scholarly journals Tooth in Intracranial Compartment after Traumatic Brain Injury

2017 ◽  
Vol 36 (01) ◽  
pp. 26-28
Author(s):  
Benedito Pereira ◽  
Radmila Holanda ◽  
José Targino Neto ◽  
Luciano Holanda

AbstractA 25-year-old patient was admitted to the emergency room presenting headaches after a traumatic brain injury (TBI) 30 days before, when he collided frontally with another driver. After a skull radiography, the presence of a foreign body was observed in the frontal sinus. A cranial computed tomography (CT) scan found that it was a tooth. The patient underwent surgical treatment for the removal of the tooth. Traumatic brain injury caused by non-missile penetrating objects is unusual, and has been described in case reports in the literature. To the best of our knowledge, no similar reports can be found in the literature.

2019 ◽  
pp. 55-59
Author(s):  
Eghosa Morgan ◽  
Olufemi Bankole ◽  
Okezie Kanu ◽  
Omotayo Ojo ◽  
Edward Poluyi

Background: The enormous disease burden of patients with traumatic brain injury (TBI) remains a huge source of concern to the patient and caregivers. Computed tomography (CCT) scan is a valuable investigative tool in patients with traumatic brain injury which can be used to predict the outcome of TBI. The use of total white blood cell as a predictive parameter in patients with TBI is still at a primordial stage. This study aimed to compare the predictive strength of total WBC count within 24 hours of TBI with cranial computed tomography scan. Methods: This research was done over one-year period at the Lagos University Teaching Hospital, Lagos. One hundred and fifty-eight patient who met the inclusion criteria were studied and the male to female ratio of 3.6:1. Results: The mean total WBC count was 14,279.94 and the area under the curve of total WBC count and CCT scan was 0.633 and 0.855 respectively. Conclusion: Our conclusion was that despite both parameters been a predictor of the outcome of TBI, the total white blood cell is a weaker predictor of outcome compared to cranial computerize tomography scan.


2021 ◽  
Vol 6 (1) ◽  
pp. 1352-1357
Author(s):  
Ajay Kumar Yadav ◽  
Binit Dev ◽  
Sushil Taparia ◽  
Parvez Kumar ◽  
Rakesh Mandal ◽  
...  

Introduction: Traumatic brain injury (TBI) in patients with head trauma is common cause for emergency visits to hospital affecting all age groups. It is one of important leading cause of death and disability worldwide besides leading to neurological disease burden. Noncontrast enhanced Multidetector computed tomography (MDCT) is imaging modality of choice for detection of various intracranial lesions. Objectives: This study was done to analyse various imaging findings on MDCT in traumatic head injury patients along with association of CT findings with clinical manifestation and mechanism of injury. Methodology: In this ethically approved prospective study, CT scan was done in 224 consecutive patients with head injury from November 2020 to February 2021. The various imaging findings seen in CT scan were documented in proforma. The data collected was analyzed with appropriate statistical test and statistical significance was calculated. Results: Total of 224 patients with diagnosis of head injury were included in the study. The male to female ratio was 2.86 and most common age group involved was between 20-40years (41.1%). The most common mode of injury was road traffic accidents (57.6%) and most of the patients presented with history of altered sensorium (35.7%). About 47.3% patients showed abnormal findings on CT scan with scalp lesion was most common findings (82%) followed by skull fractures (54.7%) and cerebral contusions (43.4%). Patients with history of RTA had more abnormal CT scan (62%) than fall injury and physical assault. Statistically significant association seen between CT scan findings with Glasgow Coma Scale and RTA (P<0.05). Conclusion: The present study showed well documented role of CT scan in diagnosis of TBI besides detection of spectrum of intracranial lesions in patients with head trauma. Road traffic accident is most common mode of head injury with most of the victims are young middle age active male. 


2019 ◽  
pp. 178-179
Author(s):  
David L. Brody

Elderly individuals over age 65 represent the fastest growing group of traumatic brain injury patients. Many elderly individuals are taking anticoagulant medications, and an initial computed tomography (CT) scan is warranted to rule out intracranial hemorrhage, though a second CT scan is generally unnecessary if the first scan is negative and the patient’s neurological condition is stable. Elderly can be more susceptible to side effects of medications; thus, smaller doses may be preferred. Balance training is advised to reduce risk of falls. Concussion may be both a cause and a consequence of neurodegenerative diseases. Driving may be especially problematic in elderly after concussion.


2015 ◽  
Vol 10 (2) ◽  
pp. 4-9
Author(s):  
SK Sah ◽  
ND Subedi ◽  
K Poudel ◽  
M Mallik

OBJECTIVE To correlate Computed Tomography (CT) findings with Glasgow Coma Scale (GCS) in patients with acute traumatic brain injury attending in Chitwan Medical College teaching hospital Chitwan, Nepal.MATERIALS AND METHODS A cross-sectional study was performed among 50 patients of acute (less than24 hours) cases of craniocerebral trauma over a period of four months. The patient’s level of consciousness (GCS) was determined and a brain CT scan without contrast media was performed. A sixth generation General Electric (GE) CT scan was utilized and 5mm and 10mm sections were obtained for infratentorial and supratentorial parts respectively.RESULT The age range of the patients was 1 to 75 years (mean age 35.6± 21.516 years) and male: female ratio was 3.1:1. The most common causes of head injury were road traffic accident (RTA) (60%), fall injury (20%), physical assault (12%) and pedestrian injuries (8%). The distribution of patients in accordance with consciousness level was found to be 54% with mild TBI (GCS score 12 to 14), 28% with moderate TBI (GCS score 11 to 8) and 18% with severe TBI (GCS score less than 7). The presence of mixed lesions and midline shift regardless of the underlying lesion on CT scan was accompanied by lower GCS.CONCLUSION The presence of mixed lesions and midline shift regardless of the underlying lesion on CT scan were accompanied with lower GCS. Patients having single lesion had more GCS level than mixed level and mid line shift type of injury.Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2); 4-9


Author(s):  
Basudev Agrawal ◽  
Rupesh Verma

Background: This study was undertaken to correlate Glasgow Coma Scale (GCS) score with Non-Contrast Computed Tomography (NCCT) findings in patients with acute traumatic brain injury (TBI) attending tertiary care Shree Narayana Hospital, Raipur, Chhattisgarh, India.Methods: A cross-sectional study was performed among 100 patients of acute traumatic head injury (those presenting to hospital within 24 hours of injury) over a period of six months. The patient’s GCS score was determined and NCCT Brain scan was performed in each case immediately (within 30 minutes) after presenting to casualty of the hospital. A 16 slice siemens Somatom CT scan was utilized and 5mm and 10mm sections were obtained for infratentorial and supratentorial parts respectively.Results: The age range of the patients was 0 to 76 years and male: female ratio was 2.85:1. Younger age group was more commonly involved, with 61% of cases seen in 11-40 years of age group. The most common causes of head injury were road traffic accident (RTA) (65%) and fall from height (25%). The distribution of patients in accordance with GCS was found to be 55% with mild TBI (GCS 12 to 14), 25% with moderate TBI (GCS 11 to 8) and 20% with severe TBI (GCS 7 or less).Conclusions: The presence of multiple lesions and midline shift on CT scan were accompanied with lower GCS, whereas patients having single lesion had more GCS level. There was significant correlation between GCS and NCCT findings in immediate post TBI.


2014 ◽  
Vol 80 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Bellal Joseph ◽  
Moutamn Sadoun ◽  
Hassan Aziz ◽  
Andrew Tang ◽  
Julie L. Wynne ◽  
...  

Anticoagulation agents are proven risk factors for intracranial hemorrhage (ICH) in traumatic brain injury (TBI). The aim of our study is to describe the epidemiology of prehospital coumadin, aspirin, and Plavix (CAP) patients with ICH and evaluate the use of repeat head computed tomography (CT) in this group. We performed a retrospective study from our trauma registry. All patients with intracranial hemorrhage on initial CT with prehospital CAP therapy were included. Demographics, CT scan findings, number of repeat CT scans, progressive findings, and neuro-surgical intervention were abstracted. A comparison between prehospital CAP and no-CAP patients was done using χ2 and Mann-Whitney U test. A total of 1606 patients with blunt TBI charts were reviewed of whom 508 patients had intracranial bleeding on initial CT scan and 72 were on prehospital CAP therapy. CAP patients were older ( P < 0.001), had higher Injury Severity Score and head Abbreviated Injury Scores on admission ( P < 0.001), were more likely to present with an abnormal neurologic examination ( P = 0.004), and had higher hospital and intensive care unit lengths of stay ( P < 0.005). Eighty-four per cent of patients were on antiplatelet therapy and 27 per cent were on warfarin. The CAP patients have a threefold increase in the rate of worsening repeat head CT (26 vs 9%, P < 0.05). Prehospital CAP therapy is high risk for progression of bleeding on repeat head CT. Routine repeat head CT remains an important component in this patient population and can provide useful information.


Brain Injury ◽  
2012 ◽  
Vol 26 (12) ◽  
pp. 1464-1471 ◽  
Author(s):  
Gaby Franschman ◽  
Sjoerd Greuters ◽  
Wim H. Jansen ◽  
Linda M. Posthuma ◽  
Saskia M. Peerdeman ◽  
...  

2016 ◽  
Vol 78 (04) ◽  
pp. 403-406 ◽  
Author(s):  
Eva Korf ◽  
Volker Tronnier ◽  
Jan Gliemroth ◽  
Jan Küchler

AbstractWe report a misinterpretation of bilateral mydriasis as blown pupils related to elevated intracranial pressure (ICP) under volatile sedation with isoflurane (Anesthetic Conserving Device [AnaConDa], Hudson RCI, Uppland Vasby, Sweden) in a 59-year-old patient with a severe traumatic brain injury with frontal contusion. The patient showed bilateral mydriasis and a missing light reflex 8 hours after changing sedation from intravenous treatment with midazolam and esketamine to volatile administration of isoflurane. Because cranial computed tomography ruled out signs of cerebral herniation, we assumed the bilateral mydriasis was caused by isoflurane and reduced the isoflurane supply. Upon this reduction the mydriasis regressed, suggesting the observed mydriasis was related to an overdose of isoflurane. Intensivists should be aware of the reported phenomenon to avoid unnecessary diagnostic investigations that might harm the patient. We recommend careful control of the isoflurane dose when fixed and dilated pupils appear in patients without other signs of elevated ICP.


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