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Blunt head trauma

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https://www.readbyqxmd.com/read/28717905/analysis-of-injury-and-mortality-patterns-in-deceased-patients-with-road-traffic-injuries-an-autopsy-study
#1
Roman Pfeifer, Sylvia Schick, Christopher Holzmann, Matthias Graw, Michel Teuben, Hans-Christoph Pape
BACKGROUND: Despite improvements in prevention and rescue, mortality rates after severe blunt trauma continue to be a problem. The present study analyses mortality patterns in a representative blunt trauma population, specifically the influence of demographic, injury pattern, location and timing of death. METHODS: Patients that died between 1 January 2004 and 31 December 2005 were subjected to a standardised autopsy. INCLUSION CRITERIA: death from blunt trauma due to road traffic injuries (Injury Severity Score ≥ 16), patients from a defined geographical area and death on scene or in hospital...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28704207/the-adult-male-rape-victim-forensic-description-of-a-series-of-57-cases
#2
Michelangelo Bruno Casali, Elisa Palazzo, Alberto Blandino, Alessio Battistini, Francesca Motta, Alessandra Kustermann, Cristina Cattaneo
A retrospective analysis on 57 adult male victims of sexual violence has been performed. Age, nationality and anamnesis of the victims, location of the assault, type of violence, number and identity of the assailants, presence of physical injuries, lapse of time between the assault and the request of medical assistance, and toxicological and semen detection tests were analyzed. Victims were mostly in the 31- to 40-year age group. Ten victims referred themselves as either active homosexuals or bisexuals. Forced oral and/or anal penetration was registered in 86...
July 13, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28700585/validation-of-the-sensitivity-of-the-national-emergency-x-radiography-utilization-study-nexus-head-computed-tomographic-ct-decision-instrument-for-selective-imaging-of-blunt-head-injury-patients-an-observational-study
#3
William R Mower, Malkeet Gupta, Robert Rodriguez, Gregory W Hendey
BACKGROUND: Clinicians, afraid of missing intracranial injuries, liberally obtain computed tomographic (CT) head imaging in blunt trauma patients. Prior work suggests that clinical criteria (National Emergency X-Radiography Utilization Study [NEXUS] Head CT decision instrument [DI]) can reliably identify patients with important injuries, while excluding injury, and the need for imaging in many patients. Validating this DI requires confirmation of the hypothesis that the lower 95% confidence limit for its sensitivity in detecting serious injury exceeds 99...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28682941/reduction-in-mortality-rates-of-postinjury-multiple-organ-dysfunction-syndrome-a-shifting-paradigm-a-prospective-population-based-cohort-study
#4
Karlijn J P van Wessem, Luke P H Leenen
INTRODUCTION: The incidence of Multiple Organ Dysfunction Syndrome (MODS) has decreased in the last decade by improvement in trauma care. However, it still remains a major cause of morbidity and mortality. This study investigated the current incidence and mortality of MODS in polytrauma patients. MATERIALS AND METHODS: A 3-year prospective study included consecutive trauma patients admitted to a Level-1 Trauma Center ICU. Isolated head injuries, drowning, asphyxiation and burns were excluded...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28674910/diagnostic-imaging-in-pediatric-thoracic-trauma
#5
Claudia Lucia Piccolo, Stefania Ianniello, Margherita Trinci, Michele Galluzzo, Michele Tonerini, Massimo Zeccolini, Giuseppe Guglielmi, Vittorio Miele
Thoracic trauma accounts for approximately 14% of blunt force traumatic deaths, second only to head injuries. Chest trauma can be blunt (90% of cases) or penetrating. In young patients, between 60 and 80% of chest injuries result from blunt trauma, with over half as a consequence of impact with motor vehicles, whereas in adolescents and adults, penetrating trauma has a statistically more prominent role. Pulmonary contusions and rib fractures are the most frequent injuries occurring. Chest X-ray is the first imaging modality of choice to identify patients presenting with life-threatening conditions (i...
July 4, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28664025/traumatic-carotid-cavernous-fistula-with-a-connection-between-the-supraclinoid-internal-carotid-artery-and-cavernous-sinus-via-a-pseudoaneurysm-presenting-with-delayed-life-threatening-epistaxis
#6
Jun Kyeung Ko, Sang Weon Lee, Tae Hong Lee, Chang Hwa Choi
Traumatic carotid cavernous fistula (CCF) presents most commonly as a direct connection between the cavernous segment of internal carotid artery (ICA) and cavernous sinus (CS), and often accompanies basal skull fracture (BSF). The most frequently reported signs and symptoms are proptosis, chemosis, and bruit. Epistaxis is uncommon symptom of CCF. A 63-year-old man with a history of BSF due to blunt head trauma eight months previously was referred to our emergency room for massive epistaxis. Cerebral angiography demonstrated a high-flow CCF with a connection between the supraclinoid portion of left ICA and CS via a pseudoaneurysm, suggesting the life-threatening epistaxis had been caused by high-flow shunting, through the gap created by the BSF...
April 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28650361/pharmacological-thromboembolic-prophylaxis-in-traumatic-brain-injuries-low-molecular-weight-heparin-is-superior-to-unfractionated-heparin
#7
Elizabeth Benjamin, Gustavo Recinos, Alberto Aiolfi, Kenji Inaba, Demetrios Demetriades
OBJECTIVE: We hypothesized that low molecular weight heparin (LMWH) is superior to unfractionated heparin (UH) for venous thromboembolism (VTE) prophylaxis in patients with severe traumatic brain injuries (TBI). SUMMARY BACKGROUND DATA: Pharmacological VTE prophylaxis with LMWH or UH is the current standard of care in TBI. Clinical work suggests that LMWH may be more effective than UH for VTE prophylaxis in trauma patients. Experimental work shows that heparinoids may have neuroprotective properties...
June 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28647095/increased-detection-of-blunt-carotid-and-vertebral-artery-injury-after-implementation-of-diagnostic-imaging-pathway-in-level-1-trauma-centre-in-western-australia
#8
Manimaran Sinnathamby, Sudhakar V Rao, Dieter G Weber
BACKGROUND: The incidence of Blunt Carotid Artery and Vertebral Artery Injury (BCVI) is relatively low in modern trauma practice. However, these injuries may be associated with severe neurological consequences. Following the introduction of a Diagnostic Imaging Pathway in Department of Health of Western Australia, we hypothesized that this injury would be less likely to be missed, and accordingly diagnosed more frequently. METHOD: A review of all major trauma (Injury Severity Scale>15) admissions at the State Major Trauma Centre in Royal Perth Hospital was undertaken from 1995 until 2013...
June 13, 2017: Injury
https://www.readbyqxmd.com/read/28643720/inferior-subconjunctival-dislocation-of-posterior-chamber-intraocular-lens-after-blunt-trauma
#9
Amit Mohan, Navjot Kaur, Vinod Sharma
Traumatic subconjunctival dislocation of the posterior chamber intraocular lens (PCIOL) is a rare and emergency condition. Here, we report an interesting variation of rare case of inferior subconjuctival dislocation of PCIOL in a 75-year-old female patient following blunt trauma to her right eye with cow's head. All the previous literature with subconjuctival dislocation of PCIOL has reported the superior dislocation of intraocular lens. Inferior subconjunctival dislocation has never been reported in previous literature...
June 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#10
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28614141/role-of-hemorrhagic-shock-in-experimental-polytrauma
#11
Stephanie Denk, Sebastian Weckbach, Philipp Eisele, Christian K Braun, Rebecca Wiegner, Julia J Ohmann, Lisa Wrba, Felix M Hoenes, Philipp Kellermann, Peter Radermacher, Ulrich Wachter, Sebastian Hafner, Oscar McCook, Anke Schultze, Annette Palmer, Sonja Braumüller, Florian Gebhard, Markus Huber-Lang
Hemorrhagic shock (HS) after tissue trauma increases the complication and mortality rate of polytrauma (PT) patients. Although several murine trauma models have been introduced, there is a lack of knowledge about the exact impact of an additional HS. We hypothesized that HS significantly contributes to organ injury, which can be reliably monitored by detection of specific organ damage markers.Therefore we established a novel clinically relevant PT plus HS model in C57BL/6 mice which were randomly assigned to control, HS, PT or PT+HS procedure (n = 8 per group)...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28612150/single-versus-multiple-solid-organ-injuries-following-blunt-abdominal-trauma
#12
Ayman El-Menyar, Husham Abdelrahman, Ammar Al-Hassani, Ruben Peralta, Hiba AbdelAziz, Rifat Latifi, Hassan Al-Thani
BACKGROUND: We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS: A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014. Data were analyzed and compared for patients with single versus multiple SOIs. RESULTS: A total of 504 patients with SOIs were identified with a mean age of 28 ± 13 years...
June 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28601333/variability-in-ct-imaging-of-blunt-trauma-among-ed-physicians-surgical-residents-and-trauma-surgeons
#13
Melissa K James, Shi-Wen Lee, Jennifer A Minneman, Maureen D Moore, Taylor R Klein, R Jonathan Robitsek, Phillip S Barie, Sebastian D Schubl
BACKGROUND: Trauma triage decisions can be influenced by both knowledge and experience. Consequently, there may be substantial variability in computed tomography (CT) scans desired by emergency medicine physicians, surgical chief residents, and attending trauma surgeons. We quantified this difference and studied the effects of each group's decisions on missed injuries, cost, and radiation exposure. METHODS: All blunt trauma activations at an urban level 1 trauma center were studied over a 6-mo period...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28600670/management-of-blunt-splenic-injury-in-a-uk-major-trauma-centre-and-predicting-the-failure-of-non-operative-management-a-retrospective-cross-sectional-study
#14
Stella R Smith, Louise Morris, Stephen Spreadborough, Waleed Al-Obaydi, Marta D'Auria, Hilary White, Adam J Brooks
PURPOSE: To review the management of patients >16 years with blunt splenic injury in a single, UK, major trauma centre and identify whether the following are associated with success or failure of non-operative management with selective use of arterial embolization (NOM ± AE): age, Injury Severity Score (ISS), head injury, haemodynamic instability, massive transfusion, radiological hard signs [contrast extravasation or pseudoaneurysm on the initial computed tomography (CT) scan], grade, and presence of intraparenchymal haematoma or splenic laceration...
June 9, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28576125/dissection-of-the-internal-carotid-artery-and-stroke-after-mandibular-fractures-a-case-report-and-review-of-the-literature
#15
Ingrid Aune Tveita, Martin Ragnar Skjerve Madsen, Erik Waage Nielsen
BACKGROUND: We present a report of a patient with blunt trauma and mandibular fractures who developed a significant cerebral infarction due to an initially unrecognized injury of her left internal carotid artery. We believe that increased knowledge of this association will facilitate early recognition and hence prevention of a devastating outcome. CASE PRESENTATION: A 41-year-old ethnic Norwegian woman presented to our Emergency Room after a bicycle accident that had caused a direct blow to her chin...
June 2, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28548592/intracranial-pressure-monitoring-in-severe-blunt-head-trauma-does-the-type-of-monitoring-device-matter
#16
Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28541852/the-pennsylvania-trauma-outcomes-study-risk-adjusted-mortality-model-results-of-a-statewide-benchmarking-program
#17
Douglas J Wiebe, Daniel N Holena, M Kit Delgado, Nathan McWilliams, Juliet Altenburg, Brendan G Carr
Trauma centers need objective feedback on performance to inform quality improvement efforts. The Trauma Quality Improvement Program recently published recommended methodology for case mix adjustment and benchmarking performance. We tested the feasibility of applying this methodology to develop risk-adjusted mortality models for a statewide trauma system. We performed a retrospective cohort study of patients ≥16 years old at Pennsylvania trauma centers from 2011 to 2013 (n = 100,278). Our main outcome measure was observed-to-expected mortality ratios (overall and within blunt, penetrating, multisystem, isolated head, and geriatric subgroups)...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28538329/perioperative-care-for-pediatric-patients-with-penetrating-brain-injury-a-review
#18
Marco Mikhael, Elizabeth Frost, Maria Cristancho
Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury...
May 19, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28495204/intracranial-pressure-monitoring-in-severe-traumatic-brain-injuries-a-closer-look-at-level-1-trauma-centers-in-the-united-states
#19
Piccinini Alice, Lewis Meghan, Benjamin Elizabeth, Aiolfi Alberto, Inaba Kenji, Demetriades Demetrios
INTRODUCTION: The Brain Trauma Foundation (BTF) recently updated recommendations for intracranial pressure (ICP) monitoring in severe traumatic brain injury (TBI). The effect of ICP monitoring on outcomes is controversial, and compliance with BTF guidelines is variable. The purpose of this study was to assess both compliance and outcomes at level I trauma centers. MATERIALS AND METHODS: The American College of Surgeons Trauma Quality Improvement Program database was queried for all patients admitted to level I trauma centers with isolated blunt severe TBI (AIS>3, GCS<9) who met criteria for ICP monitoring...
April 20, 2017: Injury
https://www.readbyqxmd.com/read/28489805/first-experience-of-ndasek-with-heads-up-surgery-a-case-report
#20
Yasser Helmy Mohamed, Masafumi Uematsu, Daisuke Inoue, Takashi Kitaoka
PURPOSE: To report a case of non-Descemet Stripping Automated Endothelial Keratoplasty (nDSAEK) using heads-up surgery. CASE/INTERVENTION: The case was a 72-years-old man who had history of left eye blunt trauma since childhood. One year ago, the patient was diagnosed to have left posttraumatic bullous keratopathy. The patient underwent lt nDSAEK by using the heads-up three-dimensional (3D) system last July. The surgery was performed with a Rescan 700 surgical microscope (Carl Zeiss), which is integrated with intraoperative optical coherence tomography (iOCT) system...
May 2017: Medicine (Baltimore)
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