scholarly journals Bilateral traumatic basal ganglia haemorrhage, a rare entity

2019 ◽  
pp. 310-315
Author(s):  
Vibhu Shankar Parashar ◽  
Vivek Kumar Kankane ◽  
Gaurav Jaiswal ◽  
Tarun Kumar Gupta
Keyword(s):  
Basal Ganglia ◽  
Head Injury ◽  
World Literature ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Case Reports ◽  
Diffuse Axonal Injury ◽  
Closed Head Injury ◽  
Rare Entity ◽  
History Of

Aims. Traumatic basal ganglia haemorrhage is rare entity but post traumatic bilateral basal ganglia hematoma is even extremely rare and was earlier presented as case reports. Its incidence is about 3% after a closed head injury however, the incidence is higher in post mortem studies. Material & Methods. Out of 1485 head injury patients admitted to our institute from January 2012 to January 2019, there were 9 cases of traumatic bilateral basal ganglia haemorrhage. The incidence of traumatic bilateral basal ganglia Haemorrhage in our series is 0.61% which is very less compared to previous literature. Results. There were 6 males and 3 females; age ranging from 19 to 50 years (average 32 years). Patients with hypertension, history of drugs abuse, history of coagulopathy, with doubtful history of trauma or unknown mode of injury were excluded from the study. The mode of injury in all the patients was road traffic accidents. Average follow up was 9.54 months. Outcome was assessed by Glasgow outcome Score. In 8 out of 9 patients, outcome was good. One patient died. All the nine cases were managed conservatively. Conclusion. We report nine cases from a single institute which to the best of our knowledge is the largest series in world literature. Prognosis is variable and dependent on many factors. The prognosis of TBGH is favourable if not associated with other disorders like hypertension, diabetes mellitus, and coagulation disorders or diffuse axonal injury.

scholarly journals Outcome of Traumatic bilateral basal ganglia Hemorrhage: Rarest entity: Prospective study of five cases: Single institutional Experience

2018 ◽  
Vol 32 (2) ◽  
pp. 322-331
Author(s):  
Neha Gupta ◽  
Vivek Kumar Kankane ◽  
Tarun Kumar Gupta
Keyword(s):  
Basal Ganglia ◽  
Head Injury ◽  
Prospective Study ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Case Reports ◽  
Closed Head Injury ◽  
Institutional Experience ◽  
History Of ◽  
Basal Ganglia Hemorrhage

Abstract Traumatic Basal ganglia hemorrhage is rare entity but bilateral basal ganglia hematoma after trauma is extremely rare and is limited to case reports. We describe five cases of traumatic bilateral basal ganglia hemorrhage, and its outcome and management. All Cases were managed conservatively. The general incidence of TBGH is reported between 2.4-3% of closed head injury. However, the incidence is higher in post mortem studies (9.8%). Five consecutive patients of TBGH, shown in initial Noncontrast CT (NCCT) head, admitted in our institute from August 2013 to August 2016, during this period total patient admitted of head injury is 1061 so incidence of Traumatic bilateral basal ganglia Hemorrhage in our series is 0.47% which is very less compare to previous literature formed the prospective study group. There were 3 males and 2 females; age ranging from 20 to 45 years (average 30 years).Hypertensive patients, drugs abuse history, history of coagulopathy with doubtful history of trauma or unknown mode of injury was excluded from the study. All patients had sustained road traffic accidents. NCCT head done of all patients after initial resuscitation. GCS at admission were 9 to 12 (mean 10.4), Outcome assessed by Glasgow outcome Score. All patients outcome was good. Average follow up 8.54 months.

Acute subdural hematoma and diffuse axonal injury after severe head trauma

1988 ◽  
Vol 68 (6) ◽  
pp. 894-900 ◽  
Author(s):  
Juan Sahuquillo-Barris ◽  
Jose Lamarca-Ciuro ◽  
Jorge Vilalta-Castan ◽  
Enrique Rubio-Garcia ◽  
Manuel Rodriguez-Pazos
Keyword(s):  
Head Injury ◽  
Subdural Hematoma ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Acute Subdural Hematoma ◽  
Content Type ◽  
Hypoxic Brain ◽  
Clinicopathological Findings

✓ The association of acute subdural hematoma (SDH) and diffuse axonal injury has received little attention in the literature. The authors report the clinicopathological findings in six patients who died of severe head injury in whom computerized tomography revealed acute SDH as the predominant lesion. All patients were injured in road traffic accidents and lost consciousness on impact. The mean total contusion index was 17.4 and severe contusions were seen in only two cases. All patients presented histological criteria of intracranial hypertension (pressure necrosis focus in one or both parahippocampal gyri). Hypoxic brain damage was evident in the postmortem examination of three patients. In three cases, macroscopic hematic lesions were observed in the corpus callosum. All patients had widespread axonal retraction balls disseminated in the white brain matter. Three patients who survived for more than 11 days had microglial clusters. In some patients with a head injury, acute SDH may be only an epiphenomenon of a primary impact lesion of variable severity: that is, a diffuse axonal injury. In these cases, the final outcome is fundamentally dependent on the severity of the subjacent diffuse axonal injury.

scholarly journals Study of cases of head injury in a government hospital in rural Indian setting

2018 ◽  
Vol 5 (10) ◽  
pp. 3252
Author(s):  
Vinod Pusdekar ◽  
Sandeep Ambedkar ◽  
Ritesh Bodade
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
Age Group ◽  
Road Traffic Accidents ◽  
Government Hospital ◽  
History Of ◽  
Gcs Score

Background: Head injury can be defined as trauma in which the head is struck or moves violently, resulting in transient or permanent alteration of consciousness of an individual. We profiled and analyzed the cases of head injuries reporting to a government hospital a rural Indian setting.Methods: All the patients with history of antecedent head injury were firstly assessed by detailed history, with emphasis on history of unconsciousness/vomiting/convulsions/ENT bleed. Then a thorough clinical examination was undertaken, including Glasgow Coma Scale (GCS) scoring. Further, all the patients were subjected to CT scan of head for correlation of clinical findings, confirmation of diagnosis, delineation of extent of disease and suitability of operative intervention etc.Results: Majority of the patients belonged to 15-44 years age group (30, 60%) and were males (38, 76%). Road traffic accidents accounted for majority (38, 76%) of the cases. GCS score was found to range between 13-15 (mild) in 18 (36%) patients, 9-12 (moderate) in 21 (42%) patients and 3-8 (severe) in 11 (22%) patients. Best recovery (88%) was shown by patients of GCS score between 13-15. Among the critical symptoms and signs, unconsciousness and abnormal plantar reflex were the commonest ones. Generalized cerebral edema without associated lesion (50%) was the commonest finding followed by extradural hematoma (EDH) (40%) on CT scan of head. As for recovery w.r.t. CT scan findings, highest rate of recovery (100%) was reported in patients with fracture without intracranial pathology, while highest mortality was reported in those having mixed lesion (90%).Conclusions: Road traffic accidents in young age group is the commonest mode of head injury and GCS score is a good predictor of recovery in head injury cases.

Brain Damage in Fatal Non-Missile Head Injury in Relation to Age and Type of Injury

1989 ◽  
Vol 34 (1) ◽  
pp. 399-401 ◽  
Author(s):  
J.H. Adams ◽  
D. Doyle ◽  
I. Ford ◽  
D.I. Graham ◽  
M. McGee ◽  
...  
Keyword(s):  
Head Injury ◽  
Brain Damage ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
Diffuse Axonal Injury ◽  
Diffuse Brain Swelling ◽  
Type Of Injury ◽  
The Relationship ◽  
Diffuse Brain

Brain damage in a series of 635 fatal non-missile head injuries has been analysed with particular reference to the age of the patient and the type of injury. The differences in the type of brain damage in relation to age were less than we had anticipated, lending further support to the contention that the aged brain has a reduced potential for recovery. The analysis confirms the relationship between road traffic accidents, diffuse axonal injury, gliding contusions and ‘basal ganglia’ haematomas, and the importance of diffuse brain swelling resulting from a head injury in children.

scholarly journals Acute subdural hematoma and diffuse axonal injury in fatal road traffic accident victims: a clinico-pathological study of 15 patients

2003 ◽  
Vol 61 (3B) ◽  
pp. 746-750 ◽  
Author(s):  
Sebastião Nataniel Silva Gusmão ◽  
José Eymard Homem Pittella
Keyword(s):  
Head Injury ◽  
Hospital Admission ◽  
Subdural Hematoma ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Acute Subdural Hematoma ◽  
Road Traffic Accidents ◽  
Pathological Study

OBJECTIVE: Although acute subdural hematoma (ASDH) and diffuse axonal injury (DAI) are commonly associated in victims of head injury due to road traffic accidents, there are only two clinico-pathological studies of this association. We report a clinical and pathological study of 15 patients with ASDH associated with DAI. METHOD: The patients were victims of road traffic accidents and were randomly chosen. The state of consciousness on hospital admission was evaluated by the Glasgow coma scale. For the identification of axons the histological sections of the brain were stained with anti-neurofilament proteins. RESULTS: Twelve of the 15 patients were admitted to hospital in a state of coma; in three patients, the level of consciousness was not evaluated, as they died before hospital admission. CONCLUSION: The poorer prognosis in patients with ASDH who lapse into coma immediately after sustaining a head injury, as described by several authors, can be explained by the almost constant association between ASDH and DAI in victims of fatal road traffic accidents.

Outcome of “DESTITUTE” Head Injury Patients at a Tertiary Care Neurosurgical Centre: A KGMU Experience of 10 Years

2019 ◽  
Vol 16 (01) ◽  
pp. 67-70
Author(s):  
Rohan Dilip Digarse ◽  
Bal Krishna Ojha ◽  
Anil Chandra ◽  
Chhitij Srivastava ◽  
Sunil Kumar Singh
Keyword(s):  
Head Injury ◽  
World Literature ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Average Length ◽  
Tertiary Care ◽  
Economic Resources ◽  
Average Length Of Stay ◽  
Male Patients ◽  
Discharge Against Medical Advice

Abstract Introduction Many patients are admitted to hospitals as destitute or unknown, after having met with accidents. What happens to these patients after admission is not much reported in world literature. With the ever increasing number of road traffic accidents (RTAs), a significant number of such patients are reported worldwide. Material and Methods We conducted a retrospective analysis of the departmental case records of destitute patients from January 2009 till December 2018 in our institute. The mode of presentation, demographic profile, computed tomography scan findings, hospital course, and outcome at discharge were analyzed. Results Out of 128 patients, there were 114 (89.1%) male patients, maximum being in the 21 to 30 years age group. The mean age was 36.4 years with ages ranging from 10 to 70 years. The average length of stay in hospital was of approximately 6 days with maximum being 37 days. The main cause of head injury was RTA in 66 patients (51.5%). Majority, that is, 84 patients, had a Glasgow Coma Scale score of < 8 at admission. Forty-two head injury patients were operated in all, while the rest were managed conservatively. Forty-nine (38.2%) patients died in hospital, and 44 (34.3%) patients had good recovery. During treatment, 16 (12.5%) patients took discharge against medical advice, while identity of 63 (49.2%) patients could be established out of which 5 (3.9%) patients were either discharged to home while 51 (39.8%) patients were referred to their district hospital. Two patients (1.5%) remained unknown and were sent to destitute homes for rehabilitation. Conclusion Unknown head injury patients are usually neglected and their outcome is poorer in comparison to other patients. Their management is fraught with challenges. They need special care for which staff should be well trained and hospital must have economic resources and a good network of social workers.

scholarly journals Distal Humerus as Delayed Site of Metastasis from Small Cell Carcinoma of Gallbladder

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Mutahir A. Tunio ◽  
Mushabbab AlAsiri ◽  
Asma Mohammed F. Ali ◽  
Eyad Fawzi AlSaeed ◽  
Muhammad Shuja ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
World Literature ◽  
Case Reports ◽  
Locally Advanced ◽  
Distal Humerus ◽  
Small Cell ◽  
Rare Entity ◽  
Dismal Prognosis ◽  
Advanced Stages

Background. Small cell carcinoma (SCC) of the gallbladder is a rare entity and is often seen in elderly women. SCC of gallbladder is typically a nonsecretory carcinoid tumor without overt clinical symptoms and is often discovered at advanced stages. SCC of gallbladder carries a dismal prognosis as compared to SCC of lung and adenocarcinoma of gallbladder. To date, only 73 case reports have been published in the world literature.Case Presentation. Herein, we report a case of a 73-year-old Saudi woman who presented with one week history of right upper quadrant abdominal pain and obstructive jaundice and was found to be a case of locally advanced, metastatic SCC of gallbladder cT4N1M1 (liver, para-aortic lymph nodes, and bone). The patient was treated with neoadjuvant etoposide and cisplatin (EP) chemotherapy three cycles after biliary stenting followed by radical cholecystectomy, lymphadenectomy, and adjuvant EP chemotherapy and then one year later developed distal humerus osseous metastasis.Conclusion. SCC of the gallbladder is very rare entity and is often seen at advanced stages. Osseous metastases of peripheral skeleton from SCC gallbladder are rarely reported. Surgery is curative option but only for early stage tumors. Incorporation of chemotherapy along with radical resection increases the survival.

scholarly journals OUTCOME OF CEREBRAL CONTUSIONS DUE TO TRAUMATIC BRAIN INJURY

2020 ◽  
Vol 11 (1) ◽  
pp. 39-43
Author(s):  
Zubair Ahmed Khan ◽  
Habib sultan ◽  
Amir Aziz ◽  
Shahrukh Rizvi ◽  
Tauqeer Ahmed ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Road Traffic Accidents ◽  
Male And Female ◽  
Duration Of Hospital Stay ◽  
History Of ◽  
Age Range

ABSTRACT:BACKGROUND & OBJECTIVE: To compare the results of surgically operated vs conservatively treated patients of cerebral contusions due to traumatic brain injury. METHODOLOGY: This comparative study was conducted from January 2012 to December 2014 at the department of Neurosurgery, PGMI Lahore General Hospital, Lahore. A total of 50 patients were included in this study of both gender (male and female) and in the age range of 15-65 years. In our study 20 patients were managed conservatively while other 30 patients were operated for cerebral contusions. The mode of injury in our study was road traffic accidents and history of falls. RESULTS: Out of 50 patients, there were 41 (82%) males and 09 (18%) female patients. Their age ranged from 15 - 65 years. In this study the overall mean age is 38.36 years. The maximum numbers of patients were in their third and fourth decades of life. In our study the duration of hospital stay in conservatively managed patients was longer as compared to surgically treated patients who were discharged earlier. Mortality rate in surgically managed patients having a GCS ranged between 09 to 12 was very low contrary to the conservatively managed group, similarly the rate of delayed contusion formation and edema was also low in surgically managed patients as compared to those who were managed conservatively. CONCLUSION: Surgically managed patients of cerebral contusions in traumatic brain injury has better outcome and decreased hospital stay as compared to conservatively managed patients.

scholarly journals Visual Function of Drivers and its Relation to the Occurrence of Road Traffic Accidents in Saudi Arabia

2021 ◽  
Vol 9 (B) ◽  
pp. 1016-1020
Author(s):  
Sulaiman Aldakhil ◽  
Godwin Ovenseri-Ogbomo ◽  
Majid Moafa ◽  
Waleed Alghamdi ◽  
Muhammed Alluwimi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Binocular Vision ◽  
Visual Function ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Health Examination ◽  
Road Traffic Accidents ◽  
Good Visual Acuity ◽  
History Of ◽  
Eye Examination

BACKGROUND: The mortality rate due to road traffic accidents (RTA) is significantly high in Saudi Arabia (SA) compared to other countries. The visual function which includes good visual acuity (VA) and binocular vision are very important factors that can contribute to the incidence of RTA. AIM: The aim of this study is to investigate the association between refractive errors (REs) and the RTA in SA. METHODS: A total of 354 participants (mean age 22.67 ± 3.22 years) were recruited randomly to participate in this study from the population of Qassim district. Data collected using the questionnaire included participants’ age, sex, and education level, ocular and medical history, driving history as well as history of RTA. Ocular health examination including VA, RE measurements, and binocular vision function vision was measured and analyzed. RESULTS: The results of this study show that 48.3% of drivers had some form of REs with 3.4% being visually impaired. 217 (61.3%) of participants have had an RTA, and 119 (54.9%) of them have had more than two accidents in the past two years. The findings show no significant association between the occurrence of RTA and uncorrected REs or binocular vision dysfunction. CONCLUSION: Our data showed significantly higher rate of RTA among Saudi drivers which is much higher than any country in the world. The current Saudi regulations for obtaining driving license need to be modified, with implementing a comprehensive eye examination prior to acquiring or renewing drivers’ licenses.

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