of vascular injuries caused by gunshot wounds to the head: analysis of 12 cases. AJR Am J Roentgenol 159: 365–368PubMedGoogle Scholar
  55. Jones TH, Morawetz RB, Crowell RM, Marcoux FW, FitzGibbon SJ, DeGirolami U, Ojemann RG (1981) Thresholds of focal cerebral ischemia in awake monkeys. J Neurosurg 54: 773–782PubMedCrossRefGoogle Scholar
  56. Jones PA, Andrews PJ, Midgley S et al. (1994) Measuring the burden of secondary insults in head-injured patients during intensive care. J Neurosurg Anesthesiol 6: 4–14PubMedGoogle Scholar
  57. Kaufman HH (1993) Civilian gunshot wounds to the head. Neurosurgery 32: 962–964; Comments in: Neurosurgery 1993, 33: 770 and Neurosurgery 1993, 33: 1117-1118PubMedCrossRefGoogle Scholar
  58. Klauber MR, Marshall LF, Luerssen TG, Frankowski R, Tabaddor K, Eisenberg HM (1989) Determinants of head injury mortality: Importance of the low risk patient. Neurosurgery 24: 31–36PubMedCrossRefGoogle Scholar
  59. Kotwica Z, Brzezinski J (1993) Acute subdural haematoma in adults: an analysis of outcome in comatose patients. Acta Neurochir (Wien) 121: 95–99CrossRefGoogle Scholar
  60. Lee ST, Lui TN (1992) Early seizures after mild closed head injury. J Neurosurg 76: 435–439PubMedCrossRefGoogle Scholar
  61. Levin HS, Williams D, Crofford MJ et al. (1988) Relationship of depth of brain lesions to consciousness and outcome after closed head injury. J Neurosurg 69: 861–866PubMedCrossRefGoogle Scholar
  62. Levin HS, Williams DH, Valastro M, Eisenberg HM, Crofford MJ, Handel-SF (1990) Corpus callosal atrophy following closed head injury: detection with magnetic resonance imaging. J Neurosurg 73: 77–81PubMedCrossRefGoogle Scholar
  63. Levin HS, Saydjari C, Eisenberg HM et al. (1991) Vegetative state after closed-head injury. A Traumatic Coma Data Bank Report. Arch Neurol 48: 580–585PubMedGoogle Scholar
  64. Litofsky NS, Chin LS, Tang G, Baker S, Giannotta SL, Apuzzo ML (1994) The use of lobectomy in the management of severe closed-head trauma. Neurosurgery 34: 628–632PubMedCrossRefGoogle Scholar
  65. Lobato RD, Gomez PA, Alday R et al. (1997) Sequential computerized tomography changes and related final outcome in severe head injury patients. Acta Neurochir (Wien) 139: 385–391CrossRefGoogle Scholar
  66. Lloyd DA, Carty H, Patterson M, Butcher CK, Roe D (1997) Predictive value of skull radiography for intracranial injury in children with blunt head injury. Lancet 22/349 (9055): 821–824CrossRefGoogle Scholar
  67. Mamelak AN, Pitts LH, Damron S (1996) Predicting survival from head trauma 24 hours after injury: a practical method with therapeutic implications. J Trauma 41: 91–99PubMedCrossRefGoogle Scholar
  68. Marion DW, Penrod LE, Kelsey SF et al. (1997) Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med 20; 336: 540–546CrossRefGoogle Scholar
  69. Markwalder TM, Reulen HJ (1986) Influence of neomembranous organisation, cortical expansion and subdural pressure on the post-operative course of chronic subdural haematoma — an analysis of 201 cases. Acta Neurochir (Wien) 79: 100–106CrossRefGoogle Scholar
  70. Marmarou A, Anderson RL, Ward JD, Choi SC, Young HF (1991) NINDS traumatic coma data bank: intracranial pressure monitoring methdology. J Neurosurg 75: 21–27Google Scholar
  71. Marmarou A, Foda MA, Bandoh K et al. (1996) Posttraumatic ventriculomegaly: hydrocephalus or atrophy? A new approach for diagnosis using CSF dynamics. J Neurosurg 85: 1026–1035PubMedCrossRefGoogle Scholar
  72. Marshall LF, Barba D, Toole BM, Bowers SA (1983) The oval pupil: clinical significance and relationship to intracranial hypertension. J Neurosurg 58: 566–568PubMedCrossRefGoogle Scholar
  73. Marshall LF, Marshall SB, Klauber MR et al. (1992) The diagnosis of head injury requires a classification based on computed axial tomography. J Neurotrauma (Suppl 1) 9: 287–292Google Scholar
  74. Maset AL, Marmarou A, Ward JD et al. (1987) Pressure-volume index in head injury. J Neurosurg 67: 832–840PubMedCrossRefGoogle Scholar
  75. Massaro F, Lanotte M, Faccani G, Triolo C (1996) One hundred and twenty-seven cases of acute subdural haematoma operated on. Correlation between CT scan findings and outcome. Acta Neurochir (Wien) 138: 185–191CrossRefGoogle Scholar
  76. Mathew P, Oluoch Dlunya DL, Condon BR, Bullock R (1993) Acute subdural haematoma in the conscious patient: outcome with initial non-operative management. Acta Neurochir (Wien) 121: 100–108CrossRefGoogle Scholar
  77. May AK, Young JS, Butler K, Bassam D, Brady W (1997) Coagulopathy in severe closed head injury: is empiric therapy warranted? Am Surg 63: 233–236PubMedGoogle Scholar
  78. Mendelow AD, Teasdale G, Jennett B, Bryden J, Hessett C, Murray G (1983) Risks of intracranial haematoma in head injured adults. Br Med J 287: 1173–1176CrossRefGoogle Scholar
  79. Miller JD, Sullivan HG (1979) Severe intracranial hypertension. Int Anesthesiol Clin 17: 19–75PubMedCrossRefGoogle Scholar
  80. Miller JD, Sweet RC, Narayan R et al. (1978) Early insults to the injured brain. JAMA 240: 439–442PubMedCrossRefGoogle Scholar
  81. Miller JD, Dearden NM, Piper IR, Chan KH (1992) Control of intracranial pressure in patients with severe head injury. J Neurotrauma (Suppl 1) 9: 317–326Google Scholar
  82. Miller JD, Piper IR, Dearden NM (1993) Management of intracranial hypertension in head injury: matching treatment with cause. Acta Neurochir (Suppl) Wien 57: 152–159Google Scholar
  83. Moulton RJ, Shedden PM, Tucker WS, Muller PJ (1994) Somatosensory evoked potential monitoring following severe closed head injury. Clin Invest Med 17: 187–195PubMedGoogle Scholar
  84. Muizelaar JP, Lutz HA, Becker DP (1984) Effect of Mannitol on ICP and CBF and correlation with pressure autoregulation in severely head injuried patients. J Neurosurg 61: 700–706PubMedCrossRefGoogle Scholar
  85. Muizelaar JP, Marmarou A, Ward JD et al. (1991) Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trial. J Neurosurg 75: 731–739PubMedCrossRefGoogle Scholar
  86. Olson JD, Kaufman HH, Moake J et al. (1989) The incidence and significance of hemostatic abnormalities in patients with head injuries. Neurosurgery 24: 825–832PubMedCrossRefGoogle Scholar
  87. Patir R, Sood S, Bhatia R (1995) Post-traumatic brain abscess: experience of 36 patients. Br J Neurosurg 9: 29–35PubMedCrossRefGoogle Scholar
  88. Piek J, Chesnut RM, Marshall LF, van Berkum-Clark M, Klauber MR, Blunt BA (1992) Extracranial complications of severe head injury. J Neurosurg 77: 901–907PubMedCrossRefGoogle Scholar
  89. Plessis JJ du (1993) Depressed skull fracture involving the superior sagittal sinus as a cause of persistent raised intracranial pressure: a case report. J Trauma 34: 290–292PubMedCrossRefGoogle Scholar
  90. Polin RS, Shaffrey ME, Bogaev CA, Tisdale N, Germanson T, Bocchicchio B, Jane JA (1997) Decompressive bifrontal craniectomy in the treatment of severe refractory posttraumatic cerebral edema. Neurosurgery 41: 84–92PubMedCrossRefGoogle Scholar
  91. Raveh J, Vuillemin T (1988) The surgical one-stage management of combined cranio-maxillo-facial and frontobasal fractures. Advantages of the subcranial approach in 374 cases. J Craniomaxillofac Surg 16: 160–172PubMedCrossRefGoogle Scholar
  92. Redan JA, Livingston DH, Tortella BJ, Rush BF (1991) The value of intubating and paralysing patients with suspected head injury in the emergency department. J Trauma 31: 371–375PubMedCrossRefGoogle Scholar
  93. Reulen HJ, Graham R, Spatz M, Klatzo I (1977) Role of pressure gradients and bulk flow in dynamics of vasogenic brain edema. J Neurosurg 46: 24–35PubMedCrossRefGoogle Scholar
  94. Rimel RW, Giordani B, Barth JT, Jane JA (1982) Moderate head injury: completing the clinical spectrum of brain trauma. Neurosurgery 11: 344–351PubMedCrossRefGoogle Scholar
  95. Rohrich RJ, Hollier LH (1992) Management of frontal sinus fractures. Changing concepts. Clin Plast Surg 19: 219–232PubMedGoogle Scholar
  96. Rosner MJ, Rosner SD, Johnson AH (1995) Cerebral perfusion pressure: management protocol and clinical results. J Neurosurg 83: 949–962PubMedCrossRefGoogle Scholar
  97. Ruff RM, Marshall LF, Crouch J et al. (1993) Predictors of outcome following severe head trauma: follow-up data from the Traumatic Coma Data Bank. Brain Inj 7: 101–111; Comment in: Brain Inj 1993, 7: 99-100PubMedCrossRefGoogle Scholar
  98. Schröder ML, Muizelaar JP, Kota AJ (1994) Documented reversal of global ischema immediately after removal of an acute subdural hematoma. J Neurosurg 80: 324–327PubMedCrossRefGoogle Scholar
  99. Schunk JE, Rodgerson JD, Woodward GA (1996) The utility of head computed tomographic scanning in pediatric patients with normal neurologic examination in the emergency department. Pediatr Emerg Care 12: 160–165PubMedCrossRefGoogle Scholar
  100. Seelig JM, Becker DP, Miller JD, Greenberg RP, Ward JD, Choi SC (1981) Traumatic acute subdural hematoma: major mortality reduction in comatose patients treated within four hours. N Engl J Med 304: 1511–1518PubMedCrossRefGoogle Scholar
  101. Servadei F, Nanni A, Nasi MT, Zappi D, Vergoni G, Giuliani G, Arista A (1995) Evolving brain lesions in the first 12 hours after head injury: analysis of 37 comatose patients. Neurosurgery 37: 899–906PubMedCrossRefGoogle Scholar
  102. Shackford SR, Wald SL, Ross SE et al. (1992) The clinical utility of computed tomographic scanning and neurologic examination in the management of patients with minor head injuries. J Trauma 33: 385–394PubMedCrossRefGoogle Scholar
  103. Shaffrey ME, Polin RS, Phillips CD, Germanson T, Shaffrey CI, Jane JA (1992) Classification of civilian craniocerebral gunshot wounds: a multivariate analysis predictive of mortality. J Neurotrauma (Suppl 1) 9: 279–285Google Scholar
  104. Smith DH, Meaney DF, Lenkinski RE et al. (1995) New magnetic resonance imaging techniques for the evaluation of traumatic brain injury. J Neurotrauma 12: 573–577PubMedCrossRefGoogle Scholar
  105. Snoey ER, Levitt MA (1994) Delayed diagnosis of subdural hematoma following normal computed tomographyscan. Ann Emerg Med 23: 1127–1131PubMedCrossRefGoogle Scholar
  106. Stein SC, Spettell C, Young G, Ross SE (1993) Delayed and progressive brain injury in closed-head trauma: radiological demonstration. Neurosurgery 32: 25–30PubMedCrossRefGoogle Scholar
  107. Stocchetti N, Furlan A, Volta F (1996) Hypoxemia and arterial hypotension at the accident scene in head injury. J Trauma 40: 764–767PubMedCrossRefGoogle Scholar
  108. Synek VM (1988) EEG abnormality grades and subdivisions of prognostic importance in traumatic and anoxic coma in adults. Clin Electroencephalogr 19: 160–166PubMedGoogle Scholar
  109. Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2: 81–84PubMedCrossRefGoogle Scholar
  110. Teasdale GM, Murray G, Anderson E, Mendelow AD, MacMillan R, Jennett B, Brookes M (1990) Risks of acute traumatic intracranial haematoma in children and adults: Implications for managing head injuries. Br Med J 300: 363–367CrossRefGoogle Scholar
  111. Temkin NR, Dikmen SS, Wilensky AJ, Keihm J, Chabal S, Winn HR (1990) A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. N Engl J Med 323: 497–502; Comment in: N Engl J Med 1990, 323: 540-542 and N Engl J Med 1991, 324: 341PubMedCrossRefGoogle Scholar
  112. Toutant SM, Klauber MR, Marshall LF, Toole BM, Bowers SA, Seelig JM, Varnell JB (1984) Absent or compressed basal cisterns on first CT scan: ominous predictors of outcome in severe head injury. J Neurosurg 61: 691–694PubMedCrossRefGoogle Scholar
  113. Trevou M du, Bullock R, Teasdale E, Quin RO (1991) False aneurysms of the carotid tree due to unsuspected penetrating injury of the head and neck. Injury 22: 237–239PubMedCrossRefGoogle Scholar
  114. Trevou MD du, van Dellen JR (1992) Penetrating stab wounds to the brain: the timing of angiography in patients presenting with the weapon already removed. Neurosurgery 31: 905–911PubMedCrossRefGoogle Scholar
  115. Unterberg A, Kiening K, Schmiedek P, Lanksch W (1993) Longterm observations of intracranial pressure after severe head injury. The phenomenon of secondary rise of intracranial pressure. Neurosurgery 32: 17–23PubMedCrossRefGoogle Scholar
  116. Van den Heever CM, Van der Merwe DJ (1989) Management of depressed skull fractures. J Neurosurg 71: 186–190PubMedCrossRefGoogle Scholar
  117. Van Dongen KJ, Braakman R (1980) Late computed tomography in survivors of severe head injury. Neurosurgery 7: 14–22PubMedCrossRefGoogle Scholar
  118. Vollmer DG, Torner JC, Jane JA et al. (1991) Age and outcome following traumatic coma: why do older patients fare worse? J Neurosurg (Suppl) 75: 37–49Google Scholar
  119. Weaver DD, Winn HR, Jane JA (1982) Differential intracranial pressure in patients with unilateral mass lesions. J Neurosurg 56: 660–665PubMedCrossRefGoogle Scholar
  120. Working Party Report (1994) Antimicrobial prophylaxis in neurosurgery and after head injury. Infection in neurosurgery Working party of the British Society for antimicrobial Chemotherapy. Lancet 344: 1547–1551Google Scholar

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  • H.-G. Imhof

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