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https://www.readbyqxmd.com/read/29350373/pediatric-dural-venous-sinus-thrombosis-following-closed-head-injury-an-easily-overlooked-diagnosis-with-devastating-consequences
#1
Joe M Das, Rashmi Sapkota, Binjura Shrestha
Dural venous sinus thrombosis (DVST) is an uncommon finding after traumatic brain injury. The diagnosis can often be initially missed, particularly if not associated with an overlying fracture. Pediatric DVST following closed head injury and without an overlying fracture is very rare, with only 20 cases reported in the literature to date. Here we present the case of a 19-month-old boy who presented with a history of trivial fall and an episode of fever. On presentation, the pediatric Glasgow Coma Scale (pGCS) score was E3V4M6, and initial brain computed tomography (CT) was normal...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29344708/treatment-of-combined-traumatic-brain-injury-and-hemorrhagic-shock-with-fractionated-blood-products-versus-fresh-whole-blood-in-a-rat-model
#2
Akiva Leibowitz, Evgeni Brotfain, Leonid Koyfman, Moti Klein, Shmuel Hess, Alexander Zlotnik, Matthew Boyko
INTRODUCTION: Treatment of combined traumatic brain injury and hemorrhagic shock, poses a particular challenge due to the possible conflicting consequences. While restoring diminished volume is the treatment goal for hypovolemia, maintaining adequate cerebral perfusion pressure and avoidance of secondary damage remains a treatment goal for the injured brain. Various treatment modalities have been proposed, but the optimal resuscitation fluid and goals have not yet been clearly defined...
January 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29338544/a-direct-comparison-between-norepinephrine-and-phenylephrine-for-augmenting-spinal-cord-perfusion-in-a-porcine-model-of-spinal-cord-injury
#3
Femke Streijger, Kitty So, Neda Manouchehri, Ana Gheorghe, Elena B Okon, Ryan M Chan, Benjamin Ng, Katelyn Shortt, Mypinder Singh Sekhon, Donald E Griesdale, Brian K Kwon
Current clinical guidelines recommend elevating the mean arterial blood pressure (MAP) to increase spinal cord perfusion in patients with acute spinal cord injury (SCI). This is typically achieved with vasopressors such as norepinephrine (NE) and phenylephrine (PE). These drugs differ in their pharmacologic properties and potentially have different effects on spinal cord blood flow (SCBF), oxygenation (PO2), and downstream metabolism after injury. Using a porcine model of thoracic SCI, we evaluated how these vasopressors influenced intraparenchymal SCBF, PaPO2, hydrostatic pressure, and metabolism within the spinal cord adjacent to the injury site...
January 16, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29332781/pediatric-extracorporeal-cardiopulmonary-resuscitation-patient-with-traumatic-subarachnoid-hemorrhage-and-takotsubo-syndrome
#4
Thomas E Pearson, Meg A Frizzola, Marc A Priest, Monica A Rochman, Curtis D Froehlich
Takotsubo syndrome is rare in pediatric patients but must be considered in patients with subarachnoid hemorrhage with pulmonary edema and cardiomyopathy. A systematic, collaborative approach is needed to facilitate emergent transfer of patients where extracorporeal cardiopulmonary resuscitation (e-CPR) is used as a lifesaving measure. Extracorporeal membrane oxygenation (ECMO) use in transport requires preplanning, role delineation, resources, and research efforts to be successful. We present an unusual transport case of successful e-CPR/ECMO treatment of Takotsubo syndrome in a 12-year-old boy with an isolated traumatic intracranial injury, cardiomyopathy with pulmonary edema, and multiple cardiac arrests...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29330079/impact-of-platelet-transfusion-on-intracerebral-hemorrhage-ich-in-patients-on-antiplatelet-therapy-an-analysis-based-on-ich-score
#5
Gregory D Arnone, Prateek Kumar, Matt C Wonais, Darian R Esfahani, Sally A Campbell-Lee, Fady T Charbel, Sepideh Amin-Hanjani, Ali Alaraj, Andreea Seicean, Ankit I Mehta
OBJECTIVE: Platelet transfusions for intracerebral hemorrhage (ICH) patients on antiplatelet therapy (APT) remain controversial. Diverging past research and differences in platelet preparation warrant further investigation of this topic. In this study, the association between platelet transfusion and clinical outcomes of ICH is investigated in patients matched by ICH score, a validated predictor of mortality. METHODS: A consecutive review of all patients from 2012 to 2015 with non-traumatic ICH was performed...
January 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29328003/characterizing-the-type-and-location-of-intracranial-abnormalities-in-mild-traumatic-brain-injury
#6
Harri Isokuortti, Grant L Iverson, Noah D Silverberg, Anneli Kataja, Antti Brander, Juha Öhman, Teemu M Luoto
OBJECTIVE The incidence of intracranial abnormalities after mild traumatic brain injury (TBI) varies widely across studies. This study describes the characteristics of intracranial abnormalities (acute/preexisting) in a large representative sample of head-injured patients who underwent CT imaging in an emergency department. METHODS CT scans were systematically analyzed/coded in the TBI Common Data Elements framework. Logistic regression modeling was used to quantify risk factors for traumatic intracranial abnormalities in patients with mild TBIs...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29324771/impact-of-grouping-complications-on-mortality-in-traumatic-brain-injury-a-nationwide-population-based-study
#7
Chung-Han Ho, Fu-Wen Liang, Jhi-Joung Wang, Chung-Ching Chio, Jinn-Rung Kuo
Traumatic brain injury (TBI) is an important health issue with high mortality. Various complications of physiological and cognitive impairment may result in disability or death after TBI. Grouping of these complications could be treated as integrated post-TBI syndromes. To improve risk estimation, grouping TBI complications should be investigated, to better predict TBI mortality. This study aimed to estimate mortality risk based on grouping of complications among TBI patients. Taiwan's National Health Insurance Research Database was used in this study...
2018: PloS One
https://www.readbyqxmd.com/read/29303876/optical-coherence-tomography-angiography-description-of-ocular-decompression-retinopathy-after-deep-sclerectomy-in-traumatic-glaucoma
#8
Lauriane Salinas, Ankita Chaudhary, Kaweh Mansouri
PURPOSE: To present a case of ocular decompression retinopathy (ODR) occurring after uncomplicated deep sclerectomy with Mitomycin C using optical coherence tomography angiography (OCTA). PATIENT AND METHOD: Single case report. RESULTS: A 55-year-old man with traumatic glaucoma in the right eye complained of blurred vision. Visual acuity was 20/25 and intraocular pressure (IOP) was 50▒mm Hg. Deep sclerectomy with Mitomycin C was performed...
January 4, 2018: Journal of Glaucoma
https://www.readbyqxmd.com/read/29303451/traumatic-midline-subarachnoid-hemorrhage-on-initial-computed-tomography-as-a-marker-of-severe-diffuse-axonal-injury
#9
Daddy Mata-Mbemba, Shunji Mugikura, Atsuhiro Nakagawa, Takaki Murata, Kiyoshi Ishii, Shigeki Kushimoto, Teiji Tominaga, Shoki Takahashi, Kei Takase
OBJECTIVE The objective of this study was to test the hypothesis that midline (interhemispheric or perimesencephalic) traumatic subarachnoid hemorrhage (tSAH) on initial CT may implicate the same shearing mechanism that underlies severe diffuse axonal injury (DAI). METHODS The authors enrolled 270 consecutive patients (mean age [± SD] 43 ± 23.3 years) with a history of head trauma who had undergone initial CT within 24 hours and brain MRI within 30 days. Six initial CT findings, including intraventricular hemorrhage (IVH) and tSAH, were used as candidate predictors of DAI...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29303442/blossoming-contusions-identifying-factors-contributing-to-the-expansion-of-traumatic-intracerebral-hemorrhage
#10
Joseph A Carnevale, David J Segar, Andrew Y Powers, Meghal Shah, Cody Doberstein, Benjamin Drapcho, John F Morrison, John R Williams, Scott Collins, Kristina Monteiro, Wael F Asaad
OBJECTIVE Traumatic brain injury (TBI) remains a significant cause of neurological morbidity and mortality. Each year, more than 1.7 million patients present to the emergency department with TBI. The goal of this study was to evaluate the prognosis of traumatic cerebral intraparenchymal hemorrhage (tIPH), to develop subclassifications of these injuries that relate to prognosis, and to provide a more comprehensive assessment of hemorrhagic progression contusion (HPC) by analyzing the rate at which tIPH "blossom" (i...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29303440/predictive-value-of-positive-high-sensitivity-troponin-t-in-intubated-traumatic-brain-injury-patients
#11
Ayman El-Menyar, Mohammad Asim, Rifat Latifi, Shrikant I Bangdiwala, Hassan Al-Thani
OBJECTIVE The clinical relevance of high-sensitivity troponin T (HsTnT) in trauma patients is not well explored. In this study, the authors aimed to study the predictive value of serum HsTnT in intubated patients who had sustained traumatic brain injury (TBI). METHODS A retrospective analysis was conducted for all intubated TBI patients between 2010 and 2014 at a national level 1 trauma center. Data were analyzed and compared based on the HsTnT status on admission (group 1, negative results; and group 2, positive results)...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29302799/early-abnormal-transient-hyperemic-response-test-can-predict-delayed-ischemic-neurologic-deficit-in-subarachnoid-hemorrhage
#12
Hosam Al-Jehani, Mark Angle, Judith Marcoux, Jeanne Teitelbaum
BACKGROUND: Early detection of vasospasm is crucial to prevent significant delayed ischemic neurological deficit post subarachnoid hemorrhage. The standard methods of detection, including cerebral angiogram and computed tomography are invasive and not safe to be repeated, as is very often indicated clinically. Transient hyperemic response test has been previously used to predict autoregulation failure in traumatic brain injury and subarachnoid hemorrhage. AIMS: We investigate the usability of transient hyperemic response test as a predictor of clinical vasospasm in a cohort of patients with aneurismal subarachnoid hemorrhage...
January 4, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29298239/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-pelvic-blunt-trauma-and-life-threatening-hemorrhage-a-20-year-experience-in-a-level-i-trauma-center
#13
Audrey Pieper, Frédéric Thony, Julien Brun, Mathieu Rodière, Bastien Boussat, Catherine Arvieux, Jérôme Tonetti, Jean-François Payen, Pierre Bouzat
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used as a non-invasive clamp of the aorta after diverse post-traumatic injuries. Balloon inflation in zone 3 (from the lower renal artery to the aortic bifurcation) can be performed to stop on-going bleeding after severe pelvic trauma with life-threatening hemorrhage. The aim of our study was to describe our 20-year experience with REBOA in terms of efficacy and safety in patients with a suspicion of severe pelvic trauma and extreme hemorrhagic shock...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29290895/falls-from-height-a-retrospective-analysis
#14
Kasim Turgut, Mehmet Ediz Sarihan, Cemil Colak, Taner Güven, Ali Gür, Sükrü Gürbüz
BACKGROUND: Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. METHODS: A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29289804/endovascular-management-of-multiple-dysplastic-aneurysms-in-a-young-male-with-an-unknown-underlying-etiology-a-case-report-and-review-of-the-literature
#15
Tyler Scullen, Mansour Mathkour, Joseph Lockwood, Leah Ott, Ricky Medel, Aaron S Dumont, Peter S Amenta
BACKGROUND: Intracranial aneurysms (IA) are the leading cause of non-traumatic subarachnoid hemorrhage and are most commonly associated with the anterior cerebral artery (ACA) and anterior communicating artery complex. We describe the presentation and management of a 27-year-old male with concurrent bilateral A1-2 junction aneurysms and fusiform intraorbital ophthalmic artery (OA) aneurysms. CASE DESCRIPTION: A 27-year-old male with no past medical history presented with three months of headaches...
December 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29288413/anatomical-and-functional-outcomes-following-vitrectomy-for-dense-vitreous-hemorrhage-related-to-terson-syndrome-in-children
#16
Isil Sayman Muslubas, Murat Karacorlu, Mumin Hocaoglu, Mehmet Giray Ersoz, Serra Arf
PURPOSE: Our purpose was to assess anatomical and functional outcomes of vitrectomy in pediatric cases of Terson syndrome. METHODS: A total of 11 eyes of seven children diagnosed with Terson syndrome secondary to traumatic brain injury and 17 eyes of 12 children diagnosed with Terson syndrome secondary to nontraumatic brain hemorrhage who had 20-gauge or 23-gauge pars plana or pars plicata vitrectomy were included in this retrospective study. The primary outcome was the change in visual acuity from the preoperative examination to postoperative final follow-up...
December 29, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29287058/activities-of-the-thor-aabb-working-party
#17
Mark H Yazer, Philip C Spinella
The AABB (formerly the American Association of Blood Banks) is an international authority on transfusion medicine and tissue banking. The Trauma, Hemostasis and Oxygenation Research (THOR) Network is an international multidisciplinary network of civilian and military providers ranging from first responders and medics to critical care physicians, and from basic scientists to clinical trialists. The THOR Network's vision is to improve outcomes from traumatic hemorrhagic shock by optimizing the acute phase of resuscitation...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29285499/prediction-models-to-advance-individualized-resuscitation-in-trauma-hemorrhage-and-acute-traumatic-coagulopathy-atc-even-the-longest-journey-starts-with-first-steps-lao-tzu-chinese-philosopher
#18
EDITORIAL
https://www.readbyqxmd.com/read/29282438/management-of-unruptured-traumatic-middle-meningeal-artery-pseudoaneurysms-through-onyx-embolization
#19
Nicolas K Khattar, Andrew C White, Enzo M Fortuny, Rob T Hruska, Robert F James
Traumatic pseudoaneurysms of the middle meningeal artery (MMA) represent less than 1% of all intracranial aneurysms, and occur mostly in association with temporal bone fractures following head trauma. Given the unknown natural history, it is unclear whether they should be treated. We present two cases of MMA pseudoaneurysms discovered during trauma workups. The first patient is a 44-year-old male with severe traumatic brain injury (TBI) following a motor vehicle accident. The patient was found to have two right-sided middle meningeal artery pseudoaneurysms that were treated successfully with Onyx® (Medtronic, Minneapolis, MN) embolization...
October 23, 2017: Curēus
https://www.readbyqxmd.com/read/29282400/diagnostic-and-therapeutic-approach-in-a-case-of-severe-post-traumatic-hyphema-with-subtotal-iridodialysis
#20
Filippo Romanazzi, Anna Morano, Antonio Caccavale
Purpose: To report our diagnostic ultrasound-based approach and surgical strategy in a case of severe blunt trauma with complete hyphema, 270° iris disinsertion, and traumatic subluxated cataract. Case Report: A 70-year-old male was referred to our hospital for a blunt trauma in his right eye. A complete examination revealed visual acuity consisting in light perception, a complete hyphema, and an intraocular pressure of 45 mm Hg with moderate pain. Our diagnostic approached was ultrasound based with B-scan examination showing some vitreous hemorrhage and ultrasound biomicroscopy showing a large iris disinsertion of 270° with the iris entirely dislocated in the inferior sector of the anterior chamber...
September 2017: Case Reports in Ophthalmology
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