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Cervical trauma

Andre S Madsen, John L Bruce, George V Oosthuizen, Wanda Bekker, Grant L Laing, Damian L Clarke
BACKGROUND: This paper reviews our experience with penetrating cervical venous trauma and aims to validate the selective non-operative management (SNOM) of these injuries. METHODS: This was a retrospective review of a prospectively maintained registry. All patients presenting alive with an injury to the internal jugular vein, subclavian vein or innominate vein following a PNI were reviewed for a 6-year period. RESULTS: Among 817 patients admitted for the management of PNI, 76 (9...
March 15, 2018: World Journal of Surgery
Mayur B Patel, John J Como, Elliott R Haut
No abstract text is available yet for this article.
March 14, 2018: JAMA Surgery
Xiao Wu, Ajay Malhotra, Bertie Geng, Vivek B Kalra, Khalid Abbed, Howard P Forman, Pina Sanelli
Importance: Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding. Objective: To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma. Design, Setting and Participants: This cost-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice...
March 14, 2018: JAMA Surgery
Andrew T Koogler, Michael Kushelev
A 76-year-old male presented for reverse total shoulder arthroplasty (TSA) in the beach chair position. A preoperative interscalene nerve catheter was placed under direct ultrasound-guidance utilizing a posterior in-plane approach. On POD 2, the catheter was removed. Three weeks postoperatively, the patient reported worsening dyspnea with a subsequent chest X-ray demonstrating an elevated right hemidiaphragm. Pulmonary function testing revealed worsening deficit from presurgical values consistent with phrenic nerve palsy...
2018: Case Reports in Anesthesiology
Catherine M Kuza, Monica S Vavilala, Rebecca M Speck, Richard P Dutton, Maureen McCunn
BACKGROUND: Few trauma guidelines evaluate and recommend anesthesiology practices and there are no trauma anesthesia-specific guidelines. There is no information on how anesthesiologists perceive clinical practice patterns. Our objective was to understand the perceptions of anesthesiologists regarding trauma anesthesia practices. METHODS: A survey assessing anesthesia management of trauma patients was distributed to 21,491 anesthesiologists. A subset of 10 of these questions was subsequently reviewed by a trauma anesthesiology focus group through a 3-round web-based Delphi process...
March 12, 2018: Anesthesia and Analgesia
Ji-Hui Zhang, Liu-Jun Zhao
Instability of the cervical spine disease requires surgery to restore stability. In the past, surgical methods were divided into two kinds of anterior and posterior. But each has its own disadvantages:anterior vertebral screw has a higher failure rate, sometimes need a second operation; and posterior pedicle screw, lateral mass screw and facet joint screw may make greater trauma, lead to longer hospitalization. For general instable cervical spine disease, according to the location of the disease, only with the anterior or posterior approach can achieve a stable effect...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Tsunehiko Konomi, Kota Suda, Satoko Matsumoto, Miki Komatsu, Masahiko Takahata, Norimasa Iwasaki, Akio Minami
Introduction: There are considerable risks for vertebral artery (VA) injury in case of corrective surgery for a severe and rigid cervical kyphotic deformity. This case report describes a rare case of surgical management for pre-existing traumatic rigid cervical kyphosis associated with unilateral VA occlusion. Case presentation: A 73-year-old male fell down and injured his neck. He was referred to our hospital 10 months after injury because his degree of head drop progressed gradually to a chin-on-chest position such that he could not look straight forward...
2018: Spinal Cord Series and Cases
Erkan Gokce, Murat Beyhan
Objective: The nuchal ligament (NL) extends from the external occipital protuberance and median nuchal line to the spinous process of the 7th cervical vertebrae. In this study, we evaluated the incidence, location level, and size of ossifications of the NL (ONL) in patients who underwent cervical computed tomography (CT) for various reasons. Materials and Methods: The present study included 481 patients (187 females and 294 males) who underwent cervical CT from February 2011 to November 2016 due to reasons such as trauma, cervical spondylosis, neck pain, and screening for metastasis...
February 2018: Eurasian Journal of Medicine
Daniel Novick, Raina Wallace, Jody C DiGiacomo, Anand Kumar, Steven Lev, L D George Angus
BACKGROUND: The newest CT scanners provide resolution comparable to MRIs leading many to question when and whether cervical spine MRIs are warranted. METHODS: An 8 year retrospective review identified 241 patients who underwent CT scan and MRI of the cervical spine. The initial clinical examination, cervical spine CT scan, and cervical spine MRI were compared to identify cervical spine injuries that would have been missed had the MRI not been performed. RESULTS: The CT scans were normal in 153 patients, and abnormal in 88...
March 6, 2018: American Journal of Surgery
Aaron M Rutman, Justin E Vranic, Mahmud Mossa-Basha
Blunt cerebrovascular injury (BCVI) is a relatively rare but potentially devastating finding in patients with high-energy blunt force trauma or direct cervical and/or craniofacial injury. The radiologist plays an essential role in identifying and grading the various types of vascular injury, including minimal intimal injury, dissection with raised intimal flap or intraluminal thrombus, intramural hematoma, pseudoaneurysm, occlusion, transection, and arteriovenous fistula. Early identification of BCVI is important, as treatment with antithrombotic therapy has been shown to reduce the incidence of postinjury ischemic stroke...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Joseph Marcotte, Joshua Hazelton, Chirag Arya, Michael Dalton, Amber Batool, John Gaughan, Linh Nguyen, John Porter, Nicole Fox
BACKGROUND: The indications for surgical feeding tube (SFT) placement in trauma patients are poorly defined. Patient selection is critical as complications from SFTs have been reported in up to 70% of patients. A previous analysis by our group determined that 25% of the SFTs we placed were unnecessary and that older patients, patients with head and spinal cord injuries, and patients who needed a tracheostomy were more likely to require long term SFTs. Following this study, we modified our institutional guidelines for SFT placement...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Sang Won Kim, Jun Nyung Lee, Hyun Tae Kim, Eun Sang Yoo
A vesicocutaneous fistula (VCF) is a tract that is formed abnormally between the bladder and the external surface of the body. VCF results in a great deal of inconvenience, discomfort, and physical disability for the affected patient. This condition can be caused by extensive trauma with pelvic bone fracture, radical pelvic surgery, irradiation of pelvic malignancies, hip arthroplasty, a large bladder calculus, and various other pathologies. The management of VCF should be approached on a case-by-case basis because of the complexity of the disease...
March 2018: Turkish Journal of Urology
Paul S Page, Zhikui Wei, Nathaniel P Brooks
OBJECTIVE Motorcycle helmets have been shown to decrease the incidence and severity of traumatic brain injury due to motorcycle crashes. Despite this proven efficacy, some previous reports and speculation suggest that helmet use is associated with a higher likelihood of cervical spine injury (CSI). In this study, the authors examine 1061 cases of motorcycle crash victims who were treated during a 5-year period at a Level 1 trauma center to investigate the association of helmet use with the incidence and severity of CSI...
March 6, 2018: Journal of Neurosurgery. Spine
Jing Wang, Adam E M Eltorai, J Mason DePasse, Wesley Durand, Daniel Reid, Alan H Daniels
BACKGROUND: Cervical spine injuries are a common cause of morbidity and mortality, but optimal treatment is debated. Prior studies showed substantial variation in treatment. We examined treatment variation in arthrodesis and halo/tong placement in cervical spine injury patients. METHODS: We used the Healthcare Cost and Utilization Project National Inpatient Sample, 2000-2011. Patients were identified based on International Classification of Diseases, 9th Revision diagnosis codes...
February 28, 2018: World Neurosurgery
Qi Wen, Giulia M Muraca, Joseph Ting, Sarah Coad, Kenneth I Lim, Sarka Lisonkova
OBJECTIVE: Instrumental vaginal delivery is associated with birth trauma to infant and obstetric trauma to mother. As caesarean delivery rates increased during the past decades, the rate of instrumental vaginal delivery declined. We examined concomitant temporal changes in the rates of severe birth trauma and maternal obstetric trauma. DESIGN: A retrospective observational study. SETTINGS AND PARTICIPANTS: All hospital singleton live births in Washington State, USA, 2004-2013, excluding breech delivery...
March 2, 2018: BMJ Open
A Taha, S L M Bakker
In patients with pre-existent cervical spinal canal stenosis, minimal trauma, leading to neck hyperextension, can cause a significant increase of spinal cord compression. However, spinal cord injury is generally associated with major trauma and is usually not expected in patients with minor trauma. The resulting symptoms are diverse, making it even more difficult to diagnose. To illustrate the variety in symptoms at presentation, we describe two male patients aged 66 and 69. Rapid diagnosis is important as acute neurosurgical intervention may be indicated...
2018: Nederlands Tijdschrift Voor Geneeskunde
David Z Cai, Geoffrey Liu, Christopher F Wolf, Zachary M Mansell, Jonathan P Eskander, Mark Eskander
Brown-Séquard syndrome, while uncommon, is a neurological condition that classically results from the hemisection of the spinal cord as a result of a penetrating injury to the spinal cord. We present a reported case of blunt trauma causing a high-energy cervical burst fracture/dislocation with a significant cord signal change producing Brown-Séquard syndrome. In this case, the burst fracture at the level of C5 obtained from the motor vehicle accident led to the damage of the left-sided lateral spinal thalamic tract, descending lateral cortical spinal tracts, and ascending dorsal column...
January 2018: Asian Journal of Neurosurgery
Maria Isabel Bento Ayres Pereira Harry Leite, Sérgio Azevedo Ferreira Alves, Rui Paulo Vicente Reinas, Marta Gomes Rodrigues, Ana Sofia Martins das Neves Garrido, Otília Peixoto da Cunha, Joana Sofia Oliveira Rodrigues, Maria de Fátima Oliveira Santos Poças, Mário António Leite Resende Martins
A previously healthy 13-year-old girl presented with a 9-day history of acute onset severe neck pain associated with limited range of movement. Medical evaluation at day 2 was suggestive of muscle contracture, and she was discharged home with diazepam, antiinflammatory agents, and rest; however, she returned because of progressive clinical worsening with left arm distal paresthesia and paralysis since day 3. There was no history of trauma or other systemic complaints, and her familial medical history was unremarkable...
February 28, 2018: Pediatric Emergency Care
Joseph Cormier, Lisa Gwin, Lars Reinhart, Rawson Wood, Charles Bain
STUDY DESIGN: This study combined all prior research involving human volunteers in low-speed rear-end impacts and performed a comparative analysis of real-world crashes using the National Automotive Sampling System - Crashworthiness Data System. OBJECTIVE: The aim of this study was to assess the rates of neck pain between volunteer and real-world collisions as well as the likelihood of an injury beyond symptoms as a function of impact severity and occupant characteristics in real-world collisions...
February 27, 2018: Spine
Yann Facchinello, Andréane Richard-Denis, Marie Beauséjour, Cynthia Thompson, Jean-Marc Mac-Thiong
STUDY DESIGN: Post hoc analysis of prospectively collected data. OBJECTIVES: Assess the influence of surgical timing on neurological recovery using classification tree analysis in patients sustaining cervical traumatic spinal cord injury. SETTING: Hôpital du Sacré-Coeur de Montreal METHODS: 42 patients sustaining cervical SCI were followed for at least 6 months post injury. Neurological status was assessed from the American Spinal Injury Association impairment scale (AIS) and neurological level of injury (NLI) at admission and at follow-up...
February 26, 2018: Spinal Cord
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