scholarly journals Analytical report on post traumatic hydrocephalus

YMER Digital ◽  
2022 ◽  
Vol 21 (01) ◽  
pp. 144-147
Author(s):  
R Srinivas ◽  
◽  
Mohamed Naleer ◽  
Kishore Kumar ◽  
◽  
...  

Post-traumatic hydrocephalus (PTH) is a field and disorder less explored in neurosurgery though we see many cases. The commonest causes in our set up includes head injury for which people have undergone decompressive craniectomies, severe head injuries with raised ICP. We did a clinical analysis on 23 cases in a period of 3 years duration from 2018 -2021. We did Evd in few cases for emergency purposes when there was decerebration and we went ahead with VP shunt in all the patients who had gross ventricular dilatation. We have projected our analytical report in these cases. METHODS A retrospective study was conducted in the Department of Neurosurgery in Sri Ramachandra medical college. The clinical outcome of patients diagnosed with PTH was studied. These cases were treated by surgery. The stastical analysis along with cause of the hydrocephalus with the outcome in pre and postoperative period were studied. RESULTS Among the 23 patients studied 82% were males. Road traffic accident was the main cause of injury. The other main cause was a fall from height. Assault was another reason for head injuries which we recorded. We found all road traffic accidents were only because of bike riders either pillion or the people driving the vehicle. . Craniotomy was done in 50 % of the patients, 90 % of the patients recovered who had a gcs of 13 to 7. People with gcs lss than 7 were intubated recovery rate was 7.5 %. . There was 100%mortality because of primary head injury in all the patients who had brain stem contusions with dilated pupil. CONCLUSIONS Trauma to head and who were operated had the highest incidence of post tramatic head injury. Smaller the decompressive craniectomies had symptomatic post traumatic head ache with post traumatic hydrocephalus.. CT scan of the brain is considered the choice of investigation toearly diagnose PTH.we even analysed the ct scan and found when there was periventricular lucency the patient outcome after VP shunting is good. KEY WORDS Hydrocephalus, Head Injury, Trauma

Author(s):  
Kana Ram Patel ◽  
Jagdish Jugtawat ◽  
Shalender Kumar ◽  
P.C. Vyas

Accidents are not due to external factors all the time but often they occur due to failure of control of self-conscience and free thoughts. Road Traffic Accidents is still the major cause of death worldwide including India. A retrospective study has been conducted in Dr. S.N. Medical College, Jodhpur (Raj.), in the year 2019 to study the pattern and distribution of Head Injuries of fatal road traffic accidents and to prepare the demographic profile of it. Out of total 901 cases, male to female ratio was 9:1, and commonest age group affected was 21-30 years (39.8%). Among total victims, Hindus were 748 (83%) and rests were Muslims 103 (11.4%) and other religions. Head injury was the most common injury, present alone in 509 cases (56.4%) and in 392 (43.6) cases along with other injuries. Skull fractures were found in 451 (50.5), in which linear/fissure fracture (32.9%) was most common. Most common bone fractured was temporal bone. The commonest variety of intracranial hemorrhage was subdural hemorrhage and craniotomy was done in 29 (3.2%) cases. Keywords: Accidents, Road traffic, Head injury, Fractures.


2018 ◽  
Vol 5 (10) ◽  
pp. 3252
Author(s):  
Vinod Pusdekar ◽  
Sandeep Ambedkar ◽  
Ritesh Bodade

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.


Author(s):  
Satabdi Mitra ◽  
Saumabrata Panja

Background: Enquiry into unnatural deaths with all its manners being, suicidal, accidental or homicidal depends on circumstantial evidences for acceptable judgment in court of law. Objectives were to study socio-demographic characteristics of the study and to find out influencing factors, if any, behind these sudden, suspicious, undesirable deaths.Methods: A record-based, descriptive study with cross-sectional design was conducted for first six months of 2017 in NRS medical college hospital among 1603 unnatural deaths undergone police inquest. Besides the records obtained from medical record section, findings were corroborated from mortuary. Data were analyzed in SPSS 22.0 and Epi Info 7.0.Results: Mean age of the deceased was 37.18±17.42 years. Regarding cause of injury, more than 1/3rd (36.6%) was attributed to poisoning, followed by burn injury (24.8%), road traffic accidents (22.8%), fall from height (6.9%) and others the rest. Majority (68.3%) died within twenty hours of reaching the health care facility. More than half of the deceased committed suicide followed by accident and suicide the least. Binary logistic regression revealed, unnatural deaths inflicted by selves or others, i.e. suicide or homicide respectively, had statistically significant (p<0.05) association to productive age, urban residence, burn and RTA, longer survival and conservative nature of management.Conclusions: As suicide was found to comprise lion share of unnatural deaths, development and implementation of addressing the issue at all the levels, starting from individual to community is the need of the hour.


1970 ◽  
Vol 8 (2) ◽  
pp. 110-113
Author(s):  
R Bhandari ◽  
IP Mahato ◽  
M Paudel ◽  
R Giri

Background: Head injury is a common presentation in emergency rooms. Management often is decided by time of trauma, clinical presentations and availability of facilities. Objective: To outline the general characteristics of head injury patients presenting to emergency. Methods: This is an observational (case series) study done in BPKIHS emergency room over a period of six months. All the acute head trauma cases presenting to the department of emergency, BPKIHS, were evaluated based on the semi closed clinical performa including major clinical indicators of intracranial trauma. Results: Among 255 head injury patients, males were more common. Fall was the commonest mode of injury resulting in 71.42% in those under ten years where as road traffic accidents was commonest in twenty to fifty years age group.23% reached the hospital after 12 hours of injury. Loss of consciousness and vomiting were the commonest history. 9.4% had consumed alcohol at presentation. Mild head injury was commonest (76.5%). 23% were discharged from emergency within 12 hours. 14.9% underwent neurosurgical intervention. 187 of 255 underwent CT scan, 132 were abnormal. Contusions were commonest. For the normal CT scan the mean GCS score was 13.65 and for abnormal CT scans the mean GCS was 12.48 with SD of 2.8 and 3.4 respectively, p=0.025. Keywords: head injury; clinical features; emergency; classification; Glasgow coma score; CT scan. DOI: 10.3126/hren.v8i2.4422 Health Renaissance, May-Aug 2010; Vol 8 (No.2):11--113


2015 ◽  
Vol 100 (12) ◽  
pp. 1136-1140 ◽  
Author(s):  
Robin Marlow ◽  
Julie Mytton ◽  
Ian K Maconochie ◽  
Hazel Taylor ◽  
Mark D Lyttle

BackgroundThe number of children admitted to hospital is increasing year on year, with very short-stay admissions doubling in the last decade. Childhood head injury accounts for half a million emergency department attendances in the UK every year. The National Institute for Health and Care Excellence (NICE) has issued three iterations of evidence-based national guidance for head injury since 2003.ObjectivesTo assess if any changes in the rates of admission, death or causes of head injury could be temporally associated with the introduction of sequential national guidelines by longitudinal analysis of the epidemiology of paediatric head injury admissions in England from 2000 to 2011.MethodsRetrospective analysis of English Hospital Episode Statistics data of children under the age of 16 years old admitted to hospital with the discharge diagnosis of head injury.ResultsThe number of hospital admissions with paediatric head injury in England rose by 10% from 34 150 in 2000 to 37 430 in 2011, with the proportion admitted for less than 1 day rising from 38% to 57%. The main cause of head injury was falls (42–47%). Deaths due to head injury decreased by 52% from 76 in 2000 to 40 in 2011. Road traffic accidents were the main cause of death in the year 2000 (67%) but fell to 40% by 2011. In 2000, children who were admitted or died from head injuries were more than twice as likely to come from the most deprived homes compared with least deprived homes. By 2011, the disparity for risk of admission had narrowed, but no change was seen for risk of death.ConclusionsTemporal relationships exist between implementation of NICE head injury guidance and increased admissions, shorter hospital stay and reduced mortality. The underlying cause of this association is likely to be multifactorial.


Author(s):  
B. Irfan ◽  
M. Nayil ◽  
K. Kaiser ◽  
R. Altaf ◽  
S. Hilal ◽  
...  

Abstract Background Head injury is a major health hazard throughout the world. Overall, the mortality/morbidity has not changed much in the last few decades. In developing nations, the situation is worse. Methods The study was conducted for a period of 1 year. The data collected include demographic profile, mode, circumstances and timing of the injury, neurological assessment using Glasgow Coma Scale (GCS) scoring, computed tomography (CT) scan findings, type of management, and outcome. Results Transport-related injuries and falls were the common cause of head injury, with more severe injuries seen in patients without wearing helmets and seat belts. The youth is at high risk of receiving head injuries. The summer season showed a maximum incidence of head injuries. The most common lesions on CT scan were linear fracture of the skull and brain contusion. Mortality rate was 26% and it correlated with the GCS at presentation. Conclusion Head injury mostly affects young people and males outnumber females. Road traffic accident is the major cause. People not abiding by the traffic rules, such as wearing helmets and seat belts, were at high risk of developing head injury and poor outcome.


Author(s):  
Mangesh Ramchandra Ghadge ◽  
Dinesh Ramesh Samel

Background: Trauma is a largely preventable cause of death. Trauma can be avoided and death can be averted if timely medical services are made available. Hence it is important to know the causes of trauma, the factors associated with it and the types of fatal injuries associated with these causes.Methods: A ten years record based study of the autopsies conducted in the Forensic Medicine department of a rapidly growing metropolitan area was undertaken from the autopsy registers and post mortem records.Results: It was noted that the young age groups of 16 to 30 years and 31 to 40 years are most vulnerable. Major cause of trauma was road traffic accidents, followed by fall from height. Other causes are Rail accidents, domestic accidents, building collapse and industrial accidents. Head injuries and shock with hemorrhage are the major causes of death due to trauma.Conclusions: Overall, males and younger population forms a major proportion of trauma victims. Among female victims the major causes of trauma were domestic accidents and house collapse and among male victims road traffic accidents, fall from height and railway accidents were major causes.


1970 ◽  
Vol 5 (2) ◽  
pp. 24-28 ◽  
Author(s):  
M Ahmad ◽  
FN Rahman ◽  
MH Chowdhury ◽  
AKMS Islam ◽  
MA Hakim

This study was conducted at the Dhaka Medical College (DMC) morgue among 100 postmortem cases of Road Traffic Accident (RTA) victims over a period of one year. The objective of this study was to find out incidences of head injury among the RTA victims along with other injuries and also to overview the present situation of RTA in the country. Out of 100 cases, 64% were male and 36% female. The highest incidence of RTA (28%) was observed among the age group 31 to 40 years. The highest number of victims were pedestrians (68%). Considering recorded causality by type of collision, hit pedestrian was the most common (39%), followed by head on collision (20%). Regarding injury pattern in different parts of body, all the victims had multiple abrasion and bruise, 90% had laceration, 78% had injury to brain and 77% victims had injury to abdominal organs like liver and spleen. In the skull, Linear/fissured fracture was the commonest type of fracture (36%), followed by comminuted fracture (18%). Temporal bone was observed most prone to be fractured (23%), followed by parietal bone (17%). Most of the victims had subdural haemorrhage (43%), followed by sub arachnoid haemorrhage (36%). Key words: Road traffic accident, head injury, postmortem. DOI: 10.3329/jafmc.v5i2.4579 JAFMC Bangladesh Vol.5(2) (December) 2009, pp.24-28


2015 ◽  
Vol 11 (3) ◽  
pp. 241-246 ◽  
Author(s):  
R Shrestha ◽  
SK Shrestha ◽  
SR Kayastha ◽  
N Parajuli ◽  
D Dhoju ◽  
...  

Background Physical trauma is one of the major cause of mortality and morbidity among young and active age group and its increasing trend is of main concern. There are only few studies concerning the spectrum of physical trauma in Nepal. Objective This study aims to evaluate the epidemiological spectrum, the extent, severity of the physical trauma and the outcome evaluation of patients with physical trauma over a period of one year in the emergency department of the Kathmandu University Hospital and compare the same parameters with those patients presenting to the various outreach centers of the hospital in the community. Methods Patient treatment files from the emergency department and the reports from various outreach centers were retrieved for a period of one year (May 2011 to April 2012). Epidemiological information, mode, type and anatomic location of injuries were recorded. Outcome evaluation was assessed by number of patients discharged from emergency department of the hospital or the outreach centers after the treatment, patients admitted for inpatient management and referred to other centers for further specialty management. Result In a period of one year, total 2205 (20%) of physical trauma cases presented to the emergency department and 1994 (6.12%) in the outreach centres. Most commonly involved age group in physical trauma both in Hospital set up and in Community set up were the young adults (15 to 49 years). Fall from height was the commonest mode of injury followed by road traffic accidents among the patients coming to the hospital while significant number of trauma patients coming to outreach centers were due to fall from height. In the hospital set up, 1525 (69.2%) of the cases were discharged while 537 (24.4%) needed inpatient management and 85 (3.8%) needed referral to other centers for the specialty management. In case of outreaches, half of the patients were discharged after the primary treatment and almost another half were referred to the hospital, mainly for need of further investigations. Conclusion Fall related injuries and road traffic accidents are the most common mode of trauma in the hospital set up and fall related injuries are the single most important mode of trauma seen in the outreaches. Mostly young adults in their active period of life are involved in physical trauma so appropriate preventive measures through public health approach should be included in comprehensive trauma management for reducing mortality and morbidity rates related to physical trauma. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12513 Kathmandu Univ Med J 2013; 43(3):241-246


1989 ◽  
Vol 34 (1) ◽  
pp. 399-401 ◽  
Author(s):  
J.H. Adams ◽  
D. Doyle ◽  
I. Ford ◽  
D.I. Graham ◽  
M. McGee ◽  
...  

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.


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