The Pattern of Maxillofacial Fractures in the Traumatic Brain Injury Patients in Songklanagarind Hospital: A Retrospective Study

2021 ◽  
Vol 104 (2) ◽  
pp. 185-190
Keyword(s):  
Traumatic Brain Injury ◽  
Retrospective Study ◽  
Brain Injury ◽  
Bone Fracture ◽  
Brain Injuries ◽  
Moderate Traumatic Brain Injury ◽  
Maxillofacial Fractures ◽  
Fall From Height ◽  
Frequent Site ◽  
The Mean

Background: Maxillofacial injuries are commonly associated with brain injuries, with the major etiological factors being traffic collision, violence, and fall from height. The incidence and etiology are important for the development of treatment and for the improvement of patient care in the future. Objective: To analyze the incidence of patterns of maxillofacial fractures with traumatic brain injuries and to measure the incidence of cause of injury, age, gender distribution, and length of stay in hospital. Materials and Methods: The present study was a retrospective study in Songklanagarind Hospital. The authors evaluated the patients that presented with a concomitant maxillofacial and traumatic brain injury in Songklanagarind Hospital between 2007 and 2016. The data were assessed using multiple logistic modeling and reported in term of percentage and corresponding 95% confidence intervals. Results: Eight hundred fifty-nine patients were studied, consisting of 73.3% male and 22.7% female. The mean age was 39.5 years. The severity of the traumatic brain injury was mild and 70.15% with associated alcohol consumption. The maxilla bone fracture was common in 49.9%. The patients with mild to moderate traumatic brain injury were related to the coronoid process of mandible and severe traumatic brain injury was related to Le Fort fracture type II and III. Conclusion: In the present study, the maxilla bone fracture was the most frequent site involved. In addition, there was an association between the severity of the head injury and the type of maxillofacial injury. Keywords: Traumatic brain injury, Maxillofacial fracture

scholarly journals Traumatic Brain Injury and the Importance of Neurosurgical Care: 10-year Retrospective Study on Cadavers

Folia Medica ◽  
2020 ◽  
Vol 62 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Alexandrina Nikova ◽  
Ivaylo Dimitrov ◽  
Theodossios Birbilis ◽  
Lora Zaharieva
Keyword(s):  
Health Care ◽  
Traumatic Brain Injury ◽  
Retrospective Study ◽  
Brain Injury ◽  
Mortality Rate ◽  
Brain Injuries ◽  
Common Type ◽  
Quick Response ◽  
Male Predominance ◽  
Transport Accidents

Objective: Traumatic brain injury (TBI) due to transport accidents is a serious cause of death and disability. In every case, however, quick response and a proper health care are required.   Materials and methods: We collected 10-year data retrospectively from the laboratory of forensic science and toxicology in Montana, Bulgaria with the intention to show the importance of neurosurgical care in the traumatology and its connection to mortality rate.   Results: 124 cadavers were included with significant male predominance. The data analysis shows that the mortality rate at the hospitals without neurosurgical facilities and the mortality at the scene of the accident is the same for traffic brain injuries. Furthermore, we found that the age has no correlation with the mortality rate.   Conclusion: Road injuries are the most common type of brain injury. We believe that the outcome of these TBIs depends on the availability of a neurosurgical unit.

Comparison of mannitol and hypertonic saline in the treatment of severe brain injuries

2011 ◽  
Vol 114 (2) ◽  
pp. 545-548 ◽  
Author(s):  
Nikolaos Sakellaridis ◽  
Elias Pavlou ◽  
Stylianos Karatzas ◽  
Despina Chroni ◽  
Konstantinos Vlachos ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Hypertonic Saline ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Treatment Protocol ◽  
Venous Catheter ◽  
Duration Of Action ◽  
The Mean

Object The purpose of this study was to compare the effects of mannitol and hypertonic saline in doses of similar osmotic burden for the treatment of intracranial hypertension in patients with severe traumatic brain injury. Methods The authors used an alternating treatment protocol to compare the effect of hypertonic saline with that of mannitol given for episodes of increased intracranial pressure in patients treated for severe head injury at their hospital during 2006–2008. Standard guidelines for the management of severe traumatic brain injury were followed. Elevated intracranial pressure (ICP) was treated either with mannitol or hypertonic saline. Doses of similar osmotic burden (mannitol 20%, 2 ml/kg, infused over 20 minutes, or saline 15%, 0.42 ml/kg, administered as a bolus via a central venous catheter) were given alternately to the individual patient with severe brain injury during episodes of increased pressure. The dependent variables were the extent and duration of reduction of increased ICP. The choice of agent for treatment of the initial hypertensive event was determined on a randomized basis; treatment was alternated for every subsequent event in each individual patient. Reduction of ICP and duration of action were recorded after each event. Results obtained after mannitol administration were statistically compared with those obtained after hypertonic saline administration. Results Data pertaining to 199 hypertensive events in 29 patients were collected. The mean decrease in ICP obtained with mannitol was 7.96 mm Hg and that obtained with hypertonic saline was 8.43 mm Hg (p = 0.586, equal variances assumed). The mean duration of effect was 3 hours 33 minutes for mannitol and 4 hours 17 minutes for hypertonic saline (p = 0.40, equal variances assumed). Conclusions No difference between the 2 medications could be found with respect to the extent of reduction of ICP or duration of action.

scholarly journals Epidemiology of Pediatric Traumatic Brain Injury at Sylvanus Olympio University Hospital of Lomé in Togo

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Pilakimwe Egbohou ◽  
Tabana Mouzou ◽  
Pikabalo Tchetike ◽  
Hamza Doles Sama ◽  
Sarakawabalo Assenouwe ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Traffic Accidents ◽  
Brain Injuries ◽  
Injury Severity ◽  
Road Traffic ◽  
Skull Fracture ◽  
University Hospital ◽  
Pediatric Traumatic Brain Injury ◽  
The Mean

Introduction. Severe pediatric traumatic brain injury (pTBI) is a leading cause of disability and death in children worldwide. Children victims of pTBI are admitted to the Sylvanus Olympio University Hospital (SOUH) at the multipurpose Intensive Care Unit (ICU). We aimed in this study to describe the epidemiologic characteristics and outcomes of pTBI patients admitted in this ICU. Patients and Methods. This study was conducted at the ICU of SOUH of Lome. It was a retrospective study based on patients’ records from 0 to 15 years old admitted during the period from 1 January 2012 to 30 June 2018 (5 years and 6 months). Results. We recorded 91 pTBI included in the study. The mean age was 7.7 ± 4.3 years. The male predominated with 67.0%. Road traffic accidents were the most common cause (79.1%), followed by falls (19.8%). The average pediatric Glasgow Coma Scale (pGCS) was 6.6 ± 1.4, with a mean Injury Severity Score (ISS) of 23.1 ± 8.4. The most common brain injuries found in the CT scan were brain edema (72.9%), skull fracture (69.5%), and brain contusion (55.9%). The average duration under mechanical ventilation was 2.1 ± 2.9 days, and the mean ICU stay was 4.9 ± 4.4 days. Overall mortality was 31.9% (29 cases). Factors significantly associated (p<0.05) with death were hypotension (51.7%), anemia (43.1%), hyperthermia (46.7%), GCS < 6 (64%), and ISS > 20 (48.9%). Conclusion. pTBI mortality remains high in SOUH ICU. Factors associated with mortality were secondary systemic insults, worse GCS < 6, and ISS > 20.

scholarly journals Coagulation disorder in moderate to severe traumatic brain injuries

2014 ◽  
Vol 6 (3) ◽  
pp. 22-25 ◽  
Author(s):  
Ajit Shrestha ◽  
Ramesh Man Joshi ◽  
Upendra P. Devkota
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
International Normalized Ratio ◽  
Traumatic Brain Injuries ◽  
Coagulation Disorder ◽  
Secondary Brain Injury ◽  
Multivariate Statistical ◽  
Moderate Traumatic Brain Injury

Background: Significant proportions of patients presenting with moderate to severe traumatic brain injuries are diagnosed as having coagulation disorder and subsequent secondary brain injury. We evaluated the incidence of coagulopathy in patient with moderate to severe traumatic brain injury in this study.Methods: A prospective study of 100 patients with moderate to severe traumatic brain injury was carried out over a period of 2 years. Platelet count (PC), Bleeding time (BT), Clotting time (CT), Prothrombin time (PT), International Normalized ratio (INR), activated partial thromboplastin time (aPTT) and Fibrin degradation product (FDP) were measured at the time of admission and 12 hourly for 7 days. Daily D-dimer evaluation for DIC was performed in those who had abnormal value in any one of these parameters. Coagulopathy was classified as collectively 3 abnormal parameters.Results: Among the 100 patients, 43% had severe and 57% had moderate traumatic brain injury. Coagulopathy was detected in 63% of total patients; 76.7 % (33/43) among severe traumatic brain injury and 52.7 % (30/57) among moderate (p 0.013). Multivariate statistical analysis showed deranged FDP as a significant individual predictor of coagulopathy among others (p < 0.001, Odds ratio 166.25; 95% confidence interval 31.7 + 869.7).Conclusion: Coagulopathy is common in patients with moderate to severe traumatic brain injury. Evaluation of FDP can significantly predict coagulopathy in traumatic brain injury patients.DOI: http://dx.doi.org/10.3126/ajms.v6i3.10730 Asian Journal of Medical Sciences Vol.6(3) 2015 22-25

MANAGEMENT OF MULTIPLE TRAUMATIC INTRACRANIAL HEMATOMAS

2020 ◽  
Vol 3 (1) ◽  
pp. 70-74
Author(s):  
Rustam Hazratkulov ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Surgical Treatment ◽  
Brain Injury ◽  
Hospital Stay ◽  
Treatment Outcomes ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Diagnostic Approach ◽  
Early Activation ◽  
Intracranial Hematomas

Multiple traumatic hematomas (MG) account for 0.74% of all traumatic brain injuries. A comprehensive diagnostic approach to multiple traumatic intracranial hematomas allows to establish a diagnosis in the early stages of traumatic brain injury and to determine treatment tactics. A differentiated approach to the choice of surgical treatment of multiple hematomas allows to achieve satisfactory results and treatment outcomes, which accordingly contributes to the early activation of the patient, a reduction in hospital stay, a decrease in mortality and disabilityin patients with traumatic brain injury

scholarly journals Prospective Analysis of Coagulopathy Associated with Isolated Traumatic Brain Injury and Clinical Outcome

2021 ◽  
Author(s):  
Gopal Krishna ◽  
Varun Aggarwal ◽  
Ishwar Singh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Clinical Outcome ◽  
Road Traffic ◽  
Statistical Significance ◽  
Platelet Counts ◽  
Coagulation Abnormalities ◽  
The Mean ◽  
D Dimer

Abstract Introduction Traumatic brain injury (TBI) affects the coagulation pathway in a distinct way than does extracranial trauma. The extent of coagulation abnormalities varies from bleeding diathesis to disseminated thrombosis. Design Prospective study. Methods The study included 50 patients of isolated TBI with cohorts of moderate (MHI) and severe head injury (SHI). Coagulopathy was graded according to the values of parameters in single laboratory. The incidence of coagulopathy according to the severity of TBI and correlation with disseminated intravascular coagulation (DIC) score, platelets, prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, and fibrinogen was observed. The comparison was also made between expired and discharged patients within each group. It also compared coagulation derailments with clinical presentation (Glasgow Coma Scale [GCS]) and outcome (Glasgow Outcome Scale [GOS]). Results Road traffic accident was the primary (72%) mode of injury. Fifty-two percent had MHI and rest had SHI. Eighty-four percent of cases were managed conservatively. The mean GCS was 12.23 and 5.75 in MHI and SHI, respectively. Sixty-two percent of MHI and 96% of the patients with SHI had coagulation abnormalities. On statistical analysis, DIC score (p < 0.001) strongly correlated with the severity of head injury and GOS. PT and APTT were also significantly associated with the severity of TBI. In patients with moderate TBI, D-dimer and platelet counts showed association with clinical outcome. Fibrinogen levels did not show any statistical significance. The mean platelet counts remained normal in both the groups of TBI. The mean GOS was 1.54 and 4.62 in SHI and MHI, respectively. Conclusion Coagulopathy is common in isolated TBI. The basic laboratory parameters are reliable predictors of coagulation abnormalities in TBI. Coagulopathy is directly associated with the severity of TBI, GCS, and poor outcome.

Rapid Detection of Significant Traumatic Brain Injury Requiring Emergency Intervention

2020 ◽  
pp. 000313482097335
Author(s):  
Isaac W. Howley ◽  
Jonathan D. Bennett ◽  
Deborah M. Stein
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Trauma Team ◽  
Altered Mental Status ◽  
Acute Care Surgery ◽  
Ct Scanner ◽  
Mickey Mouse ◽  
Clinically Significant ◽  
Care Surgery

Moderate and severe traumatic brain injuries (TBI) are a major cause of severe morbidity and mortality; rapid diagnosis and management allow secondary injury to be minimized. Traumatic brain injury is only one of many potential causes of altered mental status; head computed tomography (HCT) is used to definitively diagnose TBI. Despite its widespread use and obvious importance, interpretation of HCT images is rarely covered by formal didactics during general surgery or even acute care surgery training. The schema illustrated here may be applied in a rapid and reliable fashion to HCT images, expediting the diagnosis of clinically significant traumatic brain injury that warrants emergent medical and surgical therapies to reduce intracranial pressure. It consists of 7 normal anatomic structures (cerebrospinal fluid around the brain stem, open fourth ventricle, “baby’s butt,” “Mickey Mouse ears,” absence of midline shift, sulci and gyri, and gray-white differentiation). These 7 features can be seen even as the CT scanner obtains images, allowing the trauma team to expedite medical management of intracranial hypertension and pursue neurosurgical consultation prior to radiologic interpretation if the features are abnormal.

scholarly journals Reply to Comment on Tsai, Y.-C., et al. Association of Stress-Induced Hyperglycemia and Diabetic Hyperglycemia with Mortality in Patients with Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population. Int. J. Environ. Res. Public Health 2020, 17, 4266

2021 ◽  
Vol 18 (5) ◽  
pp. 2531
Author(s):  
Yu-Chin Tsai ◽  
Shao-Chun Wu ◽  
Ting-Min Hsieh ◽  
Hang-Tsung Liu ◽  
Chun-Ying Huang ◽  
...  
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Propensity Score ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Injury Analysis

Thank you for Eduardo Mekitarian Filho’s appreciation of our work on the study of stress-induced hyperglycemia (SIH) and diabetic hyperglycemia (DH) in patients with traumatic brain injuries [...]

scholarly journals Systemic and local cardiac inflammation after experimental long bone fracture, traumatic brain injury and combined trauma in mice

2021 ◽  
Vol 28 ◽  
pp. 39-46
Author(s):  
Ina Lackner ◽  
Birte Weber ◽  
Melanie Haffner-Luntzer ◽  
Simona Hristova ◽  
Florian Gebhard ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Bone Fracture ◽  
Long Bone ◽  
Cardiac Inflammation ◽  
Long Bone Fracture
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