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Minor head trauma

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https://www.readbyqxmd.com/read/29622334/pediatric-major-head-injury-not-a-minor-problem
#1
REVIEW
Aaron N Leetch, Bryan Wilson
Traumatic brain injury is a highly prevalent and devastating cause of morbidity and mortality in children. A rapid, stepwise approach to the traumatized child should proceed, addressing life-threatening problems first. Management focuses on preventing secondary injury from physiologic extremes such as hypoxemia, hypotension, prolonged hyperventilation, temperature extremes, and rapid changes in cerebral blood flow. Initial Glasgow Coma Score, hyperglycemia, and imaging are often prognostic of outcome. Surgically amenable lesions should be evacuated promptly...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29622323/pediatric-minor-head-injury-2-0-moving-from-injury-exclusion-to-risk-stratification
#2
REVIEW
James Jim L Homme
Visits for pediatric minor blunt head trauma continue to increase. Variability exists in clinician evaluation and management of this generally low-risk population. Clinical decision rules identify very low-risk children who can forgo neuroimaging. Observation before imaging decreases neuroimaging rates. Outcome data can be used to risk stratify children into more discrete categories. Decision aids improves knowledge and accuracy of risk perception and facilitates identification of caregiver preferences, allowing for shared decision making...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29606408/racial-and-ethnic-disparities-and-bias-in-the-evaluation-and-reporting-of-abusive-head-trauma
#3
Kent P Hymel, Antoinette L Laskey, Kathryn R Crowell, Ming Wang, Veronica Armijo-Garcia, Terra N Frazier, Kelly S Tieves, Robin Foster, Kerri Weeks
OBJECTIVE: To characterize racial and ethnic disparities in the evaluation and reporting of suspected abusive head trauma (AHT) across the 18 participating sites of the Pediatric Brain Injury Research Network (PediBIRN). We hypothesized that such disparities would be confirmed at multiple sites and occur more frequently in patients with a lower risk for AHT. STUDY DESIGN: Aggregate and site-specific analysis of the cross-sectional PediBIRN dataset, comparing AHT evaluation and reporting frequencies in subpopulations of white/non-Hispanic and minority race/ethnicity patients with lower vs higher risk for AHT...
March 29, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29569001/the-alcohol-intoxicated-trauma-patient-impact-on-imaging-and-radiation-exposure
#4
Christian David Weber, Jana Kristina Schmitz, Christina Garving, Klemens Horst, Hans-Christoph Pape, Frank Hildebrand, Philipp Kobbe
INTRODUCTION: The purpose of this study was to investigate the effects of alcohol intoxication in trauma patients in regard to its impact on application of computed tomography (CT) and associated radiation exposure. METHODS: We conducted a retrospective study from a continuous patient cohort. INCLUSION CRITERIA: admission to the emergency room of an urban Level 1 trauma center with trauma team activation during a 12-month period (Jan 1st-Dec 31st 2012)...
March 22, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29564212/neglected-traumatic-hip-dislocation-influence-of-the-increased-intracapsular-pressure
#5
Elsayed Ibraheem Elsayed Massoud
AIM: To investigate that the increased intracapsular pressure, during the delay period, can interrupt the blood flow to the femoral head. METHODS: An observational retrospective study included a group of 17 patients with traumatic hip dislocation, their ages at time of injury averaged 26 (range from 3 to 70) years. Outcomes were assessed clinically and radiographically at a period averaged 11.5 (range from 4 to 20) years. RESULTS: Minor trauma caused dislocation in seven and severe trauma in ten patients...
March 18, 2018: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29550926/management-of-mild-traumatic-brain-injury-trauma-energy-level-and-medical-history-as-possible-predictors-for-intracranial-hemorrhage
#6
Tomas Vedin, Sebastian Svensson, Marcus Edelhamre, Mathias Karlsson, Mikael Bergenheim, Per-Anders Larsson
PURPOSE: Head trauma is common in the emergency department. Identifying the few patients with serious injuries is time consuming and leads to many computerized tomographies (CTs). Reducing the number of CTs would reduce cost and radiation. The aim of this study was to evaluate the characteristics of adults with head trauma over a 1-year period to identify clinical features predicting intracranial hemorrhage. METHODS: Medical record data have been collected retrospectively in adult patients with traumatic brain injury...
March 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29541804/evaluation-of-a-protocol-for-early-detection-of-delayed-brain-hemorrhage-in-head-injured-patients-on-warfarin
#7
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
https://www.readbyqxmd.com/read/29516354/overuse-of-computed-tomography-for-minor-head-injury-in-young-patients-an-analysis-of-promoting-factors
#8
Michaela Cellina, Marta Panzeri, Chiara Floridi, Carlo Maria Andrea Martinenghi, Giulio Clesceri, Giancarlo Oliva
AIM: To assess the amount of computed tomography (CT) scans for minor head injury (MHI) performed in young patients in our emergency department (ED), not indicated by National Institute for Health and Clinical Excellence (NICE) and Canadian Computed Tomography Head Rules (CCHR), and to analyze factors contributing to unnecessary examinations. Secondary objectives were to calculate the effective dose, to establish the number of positive CT and to analyze which of the risk factors are correlated with positivity at CT; finally, to calculate sensitivity and specificity of NICE and CCHR in our population...
March 7, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29509505/trauma-in-the-elderly-patient
#9
Angela Atinga, Andreas Shekkeris, Michael Fertleman, Nicola Batrick, Elika Kashef, Elizabeth Dick
Major Trauma Centres and Emergency Departments are treating an increasing number of geriatric trauma patients in the UK. Elderly patients, generally defined as those over the age of 65 years, are more susceptible to injury from lesser mechanisms of trauma than younger adults. The number of geriatric trauma cases is rising yearly, accounting for > 25% of all major trauma cases nationally. The elderly have different physiological reserves and a different response to trauma, due to premorbid frailty, co-existing conditions and prescribed medication...
March 6, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29446651/mild-traumatic-brain-injury-evaluation-of-olfactory-dysfunction-and-clinical-neurological-characteristics
#10
Andrea Ciofalo, Marco De Vincentiis, Giannicola Iannella, Giampietro Zambetti, Paola Giacomello, Giancarlo Altissimi, Antonio Greco, Massimo Fusconi, Benedetta Pasquariello, Giuseppe Magliulo
OBJECTIVE: To evaluate olfactory function and clinical-neurological characteristics in a group of patients with mild head trauma. METHODS: A total of 352 patients with MTBI underwent olfactory function evaluation. The site of head trauma, loss of consciousness <20 min, memory loss, subjective presence or absence of olfaction and other clinical, neurological and radiological aspects were evaluated and compared with the olfactory dysfunction. RESULTS: A total of 33...
February 15, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29439149/pediatric-dog-bites-a-population-based-profile
#11
Jackson Fein, David Bogumil, Jeffrey S Upperman, Rita V Burke
BACKGROUND: Previous studies have identified risk factors for dog bites in children, but use data from individual trauma centers, with limited generalizability. This study identifies a population risk profile for pediatric dog bites using the National Trauma Data Bank. We hypothesized that the population at risk was younger boys, that such bites occur at home, are moderately severe, and are on the face or neck. METHODS: For this retrospective cross-sectional study, a sample of 7912 children 17 years old and younger with International Classification of Diseases (ICD)-9 event code E906...
February 8, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/29427049/favourable-outcome-in-a-child-with-symptomatic-diagnosis-of-glutaric-aciduria-type-1-despite-vertical-hiv-infection-and-minor-head-trauma
#12
Angeline Thomas, Els F M Dobbels, Priscilla E Springer, Christelle Ackermann, Mark F Cotton, Barbara Laughton
The first case of Glutaric aciduria Type 1(GA1) in an African child was reported in 2001. GA1 has a prevalence of 1:5000 in black South Africans. Although early diagnosis is essential for a favourable outcome, newborn screening is not routine in South Africa where an estimated 320,000 children have HIV infection. Neurodevelopmental delay and encephalopathy are complications of both HIV and GA1. In such a setting it is important to recognise that HIV and GA1 can occur simultaneously. We present an HIV-infected South African male child of Xhosa descent with macrocephaly who commenced combination antiretroviral therapy (ART) at 8 weeks of age in a clinical trial which included a neurodevelopmental sub-study...
February 9, 2018: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29393757/outcomes-of-chronic-subdural-hematoma-in-patients-with-liver-cirrhosis
#13
Ching-Chang Chen, Shao-Wei Chen, Po-Hsun Tu, Yin-Cheng Huang, Zhuo-Hao Liu, Alvin Yi-Chou Wang, Shih-Tseng Lee, Tien-Hsing Chen, Chi-Tung Cheng, Shang-Yu Wang, An-Hsun Chou
OBJECTIVE Burr hole craniostomy is an effective and simple procedure for treating chronic subdural hematoma (CSDH). However, the surgical outcomes and recurrence of CSDH in patients with liver cirrhosis (LC) remain unknown. METHODS A nationwide population-based cohort study was retrospectively conducted using data from the Taiwan National Health Insurance Research Database. The study included 29,163 patients who underwent first-time craniostomy for CSDH removal between January 1, 2001, and December 31, 2013...
February 2, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29392057/analysis-of-otologic-injuries-due-to-blast-trauma-by-handmade-explosives
#14
Mustafa Aslıer, Nesibe Gül Yüksel Aslıer
Objective: The aim of this study is to identify the otologic injuries due to handmade explosive-welded blast travma in the law enforcement officers during the combat operations in the curfew security region and to specify the disorders that Otolaryngology and Head Neck Surgery (OHNS) physicians can face during such operations. Methods: Medical records of patients in law enforcement who were initially treated by OHNS physicians of Silopi State Hospital during combat operations, between December 14, 2015 and January 15, 2016 were reviewed...
June 2017: Turkish Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29384561/ocular-dipping-in-a-patient-with-hemiplegic-migraine
#15
Iga N Gray, Ana G Cristancho, Daniel J Licht, Grant T Liu
A 5-year-old girl presented with acute, rapidly progressive encephalopathy following minor head trauma and was found to have ocular dipping. Her encephalopathy was secondary to a channelopathy caused by a CACNA1A mutation. This is the first reported case of ocular dipping in an encephalopathic child with CACNA1A-confirmed hemiplegic migraine. [J Pediatr Ophthalmol Strabismus. 2018;55:e4-e6.].
January 31, 2018: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/29382480/-association-between-homozygous-c-318a-gt-mutation-in-exon-2-of-the-eif2b5-gene-and-the-infantile-form-of-vanishing-white-matter-leukoencephalopathy
#16
Carmen Esmer, Gabriela Blanco Hernández, Víctor Saavedra Alanís, Jorge Guillermo Reyes Vaca, Antonio Bravo Oro
BACKGROUND: Vanishing white matter disease is one of the most frequent leukodystrophies in childhood with an autosomal recessive inheritance. A mutation in one of the genes encoding the five subunits of the eukaryotic initiation factor 2 (EIF2B5) is present in 90% of the cases. The diagnosis can be accomplished by the clinical and neuroradiological findings and molecular tests. CASE REPORT: We describe a thirteen-month-old male with previous normal neurodevelopment, who was hospitalized for vomiting, hyperthermia and irritability...
September 2017: Boletín Médico del Hospital Infantil de México
https://www.readbyqxmd.com/read/29380261/intracranial-arterial-calcifications-as-a-prognostic-factor-for-subsequent-major-adverse-cardiovascular-events-mace
#17
Frederik F Strobl, Beatrice Kuhlin, Robert Stahl, Bastian O Sabel, Andreas D Helck, Andreas Schindler, Matthias Witt, Fabian Bamberg, Maximilian F Reiser, Tobias Saam
BACKGROUND: Intracranial arterial calcifications (ICAC) are often detected on unenhanced CT of patients with an age > 60. However, association with the subsequent occurrence of major adverse cardiovascular events (MACE) has not yet been evaluated. PURPOSE: This study aimed at evaluating the association of ICAC with subsequent MACE and overall mortality. METHODS: In this retrospective, IRB approved study, we included 175 consecutive patients (89 males, mean age 78...
January 30, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29334856/stroke-after-minor-head-trauma-in-infants-and-young-children-with-basal-ganglia-calcification-a-lenticulostriate-vasculopathy
#18
Jatinder Singh Goraya, Shivankshi Berry, Kavita Saggar, Archana Ahluwalia
The authors retrospectively reviewed charts of the children with basal ganglia stroke who either had preceding minor head injury or showed basal ganglia calcification on computed tomography (CT) scan. Twenty children, 14 boys and 6 girls were identified. Eighteen were aged between 7 months to 17 months. Presentation was with hemiparesis in 17 and seizures in 3. Preceding minor head trauma was noted in 18. Family history was positive in 1 case. Bilateral basal ganglia calcification on CT scan was noted in 18...
February 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29322585/scapular-fractures-in-the-pan-scan-era
#19
Cortlyn Brown, Karim Elmobdy, Ali S Raja, Robert M Rodriguez
BACKGROUND: Scapular fractures have been traditionally taught to be associated with significant injuries and major morbidity. As we demonstrated with sternal fracture, pulmonary contusion and rib fracture, increased chest CT utilization and head-to-pelvis CT (pan-scan) protocols in blunt trauma evaluation, however, may diagnose minor, clinically irrelevant scapular fractures, possibly rendering previous teachings obsolete. OBJECTIVES: To determine the 1) percentages of scapular fractures seen on chest CT only (SOCTO) versus seen on both CXR and CT and of isolated scapular fracture (scapular fracture without other thoracic injuries), 2) frequencies of associated thoracic injury with scapular fracture, and 3) proportion of patients admitted, mortality, hospital length of stay, and injury severity scores (ISS), comparing four patient groups: scapular fracture, non-scapular fracture, scapular fracture SOCTO, and isolated scapular fracture...
January 11, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29296165/skull-base-and-craniocervical-bone-pneumatisation-two-case-reports-of-differing-presentations-and-a-review-of-the-literature
#20
Olivia Francies, Simon Morley, Tim Beale
We report two patients with increased central skull base and craniocervical junction bone pneumatisation complicated by extra-osseous gas. One patient presented with symptoms of increasing nasal blockage and 'sinus pressure' on a background of extensive nasal polyposis. He was subsequently found to have a history of repeated Valsalva's manoeuvre, the cessation of which resulted in a rapid decrease in the amount of extra-osseous gas on imaging. The second patient presented following a minor head trauma with dysarthria from a hypoglossal nerve palsy and neck pain, with extensive intra- and extra-cranial gas including within the spinal canal (pneumorrhachis)...
November 2017: Journal of Radiology Case Reports
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