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Minor head injury

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https://www.readbyqxmd.com/read/28540393/computed-tomography-scans-of-the-head-for-adult-patients-with-minor-head-injury-are-clinical-decision-rules-a-necessary-evil
#1
Desmond Wei Tan, Annabelle Mei En Lim, Daniel Yuxuan Ong, Li Lee Peng, Yiong Huak Chan, Irwani Ibrahim, Win Sen Kuan
INTRODUCTION: This study aimed to evaluate compliance with and performance of the Canadian Computed Tomography Head Rule (CCHR), and its applicability in the local adult population with minor head injury. METHODS: We conducted a retrospective study of consecutive patients who presented to the adult emergency department (ED) with minor head injury over six months. Data on predictor variables indicated in the CCHR was collected and compliance with the CCHR assessed by comparing the recommendations for head computed tomography (CT) scans to its actual usage...
May 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28526667/patient-centered-decision-support-formative-usability-evaluation-of-integrated-clinical-decision-support-with-a-patient-decision-aid-for-minor-head-injury-in-the-emergency-department
#2
Edward R Melnick, Erik P Hess, George Guo, Maggie Breslin, Kevin Lopez, Anthony J Pavlo, Fuad Abujarad, Seth M Powsner, Lori A Post
BACKGROUND: The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28499094/the-epidemiology-and-effect-of-sliding-injuries-in-major-and-minor-league-baseball-players
#3
Christopher L Camp, Frank C Curriero, Keshia M Pollack, Stephanie W Mayer, Andrea M Spiker, John D'Angelo, Struan H Coleman
BACKGROUND: Although sliding occurs frequently in professional baseball, little is known about the epidemiology and effect of injuries that occur during sliding in this population of elite athletes. PURPOSE: To describe the incidence and characteristics of sliding injuries, determine their effect in terms of time out of play, and identify common injury patterns that may represent appropriate targets for injury prevention programs in the future. STUDY DESIGN: Descriptive epidemiologic study...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28475282/risk-of-intracranial-hemorrhage-in-ground-level-fall-with-antiplatelet-or-anticoagulant-agents
#4
Michael Ganetsky, Gregory Lopez, Tara Coreanu, Victor Novack, Steven Horng, Nathan I Shapiro, Kenneth A Bauer
OBJECTIVES: Anticoagulant and antiplatelet medications are known to increase the risk and severity of traumatic intracranial hemorrhage (tICH), even with minor head trauma. Most studies on bleeding propensity with head trauma are retrospective, based on trauma registries, or include heterogeneous mechanisms of injury. The goal of this study was to determine the rate of tICH from only a common low-acuity mechanism of injury, that of a ground level fall, in patients taking one or more of the following antiplatelet or anticoagulant medications: aspirin, warfarin, prasugrel, ticagrelor, dabigatran, rivaroxaban, apixaban or enoxaparin...
May 5, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28465135/in%C3%A2-vivo-demonstration-of-traumatic-rupture-of-the-bridging-veins-in-abusive-head-trauma
#5
Giulio Zuccoli, Abdullah S Khan, Ashok Panigrahy, Mandeep S Tamber
OBJECTIVE: In victims of abusive head trauma, bridging vein thrombosis is a common finding on magnetic resonance imaging. We aimed to evaluate the utility of high-resolution coronal susceptibility-weighted imaging (SWI) in depicting bridging vein thrombosis as well as to verify the morphology of the bridging vein thrombosis on axial SWI. We additionally analyzed the correlations between bridging vein thrombosis or bridging vein deformation and other magnetic resonance imaging findings that often occur in association with abusive head trauma...
April 8, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28458854/the-outcome-of-a-pregnant-woman-with-a-minor-head-injury-an-ossified-subdural-hematoma-osdh
#6
Nese Keser, Erhan Celikoglu, İmam H Aydın, Nurver Ozbay
We experienced an ossified subdural hematoma (OSDH), which is an extremely rare form of chronic subdural hematoma (SDH), in the dominant hemisphere of a 35-year-old woman. She presented to our outpatient clinic with a complaint of a headache; she had previously experienced a head injury while she was pregnant. We performed surgery with extreme caution because the lesion was attached to the surrounding tissue. Since an OSDH is an extremely rare form of chronic SDH, neurosurgeons might not experienced them during their daily practice...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28449983/universal-head-ultrasound-screening-in-full-term-neonates-a-retrospective-analysis-of-6771-infants
#7
Elisa Ballardini, Anna Tarocco, Chiara Rosignoli, Alessandro Baldan, Caterina Borgna-Pignatti, Giampaolo Garani
BACKGROUND: Full-term neonates may have asymptomatic cranial injuries at birth and head ultrasound screening could be useful for early diagnosis. The aim of this study was to assess the prevalence and type of intracranial abnormalities and the usefulness of head ultrasound screening in these infants. METHODS: A head ultrasound screening was performed on all full-term neonates (gestational age between 37 and 42 weeks), born at Sant'Anna University Hospital of Ferrara, Italy, from June 1, 2008 through May 31, 2013...
March 30, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28439613/the-role-of-delayed-head-ct-in-evaluation-of-elderly-blunt-head-trauma-victims-taking-antithrombotic-therapy
#8
D Scantling, C Fischer, R Gruner, A Teichman, B McCracken, J Eakins
INTRODUCTION: Increasing active longevity has created an increasing surge of elderly trauma patients. The majority of these patients suffer blunt trauma and many are taking antithrombotic agents. The literature is mixed regarding the utility of routine repeat head CT in patients taking antithrombotic medications with a GCS of 15 and initial negative head CT. We hypothesized that scheduled delayed CT head 12 h after admission (D-CTH) in elderly blunt trauma victims would not identify clinically significant new hemorrhages or change management...
April 24, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28416072/-a-scandinavian-guideline-for-initial-management-of-minimal-mild-and-moderate-head-trauma-in-children
#9
Christina Rosenlund, Christina Engel Høi-Hansen, Kaare Engell Lundstrøm, Alfred Peter Born, Ole Pedersen, Ramona Åstrand
The Scandinavian Neurotrauma Committee has recently published an evidence- and consensus-based guideline for the management of minor and moderate head trauma in children. They aim is to select children for computed tomography (CT) scan, observation or early discharge, with the attempt to reduce the number of CT scans in children without missing any significant intracranial injury in need for treatment. A flow chart of the guidelines and a help sheet has been developed for clinical use. Suggestions for in-hospital observation and parental information are also presented...
April 3, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28415909/detecting-coached-neuropsychological-dysfunction-a-simulation-experiment-regarding-mild-traumatic-brain-injury
#10
Lily Lau, Michael R Basso, Eduardo Estevis, Ashley Miller, Douglas M Whiteside, Dennis Combs, Timothy J Arentsen
OBJECTIVE: Performance validity tests (PVTs) and symptom validity tests (SVTs) are often administered during neuropsychological evaluations. Examinees may be coached to avoid detection by measures of response validity. Relatively little research has evaluated whether graduated levels of coaching has differential effects upon PVT and SVT performance. Accordingly, the present experiment evaluated the effect of graduated levels of coaching upon the classification accuracy of commonly used PVTs and SVTs and the currently accepted criterion of failing two or more PVTs or SVTs...
April 18, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/28412951/understanding-discharge-communication-behaviours-in-a-pediatric-emergency-care-context-a-mixed-methods-observation-study-protocol
#11
Janet A Curran, Andrea Bishop, Amy Plint, Shannon MacPhee, Roger Zemek, Jill Chorney, Mona Jabbour, Stephen Porter, Scott Sawyer
BACKGROUND: One of the most important transitions in the continuum of care for children is discharge to home. Optimal discharge communication between healthcare providers and caregivers (e.g., parents or other guardians) who present to the emergency department (ED) with their children is not well understood. The lack of policies and considerable variation in practice regarding discharge communication in pediatric EDs pose a quality and safety risk for children and their parents. METHODS: The aim of this mixed methods study is to better understand the process and structure of discharge communication in a pediatric ED context to contribute to the design and development of discharge communication interventions...
April 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28400068/intracranial-complications-after-minor-head-injury-mhi-in-patients-taking-vitamin-k-antagonists-vka-or-direct-oral-anticoagulants-doacs
#12
Alessandro Riccardi, Beatrice Spinola, Pierangela Minuto, Maria Ghinatti, Grazia Guiddo, Michele Malerba, Roberto Lerza
INTRODUCTION: The correlation between chronic direct oral anticoagulants (DOACs) intake and the incidence of intracranial complications after minor head injury (MHI) is still not well defined. This study examined the incidence of complications in patients receiving vitamin K antagonists (VKA) or DOACs observed in the emergency department (ED) for MHI. METHODS: Two hundred twenty-five patients affected by MHI and receiving oral anticoagulants were recorded between January and December 2016, distinguishing those treated with VKA (118) from those receiving DOACs (107)...
April 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#13
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries. OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach. METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma"...
April 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28392325/trajectories-of-functional-recovery-following-inpatient-rehabilitation-for-traumatic-brain-injury
#14
Bret T Howrey, James E Graham, Monique R Pappadis, Carl V Granger, Kenneth J Ottenbacher
OBJECTIVE: To examine trajectories of functional recovery following rehabilitation for Traumatic Brain Injury (TBI). DESIGN: Prospective study. SETTING: Inpatient rehabilitation hospitals in the Uniform Data System for Medical Rehabilitation (UDSMR). PARTICIPANTS: A subset of Individuals receiving inpatient rehabilitation services for TBI in 2002-2010 who also had post-discharge measurement of functional independence (N=16,583)...
April 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28342701/predictive-subtle-or-overlooked-initial-head-ct-findings-in-patients-who-develop-delayed-chronic-subdural-hematoma
#15
William C Olivero, Huan Wang, Arash Farahvar, Thomas A Kim, Fei Wang
With the aging population, the incidence of chronic subdural hematoma (CSDH) is expected to rise. Once symptomatic the morbidity from CSDH is not insignificant. We studied patients who had a minor head injury and CT brain scan prior to developing CSDH to determine if there were any predictors on these scans for subsequent development of a CSDH. A retrospective review was performed on all patients operated for CSDH over a 3-year period and a review performed on those who had imaging studies at the time of a preceding minor head injury...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28341799/use-of-traumatic-brain-injury-prediction-rules-with-clinical-decision-support
#16
Peter S Dayan, Dustin W Ballard, Eric Tham, Jeff M Hoffman, Marguerite Swietlik, Sara J Deakyne, Evaline A Alessandrini, Leah Tzimenatos, Lalit Bajaj, David R Vinson, Dustin G Mark, Steve R Offerman, Uli K Chettipally, Marilyn D Paterno, Molly H Schaeffer, Jun Wang, T Charles Casper, Howard S Goldberg, Robert W Grundmeier, Nathan Kuppermann
OBJECTIVES: We determined whether implementing the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prediction rules and providing risks of clinically important TBIs (ciTBIs) with computerized clinical decision support (CDS) reduces computed tomography (CT) use for children with minor head trauma. METHODS: Nonrandomized trial with concurrent controls at 5 pediatric emergency departments (PEDs) and 8 general EDs (GEDs) between November 2011 and June 2014...
March 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28323577/mitigation-of-radiation-induced-epithelial-damage-by-the-tlr5-agonist-entolimod-in-a-mouse-model-of-fractionated-head-and-neck-irradiation
#17
Ilia A Toshkov, Anatoli S Gleiberman, Vadim L Mett, Alan D Hutson, Anurag K Singh, Andrei V Gudkov, Lyudmila G Burdelya
Radiation treatment of head and neck cancer frequently causes severe collateral damage to normal tissues including mouth mucosa, salivary glands and skin. This toxicity limits the radiation dose that can be delivered and affects the patient's quality of life. Previous studies in mice and nonhuman primates showed that entolimod, a toll-like receptor 5 (TLR5) agonist derived from bacterial flagellin, effectively reduced radiation damage to hematopoietic and gastrointestinal tissues in both total-body and local irradiation scenarios, with no protection of tumors...
May 2017: Radiation Research
https://www.readbyqxmd.com/read/28302103/age-and-the-risk-of-all-terrain-vehicle-related-injuries-in-children-and-adolescents-a-cross-sectional-study
#18
Lianne McLean, Kelly Russell, Steven McFaull, Lynne Warda, Milton Tenenbein, Jonathan McGavock
BACKGROUND: The study was designed to determine if youth <16 years are at a greater risk of serious injuries related to all-terrain vehicle (ATV) use compared to older adolescents and adults. METHODS: We performed cross sectional study of children and adults presenting to pediatric and adult emergency departments between 1990 and 2009 in Canada. The primary exposure variable was age <16 years and the primary outcome measure was moderate to serious injury determined from physician report of type and severity of injury...
March 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28255067/reducing-head-ct-use-for-children-with-head-injuries-in-a-community-emergency-department
#19
Rebecca M Jennings, Jennifer J Burtner, Joseph F Pellicer, Deepthi K Nair, Miranda C Bradford, Michele Shaffer, Neil G Uspal, Joel S Tieder
BACKGROUND AND OBJECTIVE: Clinical decision rules have reduced use of computed tomography (CT) to evaluate minor pediatric head injury in pediatric emergency departments (EDs). CT use remains high in community EDs, where the majority of children seek medical care. We sought to reduce the rate of CT scans used to evaluate pediatric head injury from 29% to 20% in a community ED. METHODS: We evaluated a quality improvement (QI) project in a community ED aimed at decreasing the use of head CT scans in children by implementing a validated head trauma prediction rule for traumatic brain injury...
March 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28251880/choosing-wisely-canada%C3%A2-five-tests-procedures-and-treatments-to-question-in-emergency-medicine
#20
Amy H Y Cheng, Sam Campbell, Lucas B Chartier, Tom Goddard, Kirk Magee, Jill McEwen, Atul K Kapur, Brian R Holroyd, Suneel Upadhye, Stephanie Couperthwaite, Brian H Rowe
OBJECTIVES: Choosing Wisely Canada (CWC) is an initiative to encourage patient-physician discussions about the appropriate, evidence based use of medical tests, procedures and treatments. We present the Canadian Association of Emergency Physicians' (CAEP) top five list of recommendations, and the process undertaken to generate them. METHODS: The CAEP Expert Working Group (EWG) generated a candidate list of 52 tests, procedures, and treatments in emergency medicine whose value to care was questioned...
March 2, 2017: CJEM
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