Patterns of Nasoorbitalethmoid Fractures in the Pediatric Population

2019 ◽  
Vol 85 (7) ◽  
pp. 730-732
Author(s):  
Thuy-My T. Le ◽  
Ryan S. Berlin ◽  
Nicholas C. Oleck ◽  
Andrew A. Dobitsch ◽  
Jordan N. Halsey ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Surgical Management ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Pediatric Population ◽  
Management Strategies ◽  
Orbital Fracture ◽  
Facial Fractures ◽  
Frontal Sinus Fracture

There is an absence of literature regarding nasoorbitoethmoid (NOE) facial fractures. Although NOE fractures are uncommon, there are a significant number in the pediatric population. These fractures also often occur in conjunction with other facial fractures because the NOE region adjoins the nose, orbit, maxilla, and cranium. They can also be a harbinger for more serious concerns such as traumatic brain injury and intracranial hemorrhage. For this reason, NOE fractures can be highly complicated and a challenge to manage. We aim to define the etiologies and patterns of NOE fractures to guide hospital and surgical management strategies. From 2001 to 2014, 15 pediatric patients were identified as having sustained an NOE fracture. Four (26.7%) of the patients were female and 11 (68.8%) were male. Average age was 11.40. The most common etiologies recorded were motor vehicle accident (n = 8), pedestrian struck (n = 3), and assault (n = 2). Orbital fracture (n = 13), nasal fracture (n = 13), and frontal sinus fracture (n = 10) were the most commonly associated facial fractures sustained alongside NOE fracture. Several patients sustained traumatic brain injury (n = 11) and loss of consciousness (n = 13). The mean Glasgow Coma Score was 10.5. In addition, eight required intubation and five required a surgical airway. Thirteen of the patients were admitted to the ICU and eight required surgical management for their fractures. Titanium plates were most commonly used (n = 4) for surgical management. Alternatively, resorbable implants were used for two patients. The remaining two were treated with closed reduction.

scholarly journals Traumatic Brain Injury Related Hospitalization and Mortality in California

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Clint Lagbas ◽  
Shahrzad Bazargan-Hejazi ◽  
Magda Shaheen ◽  
Dulcie Kermah ◽  
Deyu Pan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Age Groups ◽  
Motor Vehicle Accidents ◽  
Elderly Male ◽  
Cross Sectional ◽  
Discharge Data ◽  
Vehicle Accidents

Objective. The aim of this study is to describe the traumatic brain injury (TBI) population and causes and identify factors associated with TBI hospitalizations and mortality in California.Methods. This is a cross-sectional study of 61,188 patients with TBI from the California Hospital Discharge Data 2001 to 2009. We used descriptive, bivariate, and multivariate analyses in SAS version 9.3.Results. TBI-related hospitalizations decreased by 14% and mortality increased by 19% from 2001 to 2009. The highest percentages of TBI hospitalizations were due to other causes (38.4%), falls (31.2%), being of age≥75years old (37.2%), being a males (58.9%), and being of Medicare patients (44%). TBIs due to falls were found in those age≤4years old (53.5%),≥75years old (44.0%), and females (37.2%). TBIs due to assaults were more frequent in Blacks (29.0%). TBIs due to motor vehicle accidents were more frequent in 15–19 and 20–24 age groups (48.7% and 48.6%, resp.) and among Hispanics (27.8%). Higher odds of mortality were found among motor vehicle accident category (adjusted odds ratio (AOR): 1.27, 95% CI: 1.14–1.41); males (AOR: 1.36, 95% CI: 1.27–1.46); and the≥75-year-old group (AOR: 6.4, 95% CI: 4.9–8.4).Conclusions. Our findings suggest a decrease in TBI-related hospitalizations but an increase in TBI-related mortality during the study period. The majority of TBI-related hospitalizations was due to other causes and falls and was more frequent in the older, male, and Medicare populations. The higher likelihood of TBI-related mortalities was found among elderly male≥75years old who had motor vehicle accidents. Our data can inform practitioners, prevention planners, educators, service sectors, and policy makers who aim to reduce the burden of TBI in the community. Implications for interventions are discussed.

Treating Severe Traumatic Brain Injury: Combining Neurofeedback and Hyperbaric Oxygen Therapy in a Single Case Study

2021 ◽  
pp. 155005942110682
Author(s):  
Rebecca D White ◽  
Robert P Turner ◽  
Noah Arnold ◽  
Annie Bernica ◽  
Brigitte N Lewis ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hyperbaric Oxygen ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Short Term Memory ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Single Case ◽  
Treatment Center

In 2014, a 26-year-old male was involved in a motor vehicle accident resulting in a severe traumatic brain injury (TBI). The patient sustained a closed-head left temporal injury with coup contrecoup impact to the frontal region. The patient underwent a left side craniotomy and was comatose for 26 days. After gaining consciousness, he was discharged to a brain injury treatment center that worked with physical, speech, and occupational issues. He was discharged after eight months with significant speech, ambulation, spasticity, and cognitive issues as well as the onset of posttraumatic epilepsy. His parents sought hyperbaric oxygen treatment (HBOT) from a doctor in Louisiana. After 165 dives, the HBOT doctor recommended an addition of neurofeedback (NFB) therapy. In March 2019 the patient started NFB therapy intermixed with HBOT. The combination of NFB and HBOT improved plasticity and functionality in the areas of injury and the correlated symptoms including short-term memory, personality, language, and executive function, as well as significantly reducing the incidence of seizures. Severe brain injuries often leave lasting deficits with little hope for major recovery and there is a need for further research into long-term, effective neurological treatments for severe brain injuries. These results suggest that HBOT combined with NFB may be a viable option in treating severe brain injuries and should be investigated.

scholarly journals Retroclival and spinal subdural hematoma after traumatic brain injury - A case report and literature review

2019 ◽  
Vol 10 ◽  
pp. 86 ◽  
Author(s):  
Saúl Solorio-Pineda ◽  
Adriana Ailed Nieves-Valerdi ◽  
José Alfonso Franco-Jiménez ◽  
Guillermo Axayacalt Gutiérrez-Aceves ◽  
Luis Manuel Buenrostro-Torres ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Subdural Hematoma ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Traumatic Injury ◽  
Vascular Lesions ◽  
Vehicle Accidents ◽  
Spinal Subdural Hematoma

Background: Retroclival hematomas are rare and occur mostly in the pediatric population. They are variously attributed to trauma, apoplexy, and vascular lesions. With motor vehicle accidents (MVAs), the mechanism of traumatic injury is forced flexion and extension. There may also be associated cervical spinal and/or clivus fractures warranting fusion. Case Description: A 35-year-old male sustained a traumatic brain injury after a fall of 5 m at work. His Glasgow coma scale (GCS) on admission was 13 (M6V3O4). He had no cranial nerve deficits. The brain computed tomography (CT) showed a retroclival subdural hematoma that extended to the C2 level. Conclusions: Most retroclival hematomas are attributed to MVAs, and cranial CT and magnetic resonance studies typically demonstrate a combination of posterior fossa hemorrhage with retroclival hematomas (intra or extradural). Patients with retroclival hematomas but high GCS scores on admission usually have better prognoses following traumatic brain injuries attributed to MVA. Notable however is the frequent association with additional cervical and/or craniocervical injuries (e.g. such as odontoid fracture) that may warrant surgery/fusión.

The Mild Traumatic Brain Injury Rest and Activity Questionnaire (MTBI-RAQ): A Pilot Study

2018 ◽  
Vol 19 (2) ◽  
pp. 141-152 ◽  
Author(s):  
Karen A. Sullivan ◽  
Rebecca Cox
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Vehicle Accident ◽  
Cut Score ◽  
History Of ◽  
Cognitive Behaviours ◽  
Adult Volunteers

Objective: To develop a tool for assessing intentions to continue or change activities for recovery following mild traumatic brain injury (mTBI) and determine if they are dependent on injury context or activity type. Method: Adult volunteers with no (or no recent) history of mTBI were randomly allocated to one of two vignette conditions, each with a different injury context. The vignette described an mTBI due to a motor vehicle accident (MVA, n = 76) or sport (SPORT, n = 89). Volunteers reported their rest or activity plans for 39 behaviours comprising three behaviour types (cognitive, physical, and restful). Results: Compared to a cut-score representing no change, on average there was a significant (p <= .001) planned decrease in physical and cognitive behaviours (MVAphysicalt(53) = 7.373; SPORTphysicalt(41) = 9.281; MVAcognitivet(41) = 9.367; SPORTcognitivet(51) = −3.521) and a significant planned increase in restful behaviours, such as sleep (MVArestfult(72) = 10.006; SPORTrestfult(86) = 9.566). An overall within-group effect for behaviour-type was not identified and there was no effect of condition (MVA vs. SPORT). Conclusion: The acute rest and activity plans for a simulated mTBI are behaviour specific and not dependent on context. An expectation for blanket-rest was not was observed but rest was planned for specific behaviours. This tool could be used to guide discussions with mTBI patients about their recovery so that their plans align with advice, and it could aid further research into the relation between intended and actual rest and activity and the effect on eventual outcomes.

scholarly journals Anestesi untuk Kraniotomi Evakuasi Perdarahan Intraserebral pada Pasien Cedera Otak Traumatik dengan Tetralogy of Fallot

2020 ◽  
Vol 9 (2) ◽  
pp. 156-167
Author(s):  
Dhania A. Santosa ◽  
◽  
Hamzah Hamzah ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Tetralogy Of Fallot ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Oxygen Demand ◽  
Adult Age ◽  
Vehicle Accident ◽  
Post Surgery ◽  
Moderate Traumatic Brain Injury

Congenital heart disease (CHD) is one of the leading congenital disease with the incidence of 8 patients of 1000 livebirth. Around 85% of patients with CHD is expected to reach adult age in United States of America. Management of traumatic brain injury in patients with CHD requires combination of fine understanding on pathophysiology of CHD and neuroanesthesia technique. A male patient, 17 years of age had a motor vehicle accident and was diagnosed with moderate traumatic brain injury, intracerebral hemorrhage, epidural hemorrhage and cerebral edema with Tetralogy of Fallot, underwent an emergency craniotomy for ICH evacuation. Surgery was done under general anesthesia and lasted for approximately 3 hours. Challenges during anesthesia and surgery include maintaining optimal oxygen delivery, avoiding increase in oxygen demand and preventing catecholamine release which may trigger hypercyanotic tet spell. Patient was observed and ventilator supported in Intensive Observation Ward and was extubated at the same post surgery day. Patient was then observed in the Ward and sent home on the 14th day after the incident.

Factors influencing outcome following mild traumatic brain injury in adults

2000 ◽  
Vol 6 (5) ◽  
pp. 568-579 ◽  
Author(s):  
JENNIE PONSFORD ◽  
CATHERINE WILLMOTT ◽  
ANDREW ROTHWELL ◽  
PETER CAMERON ◽  
ANN-MAREE KELLY ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Visual Disturbance ◽  
Mild Tbi ◽  
Neuropsychological Measures ◽  
Severity Of Injury ◽  
Minor Injuries

This study aimed to investigate outcome in adults with mild traumatic brain injury (TBI) at 1 week and 3 months postinjury and to identify factors associated with persisting problems. A total of 84 adults with mild TBI were compared with 53 adults with other minor injuries as controls in terms of postconcussional symptomatology, behavior, and cognitive performance at 1 week and 3 months postinjury. At 1 week postinjury, adults with mild TBI were reporting symptoms, particularly headaches, dizziness, fatigue, visual disturbance, and memory difficulties. They exhibited slowing of information processing on neuropsychological measures, namely the WAIS–R Digit Symbol subtest and the Speed of Comprehension Test. By 3 months postinjury, the symptoms reported at 1 week had largely resolved, and no impairments were evident on neuropsychological measures. However, there was a subgroup of 24% of participants who were still suffering many symptoms, who were highly distressed, and whose lives were still significantly disrupted. These individuals did not have longer posttraumatic amnesia (PTA) duration. They were more likely to have a history of previous head injury, neurological or psychiatric problems, to be students, females, and to have been injured in a motor vehicle accident. The majority were showing significant levels of psychopathology. A range of factors, other than those directly reflecting the severity of injury, appear to be associated with outcome following mild TBI. (JINS, 2000, 6, 568–579.)

Incidence of Neck Pain in Pediatric Mild Traumatic Brain Injury in the Emergency Department

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S10.3-S11
Author(s):  
Brieana Hope Rodriguez ◽  
Danny Thomas
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Neck Pain ◽  
Mild Traumatic Brain Injury ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Motor Vehicle Accidents ◽  
Vehicle Accidents

ObjectiveTo determine (1) the frequency of reported cervical spine pain in patients diagnosed with mild traumatic brain injury (mTBI) in the Children's Hospital of Wisconsin emergency department (ED), and (2) the predictors of number of follow up visits for concussion related symptoms between those with and without neck pain.BackgroundThere has been little research on the frequency of concomitant injury, specifically neck pain associated with TBI in the pediatric population. Given the potential influence of neck pain on recovery from mTBI, we sought to report on the frequency of reported neck pain in the sample of pediatric ED patients reporting mTBI symptoms.Design/MethodsThe sample was obtained through a retrospective analysis in the setting of Children's Hospital of Wisconsin Emergency Department with a subject selection of patients diagnosed with a concussion/mTBI between the dates of 11/1/2015–06/30/2018.ResultsWe analyzed 652 charts. The frequency of reported neck pain in the pediatric population being evaluated for mTBI in the ED was 13.8%. Of these patients, 32.2% had subsequent follow up visits related to their concussion/neck pain compared to 31.1% in patients without neck pain in the ED. In regards to the TBI cause, 47.8% were due to accidental falls, 40.3% were due to other accidents not related to motor vehicles, and 10.0% were due to motor vehicle accidents.ConclusionsIn comparison to the adult mTBI population, the pediatric mTBI population had a significantly less reported frequency of neck pain in the ED. This is not surprising as the majority of adults presenting for concussions and neck pain are post-motor vehicle accidents, whereas the majority of children are presenting after accidental falls. There did not seem to be an association between concussions with concomitant neck pain and prolonged recovery or increased morbidity as determined by follow up visits.

Sign in / Sign up

Export Citation Format

Share Document