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Blunt head trauma

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https://www.readbyqxmd.com/read/28099375/routine-neurosurgical-consultation-is-not-necessary-in-mild-blunt-traumatic-brain-injury
#1
Paul R Lewis, Casey E Dunne, James D Wallace, Jason B Brill, Richard Y Calvo, Jayraan Badiee, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
BACKGROUND: The Brain Trauma Foundation guidelines provide indications for neurosurgical intervention in traumatic brain injury (TBI) with moderate or severe intracranial hemorrhage (ICH). In TBI patients with less severe ICH, the utility of neurosurgical consultation remains unclear. We sought to determine if routine neurosurgical consultation is necessary for mild blunt TBI patients with ICH. METHODS: A retrospective cohort study was conducted on 500 consecutive blunt TBI patients aged 15 years or older with Glasgow Coma Scale score ≥13 and ICH on initial head computed tomography (CT) admitted to a Level 1 trauma center over 28 months...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28088944/gastroduodenal-artery-aneurysm-a-rare-complication-of-traumatic-pancreatic-injury
#2
Annu Babu, Amulya Rattan, Maneesh Singhal, Amit Gupta, Subodh Kumar
Aneurysm of gastroduodenal artery (GDA) is rare. Most reported cases are due to pancreatitis and atherosclerosis; however, those following pancreatic trauma have not been reported. We encoun- tered GDA aneurysm in a patient of blunt abdominal trauma, who had pancreatic contusion and retroduodenal air on contrast enhanced computed tomography of abdomen. Emergency laparotomy for suspected duodenal injury revealed duodenal wall and pancreatic head contusion, mild hemo- peritoneum and no evidence of duodenal perforation...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28088089/the-traumatic-potential-of-a-projectile-shot-from-a-sling
#3
Igor Borovsky, Zvi Lankovsky, Leonid Kalichman, Victor Belkin
Herein, we analyze the energy parameters of stones of various weights and shapes shot from a sling and based on this data evaluate its traumatic potential. Four police officers proficient in the use of a sling participated in the trials. The following projectile types, shot using an overhead technique at a target 100m away were: round steel balls of different sizes and weights (24mm, 57g; 32mm, 135g; 38mm, 227g); different shaped stones weighing 100-150g and 150-200g and a golf ball (47g). Our data indicated that projectiles shot from unconventional weapons such as a sling, have serious traumatic potential for unprotected individuals and can cause blunt trauma of moderate to critical severity such as fractures of the trunk, limb, and facial skull bone, depending on the weight and shape of the projectile and the distance from the source of danger...
October 26, 2016: Forensic Science International
https://www.readbyqxmd.com/read/28033135/omega-3-fatty-acid-supplementation-and-warfarin-a-lethal-combination-in-traumatic-brain-injury
#4
Brian W Gross, Maria Gillio, Cole D Rinehart, Caitlin A Lynch, Frederick B Rogers
Polyunsaturated fatty acids such as omega-3 eicosapentaenoic acid and omega-6 docosahexaenoic acid, found in over-the-counter fish oil supplements, are often consumed for their beneficial, prophylactic, anti-inflammatory effects. Although the mechanisms of action are not fully known, a diet rich in polyunsaturated fats may reduce the risk of hyperlipidemia, atherosclerosis, high low-density lipoprotein cholesterol levels, hypertension, and inflammatory diseases. Masked by its many benefits, the risks of omega-3 fatty acid supplementation are often underappreciated, particularly its ability to inhibit platelet aggregation and promote bleeding in patients taking anticoagulant medications...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27957380/palpable-mass-on-the-head-after-minor-trauma
#5
K M Nikolakopoulos, C P Papageorgopoulou, I G Ntouvas, S Kakkos, I Tsolakis
Temporal artery is superficially exhibited and easily traumatized. Rarely, a minor and blunt trauma, especially in elderly who are under anticoagulants, can cause a pseudoaneurysm. Diagnosis should be based, primarily, on history and physical examination and secondarily on duplex ultrasound scanning which will lead to confirmation and preoperative planning. The therapeutical plan consists of surgical ligation and excision of the aneurysm. Surgery can be performed under local anesthesia with no postoperative major or minor complications...
2016: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#6
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27904004/delayed-diagnosis-of-blunt-carotid-trauma-in-a-seat-belt-syndrome-with-associated-abdominal-wall-injury-a-case-report
#7
Savino Occhionorelli, Dario Andreotti, Daniela Tartarini, Lorenzo Cappellari, Rocco Stano, Lucia Morganti, Giorgio Vasquez
: The aim of this case report is to be aware of occult carotid lesions in thoracic- abdominal trauma because, carotid artery injury consequent to blunt trauma is rare, affecting less than 1% of patients as reported in literature. A 45-years-old female, involved in a traffic accident, arrived to Emergency Room hemodynamically stable, with a Glasgow Coma Scale of 15, complaining abdominal pain, without any neurological signs. She underwent Computed Tomography (CT) scan that showed a complete disruption of left abdominal wall muscles, associated with massive bowel loops herniation...
November 28, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27896468/evaluation-of-major-trauma-in-elderly-patients-a%C3%A2-single-trauma-center-analysis
#8
Samo Kocuvan, Drago Brilej, Domen Stropnik, Rolf Lefering, Radko Komadina
BACKGROUND: The objective of the study was to gather information about elderly major trauma patients admitted to one particular Slovenian trauma centre in Celje and examine this group of polytrauma patients, specifically with respect to mechanisms of injury, injury severity and distribution of injuries. Further on, to identify morbidity and mortality rates and compare these to the younger population and, finally, to determine the factors that have the most impact on treatment results...
December 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27894431/head-and-cervical-spine-evaluation-for-the-pediatric-surgeon
#9
REVIEW
Mary K Arbuthnot, David P Mooney, Ian C Glenn
This article is designed to guide pediatric surgeons in the evaluation and stabilization of blunt head and cervical spine injuries in pediatric patients. Trauma remains the number one cause of morbidity and mortality among children, and the incidence of head injuries continues to rise. Cervical spine injuries, on the other hand, are unusual but can be devastating if missed. This article highlights the pathophysiology unique to pediatric head and cervical spine trauma as well as keys to clinical and diagnostic evaluation...
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27866218/prevalence-of-negative-ct-scans-in-a-level-one-trauma-center
#10
C K Hansen, R J Strayer, B D Shy, S Kessler, S Givre, K H Shah
PURPOSE: The rise of computed tomography (CT) use in trauma has become the subject of concern given the harms of CT including radiation, cost, over diagnosis and identification of incidental lesions. We developed a novel metric, the Negative CT Score, (∑CT-) which quantifies how often CT imaging identifies important injuries. Our objective was to describe the pattern of CT utilization in trauma at an urban academic level one trauma center using this novel metric. METHODS: This was a retrospective study of intermediate level trauma patients who received CT imaging over a 1-year study period at an urban level one trauma center...
November 19, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27863210/surgical-treatment-of-facial-artery-pseudoaneurysm-following-blunt-trauma-report-of-a-case
#11
Ali Payami, Andre H Montazem
There are few reports of pseudoaneurysm of the facial artery in the literature and very little attention has been paid to their surgical management. Practitioners should be aware of this unusual complication of facial trauma and of the alternatives for treatment of pseudoaneurysms. Surgical resection of selective head and neck pseudoaneurysms provides a safe and effective method for the treatment of these vascular lesions.
October 24, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27853132/traumatic-brain-injuries
#12
Kaj Blennow, David L Brody, Patrick M Kochanek, Harvey Levin, Ann McKee, Gerard M Ribbers, Kristine Yaffe, Henrik Zetterberg
Traumatic brain injuries (TBIs) are clinically grouped by severity: mild, moderate and severe. Mild TBI (the least severe form) is synonymous with concussion and is typically caused by blunt non-penetrating head trauma. The trauma causes stretching and tearing of axons, which leads to diffuse axonal injury - the best-studied pathogenetic mechanism of this disorder. However, mild TBI is defined on clinical grounds and no well-validated imaging or fluid biomarkers to determine the presence of neuronal damage in patients with mild TBI is available...
November 17, 2016: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/27847782/traumatic-pseudoaneurysm-related-to-calcified-nodules-of-cerebral-convexity-dura-mater-in-an-american-college-football-player
#13
Yoo Sung Jeon, Jong Gon Lee, Young Il Chun, Joon Cho, Woo Jin Choe
Repeated concussion is common among football players; however, these minor blunt head trauma rarely result in serious complications. We report a case of a young college football player who presented acute subdural hematoma, cerebral edema, and seizure due to pseudoaneurysm rupture. The pseudoaneurysm, located at the cortical branch of the middle cerebral artery, was speculated to be formed by dural calcification and adhesion with the underlying brain, possibly due to repeated concussions. Following successful excision of the pseudoaneurysm and control of brain swelling, the patient recovered without sequelae and was discharged after a short while...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27845699/renal-trauma-in-adolescent-skateboarders
#14
Fabio Campodonico, Francesco Paparo, Tiziana Calcagno, Giacomo Capponi, Giuseppe Conzi
OBJECTIVE: Kidney is the most commonly injured organ of the genitourinary tract after trauma. Half of blunt renal injuries are caused by traffic accidents, but sport activities are also included as frequent causes. Skatebording is popular among young people but it deserves being considered a potential cause of severe injuries. A number of published medical reports mainly refer to bone, joint and head injuries but no cases have been reported on urologic or kidney trauma. METHODS: We present two cases of renal trauma in adolescent males occurred while doing skateboarding...
November 2016: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/27843362/isolated-oculomotor-nerve-palsy-resulting-from-acute-traumatic-tentorial-subdural-hematoma
#15
Victoria Cui, Timur Kouliev
Acute subdural hematoma (SDH) resulting from head trauma is a potentially life-threatening condition that requires expedient diagnosis and intervention to ensure optimal patient outcomes. Rapidly expanding or large hematomas, elevated intracranial pressure, and associated complications of brain herniation are associated with high mortality rates and poor recovery of neurological function. However, smaller bleeds (clot thickness <10 mm) or hematomas occurring in infrequent locations, such as the tentorium cerebelli, may be difficult to recognize and patients may present with unusual or subtle signs and symptoms, including isolated cranial nerve palsies...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27837166/an-unusual-lethal-gunshot-wound-to-the-head
#16
Elmas Shaqiri, Bledar Xhemali, Zija Ismaili, Admir Sinamati, Gentian Vyshka
Atypical gunshot wounds present a challenge for the forensic expert, and sometimes differentiating these from a blunt trauma can be difficult. A careful crime scene investigation can be helpful in finding additional evidence and clarifying the nature of the injuries. We describe a case of an unusual craniocerebral injury that was initially interpreted as a blow from a wooden object. The appearance of the wound lacked the classical characteristics of entrance and exit bullet wounds, but the investigation showed it was due to the ricocheting of a destabilized bullet...
November 11, 2016: Medico-legal Journal
https://www.readbyqxmd.com/read/27836703/surgical-treatment-of-traumatic-intracranial-aneurysms-experiences-at-a-single-center-over-30-years
#17
Seung-Hoon Jung, Sung-Hyun Kim, Tae-Sun Kim, Sung-Pil Joo
OBJECTIVE: Traumatic intracranial aneurysms (tIA) are rare and are associated with high rates of morbidity and mortality. We describe our experiences with tIA at our institution. METHODS: We retrospectively reviewed records from patients who underwent treatment for tIA between January 1986 and December 2015. RESULTS: Data from 5,532 patients diagnosed with cerebral aneurysms between January 1986 and December 2015 in our hospital were reviewed...
November 8, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27833676/variation-of-blunt-traumatic-injury-with-age-in-older-adults-statewide-analysis-2011-14
#18
Emily Earl-Royal, Frances Shofer, Dominique Ruggieri, Rosemary Frasso, Daniel Holena
INTRODUCTION: Traumatic injury is a leading cause of death and disability in adults ≥ 65 years old, but there are few epidemiological studies addressing this issue. The aim of this study was to assess how characteristics of blunt traumatic injuries in adults ≥ 65 vary by age. METHODS: Using data from the a single-state trauma registry, this retrospective cohort study examined injured patients ≥ 65 admitted to all Level I and Level II trauma centers in Pennsylvania between 2011 and 2014 (n=38,562)...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27820555/sarcopenia-as-a-predictor-of-mortality-in-elderly-blunt-trauma-patients-comparing-the-masseter-to-the-psoas-using-computed-tomography
#19
James D Wallace, Richard Y Calvo, Paul R Lewis, Jason B Brill, Steven R Shackford, Michael J Sise, C Beth Sise, Vishal Bansal
BACKGROUND: Sarcopenia, or age-related loss of muscle mass, is measurable by computed tomography (CT). In elderly trauma patients, increased mortality is associated with decreased psoas muscle cross-sectional area (P-Area) on abdominal CT. Fall is the leading cause of injury in the elderly, and head CT is more often obtained. Masseter muscle cross-sectional area (M-Area) is readily measured on head CT. Hypothesizing that M-Area is a satisfactory surrogate for P-Area, we compared the two as markers of sarcopenia and increased mortality in elderly trauma patients...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27800203/surgical-treatment-for-occipital-condyle-fracture-c1-dislocation-and-cerebellar-contusion-with-hemorrhage-after-blunt-head-trauma
#20
Shigeo Ueda, Nobuhiro Sasaki, Miyuki Fukuda, Minoru Hoshimaru
Occipital condyle fractures (OCFs) have been treated as rare traumatic injuries, but the number of reported OCFs has gradually increased because of the popularization of computed tomography (CT) and magnetic resonance imaging (MRI). The patient in this report presented with OCFs and C1 dislocation, along with traumatic cerebellar hemorrhage, which led to craniovertebral junction instability. This case was also an extremely rare clinical condition in which the patient presented with traumatic lower cranial nerve palsy secondary to OCFs...
2016: Case Reports in Orthopedics
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