Carotid-Subclavian Bypass to Treat Carotid Dissection From Blunt Cerebrovascular Injury Without Traumatic Brain Injury or Cervical Spine Fracture

Traumatic brain injury (TBI) is common in our country. In our daily practice we are successfully managing TBI. But in some cases patient clinical conditions do not correlate with neuroimaging specially CT scan of brain. These injuries are generally missed due to lack of awareness, paucity of findings in the initial CT brain, and in some cases due to delayed clinical manifestation. For more effective and appropriate management especially blunt cerebrovascular injury we are reporting this. Moreover in RTA poly trauma make our choice of treatment more difficult but rational approach can safe a patient as did in our case.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 76-78

Download Full-text

Early antithrombotic therapy is safe and effective in patients with blunt cerebrovascular injury and solid organ injury or traumatic brain injury

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0000000000001058 ◽

2016 ◽

Vol 81 (1) ◽

pp. 173-177 ◽

Cited By ~ 29

Author(s):

Charles P. Shahan ◽

Louis J. Magnotti ◽

Paul B. McBeth ◽

Jordan A. Weinberg ◽

Martin A. Croce ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Antithrombotic Therapy ◽

Organ Injury ◽

Solid Organ ◽

Solid Organ Injury ◽

Blunt Cerebrovascular Injury ◽

Cerebrovascular Injury

Download Full-text

Surgical treatment of cervical spine fractures in ankylosing spondylitis patients: posterior stabilization using intraoperative CT scanner-based navigation

Perspectives in Surgery ◽

10.33699/pis.2020.99.5.212-218 ◽

2020 ◽

Vol 99 (5) ◽

pp. 212-218

Keyword(s):

Cervical Spine ◽

Ankylosing Spondylitis ◽

Ct Imaging ◽

Spine Fracture ◽

Cervical Spine Fracture ◽

Posterior Stabilization ◽

Visceral Injury ◽

Intraoperative Ct ◽

Screw Insertion ◽

Spinal Navigation

Introduction: The authors analyzed a series of ankylosing spondylitis patients with cervical spine fracture undergoing posterior stabilization using spinal navigation based on intraoperative CT imaging. The purpose of this study was to evaluate the accuracy and safety of navigated posterior stabilization and to analyze the adequacy of this method for treatment of fractures in ankylosed cervical spine. Methods: Prospectively collected clinical data, together with radiological documentation of a series of 8 consecutive patients with 9 cervical spine fracture were included in the analysis. The evaluation of screw insertion accuracy based on postoperative CT imaging, description of instrumentation- related complications and evaluation of morphological and clinical results were the subjects of interest. Results: Of the 66 implants inserted in all cervical levels and in upper thoracic spine, only 3 screws (4.5%) did not meet the criteria of anatomically correct insertion. Neither screw malposition nor any other intraoperative events were complicated by any neural, vascular or visceral injury. Thus we did not find a reason to change implant position intraoperatively or during the postoperative period. The quality of intraoperative CT imaging in our group of patients was sufficient for reliable trajectory planning and implant insertion in all segments, irrespective of the habitus, positioning method and comorbidities. In addition to stabilization of the fracture, the posterior approach also allows reducing preoperative kyphotic position of the cervical spine. In all patients, we achieved a stable situation with complete bone fusion of the anterior part of the spinal column and lateral masses at one year follow-up. Conclusion: Spinal navigation based on intraoperative CT imaging has proven to be a reliable and safe method of stabilizing cervical spine with ankylosing spondylitis. The strategy of posterior stabilization seems to be a suitable method providing high primary stability and the conditions for a subsequent high fusion rate.

Download Full-text

Cervicovestibular rehabilitation in adult with mild traumatic brain injury: a randomised controlled trial protocol

BMC Sports Science Medicine and Rehabilitation ◽

10.1186/s13102-019-0139-3 ◽

2019 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Pierre Langevin ◽

Philippe Fait ◽

Pierre Frémont ◽

Jean-Sébastien Roy

Keyword(s):

Traumatic Brain Injury ◽

Cervical Spine ◽

Brain Injury ◽

Neck Pain ◽

Mild Traumatic Brain Injury ◽

Controlled Trial ◽

Rehabilitation Program ◽

Conventional Approach ◽

Persistent Symptoms ◽

Link Type

Abstract Background Mild traumatic brain injury (mTBI) is an acknowledged public health problem. Up to 25% of adult with mTBI present persistent symptoms. Headache, dizziness, nausea and neck pain are the most commonly reported symptoms and are frequently associated with cervical spine and vestibular impairments. The most recent international consensus statement (2017 Berlin consensus) recommends the addition of an individualized rehabilitation approach for mTBI with persistent symptoms. The addition of an individualized rehabilitation approach including the evaluation and treatment of cervical and vestibular impairments leading to symptoms such as neck pain, headache and dizziness is, however, recommended based only on limited scientific evidence. The benefit of such intervention should therefore be further investigated. Objective To compare the addition of a 6-week individualized cervicovestibular rehabilitation program to a conventional approach of gradual sub-threshold physical activation (SPA) alone in adults with persistent headache, neck pain and/or dizziness-related following a mTBI on the severity of symptoms and on other indicators of clinical recovery. We hypothesize that such a program will improve all outcomes faster than a conventional approach (between-group differences at 6-week and 12-week). Methods In this single-blind, parallel-group randomized controlled trial, 46 adults with subacute (3 to12 weeks post-injury) persistent mTBI symptoms will be randomly assigned to: 1) a 6-week SPA program or 2) SPA combined with a cervicovestibular rehabilitation program. The cervicovestibular rehabilitation program will include education, cervical spine manual therapy and exercises, vestibular rehabilitation and home exercises. All participants will take part in 4 evaluation sessions (baseline, week 6, 12 and 26) performed by a blinded evaluator. The primary outcome will be the Post-Concussion Symptoms Scale. The secondary outcomes will be time to clearance to return to function, number of recurrent episodes, Global Rating of Change, Numerical Pain Rating Scale, Neck Disability Index, Headache Disability Inventory and Dizziness Handicap Inventory. A 2-way ANOVA and an intention-to-treat analysis will be used. Discussion Controlled trials are needed to determine the best rehabilitation approach for mTBI with persistent symptoms such as neck pain, headache and dizziness. This RCT will be crucial to guide future clinical management recommendations. Trial registration ClinicalTrials.gov Identifier - NCT03677661, Registered on September, 15th 2018.

Download Full-text