scholarly journals Management of supratentorial epidural hematoma in children: report on 49 patients

2010 ◽  
Vol 68 (6) ◽  
pp. 888-892 ◽  
Author(s):  
Wellingson Silva Paiva ◽  
Almir Ferreira de Andrade ◽  
Luis Mathias Júnior ◽  
Vinicius Monteiro de Paula Guirado ◽  
Robson Luis Amorim ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Neurological Status ◽  
Neurological Impairment ◽  
Common Symptom ◽  
Traumatic Head Injury ◽  
Patients Âgés ◽  
Vehicle Accidents ◽  
Long Term Follow Up ◽  
History Of

Traumatic head injury is a common cause of mortality and acquired neurological impairment in children. However, pediatric epidural hematomas (EDHs) are not common and few series have studied the evolution of these patients. In this study, we present the results from a sample of patients with EDH with long-term follow-up. METHOD: Between January 2006 and December 2008, 49 patients with traumatic EDH were treated at our unit. Clinical course, radiological findings and outcomes were evaluated. Neurological status was assessed using the Glasgow Coma Scale (GCS). The patients' ages ranged from one day to 16 years. The mean follow-up was six months. RESULTS: On admission, most of the patients presented mild trauma and 57% had a GCS of 13-15. The most common symptom was irritability. The most frequent mechanisms of injury were: falling from a height in 29 cases and motor vehicle accidents in 16 cases. Three of these patients presented GCS 3, but only one died. We found a late neurological deficit in nine patients. CONCLUSION: These lesions may occur following mild head trauma and in alert children with nonfocal neurological examinations. However, in children presenting irritability with subgaleal hematomas and a history of loss of consciousness, skull computed tomography must be performed.

scholarly journals Concussion and Court: The Role Litigation Plays in Time to Recovery

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S17.1-S17
Author(s):  
Jennifer McVige ◽  
Dilpreet Kaur ◽  
Michael Lillis ◽  
Brianna Albert ◽  
Kabir Jalal
Keyword(s):  
Motor Vehicle ◽  
Survival Curve ◽  
Secondary Analysis ◽  
Mechanism Of Injury ◽  
Post Injury ◽  
Patients Âgés ◽  
Vehicle Accidents ◽  
Significant Difference ◽  
History Of ◽  
Matched Samples

ObjectiveTo evaluate whether there is a difference in time to recovery (TTR) between concussion patients who have and have not pursued litigation post injury, and determine what factors might influence someone’s decision to litigate.BackgroundAn investigation on how litigation influenced TTR in all types of recovery.Design/MethodsA retrospective study of 851 adult and pediatric patients, ages 1–78 (333men and 518 women) in a concussion clinic. Injuries included, motor vehicle accidents MVA (n = 181), falls (n = 140), assaults (n = 36), sporting injuries (n = 378) and other (n = 116). Full and matched samples were studied by symptom endorsement, (headache, dizziness, sleep disturbance, attention/concentration dysfunction and moodiness), litigation/non-litigation and TTR (survival-curve). Secondary analysis reviewed abuse/depression, mechanism-of-injury and symptom type as it related to litigation/non-litigation.Results1) The odds ratio (OR) in the logistic regression model for the unmatched sample shows increasing age, fewer total symptoms (<3 symptoms vs. ≥3), history of abuse/depression, and mechanism-of-injury as significant predictors of litigation status. MVA, compared to sports/other injuries, showed the greatest rates of litigation (OR = 98.121). Higher total symptoms showed increased litigation (OR = 0.238), where abuse/depression patients are less likely to pursue litigation (OR = 0.063/OR = 0.214). 2) A survival analysis of unmatched patients suggested that patients engaging in litigation have a longer TTR (Litigation TTR M = 293 days vs. non-litigation TTR M = 130 days). However, a matched analysis, which grouped patients by age, #of symptoms, abuse/depression history, and mechanism-of-injury, showed no significant difference in survival time between patients based on litigation status. (Litigation TTR M = 269 days vs. non-litigation TTR M = 223 days).ConclusionsWhile litigation patients are often stereotyped to malinger and exaggerate symptoms, this data showed that with appropriate matched analysis, there was no difference between litigation/non-litigation patients with TTR. The desire to pursue litigation may be influenced by several factors; athletes were less likely to litigate. These findings are important for physicians and attorneys to consider when tasked with focusing on recovery time in litigation cases.

scholarly journals Application of the Monti channel in female adult with urethral injuries in pelvic trauma

2011 ◽  
Vol 25 (1) ◽  
pp. 16
Author(s):  
Hanchao Zhang ◽  
Ashok Kumar Kunwar ◽  
Yi Dai ◽  
Deyi Luo ◽  
Hong Shen
Keyword(s):  
Motor Vehicle ◽  
Pelvic Trauma ◽  
Vehicle Accidents ◽  
Number Of Patients ◽  
Long Term Follow Up ◽  
History Of ◽  
Post Traumatic ◽  
A New Technique ◽  
Urethral Defect ◽  
Urinary Reconstruction

<em>Objective</em>. To report 3 cases using the Monti ileovesicostomy as a continent catheterizable stoma in women with post-traumatic resulted in loss of the urethra. <em>Materials and Methods</em>. Between April and November 2010, the Monti technique was performed as a reconstructive procedure in 3 female patients at our institution. All cases had history of posterior urethral defect, two motor vehicle accidents, and one pelvic crush injury. Channels were created by transversely reconfigured segment of ileum. The 3 patients age was 20, 41, and 43 years. Indications, technique, complications and outcomes are reported below. <em>Results</em>. Three patients were undergone for transversely re-tubularized ileal segment urinary reconstruction. All of them were evaluated from 5 to 12 months postoperatively. All patients’ postoperative visits to our outpatient gynecological clinic about 3, 6 and 12 months respectively after Monti ileovesicostomy operation revealed no dehiscence, necrosis, stenosis or perforation of the tube. All performed catheterization through the conduit without difficulty. <em>Conclusion</em>. The Monti ileovesicostomy is a new technique for creation of a continent catheterizable stoma. Based on our data, Monti procedure seems to be a valuable technique in patients with complicated urethral defect who cannot be managed with routine urethroplastic techniques. This reconstruction provides another option for a diversion technique in patients with irreparable urethral damage. However, evaluation whether it can be extensively developed still need more investigations with larger number of patients by long-term follow up.

The natural history of pituitary apoplexy: long term follow-up study

2019 ◽  
Author(s):  
Ayesha Shaikh ◽  
Natasha Shrikrishnapalasuriyar ◽  
Giselle Sharaf ◽  
David Price ◽  
Maneesh Udiawar ◽  
...  
Keyword(s):  
Natural History ◽  
Pituitary Apoplexy ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
History Of

scholarly journals Long-Term Follow-Up of a Female Patient Treated with Olaparib—Hope for a Long Life without Relapse?

2021 ◽  
Vol 18 (7) ◽  
pp. 3430
Author(s):  
Mateusz Kozłowski ◽  
Katarzyna Nowak ◽  
Aneta Cymbaluk-Płoska
Keyword(s):  
Ovarian Cancer ◽  
Parp Inhibitor ◽  
Brca1 Gene ◽  
High Specificity ◽  
Reproductive Organs ◽  
Platinum Based Chemotherapy ◽  
Long Term Follow Up ◽  
History Of ◽  
Advanced Stages

Ovarian cancer is one of the most common cancers of the reproductive organs. As there are no symptoms in the early stages, it is mainly detected in the advanced stages. Even then, the symptoms are non-specific and include, for example, abdominal pain, early satiety, or changes in bowel habits. Both biochemical marker levels and imaging studies are used in the initial diagnosis. However, it should be emphasized that they are not characterized by high specificity. Treatment is multistage, and usually first-line debulking surgery is used followed by platinum-based chemotherapy. Here we present a clinical case of a 56-year-old female, a carrier of a mutation in the BRCA1 gene, with a history of breast cancer and with recurrent epithelial ovarian cancer. The patient was qualified for treatment with a PARP inhibitor and is currently undergoing treatment with olaparib. In the patient’s follow up of 50 months to date, there has been no recurrence of cancer. Few side effects have been observed, and the most serious one that can be effectively treated is anemia. On the basis of the described case, the authors concluded that olaparib treatment is effective, relatively safe, and does not significantly affect daily functioning.

The Role of Obesity in Motor Vehicle Injuries and Fatalities in the Pediatric Population: A Systematic Review

2021 ◽  
pp. 088506662199273
Author(s):  
Zana Alattar ◽  
Shelby Hoebee ◽  
Eyal Ron ◽  
Paul Kang ◽  
Eric vanSonnenberg
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Extremity Injury ◽  
Obese Children ◽  
Patients Âgés ◽  
Vehicle Accidents ◽  
Increased Risk ◽  
Extremity Injuries

Purpose: A systematic review done to evaluate obesity as a risk factor for injuries and mortality in motor vehicle accidents (MVAs) in the pediatric population, as there has not been a systematic review done in over 10 years. This study aims to update the literature regarding obesity as a risk factor for injuries in MVAs in the pediatric population. Materials and Methods: A systematic review was conducted according to the PRISMA guidelines with strict inclusion and exclusion criteria, resulting in the use of 3 total articles to analyze obesity as a risk factor for overall injury and mortality in the pediatric population. Results: Zaveri et al demonstrated a statistically significant, but weak, decrease in the odds of extremity injury in overweight patients ages 2 to 17 years old (odds ratio [OR] = 0.6, 95% confidence interval [CI] = 0.4-1.0, P ≤ 0.05). On the other hand, Pollack et al and Haricharan et al found an increase in extremity injury in the obese population, in ages 9 to 15 years (OR = 2.54, 95% CI = 1.15-5.59, P ≤ 0.05), and 10 to 17 years (Age 10-13: OR = 6.06, 95% CI = 2.23-16.44, P ≤ 0.05, Age 14-17 OR = 1.44, 95% CI = 1.04-2.00, P ≤ 0.05), respectively. Haricharan et al also found an increase in thoracic injuries in obese children, ages 2 to 13 and increased risk of head/face/neck injury in obese children ages 2 to 5 (OR = 3.67, 95% CI = 1.03-13.08, P ≤ 0.05), but a decreased risk of head injury in obese children ages 14 to 17 (OR = 0.33, 95% CI = 0.18-0.60, P ≤ 0.05). Conclusions: There are sparse data that are conflicting, regarding the effect of obesity on extremity injuries in the pediatric population. Obesity is not protective against thoracic, head, or abdominal injuries. However, it was found to be a risk factor for trunk injuries in ages 2 to 13, as well as head/face/neck injuries for ages 2 to 5. Since the literature is so sparse, further research is warranted in these areas.

ID: 3524040 THE NATURAL HISTORY OF AMPULLARY ADENOMAS IN FAMILIAL ADENOMATOUS POLYPOSIS SYNDROME: LONG-TERM FOLLOW-UP

2021 ◽  
Vol 93 (6) ◽  
pp. AB350
Author(s):  
Achintya D. Singh ◽  
Amit Bhatt ◽  
Abel Joseph ◽  
Neal Mehta ◽  
Gautam N. Mankaney ◽  
...  
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Natural History ◽  
Adenomatous Polyposis ◽  
Polyposis Syndrome ◽  
Long Term Follow Up ◽  
History Of

Extramedullary Plasmacytoma of The Frontal Sinus: A Case Report

FACE ◽  
2021 ◽  
pp. 273250162110536
Author(s):  
Joshua Harrison ◽  
Samantha Marley ◽  
Shawhin Shahriari ◽  
Christian Bowers ◽  
Anil Shetty
Keyword(s):  
Frontal Sinus ◽  
Surgical Excision ◽  
Extramedullary Plasmacytoma ◽  
High Rate ◽  
Solitary Plasmacytoma ◽  
Case Presentation ◽  
Long Term Follow Up ◽  
History Of

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.

Circumferential fracture of the skull base causing craniocervical dislocation

2002 ◽  
Vol 97 (1) ◽  
pp. 118-122 ◽  
Author(s):  
Ganesh Rao ◽  
Adam S. Arthur ◽  
Ronald I. Apfelbaum
Keyword(s):  
High Speed ◽  
Unusual Case ◽  
Motor Vehicle ◽  
Neurological Impairment ◽  
Craniocervical Junction ◽  
Motor Vehicle Accidents ◽  
Review Of The Literature ◽  
Content Type ◽  
Vehicle Accidents ◽  
Fine Print

✓ Fractures of the craniocervical junction are common in victims of high-speed motor vehicle accidents; indeed, injury to this area is often fatal. The authors present the unusual case of a young woman who sustained a circumferential fracture of the craniocervical junction. Despite significant trauma to this area, she suffered remarkably minor neurological impairment and made an excellent recovery. Her injuries, treatment, and outcome, as well as a review of the literature with regard to injuries at the craniocervical junction, are discussed.

Sign in / Sign up

Export Citation Format

Share Document