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Blunt head trauma

Amer Afaneh, Jennifer Ford, Jenna Gharzeddine, Alexandre Mazar, R David Hayward, Joseph Buck
OBJECTIVE: To determine the likelihood that head injured patients on Warfarin with a negative initial head CT will have a positive repeat head CT. A retrospective chart review of our institution's trauma registry was performed for all patients admitted for blunt head trauma and on Warfarin anti-coagulation from January 2009 to April 2014. Inclusion criteria included patients over 18 years of age with initial GCS ≥ 13, INR greater than 1.5 and negative initial head CT. Initial CT findings, repeat CT findings and INR were recorded...
March 15, 2018: BMC Research Notes
Jing Li Huang, Theo A Woehrle, Pat Conway, Catherine A McCarty, Madeline M Eyer, Steven D Eyer
PURPOSE: In 2007, Essentia Health St. Mary's Medical Center (SMMC), a Level II trauma center in northeastern Minnesota, implemented a protocol for patients who presented with blunt head trauma and were receiving warfarin for anticoagulation. The purpose of this study was to determine the incidence and risk factors of early delayed, warfarin-associated intracranial hemorrhage (ICH). METHODS: Adult patients with signs and symptoms of head injury on warfarin who were admitted by protocol to SMMC between March 2007 and June 2015 were included...
March 14, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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
Keita Shibahashi, Kazuhiro Sugiyama, Yoshihiro Okura, Hidenori Hoda, Yuichi Hamabe
BACKGROUND: Data on traumatic intraventricular hemorrhage (IVH) are currently limited, and therefore, the condition is not fully understood. The aim of this study was to determine the epidemiology of traumatic IVH and its effects on outcome in patients with blunt head trauma. METHODS: Using a nationwide trauma registry-the Japan Trauma Data Bank, we identified patients who underwent head computed tomography (CT) after blunt head trauma and had intracranial injuries between 2004 and 2015...
March 9, 2018: World Neurosurgery
Shaylan K Govind, Neil H Merritt
BACKGROUND: The objective of our study was to identify the most common mechanisms of injury leading to death in our pediatric population. METHODS: A retrospective cohort of fatally injured children 0-17 years old treated at our trauma center during 2000-2015. RESULTS: The mortality rate in our population was 8% (n = 103). Fifty-five percent were male. The majority (76%) of fatal injuries were blunt. Overall, motor vehicle collisions (MVCs) were the most common mechanism of injury (61%), followed by assault/abuse (9%)...
March 6, 2018: American Journal of Surgery
Susan Yoong, Ravi Kothari, Adam Brooks
INTRODUCTION: Whole body computed tomography has become standard practice in many centres in the management of severely injured trauma patients, however, the evidence for it's diagnostic accuracy is limited. AIM: To assess the sensitivity of whole body CT in major trauma. METHOD: Retrospective review of all patients with injury severity score (ISS) > 15 presenting with blunt trauma to a UK Major Trauma Centre between May 2012 and April 2014...
March 8, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Vijay Krishnamoorthy, Monica S Vavilala, Nophanan Chaikittisilpa, Frederick P Rivara, Nancy R Temkin, Abhijit V Lele, Edward F Gibbons, Ali Rowhani-Rahbar
OBJECTIVES: To examine the impact of early myocardial workload on in-hospital mortality following isolated severe traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: Data from the National Trauma Databank, a multicenter trauma registry operated by the American College of Surgeons, from 2007 to 2014. PATIENTS: Adult patients with isolated severe traumatic brain injury (defined as admission Glasgow Coma Scale < 8 and head Abbreviated Injury Score ≥ 4)...
March 3, 2018: Critical Care Medicine
J Adamec, Petra Dorfner, M Graw, S Lochner, S N Kunz
Injuries resulting from blows with beer steins are a frequent occurrence during annual autumn fairs or at beer halls in South Germany and Austria. The majority of these cases are tried in court and thus being assessed by a forensic medicine expert. The article at hand gives a short overview on the injury potential of one-litre beer steins and explains the key variables to consider when analyzing beer stein injuries. On the basis of representative cases, which were assessed by specialists from the Institute of Legal Medicine of the Munich University over the last 5 years, the main biomechanical aspects and resulting injuries of one-litre beer stein assaults are discussed...
March 4, 2018: International Journal of Legal Medicine
K K Devulapalli, J F Talbott, J Narvid, A Gean, B Rehani, G Manley, A Uzelac, E Yuh, M C Huang
BACKGROUND AND PURPOSE: In blunt traumatic brain injury with isolated falcotentorial subdural hematoma not amenable to neurosurgical intervention, the routinely performed, nonvalidated practice of serial head CT scans frequently necessitates increased hospital resources and exposure to ionizing radiation. The study goal was to evaluate clinical and imaging features of isolated falcotentorial subdural hematoma at presentation and short-term follow-up. MATERIALS AND METHODS: We performed a retrospective analysis of patients presenting to a level 1 trauma center from January 2013 to March 2015 undergoing initial and short-term follow-up CT with initial findings positive for isolated subdural hematoma along the falx and/or tentorium...
March 1, 2018: AJNR. American Journal of Neuroradiology
Joshua H Hill, Paul Bonner, M Shay O'Mara, Teresa Wood, Michael Lieber
OBJECTIVE: We postulate that in patients with blunt trauma on anticoagulant or antiplatelet agents, incidence and complication rate of delayed intracranial hemorrhage (DICH) after an initially negative head CT is low and routine repeat head CT is not warranted. DESIGN: A retrospective, observational study performed from 2008 to 2012. PATIENTS: A total of 338 patients with blunt trauma with pre-admission history of any anticoagulant use, who had an initially negative head CT, followed by a repeat CT within 48 hours...
February 27, 2018: Brain Injury: [BI]
Soo Hoon Lee, Daesung Lim, Dong Hoon Kim, Seong Chun Kim, Tae Yun Kim, Changwoo Kang, Jin Hee Jeong, Yong Joo Park, Sang Bong Lee, Rock Bum Kim
BACKGROUND: Mortality prediction in patients with brain trauma during initial management in the emergency department (ED) is essential for creating the foundation for a better prognosis. OBJECTIVE: This study aimed to create a simple and useful survival predictive model for patients with isolated blunt traumatic brain injury that is easily available in the ED. METHODS: This is a retrospective study based on the trauma registry data of an academic teaching hospital...
February 22, 2018: Journal of Emergency Medicine
Khuram Khan, Saqib Saeed, Alexius Ramcharan, Sanjiv Gray
INTRODUCTION: Traumatic brain injury (TBI) is one of the main causes of morbidity and mortality in young trauma patients with resultant multi-organ effects. Hypopituitarism following TBI can be debilitating and life threatening. TBI which causes hypopituitarism may be characterized by a single head injury, such as from a motor vehicle accident, or by chronic repetitive head trauma, as seen in combative supports including boxing, kick-boxing, and football. In the majority of cases, a diagnosis of hypopituitarism can be entirely missed resulting in severe neuro-endocrine dysfunction...
February 9, 2018: International Journal of Surgery Case Reports
Debora Lee Oh, Petra Jerman, Sara Silvério Marques, Kadiatou Koita, Sukhdip Kaur Purewal Boparai, Nadine Burke Harris, Monica Bucci
BACKGROUND: Early detection of and intervention in childhood adversity has powerful potential to improve the health and well-being of children. A systematic review was conducted to better understand the pediatric health outcomes associated with childhood adversity. METHODS: PubMed, PsycArticles, and CINAHL were searched for relevant articles. Longitudinal studies examining various adverse childhood experiences and biological health outcomes occurring prior to age 20 were selected...
February 23, 2018: BMC Pediatrics
Rena Pombo, Etta Johnson, Alejandra Gamboa, Bennet Omalu
Manic episodes induced by antidepressant withdrawal are rarely reported. Mirtazapine is a tetracyclic, piperazinoazepine compound and is a noradrenergic, adrenergic, serotonergic, histaminergic, and muscarinic-antagonist antidepressant that is used for the treatment of major depression and other psychiatric illnesses. There are several reported cases of manic/hypomanic episodes induced by mirtazapine withdrawal based on suspected clinical symptoms that were not confirmed by autopsy and toxicology. We present the first reported case of mirtazapine withdrawal-induced mania/hypomania associated with sudden death and confirmed by autopsy and toxicology...
October 2017: Journal of Pharmacology & Pharmacotherapeutics
James A Chenoweth, Samuel D Gaona, Mark Faul, James F Holmes, Daniel K Nishijima
Importance: Current guidelines conflict on the management of older adults who have blunt head trauma taking anticoagulant and antiplatelet medications. This is partially due to the limited data comparing patients who are taking these medications with those who are not. Objective: To investigate the incidence of delayed traumatic intracranial hemorrhage in older adults with head trauma, including those taking anticoagulant and antiplatelet medications. Design, Setting, and Participants: This prospective observational cohort study included patients 55 years and older who had blunt head trauma and were transported via emergency medical services between August 1, 2015, and September 30, 2016...
February 14, 2018: JAMA Surgery
Jordan Bade-Boon, Joseph K Mathew, Mark C Fitzgerald, Biswadev Mitra
BACKGROUND: Blunt thoracic aortic injury (BTAI) is an uncommon diagnosis, usually developing as a consequence of high-impact acceleration-deceleration mechanisms. Timely diagnosis may enable early resuscitation and reduction of shear forces, essential to prevent worsening of the injury prior to definitive management. Death is commonly due to haemorrhagic shock, but clinical features may be absent until sudden and massive haemorrhage. OBJECTIVES: The aim of this systematic review was to determine the proportion of patients with BTAI who present with unstable vital signs...
February 9, 2018: Emergency Medicine Journal: EMJ
Ashwath Kumar, Anthony Alvarado, Kushal Shah, Paul M Arnold
BACKGROUND: The standard of care for isolated mild traumatic subarachnoid hemorrhage (itSAH) involves serial head CT examinations at dedicated time-intervals to monitor neurologic status and hemorrhagic progression. Considering recent evidence questioning such an aggressive monitoring protocol, this study aimed to assess the necessity of repeat head CT imaging in managing itSAH. METHODS: All patients who presented to our academic institution with mild traumatic brain injury were evaluated...
February 10, 2018: World Neurosurgery
Yang Wan, Kenneth E Stewart, Martin Q Lansdale
PURPOSE: Computed tomography (CT) scans play a vital role in the diagnosis and evaluation of trauma patients. Repeat CT scans occurred often among transferred trauma patients. The objective was to describe CT use and identify patient- and hospital-level factors associated with repeat CT scans among inter-facility transferred major trauma patients. METHODS: A retrospective cohort study was conducted using data extracted from the Oklahoma State Trauma Registry between 2009 and 2015...
February 8, 2018: Emergency Radiology
Erkan Öztürk, Eren Yılmaz, İlker Erdinç Öztürk, Beldan Polat, Kadir Serkan Orhan
Intramuscular hemangiomas (IMH) account for <%1 of all hemangiomas and are rarely located in the head and neck region. The most common site of origin in the head and neck is the masseter muscle, whereas IMH originating from the scalene muscles are rarely seen. Surgical excision of intramuscular hemangioma is considered the main treatment modality. Here we present the case of a male patient aged 17 with IMH that occured after blunt trauma in the supraclavicular region, fed by the thyrocervical and costocervical trunks, and with an arteriovenous shunt...
June 2017: Turkish Archives of Otorhinolaryngology
Corey S Scher
PURPOSE OF REVIEW: The percentage of people over the age of 65 is growing rapidly and anesthesiologists must develop a medical understanding that is comprehensive to meet the unique medical needs of this population. The changing physiology of an elderly population makes them extremely vulnerable to trauma and the administration of blood products. Although most of these cases involve orthopedic attention, it is not less dangerous as a blunt trauma case. RECENT FINDINGS: This article addresses some of the main concerns for the anesthesiologists of providing a hemostatic resuscitation in the geriatric population...
April 2018: Current Opinion in Anaesthesiology
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