Head Injury
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2021 ◽  
Vol 12 ◽  
pp. 590
Raj Swaroop Lavadi ◽  
B. V. Sandeep ◽  
Manpreet Singh Banga ◽  
Sangamesh Halhalli ◽  
Anantha Kishan

Background: Cerebral venous thrombosis (CVT) is a rare entity typically occurring in patients in hypercoagulable states. They can also occur in cases of trauma. The symptoms are nonspecific. Case Description: A 28-year-old male presented to the emergency department with a head injury. During the necessary imaging, it was found that he had a depressed skull fracture and other signs of traumatic brain injury. Unbeknownst to the patient and the patient party, it was also revealed that the patient only had one kidney. Wound debridement and excision of the depressed fracture were performed. A postoperative MRI revealed that the patient had CVT. Conclusion: There should be a high index of suspicion for CVT in case of traumatic head injuries. The surgeon should plan management according to the patient’s comorbidities.

2021 ◽  
Vol 9 (11) ◽  
pp. 577-580
Neetin P. Mahajan ◽  
Tushar Patil ◽  
Kartik Pande ◽  
Kunal Chaudhari

Introduction:Gerhard Kuntscher first introduced the technique of intramedullary nailing in 1940s . It is a clover leaf shaped hollow tubular nail for intramedullary fixation of long bones. This nailing system has been a technological breakthrough for femur fixation which can be both anterograde or retrograde. Case Report:A 34 year old Male patient resident of Shahapur brought by relatives to JJ hospital, with chief complaint of pain at left knee since 8 days. Patient had A/H/O RTA after fall from bike in 31/12/2012 with head injury with left shaft femur fracture. Patient was operated at JJH with left femur ILN. History of head injury operated in JJ hospital with no details known to patient. There was also history decreased vision in left eye since trauma. Discussion:Interlocking intramedullary nails are used as gold standard treatment in majority of tibial and femoral diaphyseal fractures. It can be removed in certain circumstances when it causes soft tissue irritation, prominent locking screws, implant failure, infection, nonunion, malunion etc. Conclusion:This study shows that in removal of stuck or bent femur interlocking nails in which all other closed techniques have failed, open longitudinal femoral osteotomy with retrograde hitting of the nail can effectively aid in successful removal of nail.

2021 ◽  
Vol 8 (12) ◽  
pp. 3583
Fahad Ansari ◽  
Arvind Rai

Background: The Glasgow coma scale (GCS) is the most commonly used scale while the full outline of unresponsiveness (FOUR) score is a new validated coma scale in the evaluation of the level of consciousness in head injury patients. The aim of the study was to compare and assess the effectiveness of the FOUR score and the GCS in patients of traumatic head injury.Methods: This was a prospective observational study conducted in the department of surgery, Gandhi medical college, Bhopal during a 2 year period in which 100 patients of traumatic head injury were evaluated. The FOUR score and GCS score of these patients were assessed on admission and outcome followed for 2 weeks.Results: The mean age group of 100 patients was 25-45 years with 79% male and 21% female patients. The FOUR scale was found to have a marginally higher sensitivity of 65.6% while the GCS had a sensitivity of 64.2%. The FOUR scale however had a higher specificity of 71.5% compared to 66.4% of GCS. The Youden index showed that FOUR scale (46%) has a better prediction for death than GCS (35%). FOUR had a higher accuracy of 75% than GCS with an accuracy of 65%.Conclusions: Both FOUR score and GCS are valuable scales in assessment of traumatic head injury. The FOUR scale however is more accurate than the GCS in predicting outcome of head injury patients. 

2021 ◽  
Vol 13 (13) ◽  
pp. 20066-20071
Jahan Ahmed ◽  
Sorang Tadap ◽  
Millo Tasser ◽  
Koj Rinya ◽  
Nekibuddin Ahmed ◽  

We document the rescue of a Red Panda from Yachuli circle, Lower Subansiri district and successful translocation to Eaglenest Wildlife Sanctuary, West Kameng district of Arunachal Pradesh, India. The head injury was surgically managed under the anaesthetic combination of ketamine and xylazine, and reversed with yohimbine. The animal was successfully rehabilitated and translocated in the Eaglenest Wildlife Sanctuary.

2021 ◽  
pp. 000313482110635
Jordan Perkins ◽  
Jacob Shreffler ◽  
Danielle Kamenec ◽  
Alexandra Bequer ◽  
Corey Ziemba ◽  

Background: Many patients undergo two head computed tomography (CT) scans after mild traumatic brain injury (TBI). Radiographic progression without clinical deterioration does not usually alter management. Evidence-based guidelines offer potential for limited repeat imaging and safe discharge. This study characterizes patients who had two head CTs in the Emergency Department (ED), determines the change between initial and repeat CTs, and describes timing of repeat scans. Methods: This retrospective series includes all patients with head CTs during the same ED visit at an urban trauma center between May 1st, 2016 and April 30th, 2018. Radiographic interpretation was coded as positive, negative, or equivocal. Results: Of 241 subjects, the number of positive, negative, and equivocal initial CT results were 154, 50, and 37, respectively. On repeat CT, 190 (78.8%) interpretations were congruent with the original scan. Out of the 21.2% of repeat scans that diverged from the original read, 14 (5.8%) showed positive to negative conversion, 1 (.4%) showed positive to equivocal conversion, 2 (.88%) showed negative to positive conversion, 20 (8.3%) showed equivocal to negative conversion, and 14 (5.8%) showed equivocal to positive conversion. Average time between scans was 4.4 hours, and median length of stay was 10.2 hours. Conclusions: In this retrospective review, most repeat CT scans had no new findings. A small percentage converted to positive, rarely altering clinical management. This study demonstrates the need for continued prospective research to update clinical guidelines that could reduce admission and serial CT scanning for mild TBI.

2021 ◽  
Vol 2 (21) ◽  
Florian Wilhelmy ◽  
Tim Wende ◽  
Johannes Kasper ◽  
Maxime Ablefoni ◽  
Lena Marie Bode ◽  

BACKGROUND Posterior fossa epidural hematoma rarely occurs in children after traumatic head injury. There is ongoing discussion about appropriate treatment, yet the radiological features regarding the time to resorption of the hematoma or required follow-up imaging are rarely discussed. OBSERVATIONS The authors presented the case of a 3-year-old child who was under clinical observation and receiving analgetic and antiemetic treatment in whom near-complete hematoma resorption was shown by magnetic resonance imaging as soon as 60 hours after diagnosis. The child was neurologically stable at all times and showed no deficit after observational treatment. Hematoma resorption was much faster than expected. The authors discussed hematoma drainage via the sigmoid sinus. LESSONS Epidural hematomas in children can be treated conservatively and are resorbed in a timely manner.

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S22-S22
Sonia Ajmera ◽  
Mustafa Motiwala ◽  
Matt Weeks ◽  
Chesney S Oravec ◽  
David S Hersh ◽  

2021 ◽  
Vol 11 (11) ◽  
pp. 1220
Chen-Hua Lin ◽  
Xiao Chun Ling ◽  
Wei-Chi Wu ◽  
Kuan-Jen Chen ◽  
Chi-Hsun Hsieh ◽  

Purpose—Visual complaints are common in trauma cases. However, not every institution provides immediate ophthalmic consultations 24 h per day. Some patients may receive an ophthalmic consultation but without positive findings. We tried to evaluate risk factors for ocular emergencies in trauma patients. Then, the ophthalmologists could be selectively consulted. Methods—From January 2019 to December 2019, head injuries patients concurrent with suspected ocular injuries were retrospectively reviewed. All of the patients received comprehensive ophthalmic examinations by ophthalmologists. Patients with and without ocular injuries were compared. Specific ophthalmic evaluations that could be primarily performed by primary trauma surgeons were also analyzed in detail. Results—One hundred forty cases were studied. Eighty-nine (63.6%) patients had ocular lesions on computed tomography (CT) scans or needed ophthalmic medical/surgical intervention. Near 70% (69.7%, 62/89) of patients with ocular injuries were diagnosed by CT scans. There was a significantly higher proportion of penetrating injuries in patients with ocular injuries than in patients without ocular injuries (22.5% vs. 3.9%, p = 0.004). Among the patients with blunt injuries (N = 118), 69 (58.5%) patients had ocular injuries. These patients had significantly higher proportions of periorbital swelling (89.9% vs. 67.3%, p = 0.002) and diplopia (26.1% vs. 8.2%, p = 0.014) than patients without ocular injuries. Conclusions—In patients with head injuries, concomitant ocular injuries with indications for referral should always be considered. CT serves as a rapid and essential diagnostic tool for the evaluation of concomitant ocular injuries. Ophthalmologists could be selectively consulted for patients with penetrating injuries or specific ocular presentations, thus reducing the burden of ophthalmologists.

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