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brain gunshot

N R Zembower, A Zhu, M Malczynski, C Qi
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the prevalence of brain and spinal cord injury (BSCI) patients among all patients with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) and to evaluate clinical characteristics and duration of colonization. SETTING: Tertiary care academic medical center. METHODS: Electronic medical records of BSCI patients with KPC-KP from February 2009 to December 2014 were reviewed to determine clinical characteristics...
October 18, 2016: Spinal Cord
Yoshua Esquenazi, Giridhar P Kalamangalam, Omotola A Hope, Sonia N Krish, Jeremy Slater, Nitin Tandon
OBJECTIVE: The surgical management of epilepsy following penetrating gunshot wounds (GSWs) to the head has not been described in the modern; era. Given the extensive damage to the cranium and cortex from such; injuries, the safety and efficacy of surgical intervention is unclear. We; report the surgical strategy and outcomes following resections for; medically refractory epilepsy following GSWs in four patients. METHODS: A prospectively compiled database of 325 epilepsy patients was used to identify patients undergoing epilepsy surgery for medically; refractory epilepsy following a GSW to the brain...
August 18, 2016: World Neurosurgery
Jonathan P Meizoso, Juliet J Ray, Charles A Karcutskie, Casey J Allen, Tanya L Zakrison, Gerd D Pust, Tulay Koru-Sengul, Enrique Ginzburg, Louis R Pizano, Carl I Schulman, Alan S Livingstone, Kenneth G Proctor, Nicholas Namias
INTRODUCTION: Timely hemorrhage control is paramount in trauma; however, a critical time interval from emergency department arrival to operation for hypotensive gunshot wound (GSW) victims is not established. We hypothesize that delaying surgery for more than 10 minutes from arrival increases all-cause mortality in hypotensive patients with GSW. METHODS: Data of adults (n = 309) with hypotension and GSW to the torso requiring immediate operation from January 2004 to September 2013 were retrospectively reviewed...
October 2016: Journal of Trauma and Acute Care Surgery
Kadhaya David Muballe, Timothy Hardcastle, Erastus Kiratu
OBJECTIVES Penetrating traumatic brain injuries (TBIs) can be divided into gunshot wounds or stab wounds based on the mechanisms of injury. Pediatric penetrating TBIs are of major concern as many parental and social factors may be involved in the causation. The authors describe the penetrating cranial injuries in pediatric patient subgroups at risk and presenting to the Department of Neurosurgery at the University of KwaZulu-Natal, by assessment of the Glasgow Coma Scale (GCS) score and review of the common neurological manifestations including cranial nerve abnormalities...
July 29, 2016: Journal of Neurosurgery. Pediatrics
V P Orlov
The paper presents a comparative evaluation of the methods of gunshot craniocerebral wounds draining, applied when the primary surgical treatment at the stages of medical evacuation of the limited contingent of Soviet troops in Afghanistan. An analysis of occurring infectious complications and outcomes of surgical treatment of the wounded is given. Based on clinical observations revealed most effective method of the active drainage gunshot traumatic brain injuries. The advantages of tidal drainage, appropriate for mechanical cleaning of wounds, allows controlling hemostasis, using antibacterial solutions are given...
April 2016: Voenno-medit︠s︡inskiĭ Zhurnal
Matthew L Pearn, Ingrid R Niesman, Junji Egawa, Atsushi Sawada, Angels Almenar-Queralt, Sameer B Shah, Josh L Duckworth, Brian P Head
Traumatic brain injury (TBI) is one of the leading causes of death of young people in the developed world. In the United States alone, 1.7 million traumatic events occur annually accounting for 50,000 deaths. The etiology of TBI includes traffic accidents, falls, gunshot wounds, sports, and combat-related events. TBI severity ranges from mild to severe. TBI can induce subtle changes in molecular signaling, alterations in cellular structure and function, and/or primary tissue injury, such as contusion, hemorrhage, and diffuse axonal injury...
July 6, 2016: Cellular and Molecular Neurobiology
Nikola Dragojlovic, Argyrios Stampas, Ryan S Kitagawa, Karl M Schmitt, William Donovan
: Hydrocephalus is a rare complication of traumatic spine injury. A literature review reflects the rare occurrence with cervical spine injury. We present a case of traumatic injury to the lumbar spine from a gunshot wound, which caused communicating hydrocephalus. The patient sustained a gunshot wound to the lumbar spine and had an L4-5 laminectomy with exploration and removal of foreign bodies. At the time of surgery, the patient was found to have dense subarachnoid hemorrhage in the spinal column. He subsequently had intermittent headaches and altered mental status that resolved without intervention...
June 17, 2016: American Journal of Physical Medicine & Rehabilitation
R Michael Meyer, M Benjamin Larkin, Nicholas S Szuflita, Chris J Neal, Jeffrey M Tomlin, Rocco A Armonda, Jeffrey A Bailey, Randy S Bell
OBJECTIVE Traumatic brain injury (TBI) is independently associated with deep vein thrombosis (DVT) and pulmonary embolism (PE). Given the numerous studies of civilian closed-head injury, the Brain Trauma Foundation recommends venous thromboembolism chemoprophylaxis (VTC) after severe TBI. No studies have specifically examined this practice in penetrating brain injury (PBI). Therefore, the authors examined the safety and effectiveness of early VTC after PBI with respect to worsening intracranial hemorrhage and DVT or PE...
June 17, 2016: Journal of Neurosurgery
Hernando Raphael Alvis-Miranda, Roberto Adie Villafañe, Alejandro Rojas, Gabriel Alcala-Cerra, Luis Rafael Moscote-Salazar
Craniocerebral gunshot injuries (CGI) are increasingly encountered by neurosurgeons in civilian and urban settings. Unfortunately this is a prevalent condition in developing countries, with major armed conflicts which is not very likely to achieve a high rate of prevention. Management goals should focus on early aggressive, vigorous resuscitation and correction of coagulopathy; those with stable vital signs undergo brain computed tomography scan. Neuroimaging is vital for surgical purposes, especially for determine type surgery, size and location of the approach, route of extraction of the foreign body; however not always surgical management is indicated, there is also the not uncommon decision to choose non-surgical management...
October 2015: Korean Journal of Neurotrauma
Ninh Doan, Mohit Patel, Ha Son Nguyen, Andrew Montoure, Saman Shabani, Michael Gelsomino, Karl Janich, Wade Mueller
The gunshot wound to the head (GSWH) is associated with a mortality rate of 20-90% in adults and 20-65% in the pediatric population. Due to the high rates of mortality and morbidity, the management of these patients has been a topic of high interest in the neurosurgical community. We present an 18-year-old male suffering a GSWH with the bullet following a transventricular trajectory and crossing the midsagittal plane, creating extensive intracranial injuries. Despite a calculated mortality rate of >97% from these devastating injuries, the patient survived the GSWH and made a remarkable recovery...
2016: Journal of Surgical Case Reports
Stephanie Zyck, Gentian Toshkezi, Satish Krishnamurthy, David A Carter, Adnan Siddiqui, Ali Hazama, Mayur Jayarao, Lawrence Chin
INTRODUCTION: Penetrating traumatic brain injuries (TBIs), with the exception of gunshot wounds, are relatively rare occurrences and affect all ages. Clinical presentation varies depending on the mechanism of the injury. Prompt surgical treatment is often indicated and is influenced by patient clinical examination, anatomic trajectory, and the penetrating object's size, shape, and velocity. METHODS: We present 3 cases of penetrating TBI. Their similarities and differences affecting operative and medical management are compared...
July 2016: World Neurosurgery
A A Potapov, V V Krylov, A G Gavrilov, A D Kravchuk, L B Likhterman, S S Petrikov, A E Talypov, N E Zakharova, A A Solodov
Traumatic brain injury (TBI) is one of the main causes of mortality and severe disability in young and middle age patients. Patients with severe TBI, who are in coma, are of particular concern. Adequate diagnosis of primary brain injuries and timely prevention and treatment of secondary injury mechanisms markedly affect the possibility of reducing mortality and severe disability. The present guidelines are based on the authors' experience in developing international and national recommendations for the diagnosis and treatment of mild TBI, penetrating gunshot wounds of the skull and brain, severe TBI, and severe consequences of brain injury, including a vegetative state...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
A A Potapov, V V Krylov, A G Gavrilov, A D Kravchuk, L B Likhterman, S S Petrikov, A E Talypov, N E Zakharova, A V Oshorov, A A Sychev, E V Aleksandrova, A A Solodov
Traumatic brain injury (TBI) is one of the major causes of death and disability in young and middle-aged people. The most problematic group is comprised of patients with severe TBI who are in a coma. The adequate diagnosis of primary brain injuries and timely prevention and treatment of the secondary injury mechanisms largely define the possibility of reducing mortality and severe disabling consequences. When developing these guidelines, we used our experience in the development of international and national recommendations for the diagnosis and treatment of mild traumatic brain injury, penetrating gunshot wounds to the skull and brain, severe traumatic brain injury, and severe consequences of brain injuries, including a vegetative state...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
A A Potapov, V V Krylov, A G Gavrilov, A D Kravchuk, L B Likhterman, S S Petrikov, A E Talypov, N E Zakharova, A V Oshorov, A A Solodov
Traumatic brain injury is one of the main causes of mortality and disability in young and middle-aged individuals. The patients with severe traumatic brain injury who are in coma are the most difficult to deal with. Appropriate diagnosis of the primary brain injuries and early prevention and treatment of secondary damage mechanisms largely determine the possibility of reducing mortality and severe disabling consequences. The authors compiled these guidelines based on their experience in development of international and Russian recommendations on the diagnosis and treatment of mild traumatic brain injury, penetrating gunshot injury of the skull and brain, severe traumatic brain injury, and severe consequences of brain injuries, including a vegetative state...
2015: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Michael DeCuypere, Michael S Muhlbauer, Frederick A Boop, Paul Klimo
OBJECTIVE Penetrating brain injury in civilians is much less common than blunt brain injury but is more severe overall. Gunshot wounds (GSWs) cause high morbidity and mortality related to penetrating brain injury; however, there are few reports on the management and outcome of intracranial GSWs in children. The goals of this study were to identify clinical and radiological factors predictive for death in children and to externally validate a recently proposed pediatric prognostic scale. METHODS The authors conducted a retrospective review of penetrating, isolated GSWs sustained in children whose ages ranged from birth to 18 years and who were treated at 2 major metropolitan Level 1 trauma centers from 1996 through 2013...
May 2016: Journal of Neurosurgery. Pediatrics
T L Sampaio, I P Rodrigues, D F S Pontes, T K G Ribeiro, C K Yamagushi, W N de Araújo, S N Báo
Trauma is a leading cause of death and disability worldwide. Corneal tissue donors generally are those who suffered an injury to the brain or fatal trauma caused by stroke, vehicle/motorbike accidents, gunshot wounds, and drowning or cardiovascular death. In Brazil, the Distrito Federal (DF) Eye Bank, located within a trauma center hospital, and the Secretariat of Public Security have collaborated with the aim of increasing the overall number of cornea donations from fatal trauma victims. The purpose of this study was to determine the suitability of cornea tissue for transplantation derived from trauma-related death...
December 2015: Transplantation Proceedings
Kristine H O'Phelan, Amedeo Merenda, Katherine G Denny, Kassandra E Zaila, Cynthia Gonzalez
AIM: To examine complications associated with the use of therapeutic temperature modulation (mild hypothermia and normothermia) in patients with severe traumatic brain injury (TBI). METHODS: One hundred and fourteen charts were reviewed. Inclusion criteria were: severe TBI with Glasgow Coma Scale (GCS) < 9, intensive care unit (ICU) stay > 24 h and non-penetrating TBI. Patients were divided into two cohorts: the treatment group received therapeutic temperature modulation (TTM) with continuous surface cooling and indwelling bladder temperature probes...
November 4, 2015: World Journal of Critical Care Medicine
José D Charry, Andrés M Rubiano, Juan C Puyana, Nancy Carney, P David Adelson
INTRODUCTION: Gunshot wounds to the head are more common in military settings. Recently, a damage control (DC) approach for the management of these lesions has been used in combat areas. The aim of this study was to evaluate the results of civilian patients with penetrating gunshot wounds to the head, managed with a strategy of early cranial decompression (ECD) as a DC procedure in a university hospital with few resources for intensive care unit (ICU) neuro-monitoring in Colombia. MATERIALS AND METHODS: Fifty-four patients were operated according to the DC strategy (<12 h after injury), over a 4-year period...
2016: British Journal of Neurosurgery
Sardar Bahadur, E McGilloway, J Etherington
INTRODUCTION: Injury Severity Score (ISS) and GCS can be retrospective markers of injury severity, but if used by clinicians to decide on the treatment of acutely brain-injured casualties at the point of injury may potentially limit interventions on people who may ultimately survive with good functional outcomes. METHODS: ISS/GCS and long-term outcomes were reviewed by assessing all UK military neurorehabilitation patients with an operational/combat brain injury treated over 4 years (February 2008-July 2012) at Defence Medical Rehabilitation Centre (Headley Court)...
April 2016: Journal of the Royal Army Medical Corps
M İçer, Y Zengin, R Dursun, H M Durgun, C Göya, I Yıldız, C Güloğlu
PURPOSE: To explore the effect of admission physical examination findings, anamnesis, and computed tomography on dural penetration and prognosis in patients with cranial gunshot wound (CGW). METHODS: In this study, the medical data of 56 subjects who were admitted to the Emergency Department of Dicle University Hospital with CGWs between January 2011 and December 2013 were retrospectively reviewed. The effects of type of incident (suicidal vs non-suicidal), pupil diameter and light reflex, hemodynamic status, type (bullet or pellet), velocity, trajectory of foreign material, trauma scores, and imaging findings on dural penetration and mortality were explored...
August 21, 2015: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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