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Cerebral Contusion

Susan Yoong, Ravi Kothari, Adam Brooks
INTRODUCTION: Whole body computed tomography has become standard practice in many centres in the management of severely injured trauma patients, however, the evidence for it's diagnostic accuracy is limited. AIM: To assess the sensitivity of whole body CT in major trauma. METHOD: Retrospective review of all patients with injury severity score (ISS) > 15 presenting with blunt trauma to a UK Major Trauma Centre between May 2012 and April 2014...
March 8, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Yasutaka Kobayashi
A 67-year-old woman was hospitalized for rehabilitation from the after effects of a traumatic brain injury. In addition to memory impairment, attention disorder, and executive dysfunction, she experienced musical hallucinations. Brain magnetic resonance imaging revealed cerebral contusion in the bilateral temporal lobes and the left frontal lobe. Case reports of musical hallucinations caused by traumatic brain injury are extremely rare.
January 2018: Case Reports in Neurology
Chien-En Tang, Hang-Tsung Liu, Pao-Jen Kuo, Yi-Chun Chen, Shiun-Yuan Hsu, Chih-Che Lin, Ching-Hua Hsieh
The Osteoporosis Self-assessment Tool for Asians (OSTA) is a validated index based on age and weight to predict the risk of osteoporosis in women. This cross-sectional study was designed to evaluate the impact of sexual dimorphism on the trauma patterns and the clinical outcomes of patients with high-risk OSTA scores. Trauma data of patients with high-risk OSTA scores between 1 January 2009 and 31 December 2015 were retrieved from the trauma registry system of a level I trauma center. A total of 2248 patients including 1585 women and 663 men were included in this study...
February 27, 2018: International Journal of Environmental Research and Public Health
Louise Vera Hilmer, Kee Bum Park, Iv Vycheth, Michael Wirsching
Introduction: Cerebral contusions are a common type of injury among the Cambodian population, mostly due to road traffic accidents. This article aims to assess various aspects around brain contusion focusing on the condition at admission, residing province, mechanism and time of injury, age and sex distribution with differing helmet wearing, and alcohol consumption patterns. Hospitalization-related data such as treatment and outcome were analyzed. Methods: This was a retrospective analysis of 406 cases who have been admitted during the period between May 2013 and May 2016...
January 2018: Asian Journal of Neurosurgery
Monique Sieber, Jan Dreßler, Heike Franke, Dirk Pohlers, Benjamin Ondruschka
PURPOSE: Traumatic brain injury (TBI) is a very common entity that leads to numerous fatalities all over the world. Therefore, forensic pathologists are in desperate need of supplemental methodological tools for the diagnosis of TBI in everyday practice besides the standard autopsy. The present study determined post-mortem neuron specific enolase (NSE) and S100 calcium-binding protein B (S100B) levels as biological markers of an underlying TBI in autopsy cases. METHODS: Paired serum and CSF samples of 92 fatalities were collected throughout routine autopsies...
February 14, 2018: Journal of Forensic and Legal Medicine
Supawon Srettabunjong
Septic cavernous sinus thrombosis (SCST) is an uncommon consequence of head and face infection, but a rare complication after craniofacial fracture. In this case, SCST developed in a 13-year-old girl following a minor fall during volleyball, with impact and resulting abrasive contusion of the left forehead. She developed watery rhinorrhea, progressive headache, fever, nausea, vomiting, and left proptosis with blurred vision, and was admitted to hospital 3 days after injury. Drowsiness, high-grade fever, severe headache, left ocular pain with marked periorbital swelling, and paralysis of extraocular eye movements developed...
February 21, 2018: Journal of Forensic Sciences
U K Bodanapally, K Shanmuganathan, G Issa, D Dreizin, L Guang, K Sudini, T R Fleiter
BACKGROUND AND PURPOSE: In patients with hemorrhagic contusions, hematoma volumes are overestimated on follow-up standard 120-kV images obtained after contrast-enhanced whole-body CT. We aimed to retrospectively determine hemorrhagic progression of contusion rates on 120-kV and 190-keV images derived from dual-energy CT and the magnitude of hematoma volume overestimation. MATERIALS AND METHODS: We retrospectively analyzed admission and follow-up CT studies in 40 patients with hemorrhagic contusions...
February 8, 2018: AJNR. American Journal of Neuroradiology
Daiana De Blasio, Stefano Fumagalli, Franca Orsini, Laura Neglia, Carlo Perego, Fabrizio Ortolano, Elisa R Zanier, Edoardo Picetti, Marco Locatelli, Nino Stocchetti, Luca Longhi, Peter Garred, Maria-Grazia De Simoni
We explored the involvement of the lectin pathway of complement in post-traumatic brain injury (TBI) pathophysiology in humans. Brain samples were obtained from 28 patients who had undergone therapeutic contusion removal, within 12 h (early) or from >12 h until five days (late) from injury, and from five non-TBI patients. Imaging analysis indicated that lectin pathway initiator molecules (MBL, ficolin-1, ficolin-2 and ficolin-3), the key enzymes MASP-2 and MASP-3, and the downstream complement components (C3 fragments and TCC) were present inside and outside brain vessels in all contusions...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
Takeshi Kondo, Motonori Takahashi, Azumi Kuse, Mai Morichika, Kanako Nakagawa, Yoshihiro Tagawa, Tomoya Taniguchi, Yuji Taguchi, Tomohiro Fujiwara, Junpei Tsuchiya, Masahiko Nakamura, Makoto Sakurada, Migiwa Asano, Yasuhiro Ueno
A crossbow is a bow that shoots an arrow when a gun-like trigger is pulled. Deaths caused by accidental crossbow shootings are extremely rare. Here we describe an autopsy case of a penetrating wound to the left cerebral hemisphere caused by an accidental shooting with a crossbow. A man in his early 60s who lived with his wife and had used crossbows for 20 years as his hobby was found one early morning in the shed of his house, collapsed and bleeding from the head and neck. He was taken to a hospital and died after approximately 3 days of conservative treatment...
February 2, 2018: American Journal of Forensic Medicine and Pathology
Janet D Pierce, Raeesa Gupte, Amanda Thimmesch, Qiuhua Shen, John B Hiebert, William M Brooks, Richard L Clancy, Francisco J Diaz, Janna L Harris
Following traumatic brain injury (TBI), there is significant secondary damage to cerebral tissue from increased free radicals and impaired mitochondrial function. This imbalance between reactive oxygen species (ROS) production and the effectiveness of cellular antioxidant defenses is termed oxidative stress. Often there are insufficient antioxidants to scavenge ROS, leading to alterations in cerebral structure and function. Attenuating oxidative stress following a TBI by administering an antioxidant may decrease secondary brain injury, and currently many drugs and supplements are being investigated...
January 30, 2018: Journal of Neuroscience Research
Daiichiro Ishigami, Takahiro Ota
Traumatic intracranial aneurysms are one possible complication after penetrating brain injury. A 25-year-old man with a history of major depression presented with a crossbow bolt penetrating the head. On arrival, Glasgow Coma Scale score was E4V5M6, with no apparent neurological deficit. Computed tomography (CT) of the head showed the crossbow bolt passing near the corpus callosum, with surrounding contusion. Three-dimensional rotational angiography showed no anterior cerebral artery injuries. The crossbow bolt was removed after bifrontal craniotomy, with no postoperative infection...
January 2018: NMC Case Report Journal
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
Y Chu, G X Han, Y Q Wang, H Y Shan, X P Chen, L Y Tao, M Y Zhang
OBJECTIVES: To observe the changes of cystathionine β-synthase (CBS) expression in the cerebral cortex after brain contusion at different times. METHODS: An experimental model of traumatic brain injury (TBI) in mice was established by an improved weight-drop device. Then Western blotting and immunohistochemical examination were used to detect the CBS expression in cerebral cortex around injury at different time points (1 h, 6 h, 12 h, 1 d, 2 d, 3 d, 7 d)...
June 2017: Fa Yi Xue za Zhi
Hung-Jung Lin, Chien-Chin Hsu, Chung-Ching Chio, Yu-Feng Tian, Mao-Tsun Lin, Ting-Wei Lin, Chih-Hsien Chang, Ching-Ping Chang
BACKGROUND/AIMS: In response to traumatic brain injury (TBI), activated microglia exhibit changes in their morphology from the resting ramified phenotype toward the activated hypertrophic or amoeboid phenotype. Here, we provide the first description of the mechanism underlying the neuroprotective effects of γ-secretase inhibitors on TBI outcomes in rats. METHODS: The neuroprotective effects of γ-secretase inhibitors such as LY411575 or CHF5074 on TBI-induced neurotoxicity were analysed using a neurological motor function evaluation, cerebral contusion assay, immunohistochemical staining for microglia phenotypes, lung injury score and Evans Blue dye extravasation assay of brain and lung oedema...
2017: Cellular Physiology and Biochemistry
Jose A Fernández-Abinader, Karolyn González-Colón, Caleb E Feliciano, Ana María Mosquera-Soler
OBJECTIVE: Describe the types of traumatic brain injury secondary to falls sustained by the members of an elderly population who received services at the Puerto Rico Medical Center and the demographic profile of that population. METHODS: A group of 332 adults (60 years and over) assessed for traumatic brain injury secondary to falls suffered in 2013 were included in the analysis. The cases were retrieved from the computerized database of the Neurosurgery Section...
December 2017: Puerto Rico Health Sciences Journal
Kutluay Uluc, Ulas Cikla, Deniz B Morkan, Alperen Sirin, Azam S Ahmed, Kyle Swanson, Mustafa K Baskaya
BACKGROUND: In contemporary microneurosurgery reducing retraction-induced injury to the brain is essential. Self-retaining retractor systems are commonly used to improve visualization and decrease the repetitive microtrauma, but sometimes self-retaining retractor systems can be cumbersome and the force applied can cause focal ischemia or contusions. This may increase the morbidity and mortality. Here, we describe a technique of retraction using 10-0 sutures in the arachnoid. OBJECTIVE: To evaluate the imaging and clinical results in patients where 10-0 suture retraction was used to aid the surgical procedure...
September 19, 2017: Operative Neurosurgery (Hagerstown, Md.)
Tomoki Ishigaki, Yotaro Kitano, Hirofumi Nishikawa, Genshin Mouri, Shigetoshi Shimizu, Fumitaka Miya, Hidenori Suzuki
Post-traumatic pituitary apoplexy is uncommon, most of which present with a sudden onset of severe headache and visual impairments associated with a dumbbell-shaped pituitary tumor. We experienced an unusual case of post-traumatic pituitary apoplexy with atypical clinical features. A 66-year-old man presented with mild cerebral contusion and an incidentally diagnosed intrasellar tumor after a fall accident with no loss of consciousness. The patients denied any symptoms before the accident. After 4 days, the left oculomotor nerve palsy developed and deteriorated associated with no severe headache...
2017: Clinical Medicine Insights. Case Reports
Yusuke Watanabe, Kenichi Sakakura, Naoyuki Akashi, Mami Ishikawa, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Hideo Fujita, Shin-Ichi Momomura
While most of pulmonary thromboembolism (PE) cases can be managed by thrombolytic and anticoagulation therapy, massive PE remains a life-threatening disease. Although surgical embolectomy can be a curative therapy for massive PE, peri-operative mortality for hemodynamically collapsed PE is extremely high. We present a case of hemodynamically collapsed massive PE. We avoided either thrombolytic therapy or surgical embolectomy, because the patient had recent cerebral contusion. Therefore, we managed the patient with the combination of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and conventional anticoagulation, which dramatically improved the patient's hemodynamics...
October 21, 2017: International Heart Journal
Yosuke Akamatsu, Tohru Sasaki, Masayuki Kanamori, Shinsuke Suzuki, Hiroshi Uenohara, Teiji Tominaga
Delayed neurological deterioration following mild head injury(MHI)usually occurs within 24 hours. However, some cases require delayed surgical evacuation of an acute subdural hematoma(ASDH), owing to subacute progressive hematoma enlargement. This study aimed to determine radiological or clinical parameters associated with surgical intervention in ASDH cases in which surgery was not initially considered necessary. From 2010 to 2015, 64 patients were non-surgically treated for ASDH following MHI. We evaluated the various outcomes of eventual surgical ASDH evacuation after the first 48 hours following injury, due to hematoma enlargement and clinical deterioration...
September 2017: No Shinkei Geka. Neurological Surgery
Dennis Oepen, Tim Fleiner, Andrés Oliva Y Hausmann, Susanne Zank, Wiebren Zijlstra, Peter Haeussermann
Fall rates from 3.2 to 17.1 falls per 1,000 hospital days in geriatric psychiatry facilities have been reported to date. Up to 5% of the falls result in severe injuries, but data concerning medical consequences are scare. This brief report presents a retrospective analysis of one year fall protocols from a geriatric psychiatry department focusing on consequences of falls. Fall-induced injuries were rated in four categories: no injuries, mild injuries (contusions, hematomas, abrasions), moderate injuries (lacerations, dislocations), and severe injuries (fractures, cerebral hemorrhages)...
September 18, 2017: International Psychogeriatrics
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