Traumatic Intracranial Aneurysms in Childhood: Two Cases and a Review of the Literature

Neurosurgery ◽  
1988 ◽  
Vol 22 (2) ◽  
pp. 398-408 ◽  
Author(s):  
Martin J. Buckingham ◽  
Kerry R. Crone ◽  
William S. Ball ◽  
Thomas A. Tomsick ◽  
Thomas S. Berger ◽  
...  
Keyword(s):  
Skull Base ◽  
Intracranial Aneurysms ◽  
Motor Vehicle ◽  
Skull Fracture ◽  
Penetrating Trauma ◽  
Gunshot Wounds ◽  
Male Predominance ◽  
Vehicle Accidents ◽  
Traumatic Aneurysms ◽  
Distal Anterior Cerebral Artery

Abstract Traumatic intracranial aneurysms in childhood are rare. To date, 67 well-documented cases in children have been reported. We present 2 additional cases and review the literature. Traumatic aneurysms can best be categorized based on mechanism of injury and location. Aneurysms secondary to penetrating trauma occur most commonly in teenage boys suffering gunshot wounds. Aneurysms secondary to nonpenetrating trauma occur at the skull base or in the periphery, with motor vehicle accidents and falls as the most common modes of injury. Skull base traumatic aneurysms most commonly involve the petrous, cavernous, or supraclinoid carotid artery and also show a predominance in teenage boys. Peripheral traumatic aneurysms can further be divided into distal anterior cerebral artery aneurysms secondary to trauma against the falcine edge and distal cortical artery aneurysms associated with an overlying skull fracture. Peripheral traumatic aneurysms tend to occur in younger patients with a less marked male predominance. Two-thirds of the patients suffered symptomatic aneurysmal hemorrhage, with an associated mortality rate of 31%. The clinical presentation, diagnosis, and treatment of traumatic intracranial aneurysms are discussed. (Neurosurgery 22:398-408, 1988)

scholarly journals Renal trauma: the current best practice

2018 ◽  
Vol 10 (10) ◽  
pp. 295-303 ◽  
Author(s):  
Tomer Erlich ◽  
Noam D. Kitrey
Keyword(s):  
Renal Injury ◽  
Best Practice ◽  
Motor Vehicle ◽  
Penetrating Trauma ◽  
High Energy ◽  
Renal Trauma ◽  
Common Mechanism ◽  
Trauma Patients ◽  
Vehicle Accidents ◽  
Enhanced Computed Tomography

The kidneys are the most vulnerable genitourinary organ in trauma, as they are involved in up to 3.25% of trauma patients. The most common mechanism for renal injury is blunt trauma (predominantly by motor vehicle accidents and falls), while penetrating trauma (mainly caused by firearms and stab wound) comprise the rest. High-velocity weapons impose specifically problematic damage because of the high energy and collateral effect. The mainstay of renal trauma diagnosis is based on contrast-enhanced computed tomography (CT), which is indicated in all stable patients with gross hematuria and in patients presenting with microscopic hematuria and hypotension. Additionally, CT should be performed when the mechanism of injury or physical examination findings are suggestive of renal injury (e.g. rapid deceleration, rib fractures, flank ecchymosis, and every penetrating injury of the abdomen, flank or lower chest). Renal trauma management has evolved during the last decades, with a distinct evolution toward a nonoperative approach. The lion’s share of renal trauma patients are managed nonoperatively with careful monitoring, reimaging when there is any deterioration, and the use of minimally invasive procedures. These procedures include angioembolization in cases of active bleeding and endourological stenting in cases of urine extravasation.

scholarly journals Epidemiology of children with head injury: a national overview

2016 ◽  
Vol 101 (6) ◽  
pp. 527-532 ◽  
Author(s):  
L Trefan ◽  
R Houston ◽  
G Pearson ◽  
R Edwards ◽  
P Hyde ◽  
...  
Keyword(s):  
Head Injury ◽  
Child Protection ◽  
Motor Vehicle ◽  
Social Deprivation ◽  
Descriptive Analysis ◽  
Skull Fracture ◽  
Neurological Impairment ◽  
Vehicle Accidents ◽  
School Aged Children ◽  
Trauma Networks

BackgroundThe National Confidential Enquiry describes the epidemiology of children admitted to hospital with head injury.MethodChildren (<15 years old) who died or were admitted for >4 h with head injury were identified from 216 UK hospitals (1 September 2009 to 28 February 2010). Data were collected using standard proformas and entered on to a database. A descriptive analysis of the causal mechanisms, child demographics, neurological impairment, CT findings, and outcome at 72 h are provided.ResultsDetails of 5700 children, median age 4 years (range 0–14.9 years), were analysed; 1093 (19.2%) were <1 year old, 3500 (61.4%) were boys. There was a significant association of head injury with social deprivation 39.7/100 000 (95% CI 37.0 to 42.6) in the least deprived first quintile vs. 55.1 (95% CI 52.1 to 58.2) in the most deprived fifth quintile (p<0.01). Twenty-four children died (0.4%). Most children were admitted for one night or less; 4522 (79%) had a Glasgow Coma Scale score of 15 or were Alert (on AVPU (Alert, Voice, Pain, Unresponsive)). The most common causes of head injury were falls (3537 (62.1%); children <5 years), sports-related incidents (783 (13.7%); median age 12.4 years), or motor vehicle accidents (MVAs) (401 (7.1%); primary-school-aged children). CT scans were performed in 1734 (30.4%) children; 536 (30.9%) were abnormal (skull fracture and/or intracranial injury or abnormality): 269 (7.6%) were falls, 82 (10.5%) sports related and 100 (25%). A total of 357 (6.2%) children were referred to social care because of child protection concerns (median age 9 months (range 0–14.9 years)).ConclusionsThe data described highlight priorities for targeted age-specific head injury prevention and have the potential to provide a baseline to evaluate the effects of regional trauma networks (2012) and National Institute of Health and Care Excellence (NICE) head injury guidelines (2014), which were revised after the study was completed.

Lumbosacral Plexopathy in Gunshot Wounds and Motor Vehicle Accidents

2001 ◽  
Vol 80 (4) ◽  
pp. 280-285 ◽  
Author(s):  
Faye Y. Chiou-Tan ◽  
Kenneth Kemp ◽  
Marcia Elfenbaum ◽  
Kwai-Tung Chan ◽  
James Song
Keyword(s):  
Motor Vehicle ◽  
Gunshot Wounds ◽  
Motor Vehicle Accidents ◽  
Vehicle Accidents ◽  
Lumbosacral Plexopathy

scholarly journals A Single-Center Review of Radiologically Diagnosed Maxillofacial Fractures: Etiology and Distribution

2017 ◽  
Vol 10 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Jordan N. Halsey ◽  
Ian C. Hoppe ◽  
Mark S. Granick ◽  
Edward S. Lee
Keyword(s):  
Frontal Sinus ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Facial Skeleton ◽  
Male Predominance ◽  
Vehicle Accidents ◽  
Patient Demographics ◽  
Maxillofacial Fractures ◽  
Mandible Fractures ◽  
Fracture Types

The etiology of fractures of the maxillofacial skeleton varies among studies, with motor vehicle accidents and assaults oftentimes the most common. The number of males outnumbers females throughout most studies. Fractures of the zygoma, orbit, and mandible are usually cited as most common fracture types. This study examines a single center's experience with regards to etiology and distribution of fractures. A retrospective review of all radiologically confirmed facial fractures in a level 1 trauma center in an urban environment was performed for the years 2000 to 2012. Patient demographics, etiology of injury, and location of fractures were collected. During this time period, 2,998 patients were identified as having sustained a fracture of the facial skeleton. The average age was 36.9 years, with a strong male predominance (81.5%). The most common etiologies of injury were assault (44.9%) and motor vehicle accidents (14.9%). Throughout the study period, the number of fractures as a result of assault remained relatively constant, whereas the number as a result of motor vehicle accidents decreased slightly. The most common fracture observed was of the orbit, followed by mandible, nasal bones, zygoma, and frontal sinus. Patients sustaining a fracture as a result of assault were more likely to have a mandible fracture. Patients in motor vehicle accidents were more likely to suffer fractures of the maxilla, orbit, and frontal sinus. Mandible fractures are more common in cases of assault. Motor vehicle accidents convey a large force, which, when directed at the craniofacial skeleton, can cause a variety of fracture patterns. The decreasing number of fractures as a result of motor vehicle accidents may represent improved safety devices such as airbags.

scholarly journals Versatility of Subscapular Chimeric Free Flaps in the Secondary Reconstruction of Composite Posttraumatic Defects of the Upper Face

2015 ◽  
Vol 8 (1) ◽  
pp. 42-49 ◽  
Author(s):  
MarkWinston Stalder ◽  
MatthewWhitten Wise ◽  
Charles L. Dupin ◽  
Hugo St Hilaire
Keyword(s):  
Motor Vehicle ◽  
Traumatic Injury ◽  
Free Flaps ◽  
Gunshot Wounds ◽  
High Energy ◽  
Skin Paddle ◽  
Secondary Reconstruction ◽  
Vehicle Accidents ◽  
Upper Face ◽  
Tissue Defects

High energy injuries to the upper face present challenging reconstructive problems. In some cases, initial reconstructive efforts result in unfavorable outcomes that require secondary intervention. Chimeric free flaps based on the subscapular system offer the tissue components and volume needed for these complex reconstructions. This is a series of five patients who underwent secondary reconstruction of the middle and upper face following traumatic injury. Mechanism of injury, prior attempts at reconstruction, and characteristics of the tissue defects and the flaps used in their reconstruction are described. Two patients were female and three were male. Three injuries resulted from gunshot wounds, and two from motor vehicle accidents. All patients had multiple prior failed attempts at reconstruction using local/regional tissue. Defects included symptomatic oronasal or oro-orbital fistulas, enophthalmos, and forehead contour deformities. Two of the flaps used included scapular bone and latissimus muscular components, and three included scapular bone and thoracodorsal artery perforator-based skin paddle components. All free tissue transfers were successful, and no patients suffered significant complications. Chimeric free flaps based on the subscapular system offer a valuable secondary strategy for reconstruction of composite defects of the upper face when other options have been exhausted through previous efforts.

scholarly journals Lesão Visceral em Trauma Abdominal: Um Estudo Retrospetivo

2013 ◽  
Vol 26 (6) ◽  
pp. 725
Author(s):  
Sara Leite ◽  
António Taveira-Gomes ◽  
Hugo Sousa
Keyword(s):  
Abdominal Trauma ◽  
Motor Vehicle ◽  
Penetrating Trauma ◽  
Gunshot Wounds ◽  
Vehicle Collisions ◽  
Revised Trauma Score ◽  
Abdominal Stab Wounds ◽  
Trauma Score ◽  
Pedestrian Collisions ◽  
Clinical File

Background: Abdominal trauma is a major cause of morbi-mortality all over the world which makes it essential an approach focused on rapid diagnosis and treatment. The main goals of this study are to identify global epidemiologic data of abdominal trauma in our tertiary trauma center and to study traumatic lesions, treatment and outcome.Material and Methods: Retrospective analysis of the clinical file of all patients admitted with abdominal trauma, over a period of 5 years, in a tertiary trauma center.Results: the total mean of ages was 42.6 years and the male gender was the most affected (74.2%). At admission, most patients had a Revised Trauma Score > 4. The mainly causes of trauma were blunt from motor-vehicle collisions (39.9% as motor-vehicle occupant and 10.7% from pedestrian collisions) and falls (25.5%). Penetrating trauma, by abdominal stab wounds and gunshot wounds, occurred only in 12.3% of the cases. Hollow visceral injuries were more frequent in that context. In 19.5% of the cases multiple abdominal organinjury occurred. Conservative treatment was performed in 65.3% of the cases. Global mortality was 12%, being null after penetrating lesions.Conclusions: Abdominal trauma, more frequently, is the result of motor-vehicle crashes and falls, being blunt in the majority of the cases. The most affected organs are solid and the approach is conservative. Hollow visceral lesions continue to be of difficult diagnose.

scholarly journals Impact of COVID-19 and Shelter in Place on Volume and Type of Traumatic Injuries

2021 ◽  
Vol 22 (5) ◽  
pp. 1060-1066
Author(s):  
James Murrett ◽  
Emily Fu ◽  
Zoe Maher ◽  
Crystal Bae ◽  
Wayne Satz ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Penetrating Trauma ◽  
Retrospective Chart Review ◽  
Gunshot Wounds ◽  
Health Crisis ◽  
Traumatic Injuries ◽  
Social Distancing ◽  
Level I ◽  
Novel Coronavirus ◽  
The Impact

Introduction: Very little is known about the effects of the novel coronavirus (COVID-19) pandemic and its associated social distancing practices on trauma presentations to the emergency department (ED). This study aims to assess the impact of a city-wide stay at home order on the volume, type, and outcomes of traumatic injuries at urban EDs. Methods: The study was a retrospective chart review of all patients who presented to the ED of an urban Level I Trauma Center and its urban community affiliate in the time period during the 30 days before the institution of city-wide shelter-in-place (preSIP) order and 60 days after the shelter-in-place (SIP) order and the date-matched time periods in the preceding year. Volume and mechanism of traumatic injuries were compared using paired T-tests. Results: There was a significant decrease in overall ED volume. The volume of certain blunt trauma presentations (motor vehicle collisions) during the first 60 days of SIP compared to the same period from the year prior also significantly decreased. Importantly, the volume of penetrating injuries, including gunshot wounds and stab wounds, did not differ for the preSIP and SIP periods when compared to the prior year. The mortality of traumatic injuries was also unchanged during the SIP comparison period. Conclusion: While there were significant decreases in visits to the ED and overall trauma volume, penetrating trauma, including gun violence, and other severe traumatic injuries remain a public health crisis that affects urban communities despite social distancing recommendations enacted during the COVID-19 pandemic.

scholarly journals Maxillary Fractures

2021 ◽  
pp. 1125-1149
Author(s):  
Oommen Aju Jacob ◽  
Akhilesh Prathap
Keyword(s):  
Interpersonal Violence ◽  
Motor Vehicle ◽  
Gunshot Wounds ◽  
Facial Trauma ◽  
Loss Of Function ◽  
Industrial Accidents ◽  
Comprehensive Overview ◽  
Vehicle Accidents ◽  
The Face ◽  
And Function

AbstractFacial trauma is often associated with severe morbidity with respect to loss of function and disfigurement. The maxilla is arguably the most anatomically intricate structure of the face and blunt trauma due to interpersonal violence, motor vehicle accidents, gunshot wounds, industrial accidents and falls contribute to etiology of maxillary fractures. Fractures of the midface are often challenging to the maxillofacial surgeon, due to wide variety of patterns of the fracture, diagnostic challenges and treatment dilemmas. The basic tenet in the management of these fractures is to reconstitute the vertical and horizontal buttresses of the midface, thus reestablishing structure and function. This chapter gives a comprehensive overview on the diagnosis, management and treatment of fractures of the Maxilla.

Census Data for Health Preparedness and Response

2005 ◽  
pp. 373-380
Author(s):  
Jane L. Garb ◽  
Richard B. Wait
Keyword(s):  
Disease Surveillance ◽  
Census Data ◽  
Motor Vehicle ◽  
Gunshot Wounds ◽  
Well Being ◽  
Public And Private ◽  
Vehicle Accidents ◽  
Technological Disasters ◽  
Risk Of Disease ◽  
Disease Epidemics

The epidemiologist works with researchers in various disciplines as well as public and private health practitioners who are responsible for maintaining and improving the health of the population. Health is defined as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”(WHO, 1948). The role of the epidemiologist is to provide information on the extent, etiology and risk of disease or injury. Key to this role is knowledge of the location, size and demographic makeup of the population at risk for developing disease or injury. By integrating this information with the location of cases as well as risk factors, epidemiologists can make a vital contribution to disease and injury prevention, intervention and response. This applies both to endemic or “usual” levels of both chronic diseases like cancer or heart disease and infectious diseases like pneumonia or influenza, and injuries like gunshot wounds or motor vehicle accidents. It also applies to disease epidemics or outbreaks like SARS; attacks by biological or chemical weapons such as Anthrax, ricin or sarin; and inadvertent natural or technological disasters including earthquakes, transportation disasters or widespread power interruptions. This chapter explores the types of census data for disease surveillance, prevention and intervention.

Sign in / Sign up

Export Citation Format

Share Document