scholarly journals Outcome of traumatic Extradural Hematoma (EDH) using Glasgow Outcome Scale (GOS)

2018 ◽  
Vol 5 (10) ◽  
pp. 3327
Author(s):  
Dixit V. Prajapati ◽  
Nimish J. Shah
Keyword(s):  
Traffic Accident ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Extradural Hematoma ◽  
Factors Affecting ◽  
Poor Outcome ◽  
Ct Head ◽  
Lost To Follow Up ◽  
Time Of Intervention

Background: Outcome in patient with EDH depends on various factors like GCS at presentation, Volume of hematoma, time of intervention, age, location of hematoma, etc. This study was carried out to find out correlation (if any) between outcome and various factors affecting it. Aim and objectives of this study were to study outcome of patients with traumatic EDH in terms of poor outcome (GOS score 1,2,3), Good outcome (GOS Score 4,5)Methods: This study was carried out in 91 patients having positive CT Head for EDH. Follow up was done every monthly up to 3 months. GOS was recorded at each follow up. Results: Road traffic accident was the most common mode of trauma. 16 patients were operated. Four patients died immediately after diagnosis of traumatic EDH, before doing any intervention. One patient died on 1st post-operative day. After one month, two patients were lost to follow up, 80 patients had GOS 5, four patients had GOS 4. At 2nd and 3rd month, 83 patients had GOS 5, one patient had GOS 4. 17 patients had GCS 3-8, among them, 11 patients had GOS 5, one patient had GOS 4 and five patients died (GOS 1). 15 patients had GCS 9-12, among them, 15 patients had GOS 5. 57 patients had GCS 13-15, among them, 54 patients had GOS 5. 69 patients had EDH volume <30 ml and all patients had GOS 5. 20 patients had EDH volume ≥30 ml, among them, 14 patients had GOS 5, one patient had GOS 4 and five patients died. Conclusions: GOS in EDH patient is affected by GCS and EDH volume at presentation. Lower GCS and larger EDH volume have poor outcome. Surgical intervention in larger EDH volume improves outcome.

scholarly journals Factors Affecting Clinical Outcome of Patients with Traumatic Brain Injury

2020 ◽  
Vol 9 (1) ◽  
pp. ME06-ME09
Author(s):  
Deepali Rishi Rajpal ◽  
Sachna Pramod Shetty ◽  
Manhar Shah
Keyword(s):  
Clinical Outcome ◽  
Traffic Accident ◽  
Road Traffic ◽  
Prognostic Models ◽  
P Value ◽  
Midline Shift ◽  
Factors Affecting ◽  
Severity Of Injury ◽  
Ct Head ◽  
Time Of Admission

Background: The present study aims to describe the severity of injury [Glasgow Coma Scale (GCS)] and outcome of patients [Glasgow Outcome Scale (GOS)] who presented to our hospital with TBI and factors which affect the clinical outcome.Subjects and Methods:All patients, aged equal to or more than 18 years, presenting to the Emergency Department of our hospital due to head trauma during the study period were examined and assessed using GCS at the time of admission, and GOS at the time of discharge.Results:The most common mode of injury was road traffic accident (48%). At the time of admission, 47% had GCS of 13 to 15, 37% had GCS of 9 to 12 and 16% had GCS of 3 to 8. At the time of discharge, we found that 18 patients had GOS of 1, no patient had GOS of 2, 14 patients had GOS Of 3, 28 had GOS of 4 and 29 had GOS of 5. We found that age of the patients was significantly associated with the GOS severity (p value <0.05). Furthermore, GCS at admission was found to be significantly associated with GOS at discharge (p value <0.01). Midline shift on CT head, effaced basal cistern, and presence of subarachnoid haemorrhage were also found to be significantly associated with poor GOS at discharge.Conclusion: The results of our study may be used for stratification of patients, and developing prognostic models to improve the clinical outcome of head injury.

scholarly journals Delayed deterioration following the evacuation of posterior fossa extradural hematoma

2015 ◽  
Vol 22 (1) ◽  
pp. 121-124
Author(s):  
Amit Agrawal ◽  
S. Satish Kumar ◽  
Umamaheswara Reddy V.
Keyword(s):  
Cerebral Edema ◽  
Traffic Accident ◽  
Road Traffic ◽  
Neuronal Damage ◽  
Mass Effect ◽  
Extradural Hematoma ◽  
Secondary Brain Damage ◽  
The Road ◽  
The Right

Abstract A missed or delayed detection of intracranial injuries can lead to progressive neuronal damage and secondary brain damage. We present a case of 45 year female presented 8 after the road traffic accident and had a large posterior extradural hematoma on left side with mass effect. In addition there was a small speck of right frontal contusion with localized cerebral edema. The patient initially improved after evacuation of the hematoma. However on 3rd post-operative day she was complaining of headache and became progressively drowsy. A follow up CT scan showed increase in peri-lesional edema around the right frontal contusion with squashing of the lateral ventricles suggestive of diffuse cerebral edema. The patient was shifted back to intensive care unit and responded well to further conservative management. In our patient the events could be collaborated well with existing evidence (presence of contrecoup contusion and on clinical deterioration at day 3).

scholarly journals Factors affecting survival and outcome at 3 years in extremely preterm infants.

1994 ◽  
Vol 71 (1) ◽  
pp. F28-F31 ◽  
Author(s):  
R W Cooke
Keyword(s):  
Logistic Regression ◽  
Cerebral Haemorrhage ◽  
Factors Affecting ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Cerebral Ultrasound ◽  
Male Sex ◽  
Lost To Follow Up ◽  
Ultrasound Evidence

A total of 823 infants born at 28 weeks' gestation or less were admitted to a regional referral unit between 1980 and 1989. Four hundred and sixty five (56.5%) survived to be discharged home. Twenty one subsequently died and two were lost to follow up. Four hundred and forty two (53.7%) were assessed for disabilities at the age of 3 years. Eighty four (19%) had major disabilities, of which 40 (9%) were severe. A further 39 (9%) had lesser disabilities. Three hundred and nineteen (63%) survivors appeared to be functioning normally. Logistic regression showed the likelihood of survival to be independently related to gestational age, birthweight ratio, and more recent year of birth, and inversely related to male sex and ultrasound evidence of cerebral haemorrhage or infarction. The likelihood of later disability in survivors was only independently related to cerebral ultrasound appearances.

Gamma Knife thalamotomy for treatment of essential tremor: long-term results

2010 ◽  
Vol 112 (6) ◽  
pp. 1311-1317 ◽  
Author(s):  
Ronald F. Young ◽  
Francisco Li ◽  
Sandra Vermeulen ◽  
Robert Meier
Keyword(s):  
Surgical Treatment ◽  
Essential Tremor ◽  
Gamma Knife ◽  
Surgical Intervention ◽  
Long Term Results ◽  
The Mean ◽  
Lost To Follow Up ◽  
Deep Brain

Object The goal of this report was to describe the safety and effectiveness of nucleus ventralis intermedius (VIM) thalamotomy performed with the Leksell Gamma Knife (GK) for the treatment of essential tremor (ET). Methods One hundred seventy-two patients underwent a total of 214 VIM thalamotomy procedures with the Leksell GK between February 1994 and March 2007 for treatment of disabling ET. Eleven patients were lost to follow-up less than 1 year after the procedures, so that in this report the authors describe the results in 161 patients who underwent a total of 203 thalamotomies (119 unilateral and 42 bilateral). Results There were statistically significant decreases (p < 0.0001) in tremor scores for both writing and drawing. The mean postoperative follow-up duration for all patients was 44 ± 33 months. Fifty-four patients have been followed for more than 60 months posttreatment. There were 14 patients who suffered neurological side effects that were temporary (6) or permanent (8), which accounted for 6.9% of the 203 treatments. All complications were related to lesions that grew larger than expected. Conclusions A VIM thalamotomy with the Leksell GK offers a safe and effective alternative for surgical treatment of ET. It is particularly applicable to patients who are not ideal candidates for deep brain stimulation but can be offered to all patients who are considering surgical intervention for ET.

scholarly journals Factors Affecting Road Traffic Accident in Batu Pahat, Johor, Malaysia

2018 ◽  
Vol 995 ◽  
pp. 012033
Author(s):  
Norziha Che-Him ◽  
Rozaini Roslan ◽  
Mohd Saifullah Rusiman ◽  
Kamil Khalid ◽  
M Ghazali Kamardan ◽  
...  
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Factors Affecting

Slide Tracheoplasty in the Management of Congenital Tracheal Stenosis

1997 ◽  
Vol 106 (11) ◽  
pp. 914-919 ◽  
Author(s):  
Steven H. Dayan ◽  
Michael E. Dunham ◽  
Constantine Mavroudis ◽  
Carl L. Backer ◽  
Lauren D. Holinger
Keyword(s):  
Early Diagnosis ◽  
Tracheal Stenosis ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Rare Condition ◽  
Pericardial Patch ◽  
Congenital Tracheal Stenosis ◽  
Slide Tracheoplasty ◽  
Lost To Follow Up

Long-segment congenital tracheal stenosis (LSCTS) is a rare condition. Originally, it was felt to be uniformly fatal; however, advances in technique have made surgical repair and survival possible. Our objective is to report results and technique of slide tracheoplasty for the treatment of LSCTS in the context of the overall experience at the Children's Memorial Hospital in Chicago. We reviewed 37 cases of infants and children with LSCTS. Thirty of the 37 infants underwent surgical intervention. Slide tracheoplasty resulted in survival in 1 of 2 infants, and pericardial patch tracheoplasty resulted in survival in 21 of 28 (75%). Of the 30 patients who had surgical repair, 7 (23%) have died, and 1 has been lost to follow-up (3%). Follow-up has ranged from 6 months to 13 years. Slide tracheoplasty is a satisfactory adjunct to existing techniques. With early diagnosis and appropriate management of LSCTS, survival is possible in a majority of patients.

An Innovative Modified Orbital Implant in Enucleated Eyes for Postoperative Functionality and Cosmesis

2017 ◽  
Vol 2 (1) ◽  
pp. 47-50
Author(s):  
A Dokania ◽  
Y Rizvi ◽  
Surabhi Sinha
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Surgical Mesh ◽  
Road Traffic ◽  
Muscle Attachment ◽  
Artificial Eye ◽  
Polyglactin 910 ◽  
Orbital Implant ◽  
Ocular Discomfort

ABSTRACT Orbital implants replace the volume lost by enucleated eye, impart motility to the prosthesis, and maintain cosmetic symmetry with the fellow eye. They include nonintegrated, synthetic semi-integrated, integrated, bio-integrated, and biogenic varieties. The much favored hydroxyapatite (bio-integrated) implant, due to its rough surface, needs to be wrapped in donor sclera or other wrapping materials (like polyglactin-910 mesh, polytetrafluoroethylene sheet, etc.) to which the muscles could be directly sutured. Cost factor of such wrappings is often prohibitive that add to the expense of such implants. Purpose To highlight monofilament polypropylene surgical mesh commonly used for herniorrhaphy as an alternative implant wrapping for achieving augmented implant volume and enabling easier extraocular muscle attachment in postenucleation reconstruction of artificial eye. Materials and methods Following enucleation of a nonfunctional eye in a patient who met with a road traffic accident, a 14 mm hydroxyapatite ball was used to replace the globe. The ball was wrapped with a monofilament polypropylene surgical mesh used in herniorrhaphy and sutured. The patient achieved a satisfactory cosmesis and movements of the implant for different gazes. No ocular discomfort or implant extrusion was reported following 6 months of follow-up. Conclusion Monofilament polypropylene mesh can be used safely as an orbital implant wrapping, economizing the implant cost. How to cite this article Sinha S, Rizvi Y, Dokania A. An Innovative Modified Orbital Implant in Enucleated Eyes for Postoperative Functionality and Cosmesis. Int J Adv Integ Med Sci 2017;2(1):47-50.

scholarly journals Gossypiboma: a ghastly find

2018 ◽  
pp. bcr-2017-221537
Author(s):  
Aitor de Gea Rico ◽  
Priya Krishna ◽  
Hannah Louise Devlin ◽  
Ashish Rohatgi
Keyword(s):  
Traffic Accident ◽  
Road Traffic ◽  
Epigastric Pain ◽  
Abdominal Ultrasound ◽  
Cystic Mass ◽  
Emergency Laparotomy ◽  
Complete Excision ◽  
Left Hypochondrium ◽  
Surgical History

A gossypiboma is a mass within a patient’s body comprising a cotton matrix surrounded by a foreign body granuloma. We describe an unusual presentation of a gossypiboma presenting in a 32-year-old man with acute epigastric pain and haematemesis. His surgical history revealed an emergency laparotomy following a road traffic accident 16 years ago. Initial gastroscopy showed extrinsic stomach compression. An abdominal ultrasound scan followed by a CT scan evidenced a large, well-defined, predominantly cystic mass with some solid areas occupying the left hypochondrium. Conservative management with insertion of a percutaneous drain proved to be inefficient. A laparotomy was performed; intraoperatively, the cyst was found to be ruptured and within it, a large surgical gauze was found. This was removed but required a distal pancreatectomy and gastrectomy for complete excision. He was discharged on day 74 of admission with outpatient follow-up.

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