scholarly journals A Systematic Review of Earthquake-Related Head Injuries

2019 ◽  
Vol 34 (s1) ◽  
pp. s171-s171 ◽  
Author(s):  
Yutaka Igarashi ◽  
Narumi Matsumoto ◽  
Tatsuhiko Kubo ◽  
Ryuta Nakae ◽  
Shoji Yokobori ◽  
...  
Keyword(s):  
Systematic Review ◽  
Head Injury ◽  
Soft Tissue ◽  
Intracranial Hemorrhage ◽  
Epidural Hematoma ◽  
Tissue Injury ◽  
Head Injuries ◽  
Soft Tissue Injury ◽  
Cochrane Library ◽  
Mortality And Morbidity

Introduction:Earthquakes have killed around 800,000 people globally in the past 20 years, with head injury being the main cause of mortality and morbidity.Aim:To conduct a systematic review to determine the characteristics of head injuries after earthquakes for better disaster preparedness and management.Methods:All publications related to head injuries and earthquakes were searched using Pubmed, Web of Science, the Cochrane Library, and Ichushi.Results:Thirty-six articles were included in the analysis. Head injury was the third most common cause of injury among survivors of earthquakes. The most common injury after an earthquake occurred was in the lower extremities (36.2%), followed by the upper extremities (19.9%), head (16.6%), spine (13.3%), chest (11.3%), and abdomen (3.8%). Earthquake-related head injuries were predominantly caused by a blunt strike (79%), and were more frequently associated with soft tissue injury compared to non-earthquake-related head injuries and less frequently with intracranial hemorrhage. The mean age of patients with earthquake-related head injuries was 32.6 years, and 55.1% of sufferers were male. The most common earthquake-related head injury was laceration or contusion (59.2%) while epidural hematoma was most common among inpatients with intracranial hemorrhage after an earthquake (9.5%). Early wound irrigation and debridement and antibiotics administration are needed to decrease the risk of infection. Mortality due to earthquake-related head injuries was 5.6%.Discussion:Head injury was the main cause of mortality and morbidity after an earthquake. The characteristics of earthquake-related head injuries differed from those of non-earthquake-related head injuries, including the frequency of multiple injuries, and occurrence of contaminated soft tissue injury and epidural hematoma. This knowledge is important for determining demands for neurosurgery and for adequate management of patients, especially in resource-limited conditions.

scholarly journals O40: PRE-OPERATIVE MANAGEMENT AND SENSITISATION IN VASCULARIZED COMPOSITE ALLOTRANSPLANTATION: A SYSTEMATIC REVIEW

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
L Geoghegan ◽  
M Al-Khalil ◽  
A Scarborough ◽  
A Murray ◽  
F Issa
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Tissue Injury ◽  
Management Strategies ◽  
Soft Tissue Injury ◽  
Operative Management ◽  
Hla Antibodies ◽  
Appropriate Care ◽  
Reconstructive Transplantation ◽  
Early Appropriate Care

Abstract Introduction Vascularised composite allotransplantation (VCA) permits like-for-like reconstruction following extensive soft tissue injuries. The initial management of extensive soft tissue injury can lead to the development of anti-HLA antibodies through injury, transfusion and cadaveric grafting. The role of antibody-mediated rejection, donor-specific antibodies and graft rejection in the context of VCA remains unclear. This systematic review aimed to determine whether pre-operative management strategies influence immunological outcome following VCA. Method A systematic review of MEDLINE, EMBASE and CINAHL using a PRISMA-compliant methodology up to February 2019 was conducted. Pre-operative, procedural and long-term outcome data were collected and recorded for all VCA recipients on an individual patient basis. Result The search revealed 3,847 records of which 114 met inclusion criteria and reported clinical data related to 100 patients who underwent 129 VCA transplants. Trauma (50%) and burns (15%) were the most frequent indications for VCA. Of all 114 studies, only one reported acute resuscitative management. Fifteen patients (14.7%) were sensitized prior to reconstructive transplantation with an 80% incidence of acute rejection in the first post-operative year. Seven patients demonstrated graft vasculopathy, only one of whom had demonstrated panel reactive antibodies. Conclusion Currently employed acute management strategies predispose to the development of anti-HLA antibodies, adding to the already complex immunological challenge of VCA. Early appropriate care is warranted in patients with extensive soft tissue loss where the resuscitative needs should be balanced against strategies to mitigate the immunological burden, particularly as reconstructive transplantation becomes a feasible option for future soft tissue coverage. Take-home message Acute resuscitative management may sensitise potential transplant recipients following major soft tissue injury. Early appropriate care is warranted.

scholarly journals Epidemiology of Maxillofacial Fracture – A Hospital Based Study

2020 ◽  
Vol 17 (2) ◽  
pp. 23-27
Author(s):  
Arun Kumar Mahat ◽  
Gopal Gurung ◽  
Merina Shrestha ◽  
Bishwanath Chaudhary
Keyword(s):  
Head Injury ◽  
Soft Tissue ◽  
Road Traffic ◽  
Bone Fractures ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Maxillofacial Trauma ◽  
Study Patient ◽  
Facial Bone ◽  
Accompanying Injuries

Introduction: Maxillofacial trauma is the most common problem seen by maxillofacial surgeons in Nepal. The causes of facial fractures are road traffic accidents (RTA), assaults, falls, gunshot wounds, domestic violence, sports and work injuries. Maxillofacial injury varies from soft tissue injury to facial bone fractures. This study was conducted to assess the burden of maxillofacial trauma in mid-western and far-western regions of Nepal. Material and Method: Patients with maxillofacial fractures admitted in dental ward of NGMCTH, Kohalpur, from April 2017 to April 2019 were included in the study. Patients having soft tissue injury without facial bone fractures and OPD cases were excluded from the study. Patient demographics, mechanism of injury, associated soft tissue injury, accompanying injuries to other parts of body and facial bone fractures were recorded. Patient were treated by open reduction internal fixation or lateral compression splint with circum-mandibular wiring or managed conservatively as necessary. Result: A total of 87 patients were included in the study. The age of patient ranged from 2 years to 67 years with a mean of 26.87 years. Most of the injuries occurred between the age group of 20-29 years with male: female ratio 5.2:1. The most frequent cause of facial bone fracture was RTA (51.7%) and the most frequently fractured facial bone was mandible. Contusion 54(49.5%) was the most common associated soft tissue injury. Head injury 20(52.6%) was the most common accompanying injury to other parts of body. The mean duration of hospital stay was 6.29. Conclusion: Male patient in their third decade mostly had mandible fracture due to road traffic accident. Head injury was the most common accompanying injury. Contusion was the most common type of associated soft tissue injury.  

Head and Neck Injuries from Rock Climbing: A Query of the National Electronic Injury Surveillance System

2020 ◽  
Vol 130 (1) ◽  
pp. 18-23
Author(s):  
David W. Chou ◽  
Rijul Kshirsagar ◽  
Jonathan Liang
Keyword(s):  
Cervical Spine ◽  
Soft Tissue ◽  
Head And Neck ◽  
Intracranial Hemorrhage ◽  
Tissue Injury ◽  
Skull Fracture ◽  
Soft Tissue Injury ◽  
Rock Climbing ◽  
Neck Injuries ◽  
Facial Fracture

Objective: We describe the incidence and characteristics of patients with head and neck injuries from rock climbing who present to United States emergency departments and evaluate predictors of hospitalization. Methods: The National Electronic Injury Surveillance System (NEISS) database was queried for rock climbing injuries to the head, face, mouth, neck, and ear under product code “mountain climbing” from the years 2009 to 2018. Demographics, injury characteristics, and disposition data were reviewed. Data were evaluated using chi-square analysis with Cochran-Mantel-Haenszal odds ratios (ORs). Results: An estimated 5067 patients (from 129 raw NEISS case numbers) suffered head and neck injuries from rock climbing nationally from 2009 to 2018. Concussion/closed head injury was the most common injury (44%), followed by laceration (23%), soft tissue injury (15%), neck strain/sprain (6%), skull fracture (3%), facial fracture (3%), intracranial hemorrhage (3%), cervical spine fracture (2%), unspecified facial trauma (1%), and dental trauma (0.3%). Males more frequently suffered lacerations (OR 1.6), soft tissue injuries (OR 23.3), cervical spine fractures (OR 336.7), intracranial hemorrhage (OR 582.0), and skull fractures (OR 6.2) than females. Compared to shorter falls, falls over 20 ft were more commonly associated with laceration (OR 2.0), soft tissue injury (OR 3.5), facial fracture (OR 7.5), dental trauma (OR 6.6), intracranial hemorrhage (OR 951.8), skull fracture (OR 81.2), and hospitalization (OR 3.8). Injuries associated with hospitalization included facial fracture (OR 23.7), cervical spine fracture (OR 24.6), intracranial hemorrhage (OR 2210.2), and skull fracture (OR 9.8). Conclusions: Concussions and facial lacerations are the most common head and neck injuries from rock climbing. Males more commonly suffer severe injuries. Falls over 20 ft are associated with more severe injuries and an increased likelihood of hospitalization.

Auto seat restraint soft-tissue injury

1987 ◽  
Vol 148 (2) ◽  
pp. 458-458 ◽  
Author(s):  
DR Pennes ◽  
WA Phillips
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury

scholarly journals Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

2021 ◽  
Author(s):  
Sukriti Das ◽  
Bipin Chaurasia ◽  
Dipankar Ghosh ◽  
Asit Chandra Sarker
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Care Hospital ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

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