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Head trauma,emergency

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https://www.readbyqxmd.com/read/30090144/bull-horn-head-injury-with-retained-horn-in-brain-a-rare-case-report
#1
Pavan Kumar, Vardan Kulshreshtha, Ashok Kumar, Gaurav Jaiswal, Tarun K Gupta
Pediatric head injuries are a commonly seen emergency in trauma centers worldwide. There are various modes of injury such as fall from height, road traffic accidents, objects hitting the head, assault, and battered baby. We report here a child who presented to us with a history of sustaining head injury by a stray bull on the road and a retained broken bull horn inside the brain and its subsequent management.
April 2018: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/30087752/lingual-artery-pseudoaneurysm-after-severe-facial-trauma
#2
Leyre Margallo, Estibaliz Ortiz de Zárate, Maria Franco, Maria Garcia-Iruretagoyena, Rosa Cherro, Luis Barbier, Josu Mendiola, Thomas Constantinescu
The mortality associated with high-energy trauma has several time peaks and variable prognosis. In the particular case of isolated head and neck trauma, management initially includes stabilizing the patient, especially the airway and circulation, and then proceeding to treat injured structures with debridement and often fracture fixation and coverage. We present a case of a male patient who suffered a severe facial trauma at his workplace. He underwent an initial uneventful emergency surgery for control of bleeding and mandibular osteosynthesis...
September 2018: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/30075476/characteristics-of-dog-bites-in-arkansas
#3
Aaron M Smith, Jacob Carlson, Ashley B Bartels, Cody B McLeod, Michael S Golinko
OBJECTIVE: Dog bite injuries are encountered frequently in emergency departments and can cause significant morbidity. The objective of this study was to explore the associations between the multiple variables at play during these occurrences (eg, the patient's age, the bite location, the bite severity, the dog's relationship with the patient, the breed of dog). METHODS: This two-institution study collected and analyzed dog bite data from Arkansas' only Level I trauma centers...
August 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/30067188/validation-of-the-sainte-justine-head-trauma-pathway-for-children-younger-than-two-years-of-age
#4
Sarah Spénard, Sarah Gouin, Marianne Beaudin, Jocelyn Gravel
The Sainte-Justine Head Trauma Pathway helps physicians' decision-making in the evaluation of head trauma in young children. We evaluated the pathway to identify clinically important traumatic brain injury (ciTBI) among children younger than two years who presented to a pediatric emergency department for a head trauma. The primary outcome was ciTBI, defined as a TBI complicated by death, neurosurgery, intubation or hospitalization for more than one night. Among 2258 children, we reviewed the charts of all hospitalized children ( n = 100) and a random sample of nonhospitalized children ( n = 101) and found a ciTBI in 26 patients...
August 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/30064867/paroxysmal-sympathetic-hyperactivity-after-surgery-for-cerebral-hemorrhagic-arteriovenous-malformation-a-case-report
#5
Hiroki Yamada, Ryogo Kikuchi, Jumpei Katayama, Akiyoshi Nakamura, Hiromichi Miyazaki
Paroxysmal sympathetic hyperactivity is a condition involving a sudden increase in body temperature, heart rate, blood pressure, respiratory rate, sweating, and posturing followed by severe brain injury. Most of the reported preceding disorders involve head trauma, followed by anoxic brain injury, and stroke. Here, we report an extremely rare case of 17-year-old man diagnosed with hemorrhagic arteriovenous malformation, underwent emergent surgery, was on prolonged sedation due to postoperative complications, and subsequently developed paroxysmal sympathetic hyperactivity...
July 29, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/30063541/patient-presentations-in-outpatient-settings-epidemiology-of-adult-head-trauma-treated-outside-of-hospital-emergency-departments
#6
Cheryl K Zogg, R Sterling Haring, Likang Xu, Joseph K Canner, Taylor D Ottesen, Ali Salim, Adil H Haider, Eric B Schneider
BACKGROUND: While deaths, hospitalizations, and emergency department visits for head trauma are well understood, little is known about presentations in outpatient settings. Our objective was to examine the epidemiology and extent of healthcare-seeking adult (18-64y) head trauma patients presenting in outpatient settings compared to patients receiving non-hospitalized emergency department care. METHODS: We used 2004-2013 MarketScan Medicaid/commercial claims to identify head trauma patients managed in outpatient settings (primary care provider, urgent care) and the emergency department...
July 30, 2018: Epidemiology
https://www.readbyqxmd.com/read/30062548/imaging-post-traumatic-headache
#7
REVIEW
Jill C Rau, Gina M Dumkrieger, Catherine D Chong, Todd J Schwedt
PURPOSE OF REVIEW: Headache is a frequent and debilitating symptom after mild traumatic brain injury, yet little is known about its pathophysiology and most effective treatments. The goal of this review is to summarize findings from imaging studies used during the clinical evaluation and research investigation of post-traumatic headache (PTH). RECENT FINDINGS: There are no published recommendations or guidelines for when to acquire imaging studies of the head or neck in patients with PTH...
July 30, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/30055370/a-case-of-rapid-malignant-brain-swelling-subacutely-after-reperfusion-therapy-for-internal-carotid-arterial-occlusion-a-case-report
#8
Susumu Yamaguchi, Junpei Hamabe, Nobutaka Horie, Takayuki Kishikawa, Nobuhiro Yagi, Kazuhiko Suyama
BACKGROUND: Severe complications after reperfusion therapy for acute major vessel occlusion are not well-described. We present an extremely rare case of a patient with rapid malignant brain swelling subacutely after acute ischemic stroke. CASE DESCRIPTION: An 84-year old man underwent reperfusion therapy for acute left internal carotid arterial occlusion, and complete reperfusion was achieved. Although magnetic resonance imaging on postoperative day (POD) 1 revealed a small hemorrhagic infarction and subarachnoid hemorrhage (SAH) unrelated to a left middle cerebral arterial aneurysm in the left frontal lobe, neurological deficits resolved completely...
July 25, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30041901/internal-carotid-artery-dissection-without-intracranial-infarct-following-a-minor-shoulder-trauma-the-second-pediatric-case-and-review-of-the-literature
#9
Dilek Cebeci, Ebru Arhan, Ercan Demir, Murat Uçar, Habibe Koç Uçar, Ayşe Serdaroğlu, Zeynep Öztürk
INTRODUCTION: Carotid artery dissections may occur in severe trauma such as motor vehicle accidents or may also develop due to minor trauma. We aimed to present a case with internal carotid artery dissection that referred to the pediatric neurology department due to speech impairment after minor shoulder trauma. CASE: A previously healthy 10-year-old male patient was admitted to the pediatric emergency clinic due to headache, vomiting and speech impairment. In his story, we learned that he had bumped shoulder to shoulder with his friend about 6 h ago...
July 21, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/30023435/bilateral-distal-ureteral-transection-in-the-setting-of-blunt-trauma
#10
Desiree Raygor, James Cunningham, Joseph Costa, Marie Crandall, David Skarupa
A 69-year-old obese man was involved in a high-speed head-on motor vehicle collision. He was tachycardic and normotensive on arrival. He subsequently developed hemodynamic instability requiring blood transfusion. On examination he had bilateral pneumothoraces, an anterior-posterior compression (APC) pelvic fracture, an open wound at the left groin, and gross hematuria after Foley catheter placement.CT imaging revealed hemoperitoneum, right hepatic lobe grade II lacerations, splenic laceration, mesenteric root injury with extravasated contrast, intraperitoneal and extraperitoneal bladder rupture, bilateral ureteral injuries at the level of the pelvic inlet (see figure 1), APC pelvic fracture, bilateral rib fractures, pneumothoraces, and pulmonary contusions...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/30019464/emergency-department-neuroimaging-for-epileptic-seizures
#11
Martin Salinsky, Victoria S S Wong, Paul Motika, Justin Meuse, Joseph Nguyen
OBJECTIVE: To determine the frequency and yield of neuroimaging in patients with known seizure disorders presenting to the emergency department (ED) with recurrent (nonindex) seizures. METHODS: We reviewed 822 consecutive ED visits for nonindex seizures at the Oregon Health & Science University and the VA Portland Health Care System. For each visit, we abstracted details of the clinical presentation, whether neuroimaging was obtained, the results of neuroimaging, and the results of previous neuroimaging studies, when available...
July 18, 2018: Epilepsia
https://www.readbyqxmd.com/read/30016981/blunt-trauma-to-the-antecubital-fossa-causing-brachial-artery-injury-and-minor-fractures-around-the-elbow-joint-an-easily-missed-diagnosis-with-potential-devastating-consequences-a-case-report
#12
Zi Hao Phang, Mohd Fadhli B Miskon, Sa'adon B Ibrahim
BACKGROUND: Blunt trauma causing brachial artery injury in a young patient is very rare. Cases of brachial artery injury may be associated with closed elbow dislocation or instability. Elbow dislocation may not be evident clinically and radiologically on initial presentation. CASE PRESENTATION: This is a case of a 37-year-old, right-hand dominant, Malay man who fell approximately 6 meters from a rambutan tree and his left arm hit the tree trunk on his way down. He was an active tobacco smoker with a 20 pack year smoking history...
July 18, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/30008610/falling-down-a-flight-of-stairs-the-impact-of-age-and-intoxication-on-injury-pattern-and-severity
#13
Hridesh Chatha, Ian Sammy, Michael Hickey, Abdo Sattout, John Hollingsworth
Background: Falling down a flight of stairs is a common injury mechanism in major trauma patients, but little research has been undertaken into the impact of age and alcohol intoxication on the injury patterns of these patients. The aim of this study was to compare the impact of age and alcohol intoxication on injury pattern and severity in patients who fell down a flight of stairs. Methods: This was a retrospective observational study of prospectively collected trauma registry data from a major trauma centre in the United Kingdom comparing older and younger adult patients admitted to the Emergency Department following a fall down a flight of stairs between July 2012 and March 2015...
July 2018: Trauma
https://www.readbyqxmd.com/read/30004368/high-positive-computed-tomography-yields-in-the-emergency-department-might-not-be-a-positive-finding
#14
K Swartzberg, L N Goldstein
BACKGROUND: There is growing pressure to reduce unnecessary computed tomography (CT) imaging requests that the radiology department receives from the emergency department (ED); however, information on acceptable usage rates and diagnostic yields remains scanty. OBJECTIVES: To describe the indications, clinical categories and positive yield rates of patients receiving CT scans in the ED. METHODS: A retrospective record review was done of all patients who received CT scans at an urban, adult academic ED during a 4-month period...
February 27, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/30001646/repetitive-head-injury-in-adolescent-mice-a-role-for-vascular-inflammation
#15
Limin Wu, Joon Y Chung, Shivani Saith, Lorenzo Tozzi, Erin M Buckley, Bharat Sanders, Maria A Franceschini, Sevda Lule, Saef Izzy, Josephine Lok, William J Edmiston, Lauren M McAllister, Sloane Mebane, Gina Jin, Jiaxi Lu, John S Sherwood, Sarah Willwerth, Suzanne Hickman, Joseph El Khoury, Eng H Lo, David Kaplan, Michael J Whalen
Repetitive mild traumatic brain injury during adolescence can induce neurological dysfunction through undefined mechanisms. Interleukin-1 (IL-1) contributes to experimental adult diffuse and contusion TBI models, and IL-1 antagonists have entered clinical trials for severe TBI in adults; however, no such data exist for adolescent TBI. We developed an adolescent mouse repetitive closed head injury (rCHI) model to test the role of IL-1 family members in post-injury neurological outcome. Compared to one CHI, three daily injuries (3HD) produced acute and chronic learning deficits and emergence of hyperactivity, without detectable gliosis, neurodegeneration, brain atrophy, and white matter loss at one year...
July 13, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29986857/validation-and-refinement-of-a-clinical-decision-rule-for-the-use-of-computed-tomography-in-children-with-minor-head-injury-in-the-emergency-department
#16
Martin H Osmond, Terry P Klassen, George A Wells, Jennifer Davidson, Rhonda Correll, Kathy Boutis, Gary Joubert, Serge Gouin, Simi Khangura, Troy Turner, Francois Belanger, Norm Silver, Brett Taylor, Janet Curran, Ian G Stiell
BACKGROUND: There is uncertainty about which children with minor head injury need to undergo computed tomography (CT). We sought to prospectively validate the accuracy and potential for refinement of a previously derived decision rule, Canadian Assessment of Tomography for Childhood Head injury (CATCH), to guide CT use in children with minor head injury. METHODS: This multicentre cohort study in 9 Canadian pediatric emergency departments prospectively enrolled children with blunt head trauma presenting with a Glasgow Coma Scale score of 13-15 and loss of consciousness, amnesia, disorientation, persistent vomiting or irritability...
July 9, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29985230/severely-injured-trauma-patients-with-admission-hyperfibrinolysis-is-there-a-role-of-tranexemic-acid-findings-from-the-proppr-trial
#17
Muhammad Khan, Faisal Jehan, Eileen M Bulger, Terence O'Keeffe, John B Holcomb, Charles E Wade, Martin A Schreiber, Bellal Joseph
INTRODUCTION: Administration of tranexemic acid (TXA) in coagulopathy-of-trauma (COT) gained popularity after the CRASH-2 trial. The aim of our analysis was to analyze the role of TXA in severely injured trauma patients with admission hyperfibrinolysis. METHODS: We reviewed the prospectively collected Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) database. We included patients with admission hyperfibrinolysis (Ly30>3%) on thromboelastography...
February 5, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29982209/emotional-reserve-and-prolonged-post-concussive-symptoms-and-disability-a-swedish-prospective-1-year-mild-traumatic-brain-injury-cohort-study
#18
Christian Oldenburg, Anders Lundin, Gunnar Edman, Catharina Nygren Deboussard, Aniko Bartfai
OBJECTIVE: Prolonged post-concussive symptoms (PCS) affect a significant minority of patients withmild traumatic brain injury (mTBI). The aetiology is multifactorial depending on preinjury as well as peri-injury and postinjury factors. In this study, we examine outcome from an emotional reserve perspective. DESIGN: Prospective cohort study. SETTING: Patients were recruited from three emergency departments in major university hospitals in Stockholm, Sweden...
July 6, 2018: BMJ Open
https://www.readbyqxmd.com/read/29973035/diagnostic-performance-of-brain-computed-tomography-to-detect-facial-bone-fractures
#19
Duk Ho Kim, Yoon Hee Choi, Seong Jong Yun, Sun Hwa Lee
Objective: Most patients with head trauma require brain computed tomography (CT) in the emergency department. However, the requirement for facial CT remains controversial. The aim of this study was to evaluate the diagnostic value of brain CT alone for detection of facial fractures and its ability to determine the requirement for additional facial CT. Methods: This retrospective multicenter study was conducted in two tertiary hospitals in Seoul, Republic of Korea, between January 2014 and December 2015...
June 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29971851/multiple-pediatric-head-injury-decision-rules-but-what-should-the-clinician-use
#20
James F Holmes, Peter S Dayan, Nathan Kuppermann
Traumatic brain injury (TBI) is the leading cause of traumatic death in children. As many children with TBIs have subtle symptoms and missed or delayed diagnoses may result in increased morbidity, emergency department clinicians must frequently determine which children require emergent cranial computed tomographic (CT) scanning even after apparently minor blunt head trauma. Overuse of CT scans, however, has important drawbacks, including radiation-induced malignancies. Two large cohorts have documented the association of cranial CT scanning with cancer in children...
July 3, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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