$474 Thursday, November 10, 2005 Poster Abstracts

Methods: We conducted a retrospective review of 12 patients (male - 10, female - 2) who presented with spinal cord symptoms. We investigated their clinical features, neurological findings and radiologic findings. Results: The depth and bottom time of the dive were 34.5 meters (range 22-56) and 22.7 minutes (range 10-55) respectively. The most divers ascended with appropriate decompression tables. The most frequent initial symptoms were lower limbs weakness (n - 12), sensory disturbances (in - 10) and bladder dysfunction (n - 5). The chief radiologic abnormalities were continuous (n -- 3), or non-continuous (in -- 5) high signal intensity on T2-weighted images at posterior paramedian portion of the spinal cord, mainly thoracic level. There were no abnormal findings in remaining 4 patients and they were showed good prognosis. All patients were treated with hyperbaric oxygen therapy and some received high dose dexamethasone. On discharge 5 patients had made a full recovery, 7 had some residual neurological sequalae, the most patients except one regained normal bladder function. Conclusion: Spinal cord decompression sickness is a neurological emergency. Early recognition and treatment may minimize neurologi- cal damage. Initial normal finding in M R imaging was a good predictor for prognosis in spinal decompression sickness.

1474 Pogt-traumatic Regeneration DRG Neurons after Nerve Tubulation

Masgutov, R l, Raginov, I ~ , Fomina, G 1, Chelyshev, Yu ~ . 1Kazan State Iv[ediea[ University, Kazan, Russia

A 5-ram biodegradating material 8% Natrium-carboxy-methyl cellu- lose (18"/o NaCMC) filled silicon tube was implanted in rat's sciatic nerve. In the first animal group a 0.95% xymedon solution was added into an 8% NaCMC solution. The second group was given an 8% xymedon free NaCMC solution. Intact DRG of rats on L5 level served as the controls. On 30-th day xymedon receiving animals demonstrated a 71,4% (p < 0,05) increase of the number of survived neurons, a 35,2% increase (p < 0,05) in IB4 + subpopulations of neurons and a 42,2% (iJ < 0,05) increase in the NF200 + subpopulations in relations to the second group. The functional recovery we assessed to the sciatic functional index (SFI) on 2-, 7-, 11-, 14-, 18-, 21-, 25-, 28 days after operation [Bain et al., 1989; Inserra et al., 1998]. On 28 t5 day after operation in xymedon 0.95% group SFI increased on 35.7"/0 (P < 0,05), comparison group without xymedon. We conclude that xymedon stimulate the survival and/or differentiation, probably in the first turn, Schwann cells in potential space of regenerative mxonal growth. The xymedon to act indirectly can suppress posttraumatic death of DRG neurons.

1475 The inddenee of brain injuries in a population-based cohort in Finland

Numminen, H ~. 1South Karelia Central Hospital~ Lappeenranta, Finland

There is much variability in incidences of brain injuries reported from different countries. Tiffs abstract reports findings from a population based follow-up study done in the southeast Finland. All brain injuries were registered prospectively from April 2002 to March 2004 in an area of three municipalities consisting of 83.857 inhabitants aged 15 years or older. The case findings were based on monthly contact with the three health care centers and the South Karelia Central Hospital which was the only hospital taken care of brain injuries in the study area. All together 310 patients having 313 different brain injuries were included in the study. The primary place of care was the health care center in 64%, the central hospital in 33% and an other place in 3% of cases. Brain CT was done for 41.9% of cases. The crude annual incidence for men aged 15-64 years was 176 and for men aged 65 years or older 363. The corresponding figures for women were 138 and 263. 73.5% of all injuries were classified into concussions, 9.3% into intracerebral contusions and 17.2"/o into other intracranial

bleedings, mainly subdural hematomas. The 30-day case-fatality rate was 3.8%. To scrutinize the case finding checking of death certificates will be done later and adjusted incidence rates will be presented.

1476 Closed head injuxy-I~equency and character lesion of brain

Raicevie, R ~, Markovic, L ~, Radosavljevic, A 1, Lepic, T ~ . 1Department of Neurology, Department of Radiology. Military Medical Academy. Belgrade, Serbia and Montenegro

Inil'oduefion: Neurotrauma syndrome by its complexity but also by its frequency represent one of the leading problems of modern medicine. In closed head injuries syndrome usually is lacking connection between clinical phenomenology and objective conferment of brain tissue lesions. Methods: According to that, the major outcome or goal of those studies was to determinate frequency and characeristics of brain tissue lesions using MRI and CT. As well as confemfing connections between those demages with clinical parameters such as neurologic deficit and consciousness deficit disorders evaluating sensitivity and specificity of neororadiologic procedures. 40 patiens with closed head injuries were investigated by the same neurologist. Grade of neurological deficit (Canadian neurological scale) and consciousness deficit disorders (Glasgow coma scale) were determined to all patients. All patiens were investigated by MRI and CT. Results: In this study the MRI presented significant higer specifity and sensitivity especially determing smaller ishemic and contusion lesions with significant correlation related to CT. A technique called MRI has helped improve diagnosis and treatment of closed head injuries patients. Conehision: This is method that might be useful to plan further evaluation and possible treatment in significant number of cases.

1477 Intra-hospitaI nlortali[y of patients with severe head injury: a prospective cohort study of 754 patients t~oin the Flohantpolis trauma data bank

Martins, ET 1, Meinerz, j1, Rigo, LA ~, Schroeder, H K ~, • • . 7 • ]

Deschamps, IK ~, DAwla, JM=, Lmhares, MN , Andrade Athaide Jr., AT 1, Walz, R 2'4. 1Unidade de Trauma, Hospital Governador Celso Ramos, Florian@olis, SC, Brazil; 2Departamento de Ch'nica fPI~dica, UFSC, Florian@olis, Brazil; 3Neurosurgery Division, UFSC, Florian@olis, Brazil," 4 Centro de Cirurgia de Epilepsia, Hospital Governador Celso Ramos, Florian@olis, Brazil

Background: Head trauma is a major worldwide cause of incapacity and mortality. While is clear that a number of clinical, demographic and neurosurgical characteristics of patients are associated with outcome, studies presenting data on the incremental prognostic power of these variables may have when used in a multivariate manner. Here we evaluate the intra-hospital mortality of patients with severe head injury using a multiple logistic regression analysis. Methods: We analyze the association between clinical, demographic and neurosurgical variables and intra-hospital death of all consecutive patients (n - 754) with severe head injury (adnffssion Glasgow scale _<8) in attended at our trauma unit between January 1994 and April 2005. Results: Eighty four percent of patients were male. The mean age of patients was 34,8 (± 16, 3) years. The overall mortality was thirty three percent. After the multiple logistic regression, the adjusted odds ratio (95% CI) for death was clinically relevant for: higher age ( > 60 years) in comparison to younger (up to 45 years) (OR -- 2.5, 1.2-~.1, p -- 0.006); presence of surgically evacuated mass lesion in comparison to Marshall Type I injury (OR -- 3.75, 0.78-18.03, p -- 0.08); presence of sub-arachnoid hemorrhage (OR -- 1.79, 1.18 2.70, p -- 0.006); Glasgow Scale 3 or 4 in comparison to 7 or 8 (OR - 3.98, 2.50 6.34, p < 0.00001); pupilary exanffnation anisocoric (OR - 2.63, 1.67-4.14,

Poster Abstracts Thursday, November 10, 2005 $475

p < 0.0001), mJdryatic (OR -- 11.0, 5.29-22.84, p < 0.00001), miotic (OR -- 2.09, 1.24-3.54, p -- 0.0006) in comparison to isocoric pupils. Conclusion: Age, Marshall Tomograplfic Classification, presence of sub-arachnoid hemorrhage, Glasgow Scale and pupilary examina- tion are independently associated with intra-hospital death of patients with severe head injury (Work supported by CNPq 472840/ 2004- 5).

1478 Stroke alter Burn

Minn, y1, Cho, S a, Kwon, K 1. ~Department of Neurology, Hallym University college of Medicine, Seou~ Korea

Background: Burn is one of most disabling conditions. Various CNS complications including stroke, may develop with burn injury.

However, as far as we know, there was only one postmortem study after burn. Method: We reviewed medical records of 13,468 patients admitted to Burn Center of Hangang Sacred Heart Hospital due to burn injury from Jan. 1997 to Mar. 2005. Result: Nine patients (M : F - 5 : 4, mean age 55) developed stroke during treatment of burn (10.07%). Seven patients developed stroke in septic condition after burn (3 ICH, 1 subdural hematoma, 2 large artery infarction, 1 multiple hemorrhagic infarction). Six of them were proven in blood culture (12 Candida, 3 Staphylococcus, 1 Klebsiella) and three had endocarditis. Median duration between burn and stroke onset was 33 days (17days-307 days). The mechanisms of stroke in the other two patients were probably unrelated to burn. Conclusion: Stroke is rare complication of patients who survive after burn. Sepsis is major cause of stroke after burn.