scholarly journals Isolated Unilateral Vocal Fold Palsy following Skull Base Fracture: A Case Report

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Marina MB ◽  
Hazleigh NM ◽  
Thean YK ◽  
Sani A.
Keyword(s):  
Skull Base ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Closed Head Injury ◽  
Lower Cranial Nerve ◽  
Skull Base Fracture ◽  
Delayed Onset ◽  
Complex Anatomy ◽  
Vocal Fold Palsy ◽  
High Index Of Suspicion

Isolated lower cranial nerve (CN) palsy affecting the CN X resulting from a skull base fracture is very rare. The clinical manifestation and natural history is related closely to the complex anatomy of this region and mechanism of injury. Here, we report a case of a 54 year-old man who presented with a delayed onset of dysphonia and dysphagia with aspiration following a closed head injury sustained from a motor vehicle accident. Injection laryngoplasty was implemented to alleviate symptoms of his CN X palsy, which eventually almost completely resolved. High index of suspicion should be maintained when investigating possible skull base fractures, especially with a suggestive clinical presentation of lower CN palsies affecting one or all the lower CNs. Delayed onset of these CN palsies are likely to have more favourable outcomes.

Return of Memory and Sleep Efficiency Following Moderate to Severe Closed Head Injury

2008 ◽  
Vol 23 (4) ◽  
pp. 320-326 ◽  
Author(s):  
Michael J. Makley ◽  
Lisa Johnson-Greene ◽  
Patrick M. Tarwater ◽  
Andrew J. Kreuz ◽  
J. Spiro ◽  
...  
Keyword(s):  
Brain Injury ◽  
Head Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Closed Head Injury ◽  
Recovery Phase ◽  
Sleep Efficiency ◽  
Rehabilitation Unit ◽  
Closed Head ◽  
Unit Increase

Objective. Sleep disturbance is common in the subacute recovery phase following brain injury. A previous study from the authors' group found 68% of patients with closed head injury (CHI) had disrupted sleep on a rehabilitation unit. In the present study, the authors investigated whether improvement in sleep efficiency correlates with duration of posttraumatic amnesia (PTA) after CHI. Methods. Fourteen CHI patients were enrolled and followed prospectively. Mechanism of injury included motor vehicle accident, fall, and blunt assault. An actigraph was placed on each subject's wrist within 72 hours of admission to the rehabilitation unit and recorded data for the duration of their stay. A minimum of 7 days of continuous actigraphy data was obtained on all subjects. PTA was measured daily using the Orientation Log (O-LOG). Results. Seventy-eight percent of subjects had mean week-1 sleep efficiency scores of ≤63%. Patients admitted having already cleared PTA had significantly better week-1 sleep efficiency scores than those with ongoing amnesia ( P = .032). For those patients admitted with ongoing PTA, each 10-unit increase in sleep efficiency score correlated with 1 unit increase in O-LOG score ( P = .056). Conclusions. Disrupted sleep is common in the postacute stage following CHI. Improved sleep efficiency correlates with resolution of PTA. Decreased sleep efficiency may negatively affect memory return after traumatic brain injury. Actigraphy is uniquely suited to study the sleep patterns of these patients.

scholarly journals Facial and Orbital Fractures: A Fifteen Years Retrospective Evaluation of North East Sicily Treated Patients

2017 ◽  
Vol 11 (1) ◽  
pp. 546-556 ◽  
Author(s):  
Michele Runci ◽  
Francesco Saverio De Ponte ◽  
Roberto Falzea ◽  
Ennio Bramanti ◽  
Floriana Lauritano ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Developed Countries ◽  
Orbital Floor ◽  
Orbital Fractures ◽  
Diagnosis And Management ◽  
North East ◽  
The North ◽  
Complex Anatomy ◽  
Mandibular Body

Background:Orbital fractures are classified as diseases usually related to common midface trauma. It represents the most challenging treatment due to the complex anatomy, physiology, and aesthetic role. A midface trauma involves also the zygomatic complex and the nose, however the orbit fracture seems to be a more frequent disease due to its anatomical features.Objective:The purpose of this work is to retrospectively evaluate and record the frequency of the midfacial traumas and orbital fractures observed in the North Eastern Sicily. The results of the present data may be useful for the clinicians in order to recognize the kind of fracture just from the first general visit having a quick diagnosis and management.Methods:In the years between 2001 and 2016, about 1200 patients with midfacial trauma and about 100 patients involving the orbital floor have been evaluated. All those patients underwent the surgical fracture reduction and a CT scan follow up control at one month, three months, six months and one year.Results:Data showed high percentage of orbital floor, nose and mandibular body and ramus fractures; moreover the most frequent causes of fractures seem to be related to motor vehicle accident, followed by assaults, work and fall.Conclusion:The results have highlighted the changing trends in the causes of facial injuries, particularly the increasing incidence of assaults and the falling incidence of motor vehicle accidents in developed countries. The quick diagnosis and management proved fundamental for the successful treatment. Clinicians should be able to recognize the first symptoms in order to avoid possible complications.

scholarly journals Traumatic Aortic Injury in a 3-Year-Old Child - A Case Report and Literature Review

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Aljohani M ◽  
◽  
Alanazi S ◽  
Keyword(s):  
Case Report ◽  
Significant Contribution ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Aortic Injury ◽  
Vehicle Accidents ◽  
Vehicle Accident ◽  
Pseudo Aneurysm ◽  
High Index Of Suspicion ◽  
Tomography Scan

This case report describes a case of aortic injury with pseudo-aneurysm in a 3-year-old Saudi boy following a motor vehicle accident. The diagnosis was suspected on computed tomography scan, and emergency surgery was performed. A Dacron graft was inserted to repair the injured aorta. Postoperatively, absent femoral, and distal pulses were noted, and thromboembolectomy was performed with good outcome. We believe that our study makes a significant contribution to the literature because it raises awareness of aortic injury and rupture in pediatric patients with multi-organ trauma following motor vehicle accidents. A high index of suspicion and early intervention are essential in improving outcomes.

Transvenous embolization of a posterior condylar canal fistula causing pulsatile tinnitus

2020 ◽  
pp. neurintsurg-2020-016280
Author(s):  
Waleed Brinjikji ◽  
Giuseppe Lanzino ◽  
Harry J Cloft
Keyword(s):  
Skull Base ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Treatment Decision ◽  
Occipital Artery ◽  
Pulsatile Tinnitus ◽  
Transvenous Embolization ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Posterior Condylar

Dural arteriovenous fistulas of the skull base commonly present with pulsatile tinnitus. In our experience, transvenous embolization of dural arteriovenous fistulas of the skull base represents a safe and effective treatment modality due to its precision in treatment of the site of convergence of all feeding arteries and the low risk of ischemic complications. We present a case of an adult patient who presented to our institution with pulsatile tinnitus several months following a motor vehicle accident. Cerebral angiography demonstrated a dural arteriovenous fistula at the junction of the posterior condylar vein and suboccipital venous plexus supplied by branches of the vertebral artery, occipital artery, and ascending pharyngeal artery. In this operative video we demonstrate this technique and provide an in-depth discussion of our treatment decision-making process and the anatomical considerations involved in treating this lesion.

Delayed Onset Pneumo-hydrocephalus Caused by Traumatic Skull Base Fracture -A case report-

2011 ◽  
Vol 4 (1) ◽  
pp. 61
Author(s):  
Hyoung Seop Kim ◽  
Jong Moon Kim ◽  
Gwang Bok Park ◽  
Myoung Sik Bae
Keyword(s):  
Case Report ◽  
Skull Base ◽  
Skull Base Fracture ◽  
Delayed Onset

An uncommon potentially lethal injury: Traumatic pericardial rupture with herniation of the heart

Trauma ◽  
2016 ◽  
Vol 19 (2) ◽  
pp. 139-141
Author(s):  
TA Yuvaraj Davidson ◽  
Parma Nand
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Fatal Outcome ◽  
Traumatic Rupture ◽  
Trauma Patients ◽  
Vehicle Accident ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Treatable Condition ◽  
Insight Into

Traumatic rupture of the pericardium with herniation of the heart can be a potentially lethal injury that can be easily overlooked. Prompt diagnosis and repair can be lifesaving. We report such a case with successful repair of this injury in a 45-year-old male who sustained multiple injuries following a motor vehicle accident. CT scan revealed rupture of the pericardium with herniation of the heart. The pericardial tear was promptly repaired by primary closure. This report gives an insight into this life threatening, yet promptly treatable condition, which can be easily missed resulting in a fatal outcome. Having a high index of suspicion while treating thoracic trauma patients can prevent fatalities. Immediate referral to a cardiothoracic service or closure of the tear through a thoracotomy, if the expertise is available, can be lifesaving.

scholarly journals Dentures that keeps airway patent: a case report

2020 ◽  
Vol 6 (2) ◽  
pp. 394
Author(s):  
Siti F. A. Razak ◽  
Stacy A. Jamarun ◽  
Siti H. Sanudin
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Foreign Body Aspiration ◽  
Main Complaint ◽  
Vehicle Accident ◽  
Threatening Condition ◽  
Life Threatening ◽  
High Index Of Suspicion

<p class="abstract">Foreign body aspiration is a life-threatening condition that requires immediate attention and intervention. Foreign body aspiration in adults usually occurs during dental procedure or motor vehicle trauma. Classical symptoms include choking, cough, haemoptysis, hoarseness or stridor. This case report presents an incident of a foreign body lodged at the subglottic region in an adult wearing dental prosthesis; the main complaint was hoarseness post motor vehicle accident. High index of suspicion coupled with correct investigation will facilitate the diagnosis of a foreign body in the airway thus immediate intervention can be taken to prevent morbidity and mortality.</p>

Isolated Intrathoracic Injury with Air Bag Use

1995 ◽  
Vol 10 (3) ◽  
pp. 198-201 ◽  
Author(s):  
Andrew E. Sama ◽  
Douglas P. Barnaby ◽  
Kevin J. Wallis ◽  
Dominick Gadaleta ◽  
Michael H. Hall ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
High Speed ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
High Index ◽  
Vehicle Accident ◽  
Air Bag ◽  
High Index Of Suspicion ◽  
External Injury

AbstractThe restrained (air bag and seatbelt) driver of a vehicle involved in a high-speed motor-vehicle accident sustained a tear of the thoracic aorta with no signs of external injury. Air bag deployment may mask significant internal injury, and a high index of suspicion is warranted in such situations.

Delayed-Onset Posttraumatic Stress Disorder: A Prospective Evaluation

2002 ◽  
Vol 36 (2) ◽  
pp. 205-209 ◽  
Author(s):  
Richard A Bryant ◽  
Allison G Harvey
Keyword(s):  
Heart Rate ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Traumatic Event ◽  
Resting Heart Rate ◽  
Delayed Onset ◽  
Vehicle Accident

Objective: Delayed onset posttraumatic stress disorder (PTSD) refers to PTSD that develops at least 6 months after the traumatic event. This study aimed to index the features of patients who develop delayed-onset PTSD. Method: This study investigated delayed onset PTSD by prospectively assessing 103 motor vehicle accident survivors within 1 month of the motor vehicle accident for acute stress disorder, and subsequently assessing them for PTSD 6 months post-accident, and 2 years post-accident. Patients were initially assessed for symptoms of traumatic stress, anxiety, depression, and resting heart rate. Results: Five patients displayed PTSD 2 years post-trauma without meeting PTSD criteria 6 months posttrauma. Delayed onset cases were characterized by elevated psychopathology scores and resting heart rate levels within the initial month and elevated psychopathology 6 months posttrauma. Conclusions: These findings suggest that cases of delayed onset PTSD suffer subsyndromal levels of posttraumatic stress prior to the diagnosis of PTSD. These findings challenge the notion of PTSD developing after a period without symptoms.

scholarly journals P.013 Delaying CT Venograms in patients with skull base fractures improves the sensitivity of screening protocols: report of a case with delayed onset

2017 ◽  
Vol 44 (S2) ◽  
pp. S17-S17
Author(s):  
R Bokhari ◽  
J Chankowsky ◽  
J Marcoux
Keyword(s):  
Natural History ◽  
Skull Base ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Sinus Thrombosis ◽  
Screening Method ◽  
Transverse Sinus ◽  
Cerebral Venous Sinus Thrombosis ◽  
Acute Subdural Hematoma ◽  
Optimal Timing

Background: Cerebral venous sinus thrombosis (CVST) is a possible complication of closed head trauma with reported devastating outcomes. Its incidence however is unclear but believed to be frequent in patients with skull base fractures. The natural history of this under-recognized entity is not yet described, but a sensitive screening method is required to definitively address this question. Methods: Case report with literature review. Results: We report the case of a patient that sustained a severe head injury as the pedestrian in a motor vehicle accident. The patient required required a craniectomy to evacuate an acute subdural hematoma. Post-operatively, a CT venogram was performed and showed patent venous sinuses. A few days later, a double order resulted in a CTV being repeated erroneously but revealed the interval development of significant thrombosis of his left transverse sinus extending to his left internal jugular vein. We report on this patient’s outcome and follow-up. Conclusions: Further understanding of sinus thrombosis in the setting of TBI is warranted. The natural history is unclear, and most cases are discovered once symptomatic or after developing complications. Our case shows that current protocols have the potential of missing significant cases and study into the optimal timing of imaging is necessary.

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