Head Injuries in Alpine Skiing

Currently, there are about 200 ski resorts in Russia from Smolensk to Chukotka, which are located both in the low mountains (GC "Tyagacheva", "Sarochany", etc.), and in the middle mountains ("Abzakovo", "Bannoe Lake", etc. ) and highlands (regions of the Elbrus region, Dombay, Krasnaya Polyana, etc.). More than six million Russians go downhill skiing and snowboarding every year. Over the years, the quality of sports equipment and track equipment has changed significantly, which has led to an increase in speeds, an increase in injuries and a change in teaching methods. Currently, a large number of people die and are seriously injured at ski resorts every year due to the low quality of training in safe skiing, lack of control over the work of instructors, and the irresponsible attitude of the holders of ski resorts to the safety of providing services on the ski slopes.

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Complete recovery following transorbital penetrating head injury traversing the brainstem: case report

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.6.peds19106 ◽

2019 ◽

Vol 24 (6) ◽

pp. 697-701 ◽

Cited By ~ 1

Author(s):

Mark A. MacLean ◽

Karim Mukhida ◽

Jai J. S. Shankar ◽

Matthias H. Schmidt ◽

David B. Clarke

Keyword(s):

Head Injuries ◽

Relevant Literature ◽

Subsequent Development ◽

Complete Recovery ◽

Endovascular Embolization ◽

Ophthalmological Examination ◽

Trauma Resuscitation ◽

Retained Foreign Body ◽

First Case ◽

Initial Injury

Transorbital penetration accounts for one-quarter of the penetrating head injuries (PHIs) in adults and half of those in children. Injuries that traverse (with complete penetration of) the brainstem are often fatal, with survivors rarely seen in clinical practice. Here, the authors describe the case of a 16-year-old male who suffered and recovered from an accidental transorbital PHI traversing the brainstem—the first case of complete neurological recovery following such injury. Neuroimaging captured the trajectory of the initial injury. A delayed-onset carotid cavernous fistula and the subsequent development of internal carotid artery pseudoaneurysms were managed by endovascular embolization.The authors also review the relevant literature. Sixteen cases of imaging-confirmed PHI traversing the brainstem have been reported, 14 involving the pons and 12 penetrating via the transorbital route. Management and outcome of PHI are informed by object velocity, material, entry point, trajectory, relationship to neurovascular structures, and the presence of a retained foreign body. Trauma resuscitation is followed by a careful neurological examination and appropriate neuroimaging. Ophthalmological examination is performed if transorbital penetration is suspected, as injuries may be occult; the potential for neurovascular complications highlights the value of angiography. The featured case shows that complete recovery is possible following injury that traverses the brainstem.

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