scholarly journals Neurosurgical treatment of posttraumatic intracerebral haematomas

2003 ◽  
Vol 50 (2) ◽  
pp. 71-75 ◽  
Author(s):  
B. Djurovic ◽  
V. Jovanovic ◽  
Goran Tasic ◽  
Aleksandra Kacar ◽  
R. Krunic-Protic
Keyword(s):  
Ct Scan ◽  
Trauma Center ◽  
Terminal State ◽  
Intracerebral Haematoma ◽  
Lower Grade ◽  
Neurosurgical Department ◽  
Clinical Center ◽  
Neurosurgical Treatment ◽  
Temporal Localization ◽  
Intracerebral Haematomas

From January 1st to August 31st 2002 yr., Neurosurgical department of the Trauma Center, Clinical Center of Serbia, has operated 43 patients with posttraumatic intracerebral haemathoma (PTIH). From that number, 9 patients survived and 34 died. Only 4 patients with acute PTIH were in terminal state of incarceration and in spite they were operated immediately, all died. Other 39 patients have delayed PTIH where secondary CT cerebral scans showed the development of posttraumatic intracerebral haematoma that has not been verified at the incipient scanner. Indication for repeated CT scan was found for 19 patients for their focal or general neurological deterioration. 20 patients had no delayed neurological disturbances. Survivers were younger, in lower grade of coma and were mostly with temporal localization of haemathoma.

scholarly journals Neurosurgic treatment of spontaneous and traumatic intracerebral hematomas

2008 ◽  
Vol 55 (2) ◽  
pp. 123-127 ◽  
Author(s):  
B.M. Djurovic ◽  
G.M. Tasic ◽  
V.T. Jovanovic ◽  
I.M. Nikolic ◽  
R.V. Krunic-Protic ◽  
...  
Keyword(s):  
Ct Scan ◽  
Neurological Status ◽  
Intracerebral Hematoma ◽  
Intracerebral Haematoma ◽  
Brain State ◽  
Traumatic Intracerebral Haematoma ◽  
Clinical Center ◽  
Temporal Localization ◽  
The Brain ◽  
Traumatic Intracerebral Hematoma

In the period from 01.01.2000 until 31.12.2002 34 patients with spontaneous intracerebral hematoma (ICH) and with deeply disturbed state of consciousness were operated in the Department of neurosurgery of the Urgent Center, Clinical Center of Serbia. In all operated patients the indication for surgery was given on the basis of CT scan of the brain, state of consciousness, defined Glasgow coma score (GCS) and neurological status, but due to existing or threatening incarceration not even one patient was submitted to angiography of the blood vessels at the cerebral base, thus preoperatively we did not know the cause of the hemorrhage. Of 34 operated patients 22 or 64.7% died, and 12 or 35.3% survived. 14 patients were in the deepest phase of coma, where the preoperative GCS is from 3 to 5 points, and in the postoperative course only one survived, aged 25. The other survivors had somewhat less disturbed state of consciousness, they also were younger, CT scan of the brain was without blood in the chamber system. In the same period, in the Department of Neurosurgery of the Urgent Center, Clinical Center of Serbia 43 patients with traumatic intracerebral hematoma (TIH) were operated; 9 patients survived, 34 died. Only 4 patients had acute TIH. All of them were in the terminal stage of incarceration, and despite being immediately submitted to surgery all of them died. The remaining 39 patients had, the so called delayed TIH where the secondary CT scan of the brain showed development of the traumatic intracerebral haematoma that was not verified on the incipient scanner. Indication for a repeated CT scan was given in 19 patients due to focal or general neurological deterioration. However in 20 patients subsequent neurological disturbances were not registered. Those that survived were younger patients, and they were not in the deepest stage of coma, most often they had a temporal localization of hematoma.

scholarly journals Neurosurgical treatment of spontaneous intracerebral haematomas

2004 ◽  
Vol 51 (3) ◽  
pp. 73-77
Author(s):  
B. Djurovic ◽  
Goran Tasic ◽  
V. Jovanovic ◽  
R. Krunic-Protic
Keyword(s):  
Trauma Centre ◽  
Age Group ◽  
Neurosurgical Department ◽  
Disturbance Of Consciousness ◽  
Younger Age ◽  
Clinical Centre ◽  
Neurosurgical Treatment ◽  
Intraventricular Bleeding ◽  
Gcs Score ◽  
Intracerebral Haematomas

There have been 34 patients with spontaneous intracerebral haematomas (ICH) operated, from the 1st January 2002.Yr to the 31st December 2002. Yr., at the Neurosurgical Department of Trauma Centre (Clinical Centre of Serbia). They all were with the serious disturbance of consciousness. none of these patients had angiography, so preoperatively we didn?t know the reason of bleeding. From 34 operated patients, 22 or 64.7% died and 12 or 35.3% survived. There were 14 patients in the deepest state of coma, where preoperatively GCS score was 3 to 5. Only one patient age 25 survived postoperatively. Other survivors have less disturbed state of consciousness, CT findings without intraventricular bleeding and were also in younger age group.

scholarly journals Enlargement of Post-Traumatic Intracerebral Haematoma: Incidence and Time Course

2005 ◽  
Vol 33 (1) ◽  
pp. 119-122 ◽  
Author(s):  
WG Liu ◽  
Y Yao ◽  
JY Zhou ◽  
XF Yang
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Time Course ◽  
Ct Scans ◽  
Intracerebral Haematoma ◽  
Automated Method ◽  
Haematoma Volume ◽  
Traumatic Intracerebral Haematoma ◽  
Radiographic Criterion ◽  
Post Traumatic

We retrospectively assessed the incidence and time course of enlargement in posttraumatic intracerebral haematoma (PTICH). Computed tomography (CT) scans from 165 patients who underwent a scan within 72 h and a repeat scan within 120 h of the onset of trauma were examined. A semi-automated method using region deformation-based segmentation was used to calculate the haematoma volume. The presence of haematoma enlargement was also determined based on a consensus by five observers. Seventy cases (42%) showed enlargement of the haematoma. The frequency of haematoma enlargement decreased as the interval between the onset of trauma and the initial scan increased. The discriminant value of the ratio of the haematoma volume in the second scan to that in the initial scan was ascertained, and the cut-off value for haematoma enlargement was determined to be 1.45. The radiographic criterion for enlargement in PTICH on CT scan was, therefore, defined as a ≥ 1.45 times increase in haematoma volume.

scholarly journals Challenges of diagnosis of COVID-19 in trauma patients: A case series

Trauma ◽  
2020 ◽  
pp. 146040862095060
Author(s):  
Golnar Sabetian ◽  
Farnia Feiz ◽  
Alireza Shakibafard ◽  
Hossein Abdolrahimzadeh Fard ◽  
Sepideh Sefidbakht ◽  
...  
Keyword(s):  
Ct Scan ◽  
Trauma Center ◽  
Chest Trauma ◽  
Case Series ◽  
Chest Ct ◽  
Lung Contusion ◽  
Trauma Patients ◽  
Type B ◽  
Chest Ct Scan ◽  
Pcr Test

Background Diagnosis of COVID-19 can be challenging in trauma patients, especially those with chest trauma and lung contusion. Methods We present a case series of patients from February and March 2020 who were admitted to our trauma center at Rajaee Hospital Trauma Center, in Shiraz, Iran and had positive SARS-CoV-2 PCR test or chest CT scan suggestive of COVID-19 and were admitted to the specific ICU for COVID-19. Results Eight COVID-19 patients (6 male) with mean age of 40 (SD = 16.3) years old, were presented. All patients were cases of trauma injuries, with multiple injuries including chest trauma and lung contusion, admitted to our trauma center for management of their injuries, but they were diagnosed with COVID-19 as well. Two of them had coinfection of influenza type-B and SARS-CoV-2. All patients were treated for COVID-19 and three of them died; the rest were discharged from hospital. Conclusion Since PCR for SARS-CoV-2 is not always sensitive enough to confirm the cause of pneumonia, chest CT manifestations can be helpful, though, they are not always differentiable from lung contusion. Therefore, both the CT scan and the clinical and paraclinical presentation and course of improvement can be beneficial in diagnosing COVID-19 in the trauma setting.

scholarly journals The impact of prehospital management of trauma patients on outcome of ICU treatment at Emergency center CC "Vojvodina" - one - year experience

2016 ◽  
Vol 63 (2) ◽  
pp. 19-26
Author(s):  
Vesna Pajtic ◽  
Dunja Mihajlovic ◽  
Vladimir Vrsajkov ◽  
Aleksandar Gluhovic ◽  
Slavko Lovrencic
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Trauma Center ◽  
Venous Access ◽  
Emergency Center ◽  
Prehospital Treatment ◽  
Clinical Center ◽  
One Year ◽  
Injured Patients ◽  
The Impact

Impact of prehospital treatment of traumatized patients on treatment outcome in intensive care unit at Emergency center Clinical center of Vojvodina-one year experience Introduction: Trauma is the leading cause of death in 1-44 years old population. Recommendations of prehospital treatment of injured patients rely on the speed of response and transport to referent trauma center, where the patient will be adequately treated. Aim: The aim of our study was to investigate the impact of prehospital treatment and characteristics of patients before admission of patients to Emergency center-Clinical center of Vojvodina on survival of these patients in intensive care unit of Emergency center in order to improve the treatment and outcome of these patients. Material and methods: 209 patients who were treated in intensive care unit after the initial resuscitation in Emergency center-Clinical center of Vojvodina were included in our study. Data were analyzed using SPSS 20.0 software. Differences between groups of patients were assessed by Mann-Whitney U test. Categorical variables were compared using chi-square test. Statistical significance (p) was set at a value of 0.05. Results; Patients with worse outcome were significantly older than patients who had good outcome (49.4?18.5 vs. 63?14.7, p<0.05). Patients with manifestations of hypovolemic shock, respiratory distress and with GCS=8 on admission to Emergency center also had significantly worse outcome. Patients who had been intubated before admission to Emergency center had significantly better outcome in comparison to patients who did not have secured airway (p<0.05). However the placement of venous accessin prehospital setting did not impact survival significantly. Patients who were initially treated in regional hospitals had venous access and airway placement significantly in higher percent than patients treated by emergency medical service. Conclusion: While there is no strong evidence to support the benefits of airway and venous access management in injured patients in prehospital setting, our results suggest that these interventions can be beneficial if the transport to referent trauma center is long and if they are completed by educated medical staff.

scholarly journals Predictors of severe head injury in tertiary centre

2020 ◽  
pp. 303-307
Author(s):  
Rajendra Shrestha
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
High Mortality ◽  
Severe Head Injury ◽  
Negative Impact ◽  
Total Mortality ◽  
Ct Scanning ◽  
Morbidity Rate ◽  
Neurosurgical Department ◽  
Mortality And Morbidity

Introduction: Severe head injury (SHI) is associated with a high mortality and morbidity rate and is one of the leading causes of death in intensive care units. The aim of this study was to identify predictors of hospital outcome and mortality in ICU admitted SHI patients and to estimate their impact. Methods: A retrospective analysis was carried on patients (n=321) with a severe head injury, defined as Glasgow Coma Scale (GCS) ? 8 who were admitted to the ICU neurosurgical department of National Trauma Center from 2017 to 2018. Both clinical and radiological predictors of hospitalized patients were identified. Results: Total mortality rate was 5.9%. 243 (75.7%) of the patients were male and 78 (24.3%) were female. 55 % of cases were due to traffic accidents. Patients Middle Ages group was 60%. Coexisting injuries, found in 25% of the patients aggravated the prognosis. Blood grouping pattern in SHI were B+, A+ and O+ 36.1, 28 and 24.3% respectively.45% of the patients had Tattoo which was aggravating factors. The outcome is highly correlated with GCS’ values. CT scan findings revealed that patients with subdural hygroma after few days of admission CT scan which was very important prognostic factors in SHI. Conclusions: SHI has high mortality and morbidity in today world as it has a high negative impact on young people, especially men with blood group B+. The age of the patient, presence of Tattoo, GCS at admission, the CT scanning at admission and CT scanning after a week of admission were significant predictors of outcome.

1125: TOWARD “MACHINE VISION” IN THE TRAUMA CENTER: SEMIAUTOMATED QUANTITATIVE CT SCAN ANALYSIS IN ARDS

2018 ◽  
Vol 46 (1) ◽  
pp. 546-546
Author(s):  
Daniel Wendorff ◽  
Binu Enchakalody ◽  
Leopoldo Cancio ◽  
Nicholas Wang ◽  
Stewart Wang ◽  
...  
Keyword(s):  
Machine Vision ◽  
Ct Scan ◽  
Trauma Center ◽  
Quantitative Ct ◽  
Ct Scan Analysis

scholarly journals A COMPARISON OF GLASGOW COMA SCORE WITH COMPUTED TOMOGRAPHIC FINDINGS IN CASES OF TRAUMATIC BRAIN INJURY AT TERIATRY CARE HOSPITAL BIKANER

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kapil Pareek ◽  
Dinesh Sodhi
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Trauma Center ◽  
Head Injuries ◽  
Care Hospital ◽  
Medical College ◽  
Reduce Radiation Exposure ◽  
Computed Tomographic ◽  
Gcs Score ◽  
Larger Sample

Background: Our present study aimed at correlation of GCS score with computed tomographic findings in cases of head injury and to evaluate that GCS scoring can be used as an alternate tool in clinical management of head injuries in settings where CT scans are not available or contraindicated. Methods: The present study was conducted in Department of Neurosurgery, Trauma center of S. P. Medical College and A.G. of Hospitals, Bikaner. The study group consisted of a total of 100 head injury patients presenting to the Trauma center and admitted in neurosurgery ward. Results: Contusion was the most frequent finding in cases with positive CT scan findings. All (100%) subjects with severe head injury had positive CT scan findings. Conclusions: Careful clinical selection based on GCS score before ordering CT scan can help reduce radiation exposure patients and pressure on limited resources. Studies with larger sample size would be warranted Keywords: CT scan, head injury, Glasgow Coma Scale Score

scholarly journals Does the time of the day affect multiple trauma care in hospitals? A retrospective analysis of data from the TraumaRegister DGU®

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefanie Fitschen-Oestern ◽  
Sebastian Lippross ◽  
Rolf Lefering ◽  
Tim Klüter ◽  
Matthias Weuster ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Ct Scan ◽  
Multiple Trauma ◽  
Trauma Care ◽  
Trauma Center ◽  
Injury Severity ◽  
Emergency Operation ◽  
Trauma Patients ◽  
X Ray ◽  
Multiple Trauma Patients

Abstract Background Optimal multiple trauma care should be continuously provided during the day and night. Several studies have demonstrated worse outcomes and higher mortality in patients admitted at night. This study involved the analysis of a population of multiple trauma patients admitted at night and a comparison of various indicators of the quality of care at different admission times. Methods Data from 58,939 multiple trauma patients from 2007 to 2017 were analyzed retrospectively. All data were obtained from TraumaRegister DGU®. Patients were grouped by the time of their admission to the trauma center (6.00 am–11.59 am (morning), 12.00 pm–5.59 pm (afternoon), 6.00 pm–11.59 pm (evening), 0.00 am–5.59 am (night)). Incidences, patient demographics, injury patterns, trauma center levels and trauma care times and outcomes were evaluated. Results Fewer patients were admitted during the night (6.00 pm–11.59 pm: 18.8% of the patients, 0.00–5.59 am: 4.6% of the patients) than during the day. Patients who arrived between 0.00 am–5.59 am were younger (49.4 ± 22.8 years) and had a higher injury severity score (ISS) (21.4 ± 11.5) and lower Glasgow Coma Scale (GCS) score (11.6 ± 4.4) than those admitted during the day (12.00 pm–05.59 pm; age: 55.3 ± 21.6 years, ISS: 20.6 ± 11.4, GCS: 12.6 ± 4.0). Time in the trauma department and time to an emergency operation were only marginally different. Time to imaging was slightly prolonged during the night (0.00 am–5.59 am: X-ray 16.2 ± 19.8 min; CT scan 24.3 ± 18.1 min versus 12.00 pm- 5.59 pm: X-ray 15.4 ± 19.7 min; CT scan 22.5 ± 17.8 min), but the delay did not affect the outcome. The outcome was also not affected by level of the trauma center. There was no relevant difference in the Revised Injury Severity Classification II (RISC II) score or mortality rate between patients admitted during the day and at night. There were no differences in RISC II scores or mortality rates according to time period. Admission at night was not a predictor of a higher mortality rate. Conclusion The patient population and injury severity vary between the day and night with regard to age, injury pattern and trauma mechanism. Despite the differences in these factors, arrival at night did not have a negative effect on the outcome.

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