scholarly journals 625 Intracranial Gossypiboma Nine Years After Intracranial Pressure Bolt Insertion - A Case Report

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R T S Loh ◽  
T Matys ◽  
K Allinson ◽  
T Santarius
Keyword(s):  
Intracranial Pressure ◽  
Traffic Accident ◽  
Road Traffic ◽  
Vasogenic Edema ◽  
Mass Effect ◽  
Clonic Seizure ◽  
En Bloc ◽  
Case Presentation ◽  
Left Behind ◽  
Minor Procedure

Abstract Background Resorbable hemostatic agents are commonly used to control bleeding intra- and post- operatively. Once left behind, these agents can occasionally trigger pathological, granulomatous reactions, resulting in space-occupying lesions known as gossypibomas. Here we report a case of an intracranial gossypiboma. These are notoriously difficult to diagnose as they are exceedingly rare and frequently radiologically indistinguishable from other lesions (tumors, abscess etc). Case Presentation A 35-year-old woman presented with a generalized tonic-clonic seizure and subsequent left-sided hemiparesis. MRI demonstrated an enhancing lobulated lesion subjacent to a right frontal burr hole, surrounded by vasogenic edema with mass effect and midline shift. Nine years ago, she had a triple bolt inserted to monitor intracranial pressure after sustaining traumatic brain injury in a road traffic accident. Surgicel was used to control bleeding during insertion. She made a full recovery. Co-location of the lesion with the position of triple bolt nine years ago raised a suspicion for gossypiboma. However, the minor nature of the surgery, and the length of time since surgery to presentation were placing this case well outside range of cases reported in the literature. The lesion was resected en bloc, with no recurrence 18 months later. Histological examination revealed presence of foreign material, confirming the suspicion of Surgicel-elicited gossypiboma. Conclusions We show here that gossypibomas can occur following a relatively minor procedure and remain clinically and radiologically silent for much longer than what was previously reported. Thus, they should be included in differential diagnoses despite being remarkably rare.

scholarly journals When a road traffic accident leads to a skull metastasis from hepatocellular carcinoma: A unique case presentation

2020 ◽  
Vol 21 ◽  
pp. 100745
Author(s):  
Safwan O. Alomari ◽  
Abdelwahab J. Aeshawi ◽  
Omar Jbarah ◽  
Amer A. Jaradat ◽  
Mohammed Z. Allouh
Keyword(s):  
Hepatocellular Carcinoma ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Unique Case ◽  
Case Presentation ◽  
Skull Metastasis

scholarly journals Delayed deterioration following the evacuation of posterior fossa extradural hematoma

2015 ◽  
Vol 22 (1) ◽  
pp. 121-124
Author(s):  
Amit Agrawal ◽  
S. Satish Kumar ◽  
Umamaheswara Reddy V.
Keyword(s):  
Cerebral Edema ◽  
Traffic Accident ◽  
Road Traffic ◽  
Neuronal Damage ◽  
Mass Effect ◽  
Extradural Hematoma ◽  
Secondary Brain Damage ◽  
The Road ◽  
The Right

Abstract A missed or delayed detection of intracranial injuries can lead to progressive neuronal damage and secondary brain damage. We present a case of 45 year female presented 8 after the road traffic accident and had a large posterior extradural hematoma on left side with mass effect. In addition there was a small speck of right frontal contusion with localized cerebral edema. The patient initially improved after evacuation of the hematoma. However on 3rd post-operative day she was complaining of headache and became progressively drowsy. A follow up CT scan showed increase in peri-lesional edema around the right frontal contusion with squashing of the lateral ventricles suggestive of diffuse cerebral edema. The patient was shifted back to intensive care unit and responded well to further conservative management. In our patient the events could be collaborated well with existing evidence (presence of contrecoup contusion and on clinical deterioration at day 3).

scholarly journals A Case of Diffuse Pneumocephalus With Air Bubble Sign

2020 ◽  
Vol 2 (1) ◽  
pp. 62-64
Author(s):  
Birat Thapa Magar ◽  
Mubashir Malik ◽  
Rizwan Masood Butt ◽  
Faiq Sheikh
Keyword(s):  
Ct Scan ◽  
Subarachnoid Space ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Clinical Symptoms ◽  
Clinical Status ◽  
Mass Effect ◽  
Air Bubble ◽  
History Of

 Background: Pneumocephalus is defined as presence of intracranial gas. It can be at any site in the cranium; isolated or at different sites simultaneously. Quantity of gas along with extent of mass effect caused by it & severity of clinical symptoms will determine the modality of treatment; i.e. conservative or surgical. Among many etiologies trauma is one, which is one of the most common cause as in our case. Multiple foci of gas scattered within the subarachnoid space, especially in the cisterns seen on CT scan of brain has been described as “Air bubble sign”, indicating of subdural tension PNC. Here we have presented our case with review of management of such condition, especially conservative. Case: A case of 55yrs male with history of road traffic accident was referred from another hospital. CT scan of Brain done in previous center showed diffuse PNC scattered throughout the subarachnoid space. The patient was managed conservatively and successive repeat CT scan showed gradual to complete resorption of gas and simultaneous clinical improvement of the patient. Conclusion: “Air bubble sign” described as a sign of tension PNC can be managed conservatively in absence of significant clinical symptoms and may not only be associated with subdural tension PNC. The modality of treatment of PNC as well for tension PNC should be tailored according to the patient’s clinical status.

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

Epidemiological Study of Road Traffic Accident Cases Attending the Civil Hospital, Ahmedabad

2012 ◽  
Vol 3 (8) ◽  
pp. 282-283
Author(s):  
Dr. Chhaya Lakhani ◽  
◽  
Dr. Rachana Kapadia ◽  
Dr. Dhara Prajapati ◽  
Dr. A.Bhagyalaxmi Dr. A.Bhagyalaxmi
Keyword(s):  
Epidemiological Study ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Civil Hospital

ADHD is a Risk Factor of Road Crashes: A Purposive Study of Finding Relation between ADHD and Road Traffic Accident in Bangladesh

2018 ◽  
Vol 9 (08) ◽  
pp. 20531-20536
Author(s):  
Nusrat Shamima Nur ◽  
M. S. l. Mullick ◽  
Ahmed Hossain
Keyword(s):  
Risk Factor ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Fatality Rate ◽  
Road Traffic Accidents ◽  
Road Crashes ◽  
Road Crash ◽  
Day By Day

Background: In Bangladesh fatality rate due to road traffic accidents is rising sharply day by day. At least 2297 people were killed and 5480 were injured in road traffic accidents within 1st six months of 2017.Whereas in the previous year at 2016 at least 1941 people were killed and 4794 were injured within the 1st six months. No survey has been reported in Bangladesh yet correlating ADHD as a reason of impulsive driving which ends up in a road crash.

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