Cranial Nerve Injuries In Patients With Moderate To Severe Head Trauma – Analysis of 91,196 Patients From The TraumaRegister DGU® Between 2008 And 2017

Abstract BackgroundTraumatic brain injury　(TBI)　constitutes a major cause of trauma-related disability and mortality. The epidemiology and implications of associated cranial nerve injuries　(CNI)　in moderate to severe TBI are largely unknown. We aimed to determine the prevalence of CNI in a large European cohort of TBI patients as well as clinical differences between TBI cases with and without concomitant CNI (CNI vs. control group) by means of a multinational trauma registry.MethodsThe TraumaRegister DGU® was evaluated for trauma patients with head injuries ≥2 Abbreviated Injury Scale, who had to be treated on intensive care units after emergency admission to European hospitals between 2008 and 2017. CNI and control cases were compared with respect to demographic, clinical, and outcome variables.Results1.0% (946 of 91,196) of TBI patients presented with additional CNI. On average, CNI patients were younger than control cases (44.3±20.6 vs. 51.8±23.0 years) but did not differ regarding sex distribution (CNI 69.4%; control 69.1%). Traffic accidents were encountered more frequently in CNI cases (52.3% vs. 46.7%; p<0.001; chi-squared test) and falls more commonly in the control group (45.2% vs. 37.1%; p<0.001). CNI patients suffered more frequently from concomitant face injuries (28.2% vs. 17.5%; p<0.001) and skull base fractures (51.0% vs. 23.5%; p<0.001). Despite similar mean Injury Severity Score (CNI 21.8±11.3; control 21.1±11.7) and Glasgow Coma Scale score (CNI 10.9±4.2, control 11.1±4.4), there was a considerably higher rate of anisocoria in CNI patients (20.1% vs. 11.2%; p<0.001). Following primary treatment, 50.8% of CNI and 35.5% of control cases showed moderate to severe disability (Glasgow Outcome Scale score 3-4; p<0.001).ConclusionsCNI as rare adjuncts to TBI should raise the suspicion of complicating skull base fractures and indicate higher rates of functional impairment following primary care.

Download Full-text

Children and Terror Casualties Receive Preference in ICU Admissions

Disaster Medicine and Public Health Preparedness ◽

10.1001/dmp.2012.6 ◽

2012 ◽

Vol 6 (1) ◽

pp. 14-19 ◽

Cited By ~ 4

Author(s):

Kobi Peleg ◽

Michael Rozenfeld ◽

Eran Dolev ◽

Keyword(s):

Traffic Accidents ◽

Injury Severity ◽

Road Traffic ◽

Age Groups ◽

Trauma Patients ◽

Trauma Centers ◽

Severe Injuries ◽

Level I ◽

Hospital Emergency Departments ◽

Trauma Type

ABSTRACTObjective: Trauma casualties caused by terror-related events and children injured as a result of trauma may be given preference in hospital emergency departments (EDs) due to their perceived importance. We investigated whether there are differences in the treatment and hospitalization of terror-related casualties compared to other types of injury events and between children and adults injured in terror-related events.Methods: Retrospective study of 121 608 trauma patients from the Israel Trauma Registry during the period of October 2000-December 2005. Of the 10 hospitals included in the registry, 6 were level I trauma centers and 4 were regional trauma centers. Patients who were hospitalized or died in the ED or were transferred between hospitals were included in the registry.Results: All analyses were controlled for Injury Severity Score (ISS). All patients with ISS 1-24 terror casualties had the highest frequency of intensive care unit (ICU) admissions when compared with patients after road traffic accidents (RTA) and other trauma. Among patients with terror-related casualties, children were admitted to ICU disproportionally to the severity of their injury. Logistic regression adjusted for injury severity and trauma type showed that both terror casualties and children have a higher probability of being admitted to the ICU.Conclusions: Injured children are admitted to ICU more often than other age groups. Also, terror-related casualties are more frequently admitted to the ICU compared to those from other types of injury events. These differences were not directly related to a higher proportion of severe injuries among the preferred groups.(Disaster Med Public Health Preparedness. 2012;6:14–19)

Download Full-text

Carotid Endarterectomy and Cranial Nerve Injuries

Vascular Surgery ◽

10.1007/978-1-4471-3870-9_32 ◽

2003 ◽

pp. 245-252

Author(s):

C. D. Liapis ◽

J. D. Kakisis

Keyword(s):

Carotid Endarterectomy ◽

Cranial Nerve ◽

Nerve Injuries ◽

Cranial Nerve Injuries

Download Full-text

Incidence of Cranial Nerve Injuries after Carotid Eversion Endarterectomy with a Transverse Skin Incision under Regional Anaesthesia

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2004.06.019 ◽

2004 ◽

Vol 28 (4) ◽

pp. 421-424 ◽

Cited By ~ 43

Author(s):

A. Assadian ◽

C. Senekowitsch ◽

N. Pfaffelmeyer ◽

O. Assadian ◽

H. Ptakovsky ◽

...

Keyword(s):

Cranial Nerve ◽

Regional Anaesthesia ◽

Skin Incision ◽

Nerve Injuries ◽

Eversion Endarterectomy ◽

Cranial Nerve Injuries ◽

Transverse Skin Incision

Download Full-text

Chapter-043 Cranial Nerve Injuries

Textbook for Health Workers and ANM Volume 1 and 2 ◽

10.5005/jp/books/11291_43 ◽

2011 ◽

pp. 593-605

Author(s):

Thamburaj A

Keyword(s):

Cranial Nerve ◽

Nerve Injuries ◽

Cranial Nerve Injuries

Download Full-text

3 Cranial Nerve Injuries and Their Management

Neurosurgical Intensive Care ◽

10.1055/b-0034-76136 ◽

2008 ◽

Keyword(s):

Cranial Nerve ◽

Nerve Injuries ◽

Cranial Nerve Injuries

Download Full-text

Endovascular Treatment of Unruptured Vertebro-basilar Aneurysms

Interventional Neuroradiology ◽

10.1177/15910199990050s115 ◽

1999 ◽

Vol 5 (1_suppl) ◽

pp. 83-88 ◽

Cited By ~ 3

Author(s):

S. Miyachi ◽

M. Negoro ◽

T. Okamoto ◽

O. Suzuki ◽

J. Yoshida

Keyword(s):

Surgical Treatment ◽

Endovascular Treatment ◽

Vertebral Artery ◽

Basilar Artery ◽

Cranial Nerve ◽

Perioperative Management ◽

Nerve Injuries ◽

The Past ◽

Complications Of Surgery ◽

Cranial Nerve Injuries

We reviewed 201 unruptured vertebro-basilar aneurysms encountered at our institute and 35 affiliated hospitals over the past 8 years. Of these, 106 aneurysms in 103 patients were treated with surgical or endovascular approaches: 43 aneurysms, surgically with clipping or wrapping; and 63 endovascularly with embolization. Outcome was excellent or good in 87 patients (84.5%). Among 24 patients with 36 complications, 16 had unfavorable outcomes including five deaths. Twelve patients (27.9%) with surgical treatment and two (3.3%) with endovascular treatment had unfavorable results because of treatment-related complications. Two patients with surgical treatment had complications related to perioperative management. Vascular occlusive complications were likeliest to occur in surgically treated basilar artery aneurysms (41%). Among surgically treated aneurysms the vertebral artery site was relatively associated with cranial nerve injuries. Complications numbered 36, occurring in 24 patients and 54% of complications affected outcome. Overall morbidity and mortality of surgical treatment were 18.6% and 7.0%, respectively, while those of endovascular treatment were 5.0% and 3.3%. In conclusion, complications of surgery tend to be serious and affect outcome, and endovascular treatment is safer than surgical for vertebro-basilar aneurysms. Embolizations are particularly advantageous for patients who are poor surgical risks.

Download Full-text