Bilateral Parietal Skull Fractures in Infants Attributable to Accidental Falls

Introduction: Multiple skull fractures, including bilateral parietal skull fractures (BPSFs) in infants are considered to be suspicious for abusive head trauma (AHT). The aim of this report is to describe a series of BPSF cases in infants which occurred due to accidental falls. Methods: We searched our neuroradiology database for BPSF in infants (<1 year old) diagnosed between 2006 and 2019; we reviewed initial presentation, mechanisms of injury, clinical course, head imaging, skeletal survey X-rays, ophthalmology, social work and child abuse physicians (CAP) assessments, and long-term follow-up. “Confirmed accidental BPSF” were strictly defined as having negative skeletal survey and ophthalmology evaluation and a CAP conclusion of accidental injury. Results: Twelve cases of BPSF were found; 3 were confirmed to be accidental, with a mean age at presentation of 3 months. Two infants had single-impact falls, and 1 had a compression injury; all 3 had small intracranial hemorrhages. None had bruises or other injuries, and all remained clinically well. A literature search found 10 similar cases and further biomechanical evidence that these fractures can occur from accidental falls. Conclusion: While AHT should be kept in the differential diagnosis whenever BPSFs are seen, these injuries can occur as a result of accidental falls.

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Abusive head trauma (AHT) outcome at long-term follow-up and the role of elective neurosurgical approach: A report of 22 cases

PsycEXTRA Dataset ◽

10.1037/e578482014-165 ◽

2013 ◽

Author(s):

Francesca Menegazzo ◽

Melissa Rosa Rizzotto ◽

Martina Bua ◽

Luisa Pinello ◽

Elisabetta Tono ◽

...

Keyword(s):

Head Trauma ◽

Abusive Head Trauma ◽

Long Term Follow Up

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Single-Center Long-Term Follow-Up After Intraoperative Radiotherapy as a Boost During Breast-Conserving Surgery Using Low-Kilovoltage X-Rays

Annals of Surgical Oncology ◽

10.1245/s10434-010-1265-z ◽

2010 ◽

Vol 17 (S3) ◽

pp. 352-358 ◽

Cited By ~ 42

Author(s):

Elena Blank ◽

Uta Kraus-Tiefenbacher ◽

Grit Welzel ◽

Anke Keller ◽

Markus Bohrer ◽

...

Keyword(s):

Intraoperative Radiotherapy ◽

Breast Conserving Surgery ◽

X Rays ◽

Single Center ◽

Long Term Follow Up ◽

Low Kilovoltage

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Modified Dunn procedure versus percutaneous pinning in moderate/severe stable slipped capital femoral epiphyses

Hip International ◽

10.1177/11207000211004862 ◽

2021 ◽

pp. 112070002110048

Author(s):

Claudia Galletta ◽

Alessandro Aprato ◽

Matteo Giachino ◽

Giorgio Marre’ Brunenghi ◽

Silvio Boero ◽

...

Keyword(s):

Harris Hip Score ◽

X Rays ◽

Anatomic Reduction ◽

Significant Difference ◽

Functional Scores ◽

Long Term Follow Up ◽

In Situ Fixation

Background: The modified Dunn procedure (MDP) has risen enthusiasm in treating slipped capital femoral epiphyses (SCFE) due to the anatomic reduction and high patients’ satisfaction rates at long-term follow-up. Main aim of this study is to compare clinical and radiographic outcomes of 2 cohorts with moderate to severe stable SCFE treated by MDP and in situ fixation. Methods: Medical records were analysed to collect demographic data, comorbidities and time from slip to surgery. The collected postoperative data were: avascular necrosis (AVN); complications; progression of osteoarthritis and subsequent procedures. Southwick angles (SA), alpha angles and Klein line were measured on the preoperative x-rays, on the immediate postoperative period and at the latest follow-up. Outcomes scores were recorded by the following questionnaires: the Harris Hip Score, the Hip disability and Osteoarthritis Outcome Score, the Merle d’Aubigné and Postel score and the Western Ontario and McMaster Universities Arthritis Index. Kaplan-Meier survivorship curve was calculated. Results: We compared 81 hips treated by MDP with 22 hips treated by in situ pinning (PS) for moderate/severe stable SCFE. No significant differences were found between the 2 groups in terms of age, BMI, comorbidities and preoperative slip angles. At the latest follow-up, postoperative anteroposterior mean slip angles were respectively 6.2 and 19.9° in MDP and PS group ( p = 0.3). Slip angles in frog lateral view were 11° in the MDP group and 39.7° in the PS group ( p = 0.2). MDP group achieved better correction angles on frog leg view (11° vs. 39.7°; p < 0.001). There was no statistically significant difference in the occurrence of AVN among both groups (19.7% MDP group vs. 31.8% PS group) ( p = 0.2). Conclusions: The MDP in treating severe stable SCFE showed the best deformities corrections in conjunction with the highest functional scores at long-term follow-up and similar rates of osteonecrosis compared to in situ fixation.

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Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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