Neurotrauma at the All India Institute of Medical Sciences Bhubaneswar: An Overview

2019 ◽  
Vol 16 (02/03) ◽  
pp. 113-116
Author(s):  
Chinmaya Dash ◽  
Ayusman Satapathy ◽  
Sumit Bansal ◽  
Rabi Narayan Sahu
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
India Institute ◽  
Spine Injury ◽  
Road Traffic Accidents ◽  
Medical Sciences ◽  
The Future ◽  
Severe Tbi

Abstract Background The All India Institute of Medical Sciences (AIIMS) Bhubaneswar was established as an Institution of National Importance through the All India Institute of Medical Sciences (Amendment) Ordinance passed on July 16, 2012. It is estimated that road traffic accidents lead to economic loss to the tune of approximately 3% of gross domestic product. Centers of excellence for neurotrauma are the need of the hour, and the Indian Government is focusing on preventive and curative aspects of road traffic accidents to a great extent in the recent years. In this article, we would like to highlight the resources (manpower, infrastructure, etc.) available for neurotrauma, challenges ahead, and vision for the future. Trauma Audit A retrospective analysis of all the admitted patients of traumatic brain injury (TBI) was performed from November 2018 to October 2019. A total of 149 patients were admitted during this period. Of the 149 admitted patients, 88 had mild TBI, 39 had moderate TBI, and 22 had severe TBI. The mortality was highest in patients with severe TBI, with 45.45% mortality. A total of 29 patients with traumatic spine injury were admitted during this period. Of the 29 patients, 10 had cervical spine injury, 10 had dorsal spine injury, and 9 had lumbar spine injury. Of all these patients, two patients with cervical spine injury died of refractory shock. Perceived Limitations and Challenges Lack of dedicated round-the-clock emergency operating rooms (ORs) for neurosurgical procedures, adequate number of intensive care unit (ICU) beds, various gadgets in the ICU for neurocritical care, lack of rehabilitation facilities/center, lack of various OR gadgets, and lack of manpower, especially trained nursing staff, are the limitations perceived by us. Vision for the Future A trauma block has been approved, and work on it has begun. This shall greatly help in upgrading facilities for neurotrauma at AIIMS, Bhubaneswar. Conclusion Facilities for neurotrauma at AIIMS Bhubaneswar are gradually being upgraded. With a core team, the services are improving gradually. However, the institution is in its early years, and a lot more needs to be done in terms of manpower, gadgets, and infrastructure to further improve neurotrauma care at AIIMS, Bhubaneswar. This article may help in formulating guidelines for strengthening neurotrauma facilities in AIIMS, Bhubaneswar and all the new AIIMS established in India.

scholarly journals Epidemiological study of cervical spine injury in a tertiary care center in South India

2020 ◽  
Vol 7 (9) ◽  
pp. 2895
Author(s):  
Prasanth Asher ◽  
Jijo Joseph Joseph ◽  
Varun Singh Pendro ◽  
Anilkumar Peethambaran ◽  
Rajmohan Bhanu Prabhakar
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Cervical Spine Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Spine Injury ◽  
Mechanism Of Injury ◽  
Road Traffic Accidents ◽  
Cervical Spine Injuries ◽  
Spine Injuries

Background: Cervical spine injuries, according to severity can leave victims with long standing neck pain or varying degrees of weaknesses. The purpose of this study is to determine the epidemiological pattern of cervical spine injury in our hospital so that comparison may be made with other institutions and guidance regarding management may be formulated for the betterment of patients.Methods: This cross-sectional longitudinal study was conducted in Government Medical College, Thiruvananthapuram and included all patients admitted with clinical or radiological evidence of cervical spine injury, over a period of three months.  Semi-structured questionnaire was used to collect socio demographic data and details regarding mechanism of injury. Data was analyzed using SPSS.Results: Out of 452 patients enrolled, 69.7% were males and 30.3% were females. Patients were the most commonly between 30-60 years of age (52.4%). Majority (56.1%) had hospital stays lasting less than 10 days. Most common mechanism of injury was road traffic accidents (46.6%). Neck pain was the most common symptom and cervical spine straightening was the most common radiological abnormality. The severity of injuries was more severe in patients who were not restrained by seat belt or using a helmet.Conclusion: Road traffic accidents are the most common cause for cervical spine injuries and majority of patients required only symptomatic care.

scholarly journals “Dupatta” Entanglement: Cause of Head Injury in Female Pillion Riders on Motorcycles

2017 ◽  
Vol 07 (01) ◽  
pp. 043-045
Author(s):  
Sushilkumar Shinde ◽  
Rajesh Sharma ◽  
S. Bhaskar ◽  
Ajay Chaudhary
Keyword(s):  
Head Injury ◽  
Cervical Spine Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Indian Subcontinent ◽  
Traumatic Injury ◽  
Spine Injury ◽  
Road Traffic Accidents ◽  
Direct Head ◽  
Two Wheeler

AbstractRoad traffic accidents are a major cause of head injury. Direct head-on collision, hit by vehicle, and overturning of vehicle are some of the modes of road traffic accidents leading to head injury. A dupatta is an accessory worn by many females in the Indian subcontinent. It is wrapped around the neck like a scarf. It can get entangled in the vehicle leading to skidding of vehicle and consequent traumatic injury. There are many reported cases of cervical spine injury by this mechanism. However, this can also result in head injury due to direct impact. In this article we report two cases of head injury caused by entanglement of dupatta in the tire of a two-wheeler vehicle. In both cases the dupatta got entangled in the tire of vehicle leading to skidding of bike and then leading to head injury.

Traumatic Cervical Spine Injury Pattern– A Snapshot

2012 ◽  
Vol 23 (3) ◽  
pp. 111-116
Author(s):  
M Joshi ◽  
Mahima Agrawal
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Spinal Injury ◽  
Tertiary Care ◽  
Injury Pattern ◽  
Spine Injury ◽  
Rehabilitation Centre ◽  
Cross Sectional

Abstract Study design and subjects Cross-sectional descriptive study of pattern of cervical spine injury at a tertiary care rehabilitation centre in Rajasthan. Objectives To observe the socio demographic profile and injury pattern in cervical spinal cordinjury. Methods One hundred and forty-one clients of traumatic cervical spine injury (CSI) were admitted from 1st December 2010 to 15th October 2011 at the Department of Physical Medicine and Rehabilitation, S.M.S. Medical College and Hospital, Jaipur. Detailed clinical, neurological evaluation as per American Spinal Injury Association Classification (ASIA) and radiological assessment were done along with identification of mechanism of injury, mode of evacuation and presence of associated injuries. Data analysis was done in October 2011 and results were compiled and analysed. Results Mean age in our sample was 35.87 ± 14.38 years that comprised 11 females (7.8%) and 130 males (92.2%) of whom 78 (55.3%) fell in the age group of 25 to 55 years. Majority 64 (45.4%) were illiterate, 80 (56.8%) being farmers and labourers. Greater fraction had road traffic accidents i.e., 66 (46.81%) and fall from height 56 (39.72%) as the mechanism of trauma. Only 69 (49.8%) could arrange an ambulance for transport. Majority of the injured i.e., 84 (59.57%) presented with neurologically complete picture as per ASIA classification and the most common involvement being of 5th and 6th cervical segments i.e., 103 (73.15%). Conclusion This study evaluated the demographic variables of cervical spine injury for better understanding of impact that it has and further for better allocation of our health resources, distribution and planning

scholarly journals Profile of thoracic injury at College of Medical Sciences Teaching Hospital

2014 ◽  
Vol 9 (1) ◽  
pp. 30-39
Author(s):  
D Chapagain ◽  
D Jayapal Reddy ◽  
S Shah ◽  
KG Shrestha
Keyword(s):  
Prospective Study ◽  
Hospital Stay ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Flail Chest ◽  
Length Of Hospital Stay ◽  
Thoracic Injury ◽  
Road Traffic Accidents ◽  
Medical Sciences ◽  
Night Time

Objectives: Thoracic injury is a challenge to the thoracic surgeon practicing in developing countries. This prospective study was conducted to see the mode of injury, injury types and overall outcome of thoracic injury in our settings. Materials and methods: This prospective study was conducted in 100 thoracic injury patients between December 2011 to June 2012. The demographic features, type of the trauma, radiological assessment, associated organ injuries, management of the injury, surgical interventions, morbidity, mortality, length of hospital stay were analysed. Results: In this study the ages ranged from 7 to 84 years. There were 73 (73%) males and 27 (27%) females. The majority of patients (83%) were injured during the evening and night time. The majority of patients 92(92%) sustained blunt chest injuries. The mechanism of injury was not significantly associated with length of hospital stay (P > 0.05) and mortality (P > 0.05).Road traffic accident was the most common cause of injuries affecting 68(68%) of patients followed by fall injury of 19(19%). Rib fractures, haemothorax, pneumothorax and lung contusion were the most common type of injuries accounting for 83.0%, 57%,34% and 33% respectively. Associated extra-thoracic injuries were noted in 64.0% of patients. 45(45%) of the cases of haemothorax, pneumotharax and haemopneumothorax were treated by tube thoracotomy. Four patients (04%) had undergone thoracotomy. There were 09(09%) patients of flail chest and treated conservatively. Fourty six patients (46%) were admitted in the ICU. Eleven (11%) patients were treated with ventilator support. Seventeen (17%) patients had complication. The overall length of hospital stay ranged from 0 to 25 days. Conclusion: Road traffic accidents and fall from height are the major public health problems. Preventive measures at reducing road traffic accidents and timely management with closed tube thoracotomy are the main factors to be considered in the thoracic injury. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 30-39 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9671

Cervical Spine Lesions after Road Traffic Accidents

Spine ◽  
2002 ◽  
Vol 27 (17) ◽  
pp. 1934-1940 ◽  
Author(s):  
Lars Uhrenholt ◽  
Niels Grunnet-Nilsson ◽  
Jan Hartvigsen
Keyword(s):  
Cervical Spine ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Road Traffic Accidents

scholarly journals Spine injury in patients with polytrauma as a result of road traffic accidents. Report 1

TRAUMA ◽  
2017 ◽  
Vol 18 (3) ◽  
pp. 70-74
Author(s):  
S.E. Guriev ◽  
P.V. Tanasienko ◽  
K.V. Palagniuk
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Spine Injury ◽  
Road Traffic Accidents

Spinal cord injury and its management

2010 ◽  
pp. 5045-5054
Author(s):  
M P Barnes
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Sports Injuries ◽  
Spine Injury ◽  
Neutral Position ◽  
Road Traffic Accidents ◽  
Cord Injury ◽  
The Individual

Spinal cord injury most commonly affects young men as a consequence of road traffic accidents, violence, and sports injuries; falls are a common cause in older patients. Appropriate management of the individual at the scene of an accident is vital to avoid unnecessary worsening of a spinal cord injury. Those who are unconscious should be assumed to have a cervical spine injury until proven otherwise, with (1) the head and neck held firmly (as far as possible) in a neutral position using (if available) a semi-rigid collar, and (2) transportation on a spinal board with a head immobilizer....

scholarly journals Prevalence of Neurologic Deficits in Combined Facial and Cervical Spine Injuries: A Retrospective Analysis

2020 ◽  
pp. 194338752094018
Author(s):  
Manju Roby Philip ◽  
C. S. Soumithran
Keyword(s):  
Cervical Spine ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Maxillofacial Trauma ◽  
Spine Injury ◽  
Trauma Patients ◽  
Cervical Spine Injuries ◽  
Neurologic Deficits ◽  
Retrospective Data Analysis ◽  
Spine Injuries

Study design: A retrospective data analysis of maxillofacial trauma patients with combined cervical spine injuries. Objective: This study is based on investigating the importance of timely diagnosis of patients who suffer with cervical spine injuries along with maxillofacial trauma by estimating the prevalence of neurologic deficits and its relation with etiology. Methods: A database of 4460 patients suffering from maxillofacial injuries and admitted in specialized environment surgery of Government Medical College, Trivandrum, Kerala was taken under consideration. The prevalence and types of neurologic deficits and its relation with etiology were assessed in patients with combined facial and cervical spine injuries. Results: Of 4460 patients, 48 were having cervical spine injury along with facial damage with the prevalence of 0.01%. Neurologic deficits were seen highest with etiology of road traffic accidents followed by falls from height. Most of the accidents occurred in bike riders and helmets were absent. Conclusions: It was concluded that most of the accidents engage bike riders and drivers, due to unethical and unsafe driving. There was no significant correlation found between facial and cervical spine injuries.

Detected and overlooked cervical spine injury in comatose victims of trauma: report from the Pennsylvania Trauma Outcomes Study

2006 ◽  
Vol 5 (3) ◽  
pp. 210-216 ◽  
Author(s):  
Joseph H. Piatt
Keyword(s):  
Logistic Regression ◽  
Cervical Spine ◽  
Decision Tree ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Cervical Injury ◽  
Trauma Outcomes ◽  
Severe Tbi ◽  
Outcomes Study ◽  
Gcs Score

Object This study was undertaken to determine whether a clinically useful rule could be formulated for identifying the presence of traumatic brain injury (TBI) in patients who are at exceptionally low risk of cervical spine injury. Methods The Pennsylvania Trauma Outcomes Study database was searched for cases of TBI in which the admission Glasgow Coma Scale (GCS) score was less than or equal to 8. Cases of cervical injury were identified based on diagnostic codes. Associations between cervical injury and various clinical variables were tested using chi-square analysis. The probability of cervical injury was modeled using logistic regression. Decision tree models were constructed. Statistical determinants of overlooked cervical injury were examined. The prevalence of cervical injury among 41,142 cases of TBI was 8%. Mechanism of injury, thoracolumbosacral (TLS) fracture, age, limb fracture, admission GCS score, hypotension, and facial fracture were associated with cervical injury and were incorporated into the following logistic regression model: probability = 1 / (1 + exp[4.248 − 0.417 × mechanism −0.264 ×age −0.678 ×TLS −0.299 ×limb −0.218 ×GCS −0.231 ×hypotension −0.157 ×facial]). The results of applying this model provided a rule for cervical spine clearance applicable to 28% of the cases with a negative predictive value (NPV) of 97.0%. Decision tree analysis yielded a rule applicable to 24% of the cases with an NPV of 98.2%. The prevalence of overlooked cervical injury in all individuals with severe TBI was 0.3%; the prevalence of overlooked cervical injury in patients with cervical injury was 3.9%. Overlooked cervical injury was less common in patients with associated TLS fractures (odds ratio 0.453, 95% confidence interval 0.245–0.837). Conclusions This analysis identified no acceptable rule to justify relaxing vigilance in the search for cervical injury in patients with severe TBI. Provider vigilance and consequent rates of overlooked cervical injury can be affected by environmental cues and presumably by other behavioral and organizational factors.

scholarly journals Investigating the Causes of Death in the Injured of Traffic Accidents Referred to Vali-Asr Hospital in Arak, Based on Oral Autopsy and Forensic Autopsy

2020 ◽  
Vol 23 (3) ◽  
pp. 338-347
Author(s):  
Mohammad Jamalian ◽  
◽  
Mohsen Eslamdost ◽  
Ali Rezaee ◽  
Shabanali Alizadeh ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Traffic Accidents ◽  
Causes Of Death ◽  
Road Traffic ◽  
Medical Center ◽  
Level Of Service ◽  
Road Traffic Accidents ◽  
Medical Sciences ◽  
Ethical Considerations ◽  
The Mean

Background and Aim: The deaths caused by traffic accidents are one of the three leading causes of death in Iran. Considering that all deaths from traffic accidents in the forensic organization are undergoing autopsy and also in the treatment centers under oral autopsies, the cause of death is determined, we determined that the cause of reported death from oral autopsy and medical autopsy Compare the law. Methods & Materials: In this descriptive study, patients who were admitted to the forensic medical center during the year 1395 admitted to the Vali-e-Asr Hospital in Arak, were referred. The causes of death in Vali-asr Hospital were evaluated and compared with the outcome of the forensic oral hearing.  Ethical Considerations: This study ethcally approved by the ethics committee of the Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1395.226). Results: In this study, 109 patients (1.33%) died from a total of 8153 patients with traffic accidents referred to Valiasr hospital in Arak. Of these, 68.8% were male and 31.2% were women. The Mean±SD age of the patients died was 44.03±22.43 years. Also, 59.6% of the dead died during the first 24 hours of the accident. The most common cause of death, according to the results of oral autopsy, was “multiple injuries,” accounting for 49.5% of the patients in 45 patients. Conclusion: Abundance of deaths among patients with road traffic accidents and they referred to Valiasr hospital, which was 1.33%. According to the existing standards and considering that the mortality rate in this center is less than 1.5%. It seems that the level of service delivery in this center is favorable.

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