Metabolic complications associated with severe diffuse brain injury.

Diffuse axonal injury (DAI), the severest form of diffuse brain injury, causes extensive damage throughout the cerebrum, diencephalon and brainstem. The effects of this injury, however, are not isolated to the brain. This paper discusses diffuse axonal injury, the metabolic complications to be anticipated from the systems' response to cerebral trauma in general, and the nursing implications.

Energy expenditure in acute trauma to the head with and without barbiturate therapy.

The increased energy expenditure associated with severe trauma to the head appears genuine but exhibits wide variation in its magnitude. Patients with severe acute trauma to the head without barbiturate treatment are hypermetabolic with an average energy expenditure 26 per cent over predicted. Barbiturate therapy abolishes this hypermetabolism and decreases energy expenditure to 14 per cent below predicted.

Disodium etidronate: its role in preventing heterotopic ossification in severe head injury.

Heterotopic ossification (HO) occurs in up to 75% of patients who survive severe head injury and is a major factor in prolonging their rehabilitation. Prevention of HO has not been emphasized in acute care management of patients with head injury. But with spinal cord injuries and total hip arthroplasty, HO has been prevented by use of disodium etidronate (EHDP).