scholarly journals Anesthetic management for emergency caesarean section and craniotomy together: an overview of the challenge

2020 ◽  
Vol 9 (4) ◽  
pp. 1717
Author(s):  
Nidhi Pathak ◽  
Misha Katyal
Keyword(s):  
Traumatic Brain Injury ◽  
Pregnant Woman ◽  
Brain Injury ◽  
Caesarean Section ◽  
Anesthetic Management ◽  
Skull Fracture ◽  
Fetal Distress ◽  
Anaesthetic Management ◽  
Emergency Caesarean Section ◽  
Brain Contusion

Traumatic brain injury in a pregnant woman is a challenge for anaesthesiologist, surgeon as well as paediatrician as it involves care and management of two lives together. We hereby discuss anaesthetic management of a 23 year old pregnant woman with extra axial bleed and brain contusion and skull fracture. Since the fetus was viable without signs of fetal distress, decision of doing caesarean section followed by craniotomy was taken and our patient was discharged a week later and the baby was handed over to attendant the next day.

scholarly journals Anaesthetic Management of Parturient with Acute Atrial Fibrillation for Emergency Caesarean Section

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Madhu Gupta ◽  
Shalini Subramanian ◽  
Preeti Adlakha
Keyword(s):  
Atrial Fibrillation ◽  
Caesarean Section ◽  
Mitral Stenosis ◽  
Fetal Distress ◽  
Anaesthetic Management ◽  
Acute Onset ◽  
Emergency Caesarean Section ◽  
Emergency Caesarean ◽  
Parturient Woman ◽  
Cardiac Symptoms

A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE) anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate their cardiac symptoms. They may present with complications like congestive cardiac failure, atrial fibrillation, or pulmonary thromboembolism during the antenatal, intrapartum, or postpartum period. Here we discuss the management of parturient woman with high maternal and fetal risk presenting for emergency caesarean. The merits of regional anaesthesia and the importance of invasive monitoring are also discussed.

scholarly journals What are the strongest indicators of intracerebral hemorrhage in mild traumatic brain injury?

2021 ◽  
Vol 6 (1) ◽  
pp. e000717
Author(s):  
Panu Teeratakulpisarn ◽  
Phati Angkasith ◽  
Thanakorn Wannakul ◽  
Parichat Tanmit ◽  
Supatcha Prasertcharoensuk ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
High Risk ◽  
Ct Scan ◽  
Mild Traumatic Brain Injury ◽  
Skull Fracture ◽  
Brain Ct ◽  
Baseline Characteristics ◽  
Gcs Score ◽  
The Brain

BackgroundAlthough there are eight factors known to indicate a high risk of intracranial hemorrhage (ICH) in mild traumatic brain injury (TBI), identification of the strongest of these factors may optimize the utility of brain CT in clinical practice. This study aimed to evaluate the predictors of ICH based on baseline characteristics/mode of injury, indications for brain CT, and a combination of both to determine the strongest indicator.MethodsThis was a descriptive, retrospective, analytical study. The inclusion criteria were diagnosis of mild TBI, high risk of ICH, and having undergone a CT scan of the brain. The outcome of the study was any type of ICH. Stepwise logistic regression analysis was used to find the strongest predictors according to three models: (1) injury pattern and baseline characteristics, (2) indications for CT scan of the brain, and (3) a combination of models 1 and 2.ResultsThere were 100 patients determined to be at risk of ICH based on indications for CT of the brain in patients with acute head injury. Of these, 24 (24.00%) had ICH. Model 1 found that injury due to motor vehicle crash was a significant predictor of ICH, with an adjusted OR (95% CI) of 11.53 (3.05 to 43.58). Models 2 and 3 showed Glasgow Coma Scale (GCS) score of 13 to 14 after 2 hours of observation and open skull or base of skull fracture to be independent predictors, with adjusted OR (95% CI) of 11.77 (1.32 to 104.96) and 5.88 (1.08 to 31.99) according to model 2.DiscussionOpen skull or base of skull fracture and GCS score of 13 to 14 after 2 hours of observation were the two strongest predictors of ICH in mild TBI.Level of evidenceIII.

scholarly journals Multisite medical record review of emergency department visits for traumatic brain injury

2021 ◽  
Vol 27 (S1) ◽  
pp. i42-i48
Author(s):  
Barbara A Gabella ◽  
Jeanne E Hathaway ◽  
Beth Hume ◽  
Jewell Johnson ◽  
Julia F Costich ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Skull Fracture ◽  
Signs And Symptoms ◽  
International Classification Of Diseases ◽  
Emergency Department Visits ◽  
Intracranial Injury ◽  
Imaging Results ◽  
Icd 10

BackgroundIn 2016, the CDC in the USA proposed codes from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for identifying traumatic brain injury (TBI). This study estimated positive predictive value (PPV) of TBI for some of these codes.MethodsFour study sites used emergency department or trauma records from 2015 to 2018 to identify two random samples within each site selected by ICD-10-CM TBI codes for (1) intracranial injury (S06) or (2) skull fracture only (S02.0, S02.1-, S02.8-, S02.91) with no other TBI codes. Using common protocols, reviewers abstracted TBI signs and symptoms and head imaging results that were then used to assign certainty of TBI (none, low, medium, high) to each sampled record. PPVs were estimated as a percentage of records with medium-certainty or high-certainty for TBI and reported with 95% confidence interval (CI).ResultsPPVs for intracranial injury codes ranged from 82% to 92% across the four samples. PPVs for skull fracture codes were 57% and 61% in the two university/trauma hospitals in each of two states with clinical reviewers, and 82% and 85% in the two states with professional coders reviewing statewide or nearly statewide samples. Margins of error for the 95% CI for all PPVs were under 5%.DiscussionICD-10-CM codes for traumatic intracranial injury demonstrated high PPVs for capturing true TBI in different healthcare settings. The algorithm for TBI certainty may need refinement, because it yielded moderate-to-high PPVs for records with skull fracture codes that lacked intracranial injury codes.

scholarly journals Management of Traumatic Brain Injury: A review Update

2017 ◽  
Vol 6 (2) ◽  
pp. 87-89
Author(s):  
ATM Ashadullah ◽  
Monirul Islam ◽  
Fazley Elahi Milad ◽  
Abdullah Alamgir ◽  
Md Shafiul Alam
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injuries ◽  
Skull Fracture ◽  
Traumatic Injury ◽  
Loss Of Consciousness ◽  
Extradural Haematoma ◽  
Inner Surface ◽  
Injury Patient ◽  
Extradural Haematomas

Traumatic Brain Injury leads to serious consequences. Approximately half of all deaths is related to traumatic injury and the main cause of head trauma. Extradural haematomas (EDH) develops in all major head injuries. A head injury patient who is only temporary loss of consciousness and is left asleep may sometimes be found dead in the bed next morning due to extradural haematoma. Extradural haematoma which lies in between the inner surface of skull and stripes of dural membrane, are nearly always caused by, and located near a skull fracture. The collection takes several forms in terms of size, location, speed of development and effects they exert on patient. Immediate management is necessary to decrease the bad consequences. In this review the management of traumatic brain injury is highlighted.J Shaheed Suhrawardy Med Coll, 2014; 6(2):87-89

Chikungunya–dengue co-infection during pregnancy requiring preterm Caesarean section: first case report from Bangladesh

2017 ◽  
Vol 48 (3) ◽  
pp. 234-235 ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Shahana Zaman ◽  
Nasreen Sultana ◽  
Ariful Islam ◽  
Khwaja Nazim Uddin
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Fetal Distress ◽  
Emergency Caesarean Section ◽  
Emergency Caesarean ◽  
First Case

We report the first case of chikungunya-dengue co-infection during pregnancy requiring emergency Caesarean section (CS) because of fetal distress in a Bangladeshi primigravida. Though previously unreported, this situation may become increasingly common.

scholarly journals Traumatic Brain Injury Patterns on Ct Scan: A Comparison of Motorcyclist Versus Passenger Vehicle Patients Involved in Road Traffic Accidents

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Radhiana Hassan ◽  
Muniruddin Mohamad ◽  
Muhamad Zaim Azami ◽  
Husin Ali ◽  
Hafizah Pasi
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Skull Fracture ◽  
Common Finding ◽  
Subdural Hemorrhage ◽  
Road Traffic Accidents ◽  
Passenger Vehicle ◽  
Injury Patterns

Introduction: Traumatic brain injury following road traffic accidents is a common cause of morbidity and mortality in Malaysia. We aim to determine the differences of traumatic brain injury patterns based on CT findings among motorcyclist versus passenger vehicle patients involved in road traffic accidents. Materials and method: This retrospective study was conducted in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang. A total of 100 CT scan brains of patients who were involved in road traffic accidents were retrieved and reviewed, 50 of them were motorcyclists and the other 50 were passenger vehicles. Results: Fifty percent of the motorcyclists had an abnormal CT brain finding while only 24% of the passenger vehicle showed abnormal finding. Among motorcyclist, skull fracture was the most common finding (30%) followed by subdural hemorrhage (28%). Among passenger vehicle, the most common finding was subdural hemorrhage (10%) followed by subarachnoid hemorrhage, intraparenchymal haemorrhage and skull fracture (8% each). The motorcyclist had significantly higher rate of subdural haemorrhage, extradural haemorrhage, intraparenchymal contusion and skull fracture compared to passenger vehicle patients with p value of 0.02, 0.03, 0.007 and 0.005 respectively. Conclusion: The occurrence of traumatic brain injury was significantly higher among the motorcyclist compared to passenger vehicle patients involved in road traffic accidents. The findings of this study highlighted the need for taking further measures to increase safety among the motorcyclists.

scholarly journals Delivery and Development: To what Extent can One Associate Cause and Effect?

1980 ◽  
Vol 73 (11) ◽  
pp. 786-792 ◽  
Author(s):  
Margaret Ounsted ◽  
Andrew Scott ◽  
Valerie Moar
Keyword(s):  
Caesarean Section ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Emergency Caesarean Section ◽  
Social Classes ◽  
Perinatal Factors ◽  
Case Histories ◽  
Handicapped Children ◽  
Cause And Effect ◽  
Risk Pregnancy

Data on 570 mothers and their children whose development was personally assessed from birth to four years were analysed. Strong associations were found between the incidence of fetal distress during labour, birth asphyxia, and delivery by emergency caesarean section. At the age of four years girls and children in the non-manual social classes were more advanced, developmentally, than boys and children in the manual classes. No associations were found between perinatal factors and total developmental scores; but highly significant differences were found between ‘at risk’ pregnancy groups according to their method of developmental scores. In only one of seven handicapped children could the handicap possibly have been attributable to delivery factors. Case histories of two children illustrate the dangers and difficulties of associating cause and effect in individual patients.

Factors Associated With Degree and Length of Recovery in Children With Mild and Complicated Mild Traumatic Brain Injury

Neurosurgery ◽  
2019 ◽  
Vol 85 (5) ◽  
pp. E842-E850 ◽  
Author(s):  
James E Gardner ◽  
Masaru Teramoto ◽  
Colby Hansen
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Activity Patterns ◽  
Skull Fracture ◽  
Complete Recovery ◽  
Study Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Potential Risk Factors

Abstract BACKGROUND A complicated mild traumatic brain injury (C-mTBI) is an mTBI with some form of intracranial abnormality identified radiographically. The lack of knowledge in recovery patterns and no clear guidelines on return to activity in children with C-mTBI provide unique challenges to physicians. OBJECTIVE To examine recovery patterns among three cohorts: mTBI, mTBI with skull fracture only (mTBI-SF), and C-mTBI via a cross-sectional survey. METHODS Caregivers of children with mTBI (from hospital database queries 2010–2013) were mailed a questionnaire on preinjury health, postinjury recovery, and activity patterns before and after injury. We examined degree (0-10 with 10 being complete recovery) and length (in months) of recovery in children with mTBI, and associations of potential risk factors to these variables. RESULTS Of the 1777 surveyed, a total of 285 complete responses were analyzed for this study. Data included 175 (61.4%) children with mTBI, 33 (11.6%) children with mTBI-SF, and 77 (27.0%) children with C-mTBI. Older age and C-mTBI (vs mTBI) were significantly associated with a lower degree and longer period of recovery (P < .05). Predicted probabilities of complete recovery for children with mTBI, those with mTBI-SF, and those with C-mTBI were 65.5%, 52.7%, and 40.0%, respectively. Predicted probabilities of not yet completely recovered after more than a year since injury for these groups were 11.3%, 24.4%, and 37.6%, respectively. CONCLUSION These results demonstrate significant differences in children with different forms of mTBI, and argue for further investigation of treatment plans individualized for each form of mTBI.

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