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Minor head trauma

Felipe P Andrade, Roberto Montoro, Renan Oliveira, Gabriela Loures, Luana Flessak, Roberta Gross, Camille Donnabella, Andrea Puchnick, Lisa Suzuki, Rodrigo Regacini
OBJECTIVES: 1) To verify clinical signs correlated with appropriate cranial computed tomography scan indications and changes in the therapeutic approach in pediatric minor head trauma scenarios. 2) To estimate the radiation exposure of computed tomography scans with low dose protocols in the context of trauma and the additional associated risk. METHODS: Investigators reviewed the medical records of all children with minor head trauma, which was defined as a Glasgow coma scale ≥13 at the time of admission to the emergency room, who underwent computed tomography scans during the years of 2013 and 2014...
October 1, 2016: Clinics
Janis L Vahldiek, Stefan Thieme, Bernd Hamm, Stefan M Niehues
BACKGROUND: The use of computed tomography (CT) scans of the head and cervical spine has markedly increased in patients with blunt minor trauma. The actual likelihood of a combined injury of head and cervical spine following a minor trauma is estimated to be low. PURPOSE: To determine the incidence of such combined injuries in patients with a blunt minor trauma in order to estimate the need to derive improved diagnostic guidelines. MATERIAL AND METHODS: A total of 1854 patients were retrospectively analyzed...
October 17, 2016: Acta Radiologica
Ashley Blanchard, Keven I Cabrera, Nathan Kuppermann, Peter S Dayan
OBJECTIVES: We aimed to determine the prevalence of and adverse outcomes caused by pneumocephali in children with minor blunt head trauma who had no other intracranial injuries (ie, isolated pneumocephali). METHODS: We conducted a secondary analysis of a public use dataset from a multicenter prospective study of pediatric minor head trauma. We included children younger than 18 years with Glasgow Coma Scale (GCS) scores of 14 or 15 and non-trivial mechanisms of injury who had cranial computed tomographies obtained...
October 6, 2016: Pediatric Emergency Care
Mika Ishige, Tatsuo Fuchigami, Erika Ogawa, Hiromi Usui, Ryutaro Kohira, Yoriko Watanabe, Shori Takahashi
Glutaric acidemia type 1 is a rare autosomal recessive disease caused by a deficiency of glutaryl-CoA dehydrogenase. Previous studies have reported subdural hemorrhage in untreated patients with glutaric acidemia type 1. However, there is only one report of severe acute subdural hemorrhage after minor head trauma in a patient with glutaric acidemia type 1 under guideline-recommended treatment. We report a second case of life-threatening severe acute subdural hemorrhage after a minor head trauma in a patient with glutaric acidemia type 1...
October 8, 2016: Pediatric Neurosurgery
C Ganos, M J Edwards, K P Bhatia
Traumatic injury to the nervous system may account for a range of neurologic symptoms. Trauma location and severity are important determinants of the resulting symptoms. In severe head injury with structural brain abnormalities, the occurrence of trauma-induced movement disorders, most commonly hyperkinesias such as tremor and dystonia, is well recognized and its diagnosis straightforward. However, the association of minor traumatic events, which do not lead to significant persistent structural brain damage, with the onset of movement disorders is more contentious...
2017: Handbook of Clinical Neurology
Jeffrey P Feden
Increasing concern over the acute and long-term consequences of sports-related concussion has generated widespread interest and attention. This article provides an overview of concussion in athletes, including diagnostic and management considerations, and highlights the clinical challenges associated with repeated minor head trauma in sports. [Full article available at].
October 4, 2016: Rhode Island Medical Journal
Megan M Letson, Jennifer N Cooper, Katherine J Deans, Philip V Scribano, Kathi L Makoroff, Kenneth W Feldman, Rachel P Berger
Infants with minor abusive injuries are at risk for more serious abusive injury, including abusive head trauma (AHT). Our study objective was to determine if children with AHT had prior opportunities to detect abuse and to describe the opportunities. All AHT cases from 7/1/2009 to 12/31/2011 at four tertiary care children's hospitals were included. A prior opportunity was defined as prior evaluation by either a medical or child protective services (CPS) professional when the symptoms and/or referral could be consistent with abuse but the diagnosis was not made and/or an alternate explanation was given and accepted...
October 2016: Child Abuse & Neglect
Robert Zant, Michael Melter, Christian Doerfler, Felix Schlachetzki, Ernst-Michael Jung, Stefan Schilling, Juergen Kunkel
Internal carotid artery (ICA) dissections with associated stroke are rare events in infants. The usual pathomechanisms include direct trauma to the artery, blunt intraoral trauma, or child abuse. We describe the case of a 4-month-old male patient with ICA dissection and associated middle cerebral artery territory infarction associated with hyperextension/hyperrotation after a minor head injury. Upon treatment with anticoagulants, the patient showed significant improvement of the left-sided hemiparesis. Hemorrhagic transformation that presented shortly after middle cerebral artery infarction did not further increase under heparin treatment and prevented further embolism...
September 23, 2016: Pediatric Emergency Care
Edward R Melnick
In an electronic health record (EHR) chart review of adult ED trauma patients receiving a head CT from 2008-2013 within 14 community EDs, Sharp et al. estimate that approximately 1/3 of computed tomography (CT) scans in head injury are likely avoidable based on the Canadian CT Head Rule (CCHR).(1) The analysis includes 27,240 adult trauma patients receiving head CTs and uses in-depth chart review of 100 random encounters with 2 independent abstractors (with high inter-rater reliability) to adjust the estimated number of avoidable CTs-the top Choosing Wisely initiative for emergency medicine...
September 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Audrey-Anne Brousseau, Marcel Émond, Marie-Josée Sirois, Raoul Daoust, Lauren E Griffith, Eddy Lang, Jacques Lee, Jeffrey J Perry, Marie-Christine Ouellet, René Verreault, Simon Berthelot, Éric Mercier, Nadine Allain-Boulé, Valérie Boucher, Pier-Alexandre Tardif, Natalie Le Sage
OBJECTIVES: The consequences of minor trauma involving a head injury (MT-HI) in independent older adults are largely unknown. This study assessed the impact of a head injury on the functional outcomes six months post-injury in older adults who sustained a minor trauma. METHODS: This multicenter prospective cohort study in eight sites included patients who were aged 65 years or older, previously independent, presenting to the emergency department (ED) for a minor trauma, and discharged within 48 hours...
September 9, 2016: CJEM
Stefan Candefjord, Ruben Buendia, Eva-Corina Caragounis, Bengt Arne Sjöqvist, Helen Fagerlind
OBJECTIVE: The objective of this study was to evaluate the proportion and characteristics of patients sustaining major trauma in road traffic crashes (RTCs) who could benefit from direct transportation to a trauma center (TC). METHODS: Currently, there is no national classification of TC in Sweden. In this study, 7 university hospitals (UHs) in Sweden were selected to represent a TC level I or level II. These UHs have similar capabilities as the definition for level I and level II TC in the United States...
September 2016: Traffic Injury Prevention
Nan-Ping Yang, Dinh-Van Phan, Yi-Hui Lee, Jin-Chyr Hsu, Ren-Hao Pan, Chien-Lung Chan, Nien-Tzu Chang, Dachen Chu
BACKGROUND: Epidemiological study was needed to evaluate trends in emergency department (ED) utilization that could be taken into account when making policy decisions regarding the delivery and distribution of medical resources. METHODS: A retrospective fixed-cohort study of emergency medical utilization from 2001 to 2010 was performed based on one-million people sampled in 2010 in Taiwan. Focusing on traumatic cases, the annual incidences in various groups split according to sex and age were calculated, and further information regarding location of trauma and type of trauma was obtained...
2016: World Journal of Emergency Surgery: WJES
Mariasavina Severino, Marta Bertamino, Domenico Tortora, Giovanni Morana, Sara Uccella, Renata Bocciardi, Roberto Ravazzolo, Andrea Rossi, Maja Di Rocco
BACKGROUND: Fibrodysplasia ossificans progressiva is an autosomal dominant disorder due to germline mutations of ACVR1/ALK2 causing progressive heterotopic endochondral ossifications. Evidence of central nervous system involvement has emerged only recently. METHODS: We performed an observational cross-sectional brain MRI study in 13 patients (8 females, mean age 20 years), examining the relationship of clinical and neuroradiological findings. RESULTS: All patients presented small asymptomatic lesions similar to hamartomas at the level of the dorsal medulla and ventral pons, associated with minor brainstem dysmorphisms and abnormal origin of the vestibulocochlear and facial nerves...
August 26, 2016: Journal of Medical Genetics
Michael M Dinh, Saartje Berendsen Russell, Kendall J Bein, Kirsten Vallmuur, David Muscatello, Dane Chalkley, Rebecca Ivers
OBJECTIVES: To describe population based trends and clinical characteristics of injury related presentations to Emergency Departments (EDs). DESIGN AND SETTING: A retrospective, descriptive analysis of de-identified linked ED data across New South Wales, Australia over five calendar years, from 2010 to 2014. PARTICIPANTS: Patients were included in this analysis if they presented to an Emergency Department and had an injury related diagnosis...
August 13, 2016: Injury
Heinke Pülhorn, Leann Westmoreland, Catherine McMahon
OBJECTIVES: To determine the variations in the management of patients with minor head injuries across a Trauma Network. METHODS: An 18-point questionnaire covering aspects of hospital care and follow-up of patients with minor head injuries was sent out to 19 wards in 10 different trauma units within our network. RESULTS: Fifty-eight percent of wards routinely admitting patients with minor head injuries have no management protocol in place...
October 2016: British Journal of Neurosurgery
F Lorton, C Poullaouec, E Legallais, J Simon-Pimmel, M A Chêne, H Leroy, M Roy, E Launay, C Gras-Le Guen
BACKGROUND: To date, the Pediatric Emergency Care Applied Research Network (PECARN) rule for identifying children who are at very low risk of clinically-important traumatic brain injuries after minor head trauma has not been validated prospectively in an independent population. Our goal was to evaluate the diagnostic performance of the PECARN clinical decision rule in a French pediatric population in multiple clinical settings. METHODS: We conducted a multicenter, prospective, non-interventional cohort study of patients with minor head trauma who presented to three emergency departments in France...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Lisa Buckley, C Raymond Bingham, Carol A Flannagan, Patrick M Carter, Farideh Almani, Jessica B Cicchino
Motorcycle crashes result in a significant health burden, including many fatal injuries and serious non-fatal head injuries. Helmets are highly effective in preventing such trauma, and jurisdictions that require helmet use of all motorcyclists have higher rates of helmet use and lower rates of head injuries among motorcyclists. The current study examines helmet use and characteristics of helmeted operators and their riding conditions in Michigan, following a weakening of the state's universal motorcycle helmet use law in April 2012...
October 2016: Accident; Analysis and Prevention
Adi Reuveni-Salzman, Guy Rosenthal, Oded Poznanski, Yigal Shoshan, Mony Benifla
OBJECTIVE: The prevalence of skull fractures after mild head trauma is 2 % in children of all ages and 11 % in children younger than 2 years. The current standard management for a child diagnosed with an isolated skull fracture (ISF), in our institute, is hospitalization for a 24-h observation period. Based on data from the literature, less than 1 % of all minor head injuries require neurosurgical intervention. The main objective of this study was to evaluate the risk of neurological deterioration of ISF cases, in order to assess the need for hospitalization...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Dorota Lewartowska-Nyga, Grażyna Skotnicka-Klonowicz
Head injuries in children, especially minor head injuries, still constitute a important diagnostic and therapeutic problem. Despite progress in medical sciences, there is no definition of minor head injury or standards of the management of children with a minor head injury. In consequence, the diagnostic procedure in the child who does not show any signs of central nervous system damage as a result of head injury is individual and depends on the experience and knowledge of the aid provider and as well as procedures established in a given ward...
April 2016: Developmental Period Medicine
Emily M Fortin, Jerry Fisher, Sheng Qiu, Charlene Irvin Babcock
Previous studies suggest overuse disparity of head computed tomography (CT) in white pediatric trauma patients with minor head injuries. Our study is meant to determine if race or insurance status impacts the probability of obtaining head CT in patients with a Glasgow Coma Scale (GCS) = 15. Using the 2008-2010 National Hospital Ambulatory Medical Care Survey for Emergency Departments (NHAMCS) database, the following variables were analyzed: race, emergency medical services (EMS) arrival, triage category, admission status, gender, age, and insurance status...
July 20, 2016: Emergency Radiology
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