Analytical report on post traumatic hydrocephalus

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

Mutual relationships between head injury and conduct problems in children aged 9 months to 14 years in the UK Millennium Cohort Study

Background: Research suggests a link between acquired head injury and signs of conduct disorder, with a majority of findings based on retrospective reports and comparison samples. The relationship between head injuries and conduct problems and how they may influence one another during development is currently unclear. This study aimed to investigate direct and indirect associations between head injury and conduct problems through to early adolescence. Methods: Data from the UK Millennium Cohort Study was used to investigate the relationship between conduct problems as assessed by the Strengths and Difficulties Questionnaire and parent reported head injury over time, at ages 9 months, 3, 5, 7, 11 and 14 years, using a cross-lagged path analysis. This is data from 18,552 children, participating in a UK cohort study that is representative of the UK population. We included 7,041 (3,308 male) children, who had full information about head injuries and conduct problems at age 14. Results: We found a mutual association between childhood head injuries and conduct problems but with distinct timings: Head injury between 5-7 years predicted greater chance of conduct problems at age 11 and 14 years, while greater conduct problems at 5 years predicted a significantly greater chance of a head injury at age 7-11 years. Conclusions: These findings have important implications for the timing of preventive and ameliorative interventions. Prior to school entry, interventions aiming to reduce conduct problems would appear most effective at reducing likelihood of head injuries in future years. However, equivalent interventions targeting head injuries would be better timed either as children are entering formal primary education, or soon after they have entered.

Pediatric Electrical Bicycle Road Accidents

Introduction The use of electric bicycles (EBs) among children younger than 18 years of age is rapidly increasing worldwide and becoming a substantial contributor to road accidents. We analyzed patterns and severity of pediatric bicycle-related injuries, comparing children riding EBs and classic bicycles (CBs). Materials and Methods This was a retrospective study (January 2016–December 2018) of patients arriving at our medical center due to a bicycle accident. Data were collected from medical records and included demographics, injury characteristics, treatment, and outcomes. Results Of 561 children, 197 (35%) were EB riders and 364 (65%) were CB riders. Injury severity score (ISS) of EB cyclists was significantly higher than CB cyclists (mean 4.08 ± 4.67 and 3.16 ± 2.84, respectively, p = 0.012). The rate of accidents involving motorized vehicles was higher in the EB versus CB group (25.9 vs. 11.3%, p < 0.001). Head injuries were the most common type of injury in both groups; incidence was higher in CB than in EB cyclists. However, loss of consciousness was more common in the EB group (18.3 and 12.1%, respectively, p = 0.057). Lower extremity injuries were more common in EBs versus CBs (55.8 and 37.6%, respectively, p < 0.001). Orthopaedic surgical interventions were significantly higher in the EB group (49.2 vs. 33.2%, p < 0.001), and length of stay in hospital and admission to pediatric intensive care unit were more common in EB compared with CB, although not significantly. Conclusion Injury severity of EB patients was significantly higher than that of CB patients. Accidents involving motorized vehicles were more common in the EB group. Head injury associated with loss of consciousness was significantly higher in EB patients.

Neurodevelopmental Differences, Pedohebephilia, and Sexual Offending: Findings from Two Online Surveys

The neurodevelopmental theory of pedohebephilia states that sexual interests in children arise from early neurodevelopmental perturbations, as, for example, evidenced by increased non-right-handedness, more childhood head injuries, and reduced intelligence and height. As corroborating evidence largely rests on samples of convicted men, we conducted online surveys among German-speaking (Study 1, N = 199) and English-speaking men (Study 2, N = 632), specifically targeting community members with pedohebephilic or teleiophilic interests. Although we detected theoretically meaningful sexual interest patterns in an embedded viewing time task, we could not detect expected neurodevelopmental differences between teleiophilic and pedohebephilic men in either of the two studies. Strikingly, pedohebephilic men who reported convictions for sexual offenses emerged as shorter and less intelligent than pedohebephilic men without convictions in Study 2. While elucidating possible third variable confounds, results have to be interpreted cautiously because of the methodological problems inherent to non-matched case control designs.

Improved Hemodynamic Status of Head Injured Patients in the Emergency Unit (ER): Literature Review

Background: Head injury is a serious problem that can lead to death and even death. Handling of head injuries starts from protecting the brain with blood flow to the brain so that hypoxia or brain ischemia does not occur. Hemodynamics is the result of measuring systolic and diastolic blood pressure, pulse rate, and respiratory rate. Objectives: This literature review aims to find out what interventions can be done when there is an increase in hemodynamic status in head injury patients Methods: This database search was conducted by searching on google scholars with the keywords head injury, hemodynamics. The inclusion criteria of this literature review are articles that were researched within the last 5 years with the year published 2015-2020, full text, using the Indonesian language, the article that used is the article. Results: Interventions that can be done when there is an increase in hemodynamic status in head injury patients are giving oxygen and increasing 30o, giving oxygen through a simple mask and head position 30o, giving head-up position 30o compared to 15o position, giving nasal prong oxygenation therapy and murotal therapy Al-Qur'an for 30 minutes 3 times/day. Conclusion: All interventions resulting from this literature review were in the form of giving oxygen and increasing the head 30o, giving oxygen through a simple mask and head position 30o, giving the head position 30o compared to 15o position, giving nasal branch oxygenation therapy, and murotal Al-Qur'an therapy for 30 minutes 3 times/day.

Turbans vs. Helmets: A Systematic Narrative Review of the Literature on Head Injuries and Impact Loci of Cranial Trauma in Several Recreational Outdoor Sports

When in public, faith-based mandates require practising Sikh men to wear a turban which may not be covered by hats or caps. This makes it impossible for practising Sikhs to wear helmets and other protective headwear, mandatory in many countries and facilities for engagement in recreational pursuits (e.g., skiing) and on adventure outdoor recreation camps mandatorily run for school groups. The result is often social exclusion and ostracisation in the case of school children. Despite studies into the efficacy of protective helmets in some recreational outdoor activity settings, virtually nothing is known about the protective potential of turbans. This paper systematically reviews the extant literature on head injuries in several recreational outdoor activities and sports sectors (aerial, water, winter, wheeled and animal-based sports) and finds that the extant literature is of limited value when trying to understand the spatial distribution of trauma on the cranial surface. As the data do not permit to make inferences on the protective potential of turbans, future systematic, evidence-based epidemiological studies derived from hospital admissions and forensic examinations are required. Failure to do so perpetuates social exclusion and discrimination of religious grounds without an evidentiary basis for defensible public health measures.

Association of Head Injury With Late-Onset Epilepsy: Results From the Atherosclerosis Risk in Communities Cohort

Background and Objectives:Late-onset epilepsy (LOE; i.e., epilepsy starting in later adulthood) is affects a significant number of individuals. Head injury is also a risk factor for acquired epilepsy, but the degree to which prior head injury may contribute to LOE is less well understood. Our objective was to determine the association between head injury and subsequent development of LOE.Methods:Included were 8,872 participants enrolled in the Atherosclerosis Risk in Communities (ARIC) study with continuous Centers for Medicare Services (CMS) fee-for-service (FFS) coverage (55.1% women, 21.6% black). We identified head injuries through 2018 from linked Medicare FFS claims for inpatient/emergency department care, active surveillance of hospitalizations, and participant self-report. LOE cases through 2018 were identified from linked Medicare FFS claims. We used Cox proportional hazards models to evaluate associations of head injury with LOE, adjusting for demographic, cardiovascular, and lifestyle factors.Results:The adjusted hazard ratio (HR) for developing LOE after a history of head injury was 1.88 (95%CI=1.44-2.43). There was evidence for dose-response associations with greater risk for LOE with increasing number of prior head injuries (HR=1.37, 95%CI=1.01-1.88 for 1 prior head injury and HR=3.55, 95%CI=2.51-5.02 for 2+ prior head injuries, compared to no head injuries) and with more severe head injury (HR=2.53, 95%CI=1.83-3.49 for mild injury and HR=4.90, 95%CI=3.15-7.64 for moderate/severe injury, compared to no head injuries). Associations with LOE were significant for head injuries sustained at older age (age≥67 years: HR=4.01, 95%CI=2.91-5.54), but not for head injuries sustained at younger age (age<67 years: HR=0.98, 95%CI=0.68-1.41).Discussion:Head injury was associated with increased risk of developing LOE, particularly when head injuries were sustained at an older age, and there was evidence for higher risk for LOE after a greater number of prior head injuries and after more severe head injuries.Classification of Evidence:This study provides Class I evidence that an increased risk of late-onset epilepsy is associated with head injury and increases further with multiple and more severe head injuries.

Epidemiological study of fatal road traffic accident cases

The present study is an epidemiological study of fatal Road Traffic (RTA) cases brought and admitted in our tertiary health care centre from Nov 2017 to December 2019. There were 148 fatal RTA cases involving 112 males and 36 female. In the present study males cases outnumbered the female with an approximate male female ratio of 3.1:1. Many cases of fatal head injuries were due to four & two wheelers. Most commonly seen external injuries were abrasions. Lower limbs showed fractured in 31 cases, 20.95%, and upper limbs showed fractured in 22 cases, 14.89%. So, far case fatality is concerned involvement of head plays the most important role.