Imaging of Traumatic Vascular Neck Injuries

ABSTRACT Introduction Military trauma registries can identify broad epidemiological trends from neck wounds but cannot reliably demonstrate temporal casualty from clinical interventions or differentiate penetrating neck injuries (PNI) from those that do not breach platysma. Materials and Methods All casualties presenting with a neck wound to a Role 3 Medical Treatment Facility in Afghanistan between January 1, 2016 and September 15, 2019 were retrospectively identified using the Emergency Room database. These were matched to records from the Operating Room database, and computed tomography (CT) scans reviewed to determine damage to the neck region. Results During this period, 78 casualties presented to the Emergency Room with a neck wound. Forty-one casualties underwent surgery for a neck wound, all of whom had a CT scan. Of these, 35/41 (85%) were deep to platysma (PNI). Casualties with PNI underwent neck exploration in 71% of casualties (25/35), with 8/25 (32%) having surgical exploration at Role 2 where CT is not present. Exploration was more likely in Zones 1 and 2 (8/10, 80% and 18/22, 82%, respectively) compared to Zone 3 (2/8, 25%). Conclusion Hemodynamically unstable patients in Zones 1 and 2 generally underwent surgery before CT, confirming that the low threshold for exploration in such patients remains. Only 25% (2/8) of Zone 3 PNI were explored, with the high negative predictive value of CT angiography providing confidence that it was capable of excluding major injury in the majority of cases. No deaths from PNI that survived to treatment at Role 3 were identified, lending evidence to the current management protocols being utilized in Afghanistan.

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Postmortem Radiology of Head and Neck Injuries in Fatal Traffic Accidents

Radiology ◽

10.1148/114.3.611 ◽

1975 ◽

Vol 114 (3) ◽

pp. 611-617 ◽

Cited By ~ 103

Author(s):

George J. Aiker ◽

Young S. Oh ◽

Eugene V. Leslie ◽

Judith Lehotay ◽

Victor A. Panaro ◽

...

Keyword(s):

Head And Neck ◽

Traffic Accidents ◽

Neck Injuries

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Job strain, iso-strain, and the incidence of low back and neck injuries. A 7.5-year prospective study of San Francisco transit operators

Social Science & Medicine ◽

10.1016/j.socscimed.2004.11.042 ◽

2005 ◽

Vol 61 (1) ◽

pp. 27-39 ◽

Cited By ~ 50

Author(s):

Reiner Rugulies ◽

Niklas Krause

Keyword(s):

Prospective Study ◽

San Francisco ◽

Job Strain ◽

Low Back ◽

Neck Injuries

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Feel the Burn! Fireworks-related Otolaryngologic Trauma

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211008100 ◽

2021 ◽

pp. 000348942110081

Author(s):

Alexander J. Straughan ◽

Luke J. Pasick ◽

Vrinda Gupta ◽

Daniel A. Benito ◽

Joseph F. Goodman ◽

...

Keyword(s):

United States ◽

Head And Neck ◽

Emergency Departments ◽

Closed Head Injury ◽

Penetrating Trauma ◽

The United States ◽

Neck Injuries ◽

Chi Square ◽

Injury Surveillance System ◽

Cross Sectional

Objectives: Fireworks are used commonly for celebrations in the United States, but can lead to severe injury to the head and neck. We aim to assess the incidence, types, and mechanisms of head and neck injuries associated with fireworks use from 2010 to 2019. Methods: A retrospective cross-sectional study, using data from the National Electronic Injury Surveillance System, of individuals presenting to United States Emergency Departments with head and neck injuries caused by fireworks and flares from 2010 to 2019. Incidence, types, and mechanisms of injury related to fireworks use in the US population were assessed. Results: A total of 541 patients (349 [64.5%] male, and 294 [54%] under 18 years of age) presented to emergency departments with fireworks-related head and neck injuries; the estimated national total was 20 584 patients (13 279 male, 9170 white, and 11 186 under 18 years of age). The most common injury diagnoses were burns (44.7% of injuries), laceration/avulsion/penetrating trauma (21.1%), and otologic injury (15.2%), which included hearing loss, otalgia, tinnitus, unspecified acoustic trauma, and tympanic membrane perforation. The remaining 19% of injuries were a mix, including contusion, abrasion, hematoma, fracture, and closed head injury. Associations between fireworks type and injury diagnosis (chi-square P < .001), as well as fireworks type by age group (chi-square P < .001) were found. Similarly, associations were found between age groups and injury diagnoses (chi-square P < .001); these included children 5 years and younger and adults older than 30 years. Conclusions: Fireworks-related head and neck injuries are more likely to occur in young, white, and male individuals. Burns are the most common injury, while otologic injury is a significant contributor. Annual rates of fireworks-related head and neck injuries have not changed or improved significantly in the United States in the past decade, suggesting efforts to identify and prevent these injuries are insufficient.

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