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Sample records for related head injury

  1. Boxing-related head injuries.

    Science.gov (United States)

    Jayarao, Mayur; Chin, Lawrence S; Cantu, Robert C

    2010-10-01

    Fatalities in boxing are most often due to traumatic brain injury that occurs in the ring. In the past 30 years, significant improvements in ringside and medical equipment, safety, and regulations have resulted in a dramatic reduction in the fatality rate. Nonetheless, the rate of boxing-related head injuries, particularly concussions, remains unknown, due in large part to its variability in clinical presentation. Furthermore, the significance of repeat concussions sustained when boxing is just now being understood. In this article, we identify the clinical manifestations, pathophysiology, and management of boxing-related head injuries, and discuss preventive strategies to reduce head injuries sustained by boxers.

  2. Sports-related Head Injury

    Science.gov (United States)

    ... and head gear come in many sizes and styles for many sports and must properly fit to ... to play or practice." The "Concussion Diagnosis and Management" section details circumstances in which an athlete should ...

  3. Biomechanical aspects of sports-related head injuries.

    Science.gov (United States)

    Park, Min S; Levy, Michael L

    2008-02-01

    With the increased conditioning, size, and speed of professional athletes and the increase in individuals engaging in sports and recreational activities, there is potential for rising numbers of traumatic brain injuries in sports. Fortunately, parallel strides in basic research technology and improvements in computer and video technology have created a new era of discovery in the study of the biomechanical aspects of sports-related head injuries. Although prevention will always be the most important factor in reducing the incidence of sports-related traumatic brain injuries, ongoing studies will lead to the development of newer protective equipment, improved recognition and management of concussions on the field of play, and modification of rules and guidelines to make these activities safer and more enjoyable.

  4. Fall Risk Assessment Predicts Fall-Related Injury, Hip Fracture, and Head Injury in Older Adults.

    Science.gov (United States)

    Nilsson, Martin; Eriksson, Joel; Larsson, Berit; Odén, Anders; Johansson, Helena; Lorentzon, Mattias

    2016-11-01

    To investigate the role of a fall risk assessment, using the Downton Fall Risk Index (DFRI), in predicting fall-related injury, fall-related head injury and hip fracture, and death, in a large cohort of older women and men residing in Sweden. Cross sectional observational study. Sweden. Older adults (mean age 82.4 ± 7.8) who had a fall risk assessment using the DFRI at baseline (N = 128,596). Information on all fall-related injuries, all fall-related head injuries and hip fractures, and all-cause mortality was collected from the Swedish Patient Register and Cause of Death Register. The predictive role of DFRI was calculated using Poisson regression models with age, sex, height, weight, and comorbidities as covariates, taking time to outcome or end of study into account. During a median follow-up of 253 days (interquartile range 90-402 days) (>80,000 patient-years), 15,299 participants had a fall-related injury, 2,864 a head injury, and 2,557 a hip fracture, and 23,307 died. High fall risk (DFRI ≥3) independently predicted fall-related injury (hazard ratio (HR) = 1.43, 95% confidence interval (CI) = 1.39-1.49), hip fracture (HR = 1.51, 95% CI =1.38-1.66), head injury (HR = 1.12, 95% CI = 1.03-1.22), and all-cause mortality (HR = 1.39, 95% CI = 1.35-1.43). DFRI more strongly predicted head injury (HR = 1.29, 95% CI = 1.21-1.36 vs HR = 1.08, 95% CI = 1.04-1.11) and hip fracture (HR = 1.41, 95% CI = 1.30-1.53 vs HR = 1.08, 95% CI = 1.05-1.11) in 70-year old men than in 90-year old women (P Fall risk assessment using DFRI independently predicts fall-related injury, fall-related head injury and hip fracture, and all-cause mortality in older men and women, indicating its clinical usefulness to identify individuals who would benefit from interventions. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

  5. Tackler’s head position relative to the ball carrier is highly correlated with head and neck injuries in rugby

    Science.gov (United States)

    Hasegawa, Yoshinori; Shiota, Yuki; Ota, Chihiro; Yoneda, Takeshi; Tahara, Shigeyuki; Maki, Nobukazu; Matsuura, Takahiro; Sekiguchi, Masahiro; Itoigawa, Yoshiaki; Tateishi, Tomohiko; Kaneko, Kazuo

    2018-01-01

    Objectives To characterise the tackler’s head position during one-on-one tackling in rugby and to determine the incidence of head, neck and shoulder injuries through analysis of game videos, injury records and a questionnaire completed by the tacklers themselves. Methods We randomly selected 28 game videos featuring two university teams in competitions held in 2015 and 2016. Tackles were categorised according to tackler’s head position. The ‘pre-contact phase’ was defined; its duration and the number of steps taken by the ball carrier prior to a tackle were evaluated. Results In total, 3970 tackles, including 317 (8.0%) with the tackler’s head incorrectly positioned (ie, in front of the ball carrier) were examined. Thirty-two head, neck or shoulder injuries occurred for an injury incidence of 0.8% (32/3970). The incidence of injury in tackles with incorrect head positioning was 69.4/1000 tackles; the injury incidence with correct head positioning (ie, behind or to one side of the ball carrier) was 2.7/1000 tackles. Concussions, neck injuries, ‘stingers’ and nasal fractures occurred significantly more often during tackles with incorrect head positioning than during tackles with correct head positioning. Significantly fewer steps were taken before tackles with incorrect head positioning that resulted in injury than before tackles that did not result in injury. Conclusion Tackling with incorrect head position relative to the ball carrier resulted in a significantly higher incidence of concussions, neck injuries, stingers and nasal fractures than tackling with correct head position. Tackles with shorter duration and distance before contact resulted in more injuries. PMID:29162618

  6. The "swing-ding": a golf-related head injury in children.

    Science.gov (United States)

    Wang, Arthur; Cohen, Alan R; Robinson, Shenandoah

    2011-01-01

    In recent years there has been an increased incidence of golf-associated head injuries in children and adolescents. At the authors' institution, they have identified a unique pattern of head injury associated with a swinging golf club. In this study, the authors highlight the mechanism of this injury and report their experience treating it. The authors reviewed the database of Rainbow Babies and Children's Hospital Trauma Center and performed a retrospective analysis of golf injuries recorded over a 10-year period (January 2000-April 2010). They identified 13 children (9 boys and 4 girls) who sustained head injuries in golfing accidents. All patients were 10 years of age or younger. The medical charts were reviewed and follow-up interviews were conducted to better delineate the details of the injuries. Injuries included 13 depressed skull fractures, 7 epidural hematomas, and 1 cerebral contusion. All 13 patients sustained their injuries after being struck in the head by a golf club. Seven sustained injuries on the follow-through of the initial swing and 3 sustained injuries on the backswing. All but one patient required neurosurgical intervention. Five patients developed neurological sequelae. None of the children had prior experience with golf equipment. All but one injury occurred in the child's own backyard. There was no direct supervision by an adult in any of the cases. Golfing can lead to serious head injuries in children. The authors noticed a unique pattern of golf-related head injuries, previously not described, that they have termed the "swing-ding." This golf club-inflicted injury occurs when a child stands too close to a swinging golfer and is struck in the head, subsequently sustaining a comminuted depressed skull fracture in the frontal or temporal region, with or without further intracranial injury. The study suggests that a lack of adult supervision, minimal previous golf experience, and proximity of the child to the swinging golfer are all

  7. Injury patterns and mortality rates of motorcycle-related head injuries ...

    African Journals Online (AJOL)

    Background: Motorcycles are an emerging means of public transportation in many developing countries and has a poor safety record when compared to other road users. Subsequently, motorcycle injuries have been on the rise and head injuries are the leading cause of death, severe injury and disability globally.

  8. Head Injuries

    Science.gov (United States)

    ... a severe blow to the head can still knock the brain into the side of the skull ... following certain precautions and taking a break from sports and other activities that make symptoms worse. Playing ...

  9. Head injury - first aid

    Science.gov (United States)

    ... medlineplus.gov/ency/article/000028.htm Head injury - first aid To use the sharing features on this page, ... a concussion can range from mild to severe. First Aid Learning to recognize a serious head injury and ...

  10. Attention to affective pictures in closed head injury: event-related brain potentials and cardiac responses.

    Science.gov (United States)

    Solbakk, Anne-Kristin; Reinvang, Ivar; Svebak, Sven; Nielsen, Christopher S; Sundet, Kjetil

    2005-02-01

    We examined whether closed head injury patients show altered patterns of selective attention to stimulus categories that naturally evoke differential responses in healthy people. Self-reported rating and electrophysiological (event-related potentials [ERPs], heart rate [HR]) responses to affective pictures were studied in patients with mild head injury (n = 20; CT/MRI negative), in patients with predominantly frontal brain lesions (n = 12; CT/MRI confirmed), and in healthy controls (n = 20). Affective valence similarly modulated HR and ERP responses in all groups, but group differences occurred that were independent of picture valence. The attenuation of P3-slow wave amplitudes in the mild head injury group indicates a reduction in the engagement of attentional resources to the task. In contrast, the general enhancement of ERP amplitudes at occipital sites in the group with primarily frontal brain injury may reflect disinhibition of input at sensory receptive areas, possibly due to a deficit in top-down modulation performed by anterior control systems.

  11. Risk of maltreatment-related injury: a cross-sectional study of children under five years old admitted to hospital with a head or neck injury or fracture.

    Directory of Open Access Journals (Sweden)

    Joseph Jonathan Lee

    Full Text Available To determine the predictive value and sensitivity of demographic features and injuries (indicators for maltreatment-related codes in hospital discharge records of children admitted with a head or neck injury or fracture.Population-based, cross sectional study.NHS hospitals in England.Children under five years old admitted acutely to hospital with head or neck injury or fracture.Hospital Episodes Statistics, 1997 to 2009.Maltreatment-related injury admissions, defined by ICD10 codes, were used to calculate for each indicator (demographic feature and/or type of injury: i the predictive value (proportion of injury admissions that were maltreatment-related; ii sensitivity (proportion of all maltreatment-related injury admissions with the indicator.Of 260,294 childhood admissions for fracture or head or neck injury, 3.2% (8,337 were maltreatment-related. With increasing age of the child, the predictive value for maltreatment-related injury declined but sensitivity increased. Half of the maltreatment-related admissions occurred in children older than one year, and 63% occurred in children with head injuries without fractures or intracranial injury.Highly predictive injuries accounted for very few maltreatment-related admissions. Protocols that focus on high-risk injuries may miss the majority of maltreated children.

  12. A population-based study of sport and recreation-related head injuries treated in a Canadian health region.

    Science.gov (United States)

    Harris, Andrew W; Jones, C Allyson; Rowe, Brian H; Voaklander, Donald C

    2012-07-01

    To report the rates of SR-related HIs presenting to EDs in a Canadian population-based sample. Descriptive epidemiology study. Using administrative data, sport and recreation-related emergency department presentations for persons 0-35 years of age, from April 1997 through March 2008, were obtained from the Edmonton Zone (formerly the Capital Health Region), Alberta Health Services through the Ambulatory Care Classification System. Of the 3,230,890 visits to the emergency departments of the five hospitals in Edmonton, 63,219 sport and recreation-related injury records and 4935 sport and recreation-head injury records were identified. Head injuries were most frequently treated for the activities of hockey (20.7%), cycling (12.0%), and skiing/snowboarding/sledding. Males accounted for 71.9% (n=3546) and patients less than 18 years of age sustained 3446 (69.8%) sport and recreation-head injuries. Sport and recreation-related head injuries most frequently treated in emergency departments involve common activities such as hockey, cycling, skiing/snowboarding/sledding, and soccer. Males and those less than 18 years of age sustain the majority of sport and recreation-related head injuries treated in emergency departments. These findings underscore the importance of sport-specific policies and safety promotion for the prevention of head injuries, in sports and recreational activities. Copyright © 2011 Sports Medicine Australia. All rights reserved.

  13. Age related outcome in acute subdural haematoma following traumatic head injury.

    LENUS (Irish Health Repository)

    Hanif, S

    2009-09-01

    Acute subdural haematoma (ASDH) is one of the conditions most strongly associated with severe brain injury. Reports prior to 1980 describe overall mortality rates for acute subdural haematomas (SDH\\'s) ranging from 40% to 90% with poor outcomes observed in all age groups. Recently, improved results have been reported with rapid diagnosis and surgical treatment. The elderly are predisposed to bleeding due to normal cerebral atrophy related to aging, stretching the bridging veins from the dura. Prognosis in ASDH is associated with age, time from injury to treatment, presence of pupillary abnormalities, Glasgow Coma Score (GCS) or motor score on admission, immediate coma or lucid interval, computerized tomography findings (haematoma volume, degree of midline shift, associated intradural lesion, compression of basal cisterns), post-operative intracranial pressure and type of surgery. Advancing age is known to be a determinant of outcome in head injury. We present the results of a retrospective study carried out in Beaumont Hospital, Dublin, Ireland\\'s national neurosurgical centre. The aim of our study was to examine the impact of age on outcome in patients with ASDH following severe head injury. Only cases with acute subdural haematoma requiring surgical evacuation were recruited. Mortality was significantly higher in older patients (50% above 70 years, 25.6% between 40 and 70 years and 26% below 40 years). Overall poor outcome (defined as Glasgow outcome scores 3-5) was also higher in older patients; 74.1% above 70 years, 48% between 40 and 70 years and 30% below 40 years. Poor outcome in traumatic acute subdural haematoma is higher in elderly patients even after surgical intervention.

  14. Head injury in children

    International Nuclear Information System (INIS)

    Sugiura, Makoto; Mori, Nobuhiko; Yokosuka, Reiko; Yamamoto, Masaaki; Imanaga, Hirohisa

    1981-01-01

    Findings of computerized tomography (CT) in 183 cases of head injury in children were investigated with special reference to CT findings of mild head injury. As was expected, CT findings of mild head injury fell within the normal range, in almost all cases. However, abnormal findings were noticed in 4 out of 34 cases (12%) in acute stage and 7 out of 76 cases (9%) in chronic stage. They were 3 cases of localized low density area in acute stage and 6 cases of mild cerebral atrophy in chronic stage, etc. There were some cases of mild head injury in which CT findings were normal while EEG examination revealed abnormality. Also in some cases, x-ray study demonstrated linear skull fracture which CT failed to show. These conventional techniques could be still remained as useful adjunct aid in diagnosis of head injury. CT findings of cases of cerebral contusion in their acute stage were divided as follows; normal, low density, small ventricle and ventricular and/or cisternal hemorrhage, frequency of incidence being 38, 17, 22, 11% respectively. These findings were invariably converted to cerebral atrophy from 10 days to 2 months after the impacts. In the cases with intracranial hematoma revealed by CT, only 32% of them showed clinical signs of Araki's type IV in their acute stage and 63% of them showed no neurological defects, that is Araki's type I and II. A case of extreme diffuse cerebral atrophy which followed acute subdural hematoma caused by tear of bridging veins without cortical contusion was presented. (author)

  15. Word Memory Test Predicts Recovery in Claimants With Work-Related Head Injury.

    Science.gov (United States)

    Colangelo, Annette; Abada, Abigail; Haws, Calvin; Park, Joanne; Niemeläinen, Riikka; Gross, Douglas P

    2016-05-01

    To investigate the predictive validity of the Word Memory Test (WMT), a verbal memory neuropsychological test developed as a performance validity measure to assess memory, effort, and performance consistency. Cohort study with 1-year follow-up. Workers' compensation rehabilitation facility. Participants included workers' compensation claimants with work-related head injury (N=188; mean age, 44y; 161 men [85.6%]). Not applicable. Outcome measures for determining predictive validity included days to suspension of wage replacement benefits during the 1-year follow-up and work status at discharge in claimants undergoing rehabilitation. Analysis included multivariable Cox and logistic regression. Better WMT performance was significantly but weakly correlated with younger age (r=-.30), documented brain abnormality (r=.28), and loss of consciousness at the time of injury (r=.25). Claimants with documented brain abnormalities on diagnostic imaging scans performed better (∼9%) on the WMT than those without brain abnormalities. The WMT predicted days receiving benefits (adjusted hazard ratio, 1.13; 95% confidence interval, 1.04-1.24) and work status outcome at program discharge (adjusted odds ratio, 1.62; 95% confidence interval, 1.13-2.34). Our results provide evidence for the predictive validity of the WMT in workers' compensation claimants. Younger claimants and those with more severe brain injuries performed better on the WMT. It may be that financial incentives or other factors related to the compensation claim affected the performance. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. Heading and head injuries in soccer.

    Science.gov (United States)

    Kirkendall, D T; Jordan, S E; Garrett, W E

    2001-01-01

    In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the

  17. Sequential computerized tomography changes and related final outcome in severe head injury patients

    International Nuclear Information System (INIS)

    Lobato, R.D.; Gomez, P.A.; Alday, R.

    1997-01-01

    The authors analyzed the serial computerized tomography (CT) findings in a large series of severely head injured patients in order to assess the variability in gross intracranial pathology through the acute posttraumatic period and determine the most common patterns of CT change. A second aim was to compare the prognostic significance of the different CT diagnostic categories used in the study (Traumatic Coma Data Bank CT pathological classification) when gleaned either from the initial (postadmission) or the control CT scans, and determine the extent to which having a second CT scan provides more prognostic information than only one scan. 92 patients (13.3 % of the total population) died soon after injury. Of the 587 who survived long enough to have at least one control CT scan 23.6 % developed new diffuse brain swelling, and 20.9 % new focal mass lesions most of which had to be evacuated. The relative risk for requiring a delayed operation as related to the diagnostic category established by using the initial CT scans was by decreasing order: diffuse injury IV (30.7 %), diffuse injury III (30.5 %), non evacuated mass (20 %), evacuated mass (20.2 %), diffuse injury II (12.1 %), and diffuse injury I (8.6 %). Overall, 51.2 % of the patients developed significant CT changes (for worse or better) occurring either spontaneously or following surgery, and their final outcomes were more closely related to the control than to the initial CT diagnoses. In fact, the final outcome was more accurately predicted by using the control CT scans (81.2 % of the cases) than by using the initial CT scans (71.5 % of the cases only). Since the majority of relevant CT changes developed within 48 hours after injury a pathological categorization made by using an early control CT scan seems to be most useful for prognostic purposes. Prognosis associated with the CT pathological categories used in the study was similar independently of the moment of the acute posttraumatic period at which

  18. [Prevalence of helmet use in children and adolescents in Germany and preventable bicycle-related head injuries].

    Science.gov (United States)

    Gutsche, J; Hintzpeter, B; Neuhauser, H; Schlaud, M

    2011-08-01

    Head injuries are the main cause of death in bicycle-related accidents among children and adolescents. According to a Cochrane Review, the risk of head injury (OR 0.31; 95% CI 0.26-0.37) or brain injury (OR 0.31; 95% CI 0.23-0.42) decreases by 69% if a helmet is worn. This study presents the prevalence of helmet use in cycling children and adolescents in Germany and the proportion of head injuries that could be prevented by wearing helmets. The potential effects of increased helmet wearing rates on the population attributable risk percentage for head injuries (PAR%) are demonstrated. The prevalence of helmet use in children aged 3-17 years was analysed using data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The percentage of head injuries preventable by helmet use in this group is estimated by calculating PAR%. Prevalence rates of helmet use and odds ratios from a Cochrane Review about the effectiveness of bicycle helmets for the prevention of head injuries were used for analysis. The potential effect of increased helmet use is shown in 3 scenarios by means of differences of PAR% values in the most relevant age groups. The older the children, the less likely they are to wear a helmet: 89.5% (95% CI 88.0%-90.8%) of the 3- to 6-year-old children wear a helmet when cycling but only 11.0% (95% CI 9.3%-12.9%) of 14- to 17-year-old adolescents do. In the youngest group (3-6 years) 19% of bicycle-related head injuries are attributable to the non-use of helmets, but this proportion rises to 67% in the oldest group (14-17 years). The PAR% of head injuries associated with not wearing a helmet may be reduced by more than a third by increasing the helmet wearing rate to 67% (2 out of 3) among adolescents, and may be reduced to half if 75% of adolescents wore a helmet. Particularly older children and adolescents hardly use bicycle helmets, hence the rate of preventable head injury is high. Efforts towards increasing helmet use

  19. Indices of slowness of information processing in head injury patients : Tests for selective attention related to ERP latencies

    NARCIS (Netherlands)

    Spikman, Jacoba M.; Naalt, van der Joukje; Weerden , van Tiemen; Zomeren , van Adriaan H.

    2004-01-01

    We explored the relation between neuropsychological (attention tests involving time constraints) and neurophysiological (N2 and P3 event-related potential (ERP) latencies) indices of slowness of information processing after closed head injury (CHI). A group of 44 CHI patients performed worse than

  20. Prognosis of head injury. In relation to age, CT findings and the GCS on admission

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Satoshi; Kamei, Ichiro; Ooiwa, Yoshitsugu; Hyotani, Genhachi; Yabumoto, Michio; Kuriyama, Tsuyoshi [Japanese Red Cross Society, Wakayama (Japan). Wakayama Medical Center; Kakishita, Koji; Inui, Yoshiro

    1996-02-01

    We have carried out a retrospective study of head injury patients to determine the factors that predict their outcomes. The subjects consisted of 74 head injury patients (Glasgow Coma Scale: 3-12) treated at our hospital from January, 1989 to March, 1994. Age, CT findings and the GCS on admission were investigated as outcome-predicting factors. CT findings were classified according to the TCDB (Traumatic Coma Data Bank) and the outcomes were evaluated using the Glasgow Outcome Scale 3 months after the head injury. In our study, the factors indicated favorable outcomes were as follows; age younger than 50 years old, GCS higher than 6, appearance of the basal cisterns on CT scan, existence of removable acute epidural hematoma. In contrast, the factors that indicated unfavorable outcomes were as follows; disappearance of the basal cisterns on CT scan, existence of apparent acute subdural hematoma and/or intracranial hematoma associated with cerebral contusion. Based on these findings, we can more accurately estimate the prognosis of head injury. (author)

  1. Anaphylaxis Due to Head Injury

    Directory of Open Access Journals (Sweden)

    Bruner, Heather C.

    2015-05-01

    Full Text Available Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury. [West J Emerg Med. 2015;16(3:435–437.

  2. Anaphylaxis due to head injury.

    Science.gov (United States)

    Bruner, Heather C; Bruner, David I

    2015-05-01

    Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury.

  3. OCULAR MANIFESTATIONS OF HEAD INJURIES

    Directory of Open Access Journals (Sweden)

    Kanukollu Venkata Madusudana Rao

    2016-12-01

    Full Text Available BACKGROUND This prospective study aimed to evaluate the incidence of ocular manifestations in head injury and their correlation with the intracranial lesions. MATERIALS AND METHODS A total of 108 consecutive cases of closed head injury admitted in the neurosurgical ward of a tertiary teaching hospital underwent a thorough ophthalmic assessment. Clinical examination, radiological imaging and Glasgow Coma Scale (GCS were applied to grade the severity of injury. RESULTS Total number of 108 patients of head injury were examined of which 38 patients had ocular manifestations (35.18%. Of these, 85.18% were males, 84% of injuries were due to road traffic accidents and 16% were due to fall from a height. The ocular manifestations were as follows- Orbital complications were seen in 6 patients (15.8%. Anterior segment manifestations included black eyes seen in 10 patients (26.3%, subconjunctival haemorrhage in 10.5% of patients (4 patients, corneal involvement in 21% of patients (8 patients and pupillary involvement in 50% of patients (19 patients. Posterior segment manifestations were seen in 26.3% of patients (10 patients and were as follows- Purtscher’s retinopathy in 2 patients and optic atrophy in 5 patients. Cranial nerve palsies were seen in 15 patients (39.47% and supranuclear movement disorders were seen in 3 patients (8%. CONCLUSION Even though, neurosurgeons perform comprehensive clinical examination including eye examination, the main purpose is limited to aid topical diagnosis of neurological lesions. This study emphasises the importance of a detailed eye examination by an ophthalmologist to prevent irreversible visual loss in addition to aiding in the neurological diagnosis. Pupillary involvement, papilloedema and ocular motor paresis pointed to a more severe head injury. This observational prospective study helped us to correlate the severity of head injuries in association with ocular findings in patients admitted in neurosurgical ward

  4. Head Trauma from Falling Increases Subsequent Emergency Department Visits More Than Other Fall-Related Injuries in Older Adults.

    Science.gov (United States)

    Southerland, Lauren T; Stephens, Julie A; Robinson, Shari; Falk, James; Phieffer, Laura; Rosenthal, Joseph A; Caterino, Jeffrey M

    2016-04-01

    To determine whether fall-related injuries affect return to the ED after the initial visit. Retrospective chart review. Academic Level 1 trauma center ED. Individuals aged 65 and older evaluated for a fall from standing height or less and discharged (N = 263, average age 77, 70% female). After institutional review board approval, electronic medical record data were queried. Univariate and multivariable logistic regression models were used to determine factors associated with risk of returning to the ED within 90 days. Injuries included fractures (45%, n = 117); head trauma (22%, n = 58); abrasions, lacerations, or contusions (34%, n = 88); and none (22%, n = 57). Emergency care was frequently required, with 13 (5%, 95% confidence interval (CI) = 2.3-7.6%) returning within 72 hours, 35 (13%, 95% CI = 9.2-17%] within 30 days, and 57 (22%, 95% CI = 17-27%) within 90 days. Univariately, the odds of returning to the ED within 90 days was more than two times as high for those with head trauma as for those without (odds ratio = 2.66). This remained significant in the multivariable model, which controlled for Charlson Comorbidity Index, fractures, soft tissue injuries, and ED observation unit use. More than one-third of older adults with minor head trauma from a fall will need to return to the ED in the following 90 days. These individuals should receive close attention from primary care providers. The link between minor head trauma and ED recidivism is a new finding. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. Ophthalmic manifestations of head injury.

    Science.gov (United States)

    Kowal, L

    1992-02-01

    Head injuries are frequently associated with ophthalmic problems. The commonest problems seen in this series of 161 patients with head injury were problems with poor accommodation (16% of patients; 58% of these persisted), convergence (14% of patients; 35% of these persisted), pseudomyopia (19%; 55% persisted) and optic atrophy (26% of the patients; 78% of these were mild and easily missed on routine testing, and 22% were severe). Motility disorders were common, especially cranial nerve palsies. Other less frequent motility disturbances included apparent inferior oblique palsy, comitant esotropia, and exotropia which was often of the convergence insufficiency type.

  6. Intention tremor after head injury

    International Nuclear Information System (INIS)

    Iwadate, Yasuo; Saeki, Naokatsu; Namba, Hiroki; Odaki, Masaru; Oka, Nobuo.

    1989-01-01

    Eight cases of intention tremor as a late complication of head injury were investigated. The patients ranged in age from 3 to 24 years. All received severe head injuries and lapsed into coma immediately afterward (Glasgow Coma Scale scores ≤8). Six patients exhibited decerebration or decortication. Hemiparesis was present in six cases and oculomotor nerve palsy in four. In the chronic stage, all patients displayed some degree of impairment of higher cortical function and five had dysarthria and/or ataxia. Initial computed tomography (CT) scans within 3 hours after the injury were obtained in five cases, of which four showed a hemorrhagic lesion in the midbrain or its surroundings. Other CT findings were diffuse cerebral swelling (four cases), intraventricular hemorrhage (three), and multiple hemorrhagic lesions (two). In the chronic stage, generalized cortical atrophy or ventricular enlargement was noted in five cases. These clinical features and CT findings indicate diffuse brain damage as well as midbrain damage and may reflect shearing injury. (author)

  7. Chest Injuries Associated with Head Injury | Mezue | Nigerian ...

    African Journals Online (AJOL)

    Conclusion: Associated chest injuries result in higher mortality from head injuries. This association is more likely in the young and more productive. All patients presenting with head and spinal cord injury should be specifically and carefully evaluated for associated chest injuries. Computerized tomographic has not replaced ...

  8. Traumatic injuries: imaging of head injuries

    Energy Technology Data Exchange (ETDEWEB)

    Besenski, N. [Croatian Institute for Brain Research, Zagreb (Croatia)

    2002-06-01

    Due to the forces of acceleration, linear translation, as well as rotational and angular acceleration, the brain undergoes deformation and distortion depending on the site of impact of traumatizing force direction, severity of the traumatizing force, and tissue resistance of the brain. Linear translation of accereration in a closed-head injury can run along the shorter diameter of the skull in latero-lateral direction causing mostly extra-axial lesions (subdural hematoma,epidural hematoma, subarachnoidal hemorrhage) or quite pronounced coup and countercoup contusions. Contusions are considerably less frequently present in medial or paramedial centroaxial blows (fronto-occipital or occipito-frontal). The centroaxial blows produce a different pattern of lesions mostly in the deep structures, causing in some cases a special category of the brain injury, the diffuse axonal injury (DAI). The brain stem can also be damaged, but it is damaged more often in patients who have suffered centroaxial traumatic force direction. Computed tomography and MRI are the most common techniques in patients who have suffered brain injury. Computed tomography is currently the first imaging technique to be used after head injury, in those settings where CT is available. Using CT, scalp, bone, extra-axial hematomas, and parenchymal injury can be demonstrated. Computed tomography is rapid and easily performed also in monitored patients. It is the most relevant imaging procedure for surgical lesions. Computed tomography is a suitable method to follow the dynamics of lesion development giving an insight into the corresponding pathological development of the brain injury. Magnetic resonance imaging is more sensitive for all posttraumatic lesions except skull fractures and subarachnoidal hemorrhage, but scanning time is longer, and the problem with the monitoring of patients outside the MRI field is present. If CT does not demonstrate pathology as can adequately be explained to account for

  9. Traumatic injuries: imaging of head injuries

    International Nuclear Information System (INIS)

    Besenski, N.

    2002-01-01

    Due to the forces of acceleration, linear translation, as well as rotational and angular acceleration, the brain undergoes deformation and distortion depending on the site of impact of traumatizing force direction, severity of the traumatizing force, and tissue resistance of the brain. Linear translation of accereration in a closed-head injury can run along the shorter diameter of the skull in latero-lateral direction causing mostly extra-axial lesions (subdural hematoma,epidural hematoma, subarachnoidal hemorrhage) or quite pronounced coup and countercoup contusions. Contusions are considerably less frequently present in medial or paramedial centroaxial blows (fronto-occipital or occipito-frontal). The centroaxial blows produce a different pattern of lesions mostly in the deep structures, causing in some cases a special category of the brain injury, the diffuse axonal injury (DAI). The brain stem can also be damaged, but it is damaged more often in patients who have suffered centroaxial traumatic force direction. Computed tomography and MRI are the most common techniques in patients who have suffered brain injury. Computed tomography is currently the first imaging technique to be used after head injury, in those settings where CT is available. Using CT, scalp, bone, extra-axial hematomas, and parenchymal injury can be demonstrated. Computed tomography is rapid and easily performed also in monitored patients. It is the most relevant imaging procedure for surgical lesions. Computed tomography is a suitable method to follow the dynamics of lesion development giving an insight into the corresponding pathological development of the brain injury. Magnetic resonance imaging is more sensitive for all posttraumatic lesions except skull fractures and subarachnoidal hemorrhage, but scanning time is longer, and the problem with the monitoring of patients outside the MRI field is present. If CT does not demonstrate pathology as can adequately be explained to account for

  10. Essential radiology for head injury

    International Nuclear Information System (INIS)

    Mok, D.W.H.; Kreel, L.

    1988-01-01

    The book covers the guidelines established by the Royal College of Radiologists for the radiographic evaluation of head injuries. It presents a chapter reviewing the normal radiologic anatomy of the skull in six different projections. The advantages and limitations of each projection are addressed. The third chapter, contains 43 radiographs dedicated to the calcified pineal gland and other intracranial calcifications. The book reports on specific types of fractures: linear fractures of the vault, depressed fractures of the vault, fractures in children, fractures of the base of the skull, and fractures of the facial bones

  11. Head injuries in snowboarders compared with head injuries in skiers. A prospective analysis of 1076 patients from 1994 to 1999 in Niigata, Japan.

    Science.gov (United States)

    Fukuda, O; Takaba, M; Saito, T; Endo, S

    2001-01-01

    We investigated snowboarding-related head injury cases and skiing-related head injury cases during five ski seasons at one resort area. There were 634 snowboarding-related head injuries and 442 skiing-related head injuries. The number of snowboarding head injuries increased rapidly over the study period. More male snowboarders than female snowboarders suffered head injuries. For both snowboarders and skiers, head injuries frequently occurred on the easy and middle slopes. Falls were the most frequent causes of injury in both groups. Jumping was a more frequent cause of injury in the snowboarders (30%) than in the skiers (2.5%). Injury to the occipital region predominated in the snowboarders as compared with the skiers. There were 49 organic lesions in 37 snowboarders and 46 organic lesions in 33 skiers. Subdural hematoma was frequent in the snowboarding head injury group, and fracture was frequent in the skiing head injury group compared with the snowboarding group (not significant). Subdural hematoma was likely to be caused by a fall rather than by a collision, and bone fracture was likely to be caused by a collision rather than by a fall. Four snowboarders and one skier died as a result of their head injuries. Our data suggest that snowboarding head injuries may be prevented by protection of the occipital region and refraining from jumping by beginners.

  12. Chest Injuries Associated with Head Injury

    African Journals Online (AJOL)

    Traumatic brain injury (TBI) is a common cause of mortality and severe morbidity. Although there have been significant advances in management, associated severe injuries, in particular chest injuries, remain a major challenge. Extracranial injuries, especially chest injuries increase mortality in patients with TBI in both short.

  13. Remediation of attention deficits in head injury.

    OpenAIRE

    Nag S; Rao S

    1999-01-01

    Head injury is associated with psychological sequelae which impair the patient′s psychosocial functioning. Information processing, attention and memory deficits are seen in head injuries of all severity. We attempted to improve deficits of focused, sustained and divided attention. The principle of overlapping sources of attention resource pools was utilised in devising the remediation programme. Tasks used simple inexpensive materials. Four head injured young adult males with post conc...

  14. Heading for a fall? Management of head injury in infants.

    LENUS (Irish Health Repository)

    Williamson, M

    2010-09-01

    Head injury is one of the commonest reasons for infants (< 1 year) to attend the Emergency Department (ED). Clinical management varies considerably and concern about non accidental injury results in a high admission rate in some hospitals. Information was obtained on 103 children under one year of age presenting to the ED with head injury in a prospective study. The average age was 6.7 months and 57% of patients were male. Twenty eight babies had skull x rays with 1 skull fracture diagnosed. None required CT brain scan. Ninety eight (94%) were discharged home from the ED. There were no unplanned returns, readmissions or adverse events. The incidence of traumatic brain injury in children under one year of age presenting with head injury is low and the majority can be safely discharged home.

  15. Brain SPECT in severs traumatic head injury

    International Nuclear Information System (INIS)

    Beaulieu, F.; Eder, V.; Pottier, J.M.; Baulieu, J.L.; Fournier, P.; Legros, B.; Chiaroni, P.; Dalonneau, M.

    2000-01-01

    The aim of this work was to compare the results of the early brain scintigraphy in traumatic brain injury to the long term neuropsychological behavior. Twenty four patients had an ECD-Tc99m SPECT, within one month after the trauma; scintigraphic abnormalities were evaluated according to a semi-quantitative analysis. The neuropsychological clinical investigation was interpreted by a synthetic approach to evaluate abnormalities related to residual motor deficit, frontal behavior, memory and language disorders. Fourteen patients (58%) had sequela symptoms. SPECT revealed 80 abnormalities and CT scan only 31. Statistical analysis of uptake values showed significantly lower uptake in left basal ganglia and brain stem in patients with sequela memory disorders. We conclude that the brain perfusion scintigraphy is able to detect more lesions than CT and that it could really help to predict the neuropsychological behavior after severe head injury. Traumatology could become in the future a widely accepted indication of perfusion SPECT. (authors)

  16. Sentence comprehension following moderate closed head injury in adults.

    Science.gov (United States)

    Leikin, Mark; Ibrahim, Raphiq; Aharon-Peretz, Judith

    2012-09-01

    The current study explores sentence comprehension impairments among adults following moderate closed head injury. It was hypothesized that if the factor of syntactic complexity significantly affects sentence comprehension in these patients, it would testify to the existence of syntactic processing deficit along with working-memory problems. Thirty-six adults (18 closed head injury patients and 18 healthy controls matched in age, gender, and IQ) participated in the study. A picture-sentence matching task together with various tests for memory, language, and reading abilities were used to explore whether sentence comprehension impairments exist as a result of a deficit in syntactic processing or of working-memory dysfunction. Results indicate significant impairment in sentence comprehension among adults with closed head injury compared with their non-head-injured peers. Results also reveal that closed head injury patients demonstrate considerable decline in working memory, short-term memory, and semantic knowledge. Analysis of the results shows that memory impairment and syntactic complexity contribute significantly to sentence comprehension difficulties in closed head injury patients. At the same time, the presentation mode (spoken or written language) was found to have no effect on comprehension among adults with closed head injury, and their reading abilities appear to be relatively intact.

  17. Anabolic steroids and head injury.

    Science.gov (United States)

    Mills, James D; Bailes, Julian E; Turner, Ryan C; Dodson, Sean C; Sakai, Jun; Maroon, Joseph C

    2012-01-01

    The suggestion has been made that neurological changes seen in the syndrome of chronic traumatic encephalopathy may be due to exogenous anabolic steroid use rather than traumatic brain injury. To determine whether administration of anabolic steroids alters the pathophysiology of traumatic brain injury. Sixty adult male Sprague-Dawley rats and a linear acceleration model of traumatic brain injury were used. Experimental groups were (1) preinjury anabolic steroids, (2) preinjury placebo carrier, (3) anabolic steroids without injury, (4) no steroids and no injury, (5) postinjury placebo carrier, and (6) postinjury anabolic steroids. Following a 30-day recovery, rats were euthanized, and brainstem white matter tracts underwent fluorescent immunohistochemical processing and labeling of β-amyloid precursor protein (APP), a marker of axonal injury. Digital imaging and statistical analyses were used to determine whether anabolic steroid administration resulted in a significant change in the number of injured axons. There was no statistically significant difference in number of APP-positive axons by immunohistochemical analysis between respective anabolic steroid and placebo groups. Using a standard acceleration-deceleration model of mild traumatic brain injury, we have shown successful visualization of traumatically injured axons with antibody staining of APP. Our results indicate no statistically significant effect of anabolic steroids on the number of APP-positive axons. With the use of this model, and within its limitations, we see no adverse effect or causative role of anabolic steroid administration on the brain following mild traumatic brain injury using APP counts as a marker for anatomic injury.

  18. A Comprehensive Approach to Motorcycle-Related Head Injury Prevention: Experiences from the Field in Vietnam, Cambodia, and Uganda.

    Science.gov (United States)

    Craft, Greig; Van Bui, Truong; Sidik, Mirjam; Moore, Danielle; Ederer, David J; Parker, Erin M; Ballesteros, Michael F; Sleet, David A

    2017-11-30

    Motorcyclists account for 23% of global road traffic deaths and over half of fatalities in countries where motorcycles are the dominant means of transport. Wearing a helmet can reduce the risk of head injury by as much as 69% and death by 42%; however, both child and adult helmet use are low in many countries where motorcycles are a primary mode of transportation. In response to the need to increase helmet use by all drivers and their passengers, the Global Helmet Vaccine Initiative (GHVI) was established to increase helmet use in three countries where a substantial portion of road users are motorcyclists and where helmet use is low. The GHVI approach includes five strategies to increase helmet use: targeted programs, helmet access, public awareness, institutional policies, and monitoring and evaluation. The application of GHVI to Vietnam, Cambodia, and Uganda resulted in four key lessons learned. First, motorcyclists are more likely to wear helmets when helmet use is mandated and enforced. Second, programs targeted to at-risk motorcyclists, such as child passengers, combined with improved awareness among the broader population, can result in greater public support needed to encourage action by decision-makers. Third, for broad population-level change, using multiple strategies in tandem can be more effective than using a single strategy alone. Lastly, the successful expansion of GHVI into Cambodia and Uganda has been hindered by the lack of helmet accessibility and affordability, a core component contributing to its success in Vietnam. This paper will review the development of the GHVI five-pillar approach in Vietnam, subsequent efforts to implement the model in Cambodia and Uganda, and lessons learned from these applications to protect motorcycle drivers and their adult and child passengers from injury.

  19. Unusual head and neck injury in elevator: autopsy study.

    Science.gov (United States)

    Eren, B; Türkmen, N; Dokgöz, H

    2012-10-01

    Industrial injuries related to auto-load-carrying vehicles were not frequently reported in the literature. Presented case was, 31-year-old male furniture worker. Deceased was found in awkward position in furniture workshop. Victim was observed on his knees in front of the elevator, head and neck lodged within openings of the elevator, and head and neck structures compressed-guillotined by the lower platform of the elevator were detected. We presented rare case of head and neck compression by elevator. Key words: head - neck - accidents - elevator - autopsy.

  20. Snowboard head injury: prospective study in Chino, Nagano, for two seasons from 1995 to 1997.

    Science.gov (United States)

    Nakaguchi, H; Fujimaki, T; Ueki, K; Takahashi, M; Yoshida, H; Kirino, T

    1999-06-01

    The popularity of snowboarding has been growing rapidly throughout the world. To date, however, the risk of head injury associated with this relatively new winter sport, especially in comparison with alpine skiing, has not been well analyzed. This study was conducted to assess the risk of head injury in snowboarding and to elucidate its features in comparison with skiing head injury. We prospectively analyzed 301 cases of head injuries related to snowboarding or skiing experienced from December of 1995 to May of 1997 at our institution, which is located close to the most popular skiing areas in Japan. Of those injuries, 143 cases were snowboard related and 158 cases were ski related. In addition to appropriate medical evaluation and medical care, detailed examination was performed on every patient to determine various factors, including sex, age, skill level, cause and mechanism of the accident, and the side of impact to the head. The data are statistically analyzed to elucidate unique features of snowboard head injury. During the study period, 2.2 million snowboarders and 4.2 million skiers visited the five skiing facilities that are covered by our hospital. Thus, the incidence of head injury was 6.5 per 100,000 visits for snowboarders and 3.8 per 100,000 visits for skiers. Beginning snowboarders more frequently sustained head injuries compared with beginning skiers (60 of 142 vs. 48 of 154, p = 0.022). Likewise, frequent causes of snowboarding head injuries were fall during jumping (43 of 139 vs. 2 of 147, pskiing head injuries (1.3%). Of 11 major head injury cases, 10 were caused by occipital impact. These results indicate that snowboarders, particularly beginners, are at higher risk for head injury, frequently involving occipital impact, and could lead to more major head injuries. We propose that measures should be taken to protect the head, especially the occiput, in snowboarding.

  1. Spinal cord injury and its association with blunt head trauma

    Directory of Open Access Journals (Sweden)

    Paiva WS

    2011-09-01

    Full Text Available Wellingson S Paiva, Arthur MP Oliveira, Almir F Andrade, Robson LO Amorim, Leonardo JO Lourenço, Manoel J TeixeiraDivision of Neurosurgery, University of São Paulo, BrazilBackground: Severe and moderate head injury can cause misdiagnosis of a spinal cord injury, leading to devastating long-term consequences. The objective of this study is to identify risk factors involving spine trauma and moderate-to-severe brain injury.Methods: A prospective study involving 1617 patients admitted in the emergency unit was carried out. Of these patients, 180 with moderate or severe head injury were enrolled. All patients were submitted to three-view spine series X-ray and thin cut axial CT scans for spine trauma investigations.Results: 112 male patients and 78 female patients, whose ages ranged from 11 to 76 years (mean age, 34 years. The most common causes of brain trauma were pedestrians struck by motor vehicles (31.1%, car crashes (27.7%, and falls (25%. Systemic lesions were present in 80 (44.4% patients and the most common were fractures, and lung and spleen injuries. 52.8% had severe and 47.2% moderate head trauma. Fourteen patients (7.8% suffered spinal cord injury (12 in cervical spine, one in lumbar, and one thoracic spine. In elderly patients, the presence of associated lesions and Glasgow Coma Scale (GCS < 9 were statistically significant as risk factors (P < 0.05 for spine injury.Conclusion: Spinal cord injury related to moderate and severe brain trauma usually affects the cervical spine. The incidence of spinal lesions and GCS < 9 points were related to greater incidence of spinal cord injury.Keywords: head injury, spine trauma, risk factors

  2. Video incident analysis of head injuries in high school girls' lacrosse.

    Science.gov (United States)

    Caswell, Shane V; Lincoln, Andrew E; Almquist, Jon L; Dunn, Reginald E; Hinton, Richard Y

    2012-04-01

    Knowledge of injury mechanisms and game situations associated with head injuries in girls' high school lacrosse is necessary to target prevention efforts. To use video analysis and injury data to provide an objective and comprehensive visual record to identify mechanisms of injury, game characteristics, and penalties associated with head injury in girls' high school lacrosse. Descriptive epidemiology study. In the 25 public high schools of 1 school system, 529 varsity and junior varsity girls' lacrosse games were videotaped by trained videographers during the 2008 and 2009 seasons. Video of head injury incidents was examined to identify associated mechanisms and game characteristics using a lacrosse-specific coding instrument. Of the 25 head injuries (21 concussions and 4 contusions) recorded as game-related incidents by athletic trainers during the 2 seasons, 20 head injuries were captured on video, and 14 incidents had sufficient image quality for analysis. All 14 incidents of head injury (11 concussions, 3 contusions) involved varsity-level athletes. Most head injuries resulted from stick-to-head contact (n = 8), followed by body-to-head contact (n = 4). The most frequent player activities were defending a shot (n = 4) and competing for a loose ball (n = 4). Ten of the 14 head injuries occurred inside the 12-m arc and in front of the goal, and no penalty was called in 12 injury incidents. All injuries involved 2 players, and most resulted from unintentional actions. Turf versus grass did not appear to influence number of head injuries. Comprehensive video analysis suggests that play near the goal at the varsity high school level is associated with head injuries. Absence of penalty calls on most of these plays suggests an area for exploration, such as the extent to which current rules are enforced and the effectiveness of existing rules for the prevention of head injury.

  3. Neurosurgery for management of severe head injury

    International Nuclear Information System (INIS)

    Seitz, K.; Richter, H.P.

    1998-01-01

    Neurosurgery as a treatment of severe head injuries is not restricted to invasive surgery but also includes peri-operative intensive care medicine. Thanks to the technological progress and advanced diagnostic tools, especially drug treatments and their efficiency as well as risks can be far better monitored and analysed today. (orig./CB) [de

  4. Head Injury, from Men to Model

    NARCIS (Netherlands)

    W.A. van den Brink (Willem Aart)

    2000-01-01

    textabstractIn well developed countries, injury is the leading cause of death and disability among young adults. In less developed countries the incidence of injury is high and rapidly increasing, but the relative mortality due to injuries is overshadowed by other causes, such as infections and

  5. Head injury and risk for Parkinson disease

    DEFF Research Database (Denmark)

    Kenborg, Line; Rugbjerg, Kathrine; Lee, Pei-Chen

    2015-01-01

    in medical records. Patients were matched to 1,785 controls randomly selected from the Danish Central Population Register on sex and year of birth. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. RESULTS: We observed no association between any head......OBJECTIVE: To examine the association between head injuries throughout life and the risk for Parkinson disease (PD) in an interview-based case-control study. METHODS: We identified 1,705 patients diagnosed with PD at 10 neurologic centers in Denmark in 1996-2009 and verified their diagnoses...

  6. Radial head fracture associated with posterior interosseous nerve injury

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    Full Text Available ABSTRACT Fractures of the radial head and radial neck correspond to 1.7-5.4% of all fractures and approximately 30% may present associated injuries. In the literature, there are few reports of radial head fracture with posterior interosseous nerve injury. This study aimed to report a case of radial head fracture associated with posterior interosseous nerve injury. CASE REPORT: A male patient, aged 42 years, sought medical care after falling from a skateboard. The patient related pain and limitation of movement in the right elbow and difficulty to extend the fingers of the right hand. During physical examination, thumb and fingers extension deficit was observed. The wrist extension showed a slight radial deviation. After imaging, it became evident that the patient had a fracture of the radial head that was classified as grade III in the Mason classification. The patient underwent fracture fixation; at the first postoperative day, thumb and fingers extension was observed. Although rare, posterior interosseous nerve branch injury may be associated with radial head fractures. In the present case, the authors believe that neuropraxia occurred as a result of the fracture hematoma and edema.

  7. CT analysis of missile head injury

    International Nuclear Information System (INIS)

    Besenski, N.; Jadro-Santel, D.; Jelavic-Koic, F.; Pavic, D.; Mikulic, D.; Glavina, K.; Maskovic, J.

    1995-01-01

    Between August 1991 and December 1992, CT was performed in 154 patients who had suffered missile head injury during the war in the Republic of Croatia. In 54% CT was performed 1-24 h after injury, and in 27% follow-up CT was also obtained. The wounds were penetrating, tangential or perforating (45%, 34% and 21%, respectively). Haemorrhage was the most frequent lesion in the brain (84%). Follow-up CT evolution of haemorrhage, oedema, cerebritis, abscess, secondary vascular lesions, necrosis, encephalomalacia and hydrocephalus. The most dynamic changes occurred 7-14 days after injury. In 14% of cases, deep cerebral lesions were found in the corpus callosum, septum pellucidum periventricular region and pons, although bone and shell fragments were in a different part of the brain parenchyma. Such lesions were found in penetrating injuries only. CT proved very useful for assessing the extent and type of lesions. Although different mechanisms of brain damage in missile head injury are known, here they are, to the best of our knowledge, shown for the first time by CT. (orig.)

  8. Delayed epidural hematoma after mild head injury

    Directory of Open Access Journals (Sweden)

    Radulović Danilo

    2005-01-01

    Full Text Available Background. Traumatic delayed epidural hematoma (DEH can be defined as insignificant or not seen on the initial CT scan performed after a trauma but seen on the subsequent CT scan as a “massive” epidural bleeding. Case report. We presented two cases of traumatic DEH after mild head injury. Both patients were conscious and without neurological deficit on the admission. Initial CT scan did not reveal intracranial hematoma. Repeated CT scan, that was performed after neurological deterioration, revealed epidural hematoma in both cases. The patients were operated with a favorable surgical outcome. Conclusion. Traumatic DEH could occur in the patients with head injuries who were conscious on the admission with a normal initial CT scan finding. Early detection of DEH and an urgent surgical evacuation were essential for a good outcome.

  9. Right thalamic infarction after closed head injury

    International Nuclear Information System (INIS)

    Nagaya, Takashi; Doi, Terushige; Katsumata, Tsuguo; Kuwayama, Naoto

    1986-01-01

    We reported a case of right thalamic infarction after a closed head injury. A 12-year-old boy was hit by an autotruck. He was semi-comatose, with left temporal scalp swelling and excoriation in the left lower limb. Three days after the accident, he exhibited left hemiparesis. CT scans on the day of the accident showed no abnormality, but on the following day, right thalamic infarction appeared. Right carotid angiography showed only an irregular vascular shadow in the cisternal segment of the right internal carotid artery. Vascular obstruction after closed head injury is rare, especially in the intracranial vessels, and several pathogeneses may be postulated. The right thalamic infarction in this case was supposed to be due to the damage of the perforators from the right posterior communicating artery and the right posterior cerebral artery, which were struck as a contre-coup by the force from the left side. (author)

  10. Clinical utility of MR FLAIR imaging for head injuries

    Energy Technology Data Exchange (ETDEWEB)

    Ashikaga, Ryuichiro [Kinki Univ., Osaka-Sayama, Osaka (Japan). School of Medicine

    1996-12-01

    To study the utility of fluid attenuated inversion recovery (FLAIR) MR images in the evaluation of traumatic head injury, 56 patients with traumatic head injuries were examined with long TR/TE spin-echo (SE) sequences and FLAIR sequences. In 40 of them, long TR/short TE images were added to those sequences. Careful readings of MR images were done by two well-trained neuroradiologists. The chi-square test was used for statistical evaluation of our results. The relative sensitivities of FLAIR images were significantly better than those of long TR/TE, long TR/short TE images for the detection of diffuse axonal injury (p<0.01), cortical contusion (p<0.01), and subdural hematoma (p<0.01 for long TR/TE, p<0.05 for long TR/short TE). The number of cases of epidural hematoma and brainstem injury was too small for statistical significance to be determined. In 9 patients with corpus callosum injuries. FLAIR images demonstrated the lesions as abnormally high signal intensity in the septum pellucidum and fornix. Only sagittal FLAIR images could definitely discriminate the traumatic lesions of the fornix from the surrounding CSF. In addition, FLAIR images could easily discriminate DAI of the corpus callosum from CSF of the cavum velli interpositi. MR FLAIR images were found to be useful for detecting traumatic head injuries. (author)

  11. [Diagnostic and organizational error in head injuries].

    Science.gov (United States)

    Zaba, Czesław; Zaba, Zbigniew; Swiderski, Paweł; Lorkiewicz-Muszyíska, Dorota

    2009-01-01

    The study aimed at presenting a case of a diagnostic and organizational error involving lack of detection of foreign body presence in the soft tissues of the head. Head radiograms in two projections clearly demonstrated foreign bodies that resembled in shape flattened bullets, which could not have been missed upon evaluation of the X-rays. On the other hand, description of the radiograms entered by the attending physicians to the patient's medical record indicated an absence of traumatic injuries or foreign bodies. In the opinion of the authors, the case in question involved a diagnostic error: the doctors failed to detect the presence of foreign bodies in the head. The organizational error involved the failure of radiogram evaluation performed by a radiologist.

  12. Role of age and injury mechanism on cervical spine injury tolerance from head contact loading.

    Science.gov (United States)

    Yoganandan, Narayan; Chirvi, Sajal; Voo, Liming; Pintar, Frank A; Banerjee, Anjishnu

    2018-02-17

    The objective of this study was to determine the influence of age and injury mechanism on cervical spine tolerance to injury from head contact loading using survival analysis. This study analyzed data from previously conducted experiments using post mortem human subjects (PMHS). Group A tests used the upright intact head-cervical column experimental model. The inferior end of the specimen was fixed, the head was balanced by a mechanical system, and natural lordosis was removed. Specimens were placed on a testing device via a load cell. The piston applied loading at the vertex region. Spinal injuries were identified using medical images. Group B tests used the inverted head-cervical column experimental model. In one study, head-T1 specimens were fixed distally, and C7-T1 joints were oriented anteriorly, preserving lordosis. Torso mass of 16 kg was added to the specimen. In another inverted head-cervical column study, occiput-T2 columns were obtained, an artificial head was attached, T1-T2 was fixed, C4-C5 disc was maintained horizontal in the lordosis posture, and C7-T1 was unconstrained. The specimens were attached to the drop test carriage carrying a torso mass of 15 kg. A load cell at the inferior end measured neck loads in both studies. Axial neck force and age were used as the primary response variable and covariate to derive injury probability curves using survival analysis. Group A tests showed that age is a significant (P < .05) and negative covariate; that is, increasing age resulted in decreasing force for the same risk. Injuries were mainly vertebral body fractures and concentrated at one level, mid-to-lower cervical spine, and were attributed to compression-related mechanisms. However, age was not a significant covariate for the combined data from group B tests. Both group B tests produced many soft tissue injuries, at all levels, from C1 to T1. The injury mechanism was attributed to mainly extension. Multiple and noncontiguous injuries occurred

  13. Differential protective effects of motorcycle helmets against head injury.

    Science.gov (United States)

    Singleton, Michael D

    2017-05-19

    Although numerous observational studies have demonstrated a protective effect of motorcycle helmets against head injury, the degree of protection against specific head injury types remains unclear. Experimental biomechanics studies involving cadavers, animals, and computer models have established that head injuries have varying etiologies. This retrospective cross-sectional study compared helmet protection against skull fracture, cerebral contusion, intracranial hemorrhage, and cerebral concussion in a consecutive series of motorcycle operators involved in recent traffic crashes in Kentucky. Police collision reports linked to hospital inpatient and emergency department (ED) claims were analyzed for the period 2008 to 2012. Motorcycle operators with known helmet use who were not killed at the crash scene were included in the study. Helmet use was ascertained from the police report. Skull fracture, cerebral contusion, intracranial hemorrhage, and cerebral concussion were identified from International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes on the claims records. The relative risks of each type of head injury for helmeted versus unprotected operators were estimated using generalized estimating equations. Helmets offer substantial protection against skull fracture (relative risk [RR] = 0.31, 95% confidence interval [CI], 0.23, 0.34), cerebral contusion (RR = 0.29, 95% CI, 0.16, 0.53), and intracranial hemorrhage (RR = 0.47, 95% CI, 0.35, 0.63). The findings pertaining to uncomplicated concussion (RR = 0.80, 95% CI, 0.64, 1.01) were inconclusive. A modest protective effect (20% risk reduction) was suggested by the relative risk estimate, but the 95% confidence interval included the null value. Motorcycle helmets were associated with a 69% reduction in skull fractures, 71% reduction in cerebral contusion, and 53% reduction in intracranial hemorrhage. This study finds that current motorcycle helmets do not protect equally against

  14. Computerised tomographic patterns in patients with head injury at ...

    African Journals Online (AJOL)

    2011-04-15

    Apr 15, 2011 ... The clinical severity of head injury is classified based on ... head injury include road traffic accidents (RTA), assaults, ... information in the management of patients with head ... Materials and Methods ... The right cerebral hemisphere was involved in 13 cases .... Nerve palsies – 3rd, 5th, 6th cranial nerves. 3.

  15. PRACTICAL MANAGEMENT OF HEAD INJURY | Shehu | Annals of ...

    African Journals Online (AJOL)

    For an effective practical management of head injury, a clear knowledge of the various causes and mechanism of head injury is essential. The concept of the brain in a rigid cranial cavity makes the pathophysiological mechanism of head trauma unique. Most problems occur due to poor handling of patients at the site of ...

  16. Postmortem CT of severe head injuries

    International Nuclear Information System (INIS)

    Tamura, Masaru; Tsukahara, Yoshio; Nagaseki, Yoshishige; Horikoshi, Satoru; Yodonawa, Masahiko

    1983-01-01

    CT findings of fatal head injuries were analysed for the cause of death. Postmortem CT examinations were undertaken on 14 cases who died before reaching the hospital or shortly after arrival at the hospital (immediate death group). CT were also examined in non-operative 20 cases who were comatose and who died within 24 hours after severe head injuries (early death group). In the immediate death group, the following findings were demonstrated: a huge amount of free intracranial and intraventricular air in 8 cases; traumatic basal subarachnoid hemorrhage in 3 cases; a mixture of pneumocephalus and subarachnoid hemorrhage in 2 cases, and intracranial hematoma in 1 case. In the early death group: a mixture of pneumocephalus and subarachnoid hemorrhage in 2 cases; traumatic subarachnoid hemorrhage in 5 cases; intracranial hematoma in 11 cases, and brain contusion in 2 cases. The huge amount of intracranial free air due to the severe fracture of the skull base will make the CNS collapse immediately. Basal subarachnoid hemorrhage with signs of brain-stem injuries may result in instantaneous death. Acute subdural hematoma with contusion and edema in elderly patients was the most frequent cause of death in the early death group. (author)

  17. Head injury management guidelines for general practitioners

    Directory of Open Access Journals (Sweden)

    Jeremy C Ganz

    2011-01-01

    Full Text Available A complete examination of a head injured patient in the hospital requires a number of instruments. These include a stethoscope, sphygmomanometer, ophthalmoscope, otoscope, cotton wool, safety pin, tuning fork, reflex hammer and a small key to test the plantar response. Few of these are required at the accident scene. This is because, in the hospital, the aim is optimal definitive treatment. At the accident scene, the aim is prevention of secondary injury, rapid recording of the most important findings and safe efficient transport to the hospital. This short paper reviews how the local doctor should undertake a neurosurgical assessment of traumatic brain injury patients. Moreover, the primary management at accident scenes is described and the rationale behind the approach is outlined

  18. Junior Seau: An Illustrative Case of Chronic Traumatic Encephalopathy and Update on Chronic Sports-Related Head Injury.

    Science.gov (United States)

    Azad, Tej D; Li, Amy; Pendharkar, Arjun V; Veeravagu, Anand; Grant, Gerald A

    2016-02-01

    Few neurologic diseases have captured the nation's attention more completely than chronic traumatic encephalopathy (CTE), which has been discovered in the autopsies of professional athletes, most notably professional football players. The tragic case of Junior Seau, a Hall of Fame, National Football League linebacker, has been the most high-profile confirmed case of CTE. Here we describe Seau's case, which concludes an autopsy conducted at the National Institutes of Health that confirmed the diagnosis. Since 1990, Junior Seau had a highly distinguished 20-year career playing for the National Football League as a linebacker, from which he sustained multiple concussions. He committed suicide on May 2, 2012, at age 43, after which an autopsy confirmed a diagnosis of CTE. His clinical history was significant for a series of behavioral disturbances. Seau's history and neuropathologic findings were used to better understand the pathophysiology, diagnosis, and possible risk factors for CTE. This high-profile case reflects an increasing awareness of CTE as a long-term consequence of multiple traumatic brain injuries. The previously unforeseen neurologic risks of American football have begun to cast doubt on the safety of the sport. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Trampoline-related injuries.

    Science.gov (United States)

    Larson, B J; Davis, J W

    1995-08-01

    Two hundred and seventeen patients who had sustained an injury during the recreational use of a trampoline were managed in the emergency room of Logan Regional Hospital in Logan, Utah, from January 1991 through December 1992. We retrospectively reviewed the charts and radiographs of these patients to categorize the injuries. Additional details regarding the injuries of seventy-two patients (33 per cent) were obtained by means of a telephone interview with use of a questionnaire. The injuries occurred from February through November, with the peak incidence in July. The patients were eighteen months to forty-five years old (average, ten years old); ninety-four patients (43 per cent) were five to nine years old. Eighty-four patients (39 per cent) sustained a fracture; fifty-four (25 per cent), a sprain or strain; forty-five (21 per cent), a laceration; and thirty-four (16 per cent), a contusion. Fifty-seven injuries (26 per cent) involved the elbow or forearm; forty-six (21 per cent), the head or neck; forty (18 per cent), the ankle or foot; thirty-three (15 per cent), the knee or leg; nineteen (9 per cent), the trunk or back; thirteen (6 per cent), the shoulder or arm; and nine (4 per cent), the wrist or hand. Thirteen patients (6 per cent) had a back injury, but none of them had a permanent neurological deficit. One patient who had an ocular injury was transferred to a tertiary care center. One hundred and fifty-six patients (72 per cent) were evaluated radiographically, fifteen (7 per cent) were admitted to the hospital, and thirteen (6 per cent) had an operation.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Penetrating missile-type head injury from a defective badminton racquet.

    Science.gov (United States)

    Pappano, Dante; Murray, Elizabeth; Cimpello, Lynn Babcock; Conners, Gregory

    2009-06-01

    Injuries occurring during badminton are rarely serious and primarily involve the lower extremities. We report an instance wherein a patient suffered serious brain injury related to playing with a defective badminton racquet. The possibility of similar injuries following the separation of the racquet head and shaft from the handle needs to be disseminated.

  1. Variations in the Presentation of Aphasia in Patients with Closed Head Injuries

    Directory of Open Access Journals (Sweden)

    Dara Oliver Kavanagh

    2010-01-01

    Full Text Available Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature review on the topic. In a busy acute surgical unit one can dismiss aphasia following head injury as behaviour related to intoxication. Early recognition with prolonged and intensive speech and language rehabilitation therapy yields a favourable outcome as highlighted in our experience. These may serve as a reference for clinicians faced with this unusual outcome.

  2. Variations in the presentation of aphasia in patients with closed head injuries.

    LENUS (Irish Health Repository)

    Kavanagh, Dara Oliver

    2012-01-31

    Impairments of speech and language are important consequences of head injury as they compromise interaction between the patient and others. A large spectrum of communication deficits can occur. There are few reports in the literature of aphasia following closed head injury despite the common presentation of closed head injury. Herein we report two cases of closed head injuries with differing forms of aphasia. We discuss their management and rehabilitation and present a detailed literature review on the topic. In a busy acute surgical unit one can dismiss aphasia following head injury as behaviour related to intoxication. Early recognition with prolonged and intensive speech and language rehabilitation therapy yields a favourable outcome as highlighted in our experience. These may serve as a reference for clinicians faced with this unusual outcome.

  3. Is contrast-enhanced CT indicated in acute head injury

    International Nuclear Information System (INIS)

    Mauser, H.W.; Nieuwenhuizen, O. van; Veiga-Pires, J.A.

    1984-01-01

    The authors discuss the value of intravenous contrast enhancement in CT scanning in acute head injury. In a series of seventy consecutive patients they conclude that no incremental information was obtained by performing contrast-enhanced CT scans in the acute phase of the head injury. (orig.)

  4. Subtle Symptoms Associated with Self-Reported Mild Head Injury.

    Science.gov (United States)

    Segalowitz, Sidney J.; Lawson, Sheila

    1995-01-01

    A survey of 1,345 high school students and 2,321 university students found that 30-37% reported having experienced a head injury, with 12-15% reporting loss of consciousness. Significant relationships were found between mild head injury incidence and gender; sleep difficulties; social difficulties; handedness pattern; and diagnoses of attention…

  5. Ocular Complications among Cases of Head Injury Seen in a ...

    African Journals Online (AJOL)

    Background: Head injuries with ocular involvement are of great importance due to the visual morbidity and mortality which may result. Objective: To determine the pattern of ocular complications among cases of head injury seen in Memphys Hospital for Neurosurgery, Enugu, in south-eastern Nigeria. Patients and Methods: ...

  6. CT findings and outcome in head injury

    Energy Technology Data Exchange (ETDEWEB)

    Yamaura, Akira

    1984-12-01

    CT findings and outcome were discussed in head injuries. Parenchymal findings were classified into 5 categories; ''normal'', ''hemispheric (isodense) swelling'', ''hemorrhagic lesions'', ''diffuse cerebral swelling'', and ''low density''. The worst outcome (73% mortality) was seen in ''hemispheric swelling''. This abnormality was quite often associated with acute subdural hematoma. Multiple ''hemorrhagic lesions'' were associated with much poorer outcome than single lesions. The older groups had more acute subdural hematomas and more ''hemorrhagic lesions''. And ''hemorrhagic lesions'' were more often multiple and larger in the older group. (author).

  7. Computed tomography in acute head injury

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, T; Inagawa, T; Yamada, T; Sota, K [Shimane Prefectural Central Hospital (Japan)

    1981-01-01

    After the introduction of CT (GE-CT/T) in January, 1980, we experienced 81 cases of head injury. We diagnosed these cases into normal in 50 cases, epidural hematoma in 8 cases, subdural hematoma in 5 cases, intracerebral hematoma in 3 cases, cerebral contusion or cerebral swelling in 14 cases and combined hematoma in 1 case, based on CT findings. We diagnose normal, when no abnormal finding is present intracranially. Epidural hematoma is visualized as a bicrescent-shaped high density area on CT scan. Subdural hematoma appears as a crescent-shaped high density area on CT finding. Intracranial hematoma is visualized as a high density area in the brain tissue on CT scan. Cerebral contusion presents as salt and pepper appearance on CT scan representing area of high and low density complex. Brain swelling is visualized as disappearance or compression of ventricles, cisterns, sulci and gyri.

  8. Personality disorder symptomatology and neuropsychological functioning in closed head injury.

    Science.gov (United States)

    Ruocco, Anthony C; Swirsky-Sacchetti, Thomas

    2007-01-01

    Despite an emerging literature characterizing the neuropsychological profiles of borderline, antisocial, and schizotypal personality disorders, relations between personality disorder traits and neurocognitive domains remain unknown. The authors examined associations among Millon Clinical Multiaxial Inventory-III personality disorder scales and eight neuropsychological domains in 161 patients referred for neuropsychological evaluation following closed head injury. Most personality disorder scales were associated with some decrement in cognitive function, particularly speeded processing, executive function, and language, while histrionic and narcissistic scales had positive relations with neuropsychological functioning. Results suggest that many personality disorder traits are related to neurocognitive function, particularly those functions subserved by frontal and temporal regions.

  9. Venous injury in abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Choudhary, Arabinda K. [Nemours A. I. duPont Hospital for Children, Department of Radiology, Wilmington, DE (United States); Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B. [Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Dias, Mark S. [Hershey Medical Center, Department of Neurosurgery, Hershey, PA (United States)

    2015-11-15

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  10. Venous injury in abusive head trauma

    International Nuclear Information System (INIS)

    Choudhary, Arabinda K.; Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B.; Dias, Mark S.

    2015-01-01

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  11. Head injuries (TBI) to adults and children in motor vehicle crashes.

    Science.gov (United States)

    Viano, David C; Parenteau, Chantal S; Xu, Likang; Faul, Mark

    2017-08-18

    This is a descriptive study. It determined the annual, national incidence of head injuries (traumatic brain injury, TBI) to adults and children in motor vehicle crashes. It evaluated NASS-CDS for exposure and incidence of various head injuries in towaway crashes. It evaluated 3 health databases for emergency department (ED) visits, hospitalizations, and deaths due to TBI in motor vehicle occupants. Four databases were evaluated using 1997-2010 data on adult (15+ years old) and child (0-14 years old) occupants in motor vehicle crashes: (1) NASS-CDS estimated the annual incidence of various head injuries and outcomes in towaway crashes, (2) National Hospital Ambulatory Medical Care Survey (NHAMCS)-estimated ED visits for TBI, (3) National Hospital Discharge Survey (NHDS) estimated hospitalizations for TBI, and (4) National Vital Statistics System (NVSS) estimated TBI deaths. The 4 databases provide annual national totals for TBI related injury and death in motor vehicle crashes based on differing definitions with TBI coded by the Abbreviated Injury Scale (AIS) in NASS-CDS and by International Classification of Diseases (ICD) in the health data. Adults: NASS-CDS had 16,980 ± 2,411 (risk = 0.43 ± 0.06%) with severe head injury (AIS 4+) out of 3,930,543 exposed adults in towaway crashes annually. There were 49,881 ± 9,729 (risk = 1.27 ± 0.25%) hospitalized with AIS 2+ head injury, without death. There were 6,753 ± 882 (risk = 0.17 ± 0.02%) fatalities with a head injury cause. The public health data had 89,331 ± 6,870 ED visits, 33,598 ± 1,052 hospitalizations, and 6,682 ± 22 deaths with TBI. NASS-CDS estimated 48% more hospitalized with AIS 2+ head injury without death than NHDS occupants hospitalized with TBI. NASS-CDS estimated 29% more deaths with AIS 3+ head injury than NVSS occupant TBI deaths but only 1% more deaths with a head injury cause. Children: NASS-CDS had 1,453 ± 318 (risk = 0.32 ± 0.07%) with severe head injury (AIS 4+) out of 454,973 exposed

  12. Meta-analytic evaluation of the association between head injury and risk of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Watanabe, Yukari; Watanabe, Takamitsu

    2017-10-01

    Head injury is considered as a potential risk factor for amyotrophic lateral sclerosis (ALS). However, several recent studies have suggested that head injury is not a cause, but a consequence of latent ALS. We aimed to evaluate such a possibility of reverse causation with meta-analyses considering time lags between the incidence of head injuries and the occurrence of ALS. We searched Medline and Web of Science for case-control, cross-sectional, or cohort studies that quantitatively investigated the head-injury-related risk of ALS and were published until 1 December 2016. After selecting appropriate publications based on PRISMA statement, we performed random-effects meta-analyses to calculate odds ratios (ORs) and 95% confidence intervals (CI). Sixteen of 825 studies fulfilled the eligibility criteria. The association between head injuries and ALS was statistically significant when the meta-analysis included all the 16 studies (OR 1.45, 95% CI 1.21-1.74). However, in the meta-analyses considering the time lags between the experience of head injuries and diagnosis of ALS, the association was weaker (OR 1.21, 95% CI 1.01-1.46, time lag ≥ 1 year) or not significant (e.g. OR 1.16, 95% CI 0.84-1.59, time lag ≥ 3 years). Although it did not deny associations between head injuries and ALS, the current study suggests a possibility that such a head-injury-oriented risk of ALS has been somewhat overestimated. For more accurate evaluation, it would be necessary to conduct more epidemiological studies that consider the time lags between the occurrence of head injuries and the diagnosis of ALS.

  13. Utilization of head CT during injury visits to United States emergency departments: 2012-2015.

    Science.gov (United States)

    Yun, Brian J; Borczuk, Pierre; Zachrison, Kori S; Goldstein, Joshua N; Berlyand, Yosef; Raja, Ali S

    2018-05-18

    Studies have shown increasing utilization of head computed tomography (CT) imaging of emergency department (ED) patients presenting with an injury-related visit. Multiple initiatives, including the Choosing Wisely™ campaign and evidence-based clinical decision support based on validated decision rules, have targeted head CT use in patients with injuries. Therefore, we investigated national trends in the use of head CT during injury-related ED visits from 2012 to 2015. This was a secondary analysis of data from the annual United States (U.S.) National Hospital Ambulatory Medical Care Survey from 2012 to 2015. The study population was defined as injury-related ED visits, and we sought to determine the percentage in which a head CT was ordered and, secondarily, to determine both the diagnostic yield of clinically significant intracranial findings and hospital characteristics associated with increased head CT utilization. Between 2012 and 2015, 12.25% (95% confidence interval [CI] 11.48-13.02%) of injury-related visits received at least one head CT. Overall head CT utilization showed an increased trend during the study period (2012: 11.7%, 2015: 13.23%, p = 0.09), but the results were not statistically significant. The diagnostic yield of head CT for a significant intracranial injury over the period of four years was 7.4% (9.68% in 2012 vs. 7.67% in 2015, p = 0.23). Head CT use along with diagnostic yield has remained stable from 2012 to 2015 among patients presenting to the ED for an injury-related visit. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Personality change following head injury: assessment with the NEO Five-Factor Inventory.

    Science.gov (United States)

    Lannoo, E; de Deyne, C; Colardyn, F; de Soete, G; Jannes, C

    1997-11-01

    We evaluated personality change following head injury in 68 patients at 6 months postinjury using the NEO Five-Factor Inventory to assess the five personality dimensions of the Five-Factor Model of Personality. All items had to be rated twice, once for the preinjury and once for the current status. Twenty-eight trauma patients with injuries to other parts of the body than the head were used as controls. For the head-injured group, 63 relatives also completed the questionnaire. The results showed no differences between the ratings of head-injured patients and the ratings of trauma control patients. Both groups showed significant change in the personality dimensions Neuroticism, Extraversion, and Conscientiousness. Compared to their relatives, head-injured patients report a smaller change in Extraversion and Conscientiousness. Changes were not reported on the Openness and Agreeableness scales, by neither the head-injured or their relatives, nor by the trauma controls.

  15. Time pressure management as a compensatory strategy training after closed head injury

    NARCIS (Netherlands)

    Fasotti, L; Kovacs, F; Eling, PATM; Brouwer, WH

    Following severe closed head injury, deficits in speed of information processing are common. As a result, many head-injured patients experience a feeling of "information overload" in daily tasks that once were relatively easy. Many remedial programmes have been designed that treat different aspects

  16. Head injury: audit of a clinical guideline to justify head CT

    International Nuclear Information System (INIS)

    Haydon, Nicholas B.

    2013-01-01

    Head injury causes significant morbidity and mortality, and there is contention about which patients to scan. The UK National Health Service Clinical Guideline (CG) 56 provides criteria for selecting patients with clinically important brain injury who may benefit from a head CT scan, while minimising the radiation and economic burden of scanning patients without significant injury. This study aims to audit the documentation of the use of these guidelines in a busy UK trauma hospital and discusses the comparison with an Australian (New South Wales (NSW) ) head injury guideline. A retrospective cohort study of 480 patients presenting with head injury to the emergency department over 2 months was performed. The patient notes were assessed for documentation of each aspect of the clinical guidelines. Criteria were established to assess the utilisation of the CG 56. A database of clinical data was amalgamated with the head CT scan results for each patient. For the UK CG 56, 73% of the criteria were documented, with the least documented being 'signs of basal skull fracture' and 'amnesia of events'. Thirty-two per cent of patients received head CT and of these, 24% (37 patients) were reported to have pathology. Twenty-four patients underwent head CT without clinical justification being documented, none of which had reported pathology on CT. The study shows that the head injury guidelines are not being fully utilised at a major UK trauma hospital, resulting in 5% of patients being exposed to ionising radiation without apparent documented clinical justification. The NSW guideline has distinct differences to the CG 56, with a more complex algorithm and an absence of specific time frames for head CT completion. The results suggest a need for further education and awareness of head injury clinical guidelines.

  17. Assessing the Prevalence of Traumatic Head Injury amongst Recreational Surfers in the United States.

    Science.gov (United States)

    Swinney, Christian

    2015-12-01

    Surfing is a popular recreational sport that carries a substantial risk of injury. Although head injuries are frequently documented in the surfing population, an in depth assessment of the prevalence of surfing-related head injury has not been reported. A web-based survey was conducted in May of 2015. Participants were asked a series of questions regarding surfing-related injuries and demographic characteristics. A total of 50 responses were obtained, of which 35 (70%) reported sustaining a head injury. The most common injury was laceration of the head/face (n=27), followed by concussion (n=13). Other injuries, such as skull fracture and broken nose, were also reported. Only 2 of the 50 participants reported wearing a protective helmet. Neurosurgical intervention was required in 2 instances. Increased emphasis on preventative measures by the medical community may reduce the future incidence of such injuries. Medical professionals should be aware of the most common forms of injury sustained by the surfing population in order to better recognize and treat these conditions.

  18. "Heely"-related injuries in children.

    Science.gov (United States)

    Thing, J; Wade, D; Clark, H

    2008-09-01

    "Heelys", or shoes with an integral wheel embedded into the heel, are becoming increasingly popular among children in the UK. Despite the manufacturer's claims about their safety, increasing numbers of patients are attending the emergency department with "Heely"-related injuries. To assess the number and type of "Heely"-related injuries seen in the emergency department in a busy district general hospital and to assess the number of school days lost as a result of these injuries as a secondary measure of the impact on education and lifestyle. Medical staff working in the emergency department completed proformas for all children attending the department with "Heely"-related injuries between 26 December and 26 April 2007. Data collected included age, sex, mechanism of injury, diagnosis and number of days off school as a result of the injury. 35 patients with "Heely"-related injuries of mean age 9.6 years (range 6-15) were identified during the study period. The most common mechanism of injury was a fall onto an outstretched hand (20/35, 57%). Other mechanisms of injury identified were lateral upper limb injury (7/35), traumatic lower limb injury (2/35), rotational lower limb injury (2/35), head injury (2/35) and back injury (2/35). The most common diagnosis was fracture of the distal radius (10/35), two of which had an associated distal ulna fracture. Two tibial fractures and one nasal fracture were also seen. The average number of days off school was 4.5 days (range 0-20). None of the children included in this study were using safety equipment at the time of the injury. The number of "Heely"-related injuries seen in one department over a 4-month period suggests a much higher incidence of injuries than the 46/100,000 found by the manufacturers based on Consumer Product Safety Commission data in the USA. The discrepancy is almost certainly due to the reluctance of UK children to use safety equipment and to follow the manufacturer's safety advice. Larger scale studies

  19. PEDIATRIC HEAD INJURIES, MECHANISM TO MANAGEMENT: EXPERIENCE OF A SINGLE CENTER

    Directory of Open Access Journals (Sweden)

    Pankaj

    2016-01-01

    Full Text Available INTRODUCTION Head injury is very common in modern life. Patients of any age group may have head injury however mechanism of head injury, pathophysiology and outcome of head injury is quite different in adults as compared to children. Road traffic accident is a common mode of head injury in adults while fall from height and household abuse is common mode in children. In Western countries, there is a separate registry system for pediatric head injury but there is no such system exist in india. Our present study is focused on pediatric head injury and evaluation of factors that affect the final outcome in pediatric patients.

  20. Mild head injury and attention deficit hyperactivity disorder in children.

    Science.gov (United States)

    Chasle, Veronique; Riffaud, Laurent; Longuet, Romain; Martineau-Curt, Marie; Collet, Yann; Le Fournier, Luc; Pladys, Patrick

    2016-12-01

    Post-concussion syndrome is a well-described complication following moderate and severe head trauma but whether it occurs after mild head injury in children remains unclear. The aim of this study was to evaluate whether exposure to mild head injury with potential additional risk factors (non-surgical lesion on computed tomographic, high kinetic trauma, or Glasgow Coma Scale <15) is associated with attention deficit hyperactivity disorder (ADHD) after the head trauma. This study was performed in an emergency department on children admitted between 2009 and 2013. It compared victims of mild head injury aged 6-16 years with matched children presenting isolated non-surgical forearm fracture (ratio1/2). ADHD was assessed using Conners' Global Index-Parent short version 3-40 months after the trauma. The patients were compared using chi-square test or Fisher's exact test, t test or u-test as appropriate with a p value set at 0.05. During the study period, 676 patients were admitted for mild head injury. Among them, 34 (5 %) fulfilled the inclusion criteria and were compared with 64 matched patients admitted for a forearm fracture. The groups were comparable. ADHD was observed in both groups (18 % in the mild head injury group, 11 % in the control group) with no significant differences between groups. The prevalence was high when compared to an expected frequency of 3.5-5.6 % in children aged 6-12 years in the general population. These results suggest that pre-existing ADHD may have contributed to injury proneness in both groups and does not argue for a specific risk of ADHD induced by mild head injury. The diagnosis of ADHD should be evoked at admission of children aged 6-16 years presenting with a trauma.

  1. Severe head injury in children - a preventable but forgotten epidemic

    African Journals Online (AJOL)

    Severe head injury in a child is a sociological disaster that crosses all sociological ... permanently disabled each year as a result of accidental injury." Over a ..... the daylight when transportation of the patient is more rapid; this results in some ...

  2. Computed tomography: ocular manifestations in acute head injury ...

    African Journals Online (AJOL)

    Background: Acute head injuries are common in the population. Associated ocular injuries are occasionally encountered and these are of varying nature and outcome. Methods: We reviewed 98 brain computed tomographic results retrospectively. These are cases that were done between Jan. 2013- Jan. 2014. Statistical ...

  3. Nail gun injuries to the head with minimal neurological consequences: a case series.

    Science.gov (United States)

    Makoshi, Ziyad; AlKherayf, Fahad; Da Silva, Vasco; Lesiuk, Howard

    2016-03-16

    An estimated 3700 individuals are seen annually in US emergency departments for nail gun-related injuries. Approximately 45 cases have been reported in the literature concerning nail gun injuries penetrating the cranium. These cases pose a challenge for the neurosurgeon because of the uniqueness of each case, the dynamics of high pressure nail gun injuries, and the surgical planning to remove the foreign body without further vascular injury or uncontrolled intracranial hemorrhage. Here we present four cases of penetrating nail gun injuries with variable presentations. Case 1 is of a 33-year-old white man who sustained 10 nail gunshot injuries to his head. Case 2 is of a 51-year-old white man who sustained bi-temporal nail gun injuries to his head. Cases 3 and 4 are of two white men aged 22 years and 49 years with a single nail gun injury to the head. In the context of these individual cases and a review of similar cases in the literature we present surgical approaches and considerations in the management of nail gun injuries to the cranium. Case 1 presented with cranial nerve deficits, Case 2 required intubation for low Glasgow Coma Scale, while Cases 3 and 4 were neurologically intact on presentation. Three patients underwent angiography for assessment of vascular injury and all patients underwent surgical removal of foreign objects using a vice-grip. No neurological deficits were found in these patients on follow-up. Nail gun injuries can present with variable clinical status; mortality and morbidity is low for surgically managed isolated nail gun-related injuries to the head. The current case series describes the surgical use of a vice-grip for a good grip of the nail head and controlled extraction, and these patients appear to have a good postoperative prognosis with minimal neurological deficits postoperatively and on follow-up.

  4. Spinal cord injury and its association with blunt head trauma

    OpenAIRE

    Paiva, Wellingson S; Oliveira, Arthur MP; Andrade, Almir F; Amorim, Robson LO; Lourenço, Leonardo JO; Teixeira, Manoel J

    2011-01-01

    Wellingson S Paiva, Arthur MP Oliveira, Almir F Andrade, Robson LO Amorim, Leonardo JO Lourenço, Manoel J TeixeiraDivision of Neurosurgery, University of São Paulo, BrazilBackground: Severe and moderate head injury can cause misdiagnosis of a spinal cord injury, leading to devastating long-term consequences. The objective of this study is to identify risk factors involving spine trauma and moderate-to-severe brain injury.Methods: A prospective study involving 1617 patien...

  5. Risk of Parkinson's disease after hospital contact for head injury

    DEFF Research Database (Denmark)

    Rugbjerg, Kathrine; Ritz, Beate; Korbo, Lise

    2008-01-01

    OBJECTIVE: To determine whether a hospital contact for a head injury increases the risk of subsequently developing Parkinson's disease. DESIGN: Population based case-control study. SETTING: Denmark. PARTICIPANTS: 13 695 patients with a primary diagnosis of Parkinson's disease in the Danish national...... of history of head injury. RESULTS: An overall 50% increase in prevalence of hospital contacts for head injury was seen before the first registration of Parkinson's disease in this population (odds ratio 1.5, 95% confidence interval 1.4 to 1.7). The observed association was, however, due almost entirely...... to injuries that occurred during the three months before the first record of Parkinson's disease (odds ratio 8.0, 5.6 to 11.6), and no association was found between the two events when they occurred 10 or more years apart (1.1, 0.9 to 1.3). CONCLUSIONS: The steeply increased frequency of hospital contacts...

  6. Mortality resulting from head injury in professional boxing: case report.

    Science.gov (United States)

    Baird, Lissa C; Newman, C Benjamin; Volk, Hunter; Svinth, Joseph R; Conklin, Jordan; Levy, Michael L

    2010-08-01

    The majority of boxing-related fatalities result from traumatic brain injury. Biomechanical forces in boxing result in rotational acceleration with resultant subdural hematoma and diffuse axonal injury. Given the inherent risk and the ongoing criticism boxing has received, we evaluated mortalities associated with professional boxing. We used the Velazquez Fatality Collection of boxing injuries and supplementary sources to analyze mortality from 1950 to 2007. Variables evaluated included age at time of death, association with knockout or other outcome of match, rounds fought, weight class, location of fight, and location of preterminal event. There were 339 mortalities between 1950 and 2007 (mean age, 24 +/- 3.8 years); 64% were associated with knockout and 15% with technical knockout. A higher percentage occurred in the lower weight classes. The preterminal event occurred in the ring (61%), in the locker room (17%), and outside the arena (22%). We evaluated for significant changes after 1983 when championship bouts were reduced from 15 to 12 rounds. There was a significant decline in mortality after 1983. We found no significant variables to support that this decline is related to a reduction in rounds. Rather, we hypothesize the decline to be the result of a reduction in exposure to repetitive head trauma (shorter careers and fewer fights), along with increased medical oversight and stricter safety regulations. Increased efforts should be made to improve medical supervision of boxers. Mandatory central nervous system imaging after a knockout could lead to a significant reduction in associated mortality.

  7. Mortality resulting from head injury in professional boxing.

    Science.gov (United States)

    Baird, Lissa C; Newman, C Benjamin; Volk, Hunter; Svinth, Joseph R; Conklin, Jordan; Levy, Michael L

    2010-11-01

    The majority of boxing-related fatalities result from traumatic brain injury. Biomechanical forces in boxing result in rotational acceleration with resultant subdural hematoma and diffuse axonal injury. Given the inherent risk and the ongoing criticism boxing has received, we evaluated mortalities associated with professional boxing. We used the Velaquez Fatality Collection of boxing injuries and supplementary sources to analyze mortality from 1950 to 2007. Variables evaluated included age at time of death, association with knockout or other outcome of match, rounds fought, weight class, location of fight, and location of pretermial event. There were 339 mortalities between 1950 and 2007 (mean age, 24 ± 3.8 years); 64% were associated with knockout and 15% with technical knockout. A higher percentage occurred in the lower weight classes. The preterminal event occurred in the ring (61%), in the locker room (17%), and outside the arena (22%), We evaluated for significant changes after 1983 when championship bouts were reduced from 15 to 12 rounds. There was a significant decline in mortality after 1983. We found no significant variables to support that this decline is related to a reduction in rounds. Rather, we hypothesize the decline to be the result of a reduction in exposure to repetitive head trauma (shorter careers and fewer fights), along with increased medical oversight and stricter safety regulations. Increased efforts should be made to improve medical supervisions of boxers. Mandatory central nervous system imaging after a knockout could lead to a significant reduction in associated mortality.

  8. Capabilities of Helmets for Preventing Head Injuries Induced by Ballistic Impacts

    Directory of Open Access Journals (Sweden)

    D.V. Balandin

    2004-01-01

    Full Text Available The limiting performance of ballistically loaded helmets designed to reduce head injuries is studied analytically. The projectile does not penetrate the helmet. This analysis evaluates the absolute minimum of the peak displacement of the helmet shell relative to the head, provided that criteria measuring the severity of head injuries lie within prescribed limits. Rather than optimize a specific design configuration, e.g. a viscoelastic foam liner, characteristics of a time-dependent force representing the helmet liner are calculated. The formulation reduces the limiting performance analysis to an optimal control problem.

  9. Preliminary study on the head-injury by using SPECT with 99mTc-HMPAO

    International Nuclear Information System (INIS)

    Guan Yihui; Liu Yongchang; Lin Xiangtong

    1994-01-01

    After the acute period of head trauma some cases of patients may have some symptoms, such as headache, poor memory, vertigo, et al. In this study, among 42 patients most of whom had normal CT or MRI abnormal findings of brain perfusion imaging were seen in 33 patients (78.6%). Multiple perfusion defects were observed in some patients (13/42). These indicate that the head-injury syndrome is closely related to brain blood perfusion. authors' conclusion is that the brain SPECT is able to find out the etiology of head injury syndrome

  10. Trampoline-related injuries to children.

    Science.gov (United States)

    Smith, G A; Shields, B J

    1998-07-01

    To describe the epidemiological features of trampoline-related injuries among children treated in an urban pediatric emergency department. A descriptive study of a consecutive series of patients. The emergency department of a large, urban, academic children's hospital. Children treated for trampoline-related injuries from May 1, 1995, through April 30, 1997. Two hundred fourteen children were treated for trampoline-related injuries during the study period, representing, on average, 1 child treated approximately every 3 days. Children ranged in age from 1 to 16 years (mean [SD], 9.4 [3.6] years). The area of the body most commonly injured was a lower extremity (36.0%), followed by an upper extremity (31.8%), the head (14.5%), the trunk (9.8%), and the neck (7.9%). The most common type of injury was a soft tissue injury (51.9%), followed by fracture (34.6%) and laceration (11.7%). Several patterns of trampoline-related injury were identified. Extremity fractures were more common in the upper extremities (P=.006; relative risk [RR]=1.64; 95% confidence interval [CI], 1.16-2.31); however, soft tissue injuries were more common in the lower extremities (P=.006; RR=1.66; 95% CI, 1.16-2.38). Lacerations were associated with injury to the head region (Ptrampoline was located in the backyard in 96% (119/124) of cases. Adult supervision was present at the time of injury for 55.6% (65/117) of children, including 73.3% (22/30) of children younger than 6 years. Parents reported that they had been aware of the potential dangers of trampolines before the injury event (73% [81/111]), that their child had previously attempted a flip on a trampoline (56.9% [66/116]), that this was not the child's first injury on a trampoline (10% [12/120]), and that their child continued to use a trampoline after the current injury event (54.8% [63/115]). Trampoline-related injuries to children treated in the emergency department are almost exclusively associated with the use of backyard trampolines

  11. Airbag deployment-related eye injuries.

    Science.gov (United States)

    Koisaari, Tapio; Leivo, Tiina; Sahraravand, Ahmad; Haavisto, Anna-Kaisa; Sulander, Pekka; Tervo, Timo M T

    2017-07-04

    We studied the correlation between airbag deployment and eye injuries using 2 different data sets. The registry of the Finnish Road Accident (FRA) Investigation Teams was analyzed to study severe head- and eyewear-related injuries. All fatal passenger car or van accidents that occurred during the years 2009-2012 (4 years) were included (n = 734). Cases in which the driver's front airbag was deployed were subjected to analysis (n = 409). To determine the proportion of minor, potentially airbag-related eye injuries, the results were compared to the data for all new eye injury patients (n = 1,151) recorded at the Emergency Clinic of the Helsinki University Eye Hospital (HUEH) during one year, from May 1, 2011, to April 30, 2012. In the FRA data set, the unbelted drivers showed a significantly higher risk of death (odds ratio [OR] = 5.89, 95% confidence interval [CI], 3.33-10.9, P = 2.6E-12) or of sustaining head injuries (OR = 2.50, 95% CI, 1.59-3.97, P = 3.8E-5). Only 4 of the 1,151 HUEH patients were involved in a passenger car accident. In one of the crashes, the airbag operated, and the belted driver received 2 sutured eye lid wounds and showed conjunctival sugillation. No permanent eye injuries were recorded during the follow-up. The calculated annual airbag-related eye injury incidence was less than 1/1,000,000 people, 4/100,000 accidents, and 4/10,000 injured occupants. Airbag-related eye injuries occurred very rarely in car accidents in cases where the occupant survived and the restraint system was appropriately used. Spectacle use did not appear to increase the risk of eye injury in restrained occupants.

  12. Targeted treatment of severe head injury

    African Journals Online (AJOL)

    injury is not a homogeneous concept and is poorly classified for the purposes of treatment.1 The separation of patients into 3 categories of severity (mild, moderate and severe) remains a blunt measure used to guide therapy in individual patients. Patients with severe traumatic brain injury (TBI), i.e. a Glasgow Coma Score ...

  13. Geriatric fall-related injuries.

    African Journals Online (AJOL)

    Conclusion: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk fac- tors for falls including home hazards is essential for prevention of geriatric fall-related injuries. Keywords: Accidental fall, geriatrics, injury, trauma registry. DOI: http://dx.doi.org/10.4314/ahs.v16i2.24.

  14. Optimal timing of tracheostomy after trauma without associated head injury.

    Science.gov (United States)

    Keenan, Jeffrey E; Gulack, Brian C; Nussbaum, Daniel P; Green, Cindy L; Vaslef, Steven N; Shapiro, Mark L; Scarborough, John E

    2015-10-01

    Controversy exists over optimal timing of tracheostomy in patients with respiratory failure after blunt trauma. The study aimed to determine whether the timing of tracheostomy affects mortality in this population. The 2008-2011 National Trauma Data Bank was queried to identify blunt trauma patients without concomitant head injury who required tracheostomy for respiratory failure between hospital days 4 and 21. Restricted cubic spline analysis was performed to evaluate the relationship between tracheostomy timing and the odds of inhospital mortality. The cohort was stratified based on this analysis. Unadjusted characteristics and outcomes were compared. Multivariable logistic regression was used to evaluate the effect of tracheostomy timing on mortality after adjustment for age, gender, race, payor status, level of trauma center, injury severity score, presentation Glasgow coma scale, and thoracic and abdominal abbreviated injury score. There were 9662 patients included in the study. Restricted cubic spline analysis demonstrated a nonlinear relationship between timing of tracheostomy and mortality, with higher odds of mortality occurring with tracheostomy placement within 10 d of admission compared with later time points. The cohort was therefore stratified into early and delayed tracheostomy groups relative to this time point. The resulting groups contained 5402 (55.9%) and 4260 (44.1%) patients, respectively. After multivariable adjustment, the delayed tracheostomy group continued to have significantly reduced odds of mortality (Adjusted odds ratio, 0.82, 95% confidence interval, 0.71-0.95, C-statistic, 0.700). Among non-head injured blunt trauma patients with prolonged respiratory failure, tracheostomy placement within 10 d of admission may result in increased mortality compared with later time points. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Helmet Use and Head Injury in Homer's Iliad.

    Science.gov (United States)

    Swinney, Christian

    2016-06-01

    Homer's detailed descriptions of head injuries inflicted during the Trojan War are of particular interest to individuals in the medical community. Although studies have examined the prevalence of such injuries, none have examined the preventive measures taken to avoid them. An in-depth review of helmet use in Homer's Iliad was conducted to address this previously unexplored facet of the epic. An English translation of Homer's text was reviewed for all references to helmet use. The number of helmet references in each book was recorded, along with other pertinent details for each reference. There were 87 references to helmets (40 combat, 47 noncombat). The helmet belonged to a Greek warrior in 41 cases (47.1%), a Trojan warrior in 38 cases (43.6%), a divinity in 5 cases (5.7%), and a general group of warriors in 3 cases (3.4%). Helmet use provided protective benefit to Greek warriors at a rate of 30.0% (3 of 10) and Trojan warriors at a rate of 11.1% (2 of 18). This difference was not statistically significant (P = 0.23). The overall combined protective benefit of helmet use in the text was 17.9% (5 of 28). Helmets belonging to 15 specific Greek warriors and 18 specific Trojan warriors were referenced in the text. Helmets belonging to Hector (n = 12) and Achilles (n = 8) were most frequently mentioned. Helmet use and head injury both play a prominent role in Homer's Iliad. Helmets are frequently used in combat settings but with relatively little success. Helmets are also used in various noncombat settings. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Functional brain study of chronic traumatic head injury

    International Nuclear Information System (INIS)

    Ceballos Alonso, Concepcion; Pelegrin Valero, Carmelo; Cordoba Diaz de Laspra, Elena

    2000-01-01

    Explosive aggressive behaviour is a significant clinical and medico-legal problem in patients suffering from head injury. However, experts in neuropsychiatry have proposed a specific category for this disorder: the o rganic aggressive syndrome: . The basic reason for proposing this diagnosis is that it describes the specificity of the violent conduct secondary to 'brain damage' with greater precision. Early diagnosis and treatment of the injury is critical. The impact of hnetium-99m-hexamethylpropuleneamine oxime (HMPAO) was examined for measuring brain damage in correlation to neuropsychological performance in patients with traumatic brain injury (TBI). We thus report the case of a twelve-year-old child with a history of CET, who presents with serious episodes of heteroaggressiveness and suggest the usefulness of single photon emission computerized tomography (SPECT) to establish the validity of this psychiatric diagnosis. The appearance of modern functional neuro-image techniques (SPECT) may help to increase the validity of clinical diagnoses in the field of psychiatry in general and of forensic psychiatry in particularly, as the related findings may be used as demarcation criteria to establish syndromic diagnoses (Au)

  17. The association of temporomandibular disorder pain with history of head and neck injury in adolescents.

    Science.gov (United States)

    Fischer, Dena J; Mueller, Beth A; Critchlow, Cathy W; LeResche, Linda

    2006-01-01

    To evaluate the risk of self-reported temporomandibular disorder (TMD) pain among adolescents in relation to previous head and/or neck injury. 3,101 enrollees (11 to 17 years of age) of a nonprofit integrated health-care system were interviewed by telephone. Two hundred four cases with self-reported TMD pain and 194 controls without self-reported TMD pain frequency-matched to the cases by age and gender completed standardized in-person interviews and physical examinations in which reports of previous head/neck injuries were recorded. Odds ratio (OR) estimates and 95% confidence intervals (CIs) of the relative risks of TMD pain associated with prior head and/or neck injuries were calculated using logistic regression. A greater proportion of subjects reporting TMD pain (36%) than controls (25%) had a history of head and/or neck injuries (OR = 1.8, 95% CI, 1.1-2.8). In a separate analysis, the presence of TMD based upon the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was assessed in relation to prior head and/or neck injury. Cases reporting TMD pain and meeting the RDC/TMD criteria for myofascial pain and/or arthralgia or arthritis were 2.0 (CI, 1.0-3.8) times more likely to have had a prior head injury than were controls with neither self-reported nor RDC/TMD pain diagnoses. The results suggest a modest association of prior head injuries with both self-reported and clinically diagnosed TMD pain in adolescents.

  18. Post Traumatic Cerebral Oedema in Severe Head Injury is Related to Intracranial Pressure and Cerebral Perfusion Pressure but not to Cerebral Compliance

    Directory of Open Access Journals (Sweden)

    U Nujaimin

    2009-07-01

    Full Text Available This was a prospective cohort study, carried out in the Neuro Intensive Care Unit, Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan. The study was approved by the local ethics committee and was conducted between November 2005 and September 2007 with a total of 30 patients included in the study. In our study, univariate analysis showed a statistically significant relationship between mean intracranial pressure (ICP as well as cerebral perfusion pressure (CPP with both states of basal cistern and the degree of diffuse injury and oedema based on the Marshall classification system. The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. Nevertheless the study did not find any significant relationship between midline shifts and mean ICP, CPP or cerebral compliance even though lower ICP, higher CPP and compliance were frequently observed when the midline shift was less than 0.5 cm. As the majority of our patients had multiple and diffuse brain injuries, the absence of midline shift did not necessarily mean lower ICP as the pathology was bilateral and even when after excluding the multiple lesions, the result remained insignificant. We assumed that the CT brain scan obtained after evacuation of the mass lesion to assess the state basal cistern and classify the diffuse oedema may prognosticate the intracranial pressure and cerebral perfusion pressure

  19. Acute subdural hematoma, Head injury, Functional reco

    African Journals Online (AJOL)

    kim

    EVOLUTION DES HÉMATOMES SOUS-DURAUX AIGUS .... likelihood of functional recovery from traumatic brain injury. Howard et ... associated with decreased brainstem blood flow and that ishaemia rather than mechanical compression of.

  20. Child abuse. Non-accidental head injury

    International Nuclear Information System (INIS)

    Klee, Dirk; Schaper, Joerg

    2011-01-01

    Knowledge of the radiological appearances that are the result of child abuse is an integral part of prevention of further, potentially life-threatening, injury. Radiologists must have un understanding of typical injury patterns of the skeletal system, visceral and intra-cranial structures, which should ideally be ordered chronologically. Necessary radiological investigations follow guidelines with specific criteria that are pointed out in this review. In equivocal cases of abuse, the opinion of a second (paediatric) radiologist should be sought. (orig.)

  1. Evaluation of possible head injuries ensuing a cricket ball impact.

    Science.gov (United States)

    Mohotti, Damith; Fernando, P L N; Zaghloul, Amir

    2018-05-01

    The aim of this research is to study the behaviour of a human head during the event of an impact of a cricket ball. While many recent incidents were reported in relation to head injuries caused by the impact of cricket balls, there is no clear information available in the published literature about the possible threat levels and the protection level of the current protective equipment. This research investigates the effects of an impact of a cricket ball on a human head and the level of protection offered by the existing standard cricket helmet. An experimental program was carried out to measure the localised pressure caused by the impact of standard cricket balls. The balls were directed at a speed of 110 km/h on a 3D printed head model, with and without a standard cricket helmet. Numerical simulations were carried out using advanced finite element package LS-DYNA to validate the experimental results. The experimental and numerical results showed approximately a 60% reduction in the pressure on the head model when the helmet was used. Both frontal and side impact resulted in head acceleration values in the range of 225-250 g at a ball speed of 110 km/h. There was a 36% reduction observed in the peak acceleration of the brain when wearing a helmet. Furthermore, numerical simulations showed a 67% reduction in the force on the skull and a 95% reduction in the skull internal energy when introducing the helmet. (1) Upon impact, high localised pressure could cause concussion for a player without helmet. (2) When a helmet was used, the acceleration of the brain observed in the numerical results was at non-critical levels according to existing standards. (3) A significant increase in the threat levels was observed for a player without helmet, based on force, pressure, acceleration and energy criteria, which resulted in recommending the compulsory use of the cricket helmet. (4) Numerical results showed a good correlation with experimental results and hence, the

  2. Prognosis of the computerized tomography in the severe head injury

    International Nuclear Information System (INIS)

    Garcia-Nieto, J.J.; Lorenzo Dominguez, M.T.; Martin Sanchez, M.J.; Sanchez Gonzalez, E.

    1991-01-01

    A prospective study is made with sixty five people affected of severe head injury, that is to say, with eight or less points in the Glasgow Coma Scale (GCS), when they get to the hospital. They are studied by computerized tomography at the income, but also, three and seven days after arriving. In this way, we appraise the type of the lesion the intensity and the possible effect-wass, considering in the last case, three features: a) ventricular collapse; b) the mean line structure s shift; c) perimesencefalic cisterns affectation. The findings of this study, are parametized and we were able to introduce them into a computer, getting. The relations between these findings ands the end-results. These last ones appraised throungh the Glasgow Outcome Scale (GOS). We could confirm, that certain findings in the computerized tomography have and unavoidable prognosis, where as others have a better prognosis. (Author)

  3. Head Injury as Risk Factor for Psychiatric Disorders

    DEFF Research Database (Denmark)

    Orlovska, Sonja; Pedersen, Michael Skaarup; Benros, Michael Eriksen

    2014-01-01

    . METHOD: The authors used linkable Danish nationwide population-based registers to investigate the incidence of schizophrenia spectrum disorders, unipolar depression, bipolar disorder, and organic mental disorders in 113,906 persons who had suffered head injuries. Data were analyzed by survival analysis...... and adjusted for gender, age, calendar year, presence of a psychiatric family history, epilepsy, infections, autoimmune diseases, and fractures not involving the skull or spine. RESULTS: Head injury was associated with a higher risk of schizophrenia (incidence rate ratio [IRR]=1.65, 95% CI=1...

  4. Demographic Profile and Pathological Patterns of Head Injury in Albania

    Directory of Open Access Journals (Sweden)

    Sabri Hoxha

    2014-03-01

    Full Text Available Introduction: Head injury (HI is a serious morbid state caused by structural changes of the scalp, skull, and/or its contents, due to mechanical forces. Generally, the most frequent cause of HI is road traffic accident (RTA, followed by homicidal and falling injuries. The aim of present study is to assess epidemiology data, causes and patterns responsible for HI among Albanian subjects. Methodology: All HI cases (1000 are collected by the Forensic Institute of Albania, based on medical and forensic records of traumatized subjects between 2007- 2012. The prospectively-collected and descriptive information is focused on demographic data, responsible factors, type and level of cranial and brain injury, as well as their outcome. Results: The majority of HI victims were male (84% of age range of 15yrs -35yrs (70%. RTA was the HI cause in 88%, followed by homicides (3.8%, falling (3% etc. With respect to injury mechanisms, extra-dural hematoma was found in 93% of cases, followed by cerebral edema (61%, cerebral contusion (37%, skull bone fractures (35%, etc. Severe alteration of the consciousness was observed in 57% of the cases, while amnesia lasted longer than 4 weeks in 44% of the subjects included in our study. Discussion: This survey demonstrates that the majority of HI victims' is young and middle age males target group exposed to RTA. The increase of vehicles' use in placecountry-regionAlbania is more evident than RTA-related HI, indicating that driving newer vehicles with safer technology or helmets use while motorcycling can potentially decline the fatal outcome.

  5. Development of Head Injury Assessment Reference Values Based on NASA Injury Modeling

    Science.gov (United States)

    Somers, Jeffrey T.; Melvin, John W.; Tabiei, Ala; Lawrence, Charles; Ploutz-Snyder, Robert; Granderson, Bradley; Feiveson, Alan; Gernhardt, Michael; Patalak, John

    2011-01-01

    NASA is developing a new capsule-based, crewed vehicle that will land in the ocean, and the space agency desires to reduce the risk of injury from impact during these landings. Because landing impact occurs for each flight and the crew might need to perform egress tasks, current injury assessment reference values (IARV) were deemed insufficient. Because NASCAR occupant restraint systems are more effective than the systems used to determine the current IARVs and are similar to NASA s proposed restraint system, an analysis of NASCAR impacts was performed to develop new IARVs that may be more relevant to NASA s context of vehicle landing operations. Head IARVs associated with race car impacts were investigated by completing a detailed analysis of all of the 2002-2008 NASCAR impact data. Specific inclusion and exclusion criteria were used to select 4071 impacts from the 4015 recorder files provided (each file could contain multiple impact events). Of the 4071 accepted impacts, 274 were selected for numerical simulation using a custom NASCAR restraint system and Humanetics Hybrid-III 50th percentile numerical dummy model in LS-DYNA. Injury had occurred in 32 of the 274 selected impacts, and 27 of those injuries involved the head. A majority of the head injuries were mild concussions with or without brief loss of consciousness. The 242 non-injury impacts were randomly selected and representative of the range of crash dynamics present in the total set of 4071 impacts. Head dynamics data (head translational acceleration, translational change in velocity, rotational acceleration, rotational velocity, HIC-15, HIC-36, and the Head 3ms clip) were filtered according to SAE J211 specifications and then transformed to a log scale. The probability of head injury was estimated using a separate logistic regression analysis for each log-transformed predictor candidate. Using the log transformation constrains the estimated probability of injury to become negligible as IARVs approach

  6. Do head-restraints protect the neck from whiplash injuries?

    Science.gov (United States)

    Morris, F

    1989-01-01

    Over an 11-month period a study was made of all patients presenting to an accident and emergency department who had sustained whiplash as a result of rear-bumper impacts. The patients were analysed with respect to the presence of head-restraints in their vehicles. A significant increase in the incidence of whiplash was found in patients whose vehicles did not have head-restraints fitted. Legislation requiring all passenger cars to have head-restraints fitted as standard would have a major impact in reducing the number of whiplash injuries sustained in rear bumper impacts. PMID:2712983

  7. Computed tomographic study of the complication of head injury

    International Nuclear Information System (INIS)

    Kojima, Tadashi; Waga, Shiro

    1982-01-01

    Computed tomography (CT) is quite effective in the diagnosis of traumatic intracranial hemorrhage and cerebral contusion. Two hundred and nine consecutive patients with head injury were admitted to the hospital and studied by CT in the year from 1977 to 1980. Fourty-sevenof 209 patients had the complications of head injury, including 6 patients with carotidcavernous fistula (CCF), 6 with traumatic aneurysm, 10 with pneumocephalus, 4 with intracranial foreign body, 15 with optic nerve injury, and 14 with other cranial nerve palsy. Five patients with CCF had abnormal finding on CT. Two traumatic aneurysms of the superficial temporal artery were visualized on CT after injection of contrast material, but all traumatic aneurysms of the carotid siphon were not seven on CT. CT in all 10 patients with pneumocephalus and in all 4 patients with intracranial foreign body was of diagnostic value: On CT in two patients even small air bubbles were seen in details. In the CT examination of 29 patients who presented with cranial nerve injury, we could not find out any abnormality on CT. We emphasize that CT is much less effective in the diagnosis of vascular complication of head injury and traumatic cranial nerve injury. (author)

  8. Review of adult head injury admissions into the intensive care unit of ...

    African Journals Online (AJOL)

    The most common mode of injury was road traffic accident. All the patients admitted to ICU had either moderate or severe head injury, with 73.7% having severe head injury. About 26.3% of the patients had associated cervical spine injuries and 50% had various musculoskeletal and soft tissue injuries. Cranial computed ...

  9. Psychosocial consequences of head injury in children and adolescents: implications for rehabilitation.

    Science.gov (United States)

    Livingston, M G; McCabe, R J

    1990-01-01

    Studies measuring psychosocial outcome in children and adolescents have shown that head injury leads to cognitive impairment which is directly related to the severity of injury in those with very severe head injury. Psychiatric disorders are also related to the severity of injury but here the relationship suggests that mediating factors are involved. No specific pattern of post-traumatic psychological/psychiatric dysfunction emerges from the studies, but it is clear that, as with adults, psychosocial recovery lags behind physical. Head injury affects the functioning of the young person in the family, at school, and within the wider community, often resulting in a secondary handicap of low self-esteem. The multitude of deficits which are a consequence of severe head injury present a challenge for rehabilitation specialists. A multi-disciplinary, multi-specialist, and multi-agency response is required. As a result, families are often presented with a bewildering array of treatments and programmes at different agencies. A case manager can be helpful in ensuring the appropriate use of available resources and can be the one professional in charge of a coordinating case record.

  10. Accidental and Nonaccidental Head Injuries in Infants: Distinguishing Characteristics

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-07-01

    Full Text Available One hundred fifty infants hospitalized with head injury over a 3-year period, 57 (38% due to child abuse, were studied prospectively at the Departments of Pediatric Neurosurgery, Neuro-ophthalmology, and Legal Medicine, CHRU de Lille, France.

  11. Organisation of traumatic head injury management in the Nordic countries

    DEFF Research Database (Denmark)

    Sollid, S; Sundstrøm, T; Ingebrigtsen, T

    2009-01-01

    ; 67% had specific protocols for the treatment of traumatic head injury. Computed tomography (CT) was available in 93% of the hospitals, and 59% of the hospitals could link CT scans to the regional neurosurgical department. CONCLUSIONS: Most Nordic hospitals are well prepared to manage patients...

  12. Recovery versus retest effects in attention after closed head injury

    NARCIS (Netherlands)

    Spikman, J.M.; Timmerman, M.E.; van Zomeren, A.H; Deelman, B.G.

    1999-01-01

    Recovery in 60 patients with a closed-head injury (CHI) in the first year posttrauma was assessed repeatedly with a series of attention tests. A matched group of healthy subjects was tested at the same intervals to allow us to control for practice effects. The results of a multilevel analysis for

  13. Asymmetry of critical closing pressure following head injury

    OpenAIRE

    Kumar, A; Schmidt, E; Hiler, M; Smielewski, P; Pickard, J; Czosnyka, M

    2005-01-01

    Objective: Critical closing pressure (CCP) is the arterial pressure below which the vessels collapse. Hypothetically it is the sum of intracranial pressure (ICP) and vessel wall tension in the cerebral circulation. This study investigated transhemispherical asymmetry of CCP by studying its correlation with radiological findings on computed tomography (CT) scans in head injury patients.

  14. Computed Tomography: Ocular Manifestations In Acute Head Injury

    African Journals Online (AJOL)

    Administrator

    Methods: We reviewed 98 brain computed tomographic results retrospectively. ... was also performed to compare the difference of the ocular findings and sexes. ... Ocular findings were more in males and the severity of the ocular findings was .... Male. Female. Indications. Acute mild closed head injury. 12(15.0). 1(5.6).

  15. Trampoline related injuries in adults.

    Science.gov (United States)

    Arora, Varun; Kimmel, Lara A; Yu, Kathy; Gabbe, Belinda J; Liew, Susan M; Kamali Moaveni, Afshin

    2016-01-01

    Trampoline-related injuries in adults are uncommon. Participation in trampolining is increasing following its admission as a sport in the Olympics and the opening of local recreational trampoline centres. The aim of this study was to assess the number and outcomes of adult trampoline-related orthopaedic injuries presenting to four trauma hospitals in Victoria. A cohort study was performed for the period 2007-2013. Adult patients registered by the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) who had sustained a trampolining related injury were included in this study. Descriptive analyses were used to describe the patient population, the injuries sustained and their in-hospital and 6-month outcomes. There was an increase in trampolining injuries from 2007 (n=3) to 2012 (n=14) and 2013 (n=18). Overall, fifty patients with a median age of 25 (range 16-66) were identified. Thirty-five patients (70%) had lower limb injuries, 20 patients (40%) had spinal injuries and one patient had an upper limb injury. Thirty-nine patients (78%) required surgery. Fractures of the tibia (n=13), ankle fractures (n=12) and cervical spine injuries (n=7) were the most common injuries; all of which required surgery. Complications included death, spinal cord injuries, compartment syndrome and open fractures. At 6 months post injury, more than half (52%) of the patients had not achieved a good recovery, 32% had some form of persistent disability, 14% did not get back to work and overall physical health for the cohort was well below population norms for the SF-12. Adult trampoline-related injuries have increased in the last few years in this cohort identified through VOTOR. Lower limb and spinal injuries are most prevalent. Public awareness and education are important to reduce the risk for people participating in this activity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Non-accidental head injury - the evidence

    Energy Technology Data Exchange (ETDEWEB)

    David, Timothy J. [University of Manchester, Blackley, Department of Child Health, Booth Hall Children' s Hospital, Manchester (United Kingdom)

    2008-06-15

    A postmortem examination and the CT scan documented the above injuries (neuropathology showed acute but with foci of older subdural bleeding) and indicated that in addition there were five recent rib fractures (left ribs 3-5 posteriorly and right ribs 6-7 posteriorly), a large perimacular retinal fold in the left retina, and subscalp bruising in the area of the anterior fontanelle and the occipital area. Family proceedings were commenced in order to protect the 2-year-old girl. Expert forensic, neuro- and eye pathologists instructed on behalf of the girl's father were of the view that the baby's injuries were likely to have resulted from the fall from the bed to the carpet, or alternatively from the step-father's efforts to revive the infant; other possibilities being apnoea and cerebral anoxia and cardiac arrest resulting from gastrooesophageal reflux or overly rough rocking of the baby in a baby rocker by the 2-year-old girl, the scalp bruising allegedly being the result of palpation of the baby's fontanelle by the treating paediatricians. The rib fractures were attributed to cardio-pulmonary resuscitation. This short review looks at the type of evidence that might help one to distinguish between the differing opinions offered as to the cause of this child's injuries. (orig.)

  17. Non-accidental head injury - the evidence

    International Nuclear Information System (INIS)

    David, Timothy J.

    A postmortem examination and the CT scan documented the above injuries (neuropathology showed acute but with foci of older subdural bleeding) and indicated that in addition there were five recent rib fractures (left ribs 3-5 posteriorly and right ribs 6-7 posteriorly), a large perimacular retinal fold in the left retina, and subscalp bruising in the area of the anterior fontanelle and the occipital area. Family proceedings were commenced in order to protect the 2-year-old girl. Expert forensic, neuro- and eye pathologists instructed on behalf of the girl's father were of the view that the baby's injuries were likely to have resulted from the fall from the bed to the carpet, or alternatively from the step-father's efforts to revive the infant; other possibilities being apnoea and cerebral anoxia and cardiac arrest resulting from gastrooesophageal reflux or overly rough rocking of the baby in a baby rocker by the 2-year-old girl, the scalp bruising allegedly being the result of palpation of the baby's fontanelle by the treating paediatricians. The rib fractures were attributed to cardio-pulmonary resuscitation. This short review looks at the type of evidence that might help one to distinguish between the differing opinions offered as to the cause of this child's injuries. (orig.)

  18. Injuries in recreational curling include head injuries and may be prevented by using proper footwear.

    Science.gov (United States)

    Ting, D K; Brison, R J

    2015-04-01

    Our study examines a recreational curling population to describe patterns of injury occurrence, estimate risk of injury and to gauge attitudes towards equipment-based prevention strategies. In a retrospective case series, we queried the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), a national injury surveillance database, for curling injuries entered between 1993 and 2011. Kingston General Hospital and Hotel Dieu Hospital provide the two Kingston, Ontario, sites for emergency department (ED) care and participate in CHIRPP. Each retrieved entry underwent a chart review. A secondary survey was mailed to select individuals who had experienced curling injuries to solicit details on their injury and attitudes towards equipment to prevent injury. We used descriptive statistics for rates and proportions. Over 90% of acute curling injuries resulted from a fall, and 31.7% were head impacts. We found that acute injuries requiring ED presentation occur at a rate of approximately 0.17 per 1000 athlete-exposures (95% CI: 0.12-0.22). The secondary survey was completed by 54% of potential respondents. Of survey respondents, 41.3% attributed their fall to a lack of proper footwear and 73.5% of respondents agreed with mandatory sport-specific footwear as a prevention strategy, but only 8% agreed with mandatory helmet wear. Although curling injuries requiring medical care are not common, head injuries make up a large proportion. Mandated use of appropriate footwear appears to be the most effective prevention strategy, as well as the measure deemed most acceptable by players.

  19. Incidence and severity of head and neck injuries in victims of road traffic crashes: In an economically developed country.

    Science.gov (United States)

    Bener, Abdulbari; Rahman, Yassir S Abdul; Mitra, Biswadev

    2009-01-01

    Head and neck injuries following the road traffic crashes (RTCs) are the most common cause of morbidity and mortality in most developed and developing countries and may also result in temporary or permanent disability. The aim of this study was to determine the incidence pattern of head and neck injuries, investigate its trend and identify the severity of injuries involved with road traffic crashes (RTCs) during the period 2001-2006. This is a retrospective descriptive hospital based study. The patients with head and neck injuries were seen and treated in the Accident and Emergency Department of the Hamad General Hospital and other Trauma Centers of the Hamad Medical Corporation following the road traffic crashes during the period 2001-2006. This study is a retrospective analysis of 6709 patients attended and treated at the Accident and Emergency and Trauma centers for head and neck injuries over a 6 year period. Head and neck injuries were determined according to the ICD 10 criteria. Of these, 3013 drivers, 2502 passengers, 704 pedestrians and 490 two wheel riders (motor bike and cyclists). Details of all the road traffic crash patients were compiled in the database of the Emergency Medical Services (EMS), and the data of patients with head and neck injuries were extracted from this database. A total of 6709 patients with head and neck injuries was reported during the study period. Majority of the victims were non-Qataris (68.7%), men (85.9%) and in the age group 20-44 years (68.5%). There were statistical significant differences in relation to age, nationality, gender, and accident during week ends for head and neck injuries (pQatar from road traffic crashes. The incidence of head and neck injuries is still very high in Qatar, but the severity of injury was mild in most of the victims. The findings of the study highlighted the need for taking urgent steps for safety of people especially drivers and passengers.

  20. BIOMECHANICS OF HEAD INJURY IN OLYMPIC TAEKWONDO AND BOXING

    Science.gov (United States)

    Fife, G.P.; Pieter, W.

    2013-01-01

    Objective The purpose was to examine differences between taekwondo kicks and boxing punches in resultant linear head acceleration (RLA), head injury criterion (HIC15), peak head velocity, and peak foot and fist velocities. Data from two existing publications on boxing punches and taekwondo kicks were compared. Methods For taekwondo head impacts a Hybrid II Crash Dummy (Hybrid II) head was instrumented with a tri-axial accelerometer mounted inside the Hybrid II head. The Hybrid II was fixed to a height-adjustable frame and fitted with a protective taekwondo helmet. For boxing testing, a Hybrid III Crash Dummy head was instrumented with an array of tri-axial accelerometers mounted at the head centre of gravity. Results Differences in RLA between the roundhouse kick (130.11±51.67 g) and hook punch (71.23±32.19 g, d = 1.39) and in HIC15 (clench axe kick: 162.63±104.10; uppercut: 24.10±12.54, d = 2.29) were observed. Conclusions Taekwondo kicks demonstrated significantly larger magnitudes than boxing punches for both RLA and HIC. PMID:24744497

  1. ‘Studying Injured Minds’ - The Vietnam Head Injury Study and 40 years of brain injury research

    Directory of Open Access Journals (Sweden)

    Vanessa eRaymont

    2011-03-01

    Full Text Available The study of those who have sustained traumatic brain injuries (TBI during military conflicts has greatly facilitated research in the fields of neuropsychology, neurosurgery, psychiatry, neurology and neuroimaging. The Vietnam Head Injury Study (VHIS is a prospective, long-term follow-up study of a cohort of 1,221 Vietnam veterans with mostly penetrating brain injuries, which has stretched over more than 40 years. The scope of this study, both in terms of the types of injury and fields of examination, has been extremely broad. It has been instrumental in extending the field of TBI research and in exposing pressing medical and social issues that affect those who suffer such injuries. This review summarizes the history of conflict-related TBI research and the VHIS to date, as well as the vast range of important findings the VHIS has established.

  2. Lawn mower-related injuries to children.

    Science.gov (United States)

    Vollman, David; Khosla, Kimberly; Shields, Brenda J; Beeghly, B Christine; Bonsu, Bema; Smith, Gary A

    2005-09-01

    Despite current prevention efforts, approximately 9,400 children younger than 18 years continue to receive emergency care for lawn mower-related injuries each year in the United States. In this study, we analyzed data from a consecutive series of children treated for lawn mower-related injuries during a 53-consecutive-month period in the emergency department of a large, academic children's hospital. The objective of this study was to describe the epidemiology of lawn mower-related injuries to these children and to investigate the beliefs of parents regarding lawn mower use. There were 85 children treated for lawn mower-related injuries during the study period. The mean age was 7.6 years (SD, 4.3 years; median, 5 years), and 65% were boys. Thirty-four patients (40.0%) were admitted to the hospital, including 3 (3.5%) to the pediatric intensive care unit, and 30 (35.3%) required surgical intervention in the operating room. There were 25 children with lacerations (29.4%), 22 with fractures (25.9%), 18 with amputations (21.2%), and 10 with burns (11.8%). The most common body region injured was the lower extremity, accounting for 57.6% (49 of 85) of injuries, including 33 injuries (38.8%) to the foot/toe and 16 injuries (18.8%) to the leg. The hand/finger and head/neck regions each accounted for another 18.8% of injuries. The leading mechanism of injury was run-over/back-over (22.4%), followed by other blade contact (17.6%), thrown object (12.9%), burn (10.6%), and a fall off the mower (7.0%). Lacerations accounted for 68.8% (11 of 16) of injuries to the head/neck compared with 20.3% (14 of 69) to other body regions (p lawn mower safety standard American National Standards Institute/Outdoor Power Equipment Institute B71.1-2003 should be revised to include more rigorous performance provisions regarding prevention of penetration of feet and toes under the mower and into the path of the blades, shielding of hot mower parts from access by young children, and equipping all

  3. Accidental head injuries in children under 5 years of age

    International Nuclear Information System (INIS)

    Johnson, K.; Fischer, T.; Chapman, S.; Wilson, B.

    2005-01-01

    AIM: To evaluate the type and nature of head injuries sustained by children under the age of 5 years who present to a busy accident and emergency (A and E) department following an accidental fall. MATERIALS AND METHODS: This study included all children under the age of 5 years, who over an 8-month period were referred to our A and E Department with head injury following an accidental fall. Data were collected regarding the height of the fall, whether or not stairs were involved, the type of surface that the child landed on and the height of the child. This was correlated with any soft-tissue injury or skull fracture. RESULTS: A total of 72 children (aged 4 months to 4.75 years) fulfilled all the criteria for an accidental fall. The heights of the falls ranged from less than 50 cm to over 3 m, with the majority below 1 m. Of the falls, 49 were onto a hard surface and 23 were onto a soft surface. Of the 72 children, 52 had visible evidence of head injury, 35 (71%) of 49 being the result of falls onto hard surfaces and 17 (74%) of 23 onto soft (carpeted) surfaces. There was no significant difference in the type of surface that resulted in a visible head injury. A visible head injury was seen in all children who fell from a height of over 1.5 m and in 95% of children who fell over 1 m. Of the 72 children, 32 (44%) had skull radiographs performed in accordance with established guidelines and 4 (12.5%) were identified as having a fracture. Of the 3 linear parietal fractures 2 were inflicted by falls of just over 1 m (from a work surface) and 1 by a fall of 80 to 90 cm onto the hard-edged surface of a stone fire surround. The 4th was a fracture of the base of skull following a fall from more than 3 m (from a first-storey window). CONCLUSIONS: In the vast majority of domestic accidents children do not suffer significant harm. Skull fractures are rare and probably occur in less than 5% of cases. To cause a skull fracture the fall needs to be from over 1 m or, if from a

  4. Pathophysiology of repetitive head injury in sports. Prevention against catastrophic brain damage

    International Nuclear Information System (INIS)

    Mori, Tatsuro; Kawamata, Tatsuro; Katayama, Yoichi

    2008-01-01

    The most common head injury in sports is concussion and experiencing multiple concussions in a short period of time sometimes can cause severe brain damage. In this paper, we investigate severe brain damage due to repeated head injury in sports and discuss the pathophysiology of repeated sports injury. The majority of these severe cases are usually male adolescents or young adults that suffer a second head injury before they have recovered from the first head injury. All cases that could be confirmed by brain CT scan after the second injury revealed brain swelling associated with a thin subdural hematoma. We suggested that the existence of subdural hematoma is one of the major causes of brain swelling after repeated head injury in sports. Since repeated concussions occurring within a short period may have a risk for severe brain damage, the diagnosis for initial cerebral concussion should be done appropriately. To prevent catastrophic brain damage, the player who suffered from concussion should not engage in any sports before recovery. The american Academy of Neurology and Colorado Medical Society set a guideline to return to play after cerebral concussion. An international conference on concussion in sports was held at Prague in 2004. The summary and agreement of this meeting was published and the Sports Concussion Assessment Tool (SCAT) was introduced to treat sports-related concussion. In addition, a number of computerized cognitive assessment tests and test batteries have been developed to allow athletes to return to play. It is important that coaches, as well as players and trainers, understand the medical issues involved in concussion. (author)

  5. Intraindividual variability as an indicator of malingering in head injury.

    Science.gov (United States)

    Strauss, Esther; Slick, Daniel J; Levy-Bencheton, Judi; Hunter, Michael; MacDonald, Stuart W S; Hultsch, David F

    2002-07-01

    The utility of various measures of malingering was evaluated using an analog design in which half the participants (composed of three groups: naive healthy people, professionals working with head-injured people, individuals who suffered a head injury but not currently in litigation) were asked to try their best and the remainder was asked to feign believable injury. Participants were assessed with the Reliable Digit Span (RDS) task, the Victoria Symptom Validity Test (VSVT), and the Computerized Dot Counting Test (CDCT) on three separate occasions in order to determine whether repeat administration of tests improves prediction. The results indicated that regardless of an individual's experience, consideration of both level of performance (particularly on forced-choice symptom validity tasks) and intraindividual variability holds considerable promise for the detection of malingering.

  6. Risk factors for head injury events in professional rugby union: a video analysis of 464 head injury events to inform proposed injury prevention strategies.

    Science.gov (United States)

    Tucker, Ross; Raftery, Martin; Kemp, Simon; Brown, James; Fuller, Gordon; Hester, Ben; Cross, Matthew; Quarrie, Ken

    2017-08-01

    The tackle is responsible for the majority of head injuries during rugby union. In order to address head injury risk, risk factors during the tackle must first be identified. This study analysed tackle characteristics in the professional game in order to inform potential interventions. 464 tackles resulting in a head injury assessment (HIA) were analysed in detail, with tackle type, direction, speed, acceleration, nature of head contact and player body position the characteristics of interest. Propensity to cause an HIA was significantly greater for active shoulder tackles, front-on tackles, high speeder tackles and an accelerating tackler. Head contact between a tackler's head and ball carrier's head or shoulder was significantly more likely to cause an HIA than contact below the level of the shoulder (incident rate ratio (IRR) 4.25, 95%-CI 3.38 to 5.35). The tackler experiences the majority (78%) of HIAs when head-to-head contact occurs. An upright tackler was 1.5 times more likely to experience an HIA than a bent at the waist tackler (IRR 1.44, 95% CI 1.18 to 1.76). This study confirms that energy transfer in the tackle is a risk factor for head injury, since direction, type and speed all influence HIA propensity. The study provides evidence that body position and the height of tackles should be a focus for interventions, since lowering height and adopting a bent at the waist body position is associated with reduced risk for both tacklers and ball carriers. To this end, World Rugby has implemented law change based on the present data. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Indications for computed tomography in patients with mild head injury

    International Nuclear Information System (INIS)

    Ono, Kenichiro; Wada, Kojiro; Takahara, Takashi; Shirotani, Toshiki

    2007-01-01

    The factors affecting outcome were analyzed in 1,064 patients, 621 males and 443 females aged 10 to 104 years (mean 46±23 years), with mild head injury (Glasgow Coma Scale [GCS] score≥14) but no neurological signs presenting within 6 hours after injury. Intracranial lesion was found in 4.7% (50/1,064), and 0.66% (7/1,064) required surgical treatment. The Japan Coma Scale (JCS) and GCS assessments were well correlated (r=0.797). Multivariate analysis revealed significant correlations between computed tomography (CT) abnormality and age≥60 years, male sex, JCS score≥1, alcohol consumption, headache, nausea/vomiting, and transient loss of consciousness (LOC)/amnesia. Univariate analysis revealed that pedestrian in a motor vehicle accident, falling from height, and mechanisms of injuries except blows were correlated to intracranial injury. No significant correlations were found between craniofacial soft tissue injury and intracranial injury. Patients with occipital impact, nonfrontal impact, or skull fracture were more likely have intracranial lesions. Bleeding tendency was not correlated with CT abnormality. The following indications were proposed for CT: JCS score>0, presence of accessory symptoms (headache, nausea/vomiting, LOC/amnesia), and age≥60 years. These criteria would reduce the frequency of CT by 29% (309/1,064). Applying these indications to subsequent patients with GCS scores 14-15, 114 of 168 patients required CT, and intracranial lesions were found in 13. Two refused CT. Fifty-four of the 168 patients did not need CT according to the indications, but 38 of the 54 patients actually underwent CT because of social reasons (n=21) or patient request (n=17). These indications for CT including JCS may be useful in the management of patients with mild head injury. (author)

  8. Biomechanics of Head, Neck, and Chest Injury Prevention for Soldiers

    Science.gov (United States)

    2011-03-01

    30 am – 5:00 pm Overview of Blast Physics and Applications Doubletree Hotel Crystal City Arlington VA, Between the Pentagon and National Airport at...provided) 8:30 Introduction and Overview Dr. Stefan Duma, Virginia Tech Head Injury Biomechanics 8:45 “Instrumented Helmet Data Collection and Analysis...of NASA Suit Interface and Landing Conditions” Ms. Kerry Danelson, Wake Forest University 4:05 “Modeling Human Variation: Orbit Anthropometry and

  9. The state of head injury biomechanics: past, present, and future part 2: physical experimentation.

    Science.gov (United States)

    Goldsmith, Werner; Monson, Kenneth L

    2005-01-01

    This presentation is the continuation of the article published in Critical Reviews of Biomedical Engineering, 29(5-6), 2001. That issue contained topics dealing with components and geometry of the human head, classification of head injuries, some early experimental studies, and tolerance considerations. It then dealt with head motion and load characterization, investigations during the period from 1939 to 1966, injury causation and early modeling efforts, the 1966 Head Injury Conference and its sequels, mechanical properties of solid tissues, fluid characterization, and early investigation of the mechanical properties of cranial materials. It continued with a description of the systematic investigations of solid cranial components and structural properties since 1966, fetal cranial properties, analytical head modeling, and numerical solutions of head injury. The paper concluded with experimental dynamic loading of human living and cadaver heads, dynamic loading of surrogate heads, and head injury mechanics. This portion of the paper describes physical head injury experimentation involving animals, primarily primates, human cadavers, volunteers, and inanimate physical models. In order to address the entire domain of head injury biomechanics in the two-part survey, it was intended that this information be supplemented by discussions of head injury tolerance and criteria, automotive and sports safety considerations, and the design of protective equipment, but Professor Goldsmith passed away before these sections could be completed. It is nevertheless anticipated that this attenuated installment will provide, in conjunction with the first part of the survey, a valuable resource for students and practitioners of head injury biomechanics.

  10. Patients who reattend after head injury: a high risk group.

    Science.gov (United States)

    Voss, M.; Knottenbelt, J. D.; Peden, M. M.

    1995-01-01

    OBJECTIVE--To assess risk factors for important neurosurgical effects in patients who reattend after head injury. DESIGN--Retrospective study. SUBJECTS--606 patients who reattended a trauma unit after minor head injury. MAIN OUTCOME MEASURES--Intracranial abnormality detected on computed tomography or the need for neurosurgical intervention. RESULTS--Five patients died: two from unrelated causes and three from raised intracranial pressure. On multiple regression analysis the only significant predictor for both abnormality on computed tomography (14.4% of reattenders) and the need for operation (5% of reattenders) was vault fracture seen on the skull radiograph (P personality change, and seizures were significantly associated only with abnormality on computed tomography. Headache, dizziness, nausea, and vomiting were common in reattenders but were found to have no independent significance. CONCLUSIONS--All patients who reattend after head injury should undergo computed tomography as at least 14% of scans can be expected to yield positive results. Where this facility is not available patients with predictors for operation should be urgently referred for neurosurgical opinion. Other patients can be readmitted and need referral only if symptoms persist despite symptomatic treatment or there is neurological deterioration while under observation. These patients are a high risk group and should be treated seriously. PMID:8520273

  11. Surfing-related ocular injuries.

    Science.gov (United States)

    Kim, J W; McDonald, H R; Rubsamen, P E; Luttrull, J K; Drouilhet, J H; Frambach, D A; Boyer, D S; Lambrou, F H; Hendrick, A; Weiss, J N; Engstrom, R E; Ing, M

    1998-01-01

    This report evaluates the clinical characteristics of surfing-related ocular trauma to learn the nature of such injuries and propose possible preventive measures. The authors reviewed 11 cases of surfing-related eye injuries caused by direct trauma from the surfboard, studying their mechanism of injury, the associated ocular complications, and the anatomic and visual outcomes of surgical repair. Surfing-related ocular injuries occurred exclusively in young males (mean age, 24.8 years; range, 14-37 years). The mechanism of injury most frequently responsible was impact with the sharp nose of the surfboard following a fall. Serious posterior segment complications were observed in all 11 patients, with nine patients suffering ruptured globes. Despite immediate medical attention, five patients did not recover ambulatory levels of visual acuity (>5/200). Surfing-related ocular trauma presenting to the retinal specialist typically leaves the patient with a permanent visual disability. Important factors contributing to these high-velocity injuries include the sharply pointed nose of the surfboard and the leash keeping the surfer in close proximity to the board following a fall. A simple modification in surfboard design such as blunting the sharp nose of the surfboard, or appropriate protective guards fitted over the surfboard nose, should lessen the severity of such injuries.

  12. Injuries in recreational curling include head injuries and may be prevented by using proper footwear

    Directory of Open Access Journals (Sweden)

    D. K. Ting

    2015-04-01

    Full Text Available Introduction: Our study examines a recreational curling population to describe patterns of injury occurrence, estimate risk of injury and to gauge attitudes towards equipment-based prevention strategies. Methods: In a retrospective case series, we queried the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP, a national injury surveillance database, for curling injuries entered between 1993 and 2011. Kingston General Hospital and Hotel Dieu Hospital provide the two Kingston, Ontario, sites for emergency department (ED care and participate in CHIRPP. Each retrieved entry underwent a chart review. A secondary survey was mailed to select individuals who had experienced curling injuries to solicit details on their injury and attitudes towards equipment to prevent injury. We used descriptive statistics for rates and proportions. Results: Over 90% of acute curling injuries resulted from a fall, and 31.7% were head impacts. We found that acute injuries requiring ED presentation occur at a rate of approximately 0.17 per 1000 athlete-exposures (95% CI: 0.12–0.22. The secondary survey was completed by 54% of potential respondents. Of survey respondents, 41.3% attributed their fall to a lack of proper footwear and 73.5% of respondents agreed with mandatory sport-specific footwear as a prevention strategy, but only 8% agreed with mandatory helmet wear. Conclusions: Although curling injuries requiring medical care are not common, head injuries make up a large proportion. Mandated use of appropriate footwear appears to be the most effective prevention strategy, as well as the measure deemed most acceptable by players.

  13. Four cases with localized brain-stem lesion on CT scan following closed head injury

    International Nuclear Information System (INIS)

    Saeki, Naokatsu; Odaki, Masaru; Oka, Nobuo; Takase, Manabu; Ono, Junichi.

    1981-01-01

    Cases of primary brain-stem injury following closed head injury, verified by a CT scan, have been increasingly reported. However, most of them have other intracranial lesions in addition to the brain stem, resulting in a poor outcome. The CT scan of 200 cases with severe head injury-Araki's classification of types 3 and 4 - were analysed. Four cases out of them had localized brain-stem lesion without any other significant intracranial injury on a CT scan at the acute stage and had a better outcome than had previously been reported. In this analysis, these 4 cases were studied, and the CT findings, prognosis, and pathogenesis of the localized brain-stem injury were discussed. Follow-up CT of three cases, and taken one month or more later, showed diffuse cortical atrophy. This may indicate the presence of diffuse cerebral injury which could not be seen on CT scans at the acute stage. This atrophic change may also be related with the mechanism of posttraumatic conscious impairment and posttraumatic neurological deficits, such as mental symptoms and impairment of the higher cortical function. Shearing injury is a probable pathogenesis for this diffuse cortical injury. On the other hand, one case did not have any cortical atrophy on a follow-up CT scan. Therefore, this is a case with a localized primary brain-stem injury. Coup injury against the brain stem by a tentorial margin in a case with a small tentorial opening is a possible mechanism producing the localized brain-stem injury. (J.P.N.)

  14. Field Marshal Erwin Rommel: the head injury that may have prolonged the Second World War.

    Science.gov (United States)

    Fuhrman, Heather A; Mullin, Jeffrey P; Sloffer, Chris A

    2016-07-01

    War-related head injury, indeed neurological injury in general, has been a part of the history of humankind for as long as there has been warfare. Such injuries can result in the removal of the individual from combat, thus eliminating any subsequent contribution that he or she might have made to the battle. However, at times, the injuries can have more wide-reaching effects. In the case of commanders or leaders, the impact of their injuries may include the loss of their influence, planning, and leadership, and thus have a disproportionate effect on the battle, or indeed the war. Field Marshal Erwin Rommel was a talented military strategist and leader who was respected by friends and foes alike. He held an honored reputation by the German people and the military leadership. His head injury on July 17, 1944, resulted in his being removed from the field of battle in northern France, but also meant that he was not able to lend his stature to the assassination attempt of Adolph Hitler on July 20. It is possible that, had he been able to lend his stature to the events, Hitler's hold on the nation's government might have been loosened, and the war might have been brought to an end a year earlier. The authors review Rommel's career, his injury, the subsequent medical treatment, and his subsequent death.

  15. Isolated traumatic head injury in children: Analysis of 276 observations

    Directory of Open Access Journals (Sweden)

    Bahloul Mabrouk

    2011-01-01

    Full Text Available Background : To determine predictive factors of mortality among children after isolated traumatic brain injury. Materials and Methods : In this retrospective study, we included all consecutive children with isolated traumatic brain injury admitted to the 22-bed intensive care unit (ICU of Habib Bourguiba University Hospital (Sfax, Tunisia. Basic demographic, clinical, biochemical, and radiological data were recorded on admission and during ICU stay. Results : There were 276 patients with 196 boys (71% and 80 girls, with a mean age of 6.7 ± 3.8 years. The main cause of trauma was road traffic accident (58.3%. Mean Glasgow Coma Scale score was 8 ± 2, Mean Injury Severity Score (ISS was 23.3 ± 5.9, Mean Pediatric Trauma Score (PTS was 4.8 ± 2.3, and Mean Pediatric Risk of Mortality (PRISM was 10.8 ± 8. A total of 259 children required mechanical ventilation. Forty-eight children (17.4% died. Multivariate analysis showed that factors associated with a poor prognosis were PRISM > 24 (OR: 10.98, neurovegetative disorder (OR: 7.1, meningeal hemorrhage (OR: 2.74, and lesion type VI according to Marshall tomographic grading (OR: 13.26. Conclusion : In Tunisia, head injury is a frequent cause of hospital admission and is most often due to road traffic injuries. Short-term prognosis is influenced by demographic, clinical, radiological, and biochemical factors. The need to put preventive measures in place is underscored.

  16. Ischemic Retinopathy and Neovascular Proliferation Secondary to Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Muge Coban-Karatas

    2014-01-01

    Full Text Available We report a case with severe head trauma and perforating globe injury in one eye and ischemic retinopathy and neovascular proliferation in the other eye. A 37-year-old male was brought to the emergency department after a motor vehicle accident with severe maxillofacial trauma. Ophthalmic examination revealed hematoma of the left eyelids as well as traumatic rupture and disorganization of the left globe. On the right eye, anterior segment and fundoscopic examination were normal. Primary globe repair was performed. At postoperative one-month visit, the right eye revealed no pathology of the optic disc and macula but severe neovascularization in the temporal peripheral retina. The patient was diagnosed as ischemic retinopathy and neovascular proliferation due to head trauma.

  17. [The German guideline "legal evaluation after closed head injury"].

    Science.gov (United States)

    Wallesch, C W; Fries, W; Marx, P; du Mesnil de Rochemont, R; Roschmann, R; Schmidt, R; Schwerdtfeger, K; Tegenthoff, M; Widder, B

    2013-09-01

    In 2005, the "Deutsche Gesellschaft für Neurowissenschaftliche Begutachtung" (German Society for Neuroscientific Legal Evaluation) together with other Societies published a guideline for the legal evaluation of patients with closed head injuries. Meanwhile, not only scientific progress in imaging techniques but also in other fields such as neuropsychology has necessitated a revision, which is presented here. In the mean time, the handling of guidelines has been systematised in Germany so that a registration with the Cooperation of German Medical Learned Societies is applied for and publication in the German Guideline Registry is expected. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Psychogenic Nonepileptic Seizures after Head Injury: A Case Report

    Directory of Open Access Journals (Sweden)

    Laura Scévola

    2009-01-01

    another medical illness. The gold standard for PNES diagnosis is video electroencephalogram (Video-EEG. PNESs are defined by modern psychiatry as conversion and dissociative disorders but these disorders may coexist with many others psychiatric disorders, including depression, posttraumatic stress disorder, and personality disorders. It is well known that epileptic seizures are a frequent and well-studied complication of traumatic head injury (THI. However, THI may also generate psychic symptoms including PNES. In this paper we describe a patient who developed PNES after THI in a bus accident and received a diagnosis of refractory epilepsy for 24 years until she underwent Video-EEG.

  19. Deficit in figure-ground segmentation following closed head injury.

    Science.gov (United States)

    Baylis, G C; Baylis, L L

    1997-08-01

    Patient CB showed a severe impairment in figure-ground segmentation following a closed head injury. Unlike normal subjects, CB was unable to parse smaller and brighter parts of stimuli as figure. Moreover, she did not show the normal effect that symmetrical regions are seen as figure, although she was able to make overt judgments of symmetry. Since she was able to attend normally to isolated objects, CB demonstrates a dissociation between figure ground segmentation and subsequent processes of attention. Despite her severe impairment in figure-ground segmentation, CB showed normal 'parallel' single feature visual search. This suggests that figure-ground segmentation is dissociable from 'preattentive' processes such as visual search.

  20. Hospitalised and Fatal Head Injuries in Viti Levu, Fiji: Findings from an Island-Wide Trauma Registry (TRIP 4)

    Science.gov (United States)

    Kool, Bridget; Raj, Naina; Wainiqolo, Iris; Kafoa, Berlin; McCaig, Eddie; Ameratunga, Shanthi

    2012-01-01

    Background Globally, head injury is a substantial cause of mortality and morbidity. A disproportionately greater burden is borne by low- and middle-income countries. The incidence and characteristics of fatal and hospitalised head injuries in Fiji are unknown. Methods Using prospective data from the Fiji Injury Surveillance in Hospital system, the epidemiology of fatal and hospitalised head injuries was investigated (2004–2005). Results In total, 226 hospital admissions and 50 fatalities (66% died prior to admission) with a principal diagnosis of head injury were identified (crude annual rates of 34.7 and 7.7/100,000, respectively). Males were more likely to die and be hospitalised as a result of head injury than females. The highest fatality rate was among those in the 30–44-year age group. Road traffic crashes were the leading causes of injuries resulting in death (70%), followed by ‘hit by person or object’ and falls (14% each). Among people admitted to hospital, road traffic crashes (34.5%) and falls (33.2%) were the leading causes of injury. The leading cause of head injuries in children was falls, in 15–29-year-olds road traffic crashes, and in adults aged 30–44 years or 45 years and older ‘hit by person or object’. Among the two major ethnic groups, Fijians had higher rates of falls and ‘hit by person or object’ and Indians higher rates for road traffic crashes. There were no statistically significant differences between the overall rates of head injuries or the fatal and non-fatal rates among Fijians or Indians by gender following age standardisation to the total Fijian national population. Conclusion Despite underestimating the overall burden, this study identified head injury to be a major cause of death and hospitalisation in Fiji. The predominance of males and road traffic-related injuries is consistent with studies on head injuries conducted in other low- and middle-income countries. The high fatality rate among those aged 30–44

  1. Factors Influencing Helmet Use, Head Injury, and Hospitalization Among Children Involved in Skateboarding and Snowboarding Accidents.

    Science.gov (United States)

    Sadeghian, Homa; Nguyen, Brian; Huynh, Nhan; Rouch, Joshua; Lee, Steven L; Bazargan-Hejazi, Shahrzad

    2017-01-01

    Up to 75% of skateboarders and snowboarders admitted to the hospital sustain head injuries. It is unclear why not all children and teenagers wear helmets while snowboarding and skateboarding given the protection they afford. To report on the prevalence of, and factors associated with, skateboarding and snowboarding in injured children and to explore factors that influence helmet use, head injury, and hospitalization in this sample. A cross-sectional study of skateboard- and snowboard-associated injuries from 2003 to 2012 among individuals younger than age 18 years using National Electronic Injury Surveillance System (NEISS) data from approximately 100 hospitals. Helmet use, head injury, and hospitalization. Of 1742 patients in the study, 852 (48.9%) and 890 (51.1%) were skateboarders and snowboarders, respectively. Overall, 907 (52.1%) did not use helmets, and 704 (40.4%) sustained head injuries. Multiple logistic regression analysis showed that age, race/ethnicity, location of boarding, and engaging in skateboarding influenced helmet use. Sex, race/ethnicity, helmet use, and skateboarding predicted head injury. Age, sex, skateboarding, and head injury predicted hospital admission. Statistically significant differences exist in helmet use, head injury, and hospitalization rates between skateboarders and snowboarders. Our findings suggest that injury prevention and outreach programs are needed to increase helmet use and reduce the risk of head injury and hospitalization in skateboarders and other at-risk groups. Further studies are needed to clarify the association between race/ethnicity and helmet use among skateboarders and snowboarders.

  2. Computerized tomography and prognosis in paediatric head injury

    International Nuclear Information System (INIS)

    Tomberg, T.; Rink, U.; Pikkoja, E.; Tikk, A.

    1996-01-01

    The authors have analysed the computerized tomography (CT) findings and their correlation with the clinical state, early and late outcome in children and adolescents with head injuries (HI). This study represents clinical and CT data of 82 consecutive HI patients under 18 years of age. Among them 51 (62%) were boys and 31 (38 %) girls. The application of CT to the evaluation of the morphologic manifestations of HI in children has shown some differences in forms and mechanisms of injury and in outcome compared to adults. In the paediatric HI the most frequent finding was diffuse brain swelling with CT evidence of ventricular and cisternal compression or obliteration. Prognostically the most unfavourable findings were shearing injury, intracerebral and subdural haematomas combined with brain swelling and parenchymal damage. According to the Lidcombe impairment scale, outcome from severe paediatric HI was determined in the 3rd and 6th months, one year and 2 years after the injury. The outcome two years after severe HI varied to a great extent and was better in children than in adults. Although there was long-term disruption of the patient's quality of life, our data show that as there are no predictors of individual outcomes in child HI, no child should be excluded from early and long-term rehabilitation. (author)

  3. Motorcycle helmet type and the risk of head injury and neck injury during motorcycle collisions in California.

    Science.gov (United States)

    Erhardt, Taryn; Rice, Thomas; Troszak, Lara; Zhu, Motao

    2016-01-01

    The use of novelty motorcycle helmets is often prompted by beliefs that wearing a standard helmet can contribute to neck injury during traffic collisions. The goal of this analysis was to examine the association between helmet type and neck injury risk and the association between helmet type and head injury. Data were collected during the investigation of motorcycle collisions of any injury severity by the California Highway Patrol (CHP) and 83 local law enforcement agencies in California between June 2012 and July 2013. We estimated head injury and neck injury risk ratios from data on 7051 collision-involved motorcyclists using log-binomial regression. Helmet type was strongly associated with head injury occurrence but was not associated with the occurrence of neck injury. Rider age, rider alcohol use, and motorcycle speed were strong, positive predictors of both head and neck injury. Interventions to improve motorcycle helmet choice and to counteract misplaced concerns surrounding neck injury risk are likely to lead to reductions in head injury, brain injury, and death. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Morbidity associated with golf-related injuries among children: findings from a pediatric trauma center.

    Science.gov (United States)

    Vitale, Melissa A; Mertz, Kristen J; Gaines, Barbara; Zuckerbraun, Noel S

    2011-01-01

    To describe injuries due to golf-related activities among pediatric patients requiring hospital admission. We conducted a retrospective analysis of all sports-related injuries from 2000 to 2006 using a level 1 trauma center database. Of 1005 children admitted with sports-related injuries, 60 (6%) had golf-related injuries. The mean injury severity score was significantly higher for golf-related injuries (11.0) than that for all other sports-related injuries (6.8). Most golf-related injuries occurred in children younger than 12 years (80%), at home (48%), and by a strike from a club (57%) and resulted in trauma to the head or neck (68%). Golf-related injuries, although an infrequent cause of sports-related injuries, have the potential to result in severe injuries, especially in younger children. Preventive efforts should target use of golf clubs by younger children in the home setting.

  5. Scalp Hematoma Characteristics Associated With Intracranial Injury in Pediatric Minor Head Injury.

    Science.gov (United States)

    Burns, Emma C M; Grool, Anne M; Klassen, Terry P; Correll, Rhonda; Jarvis, Anna; Joubert, Gary; Bailey, Benoit; Chauvin-Kimoff, Laurel; Pusic, Martin; McConnell, Don; Nijssen-Jordan, Cheri; Silver, Norm; Taylor, Brett; Osmond, Martin H

    2016-05-01

    Minor head trauma accounts for a significant proportion of pediatric emergency department (ED) visits. In children younger than 24 months, scalp hematomas are thought to be associated with the presence of intracranial injury (ICI). We investigated which scalp hematoma characteristics were associated with increased odds of ICI in children less than 17 years who presented to the ED following minor head injury and whether an underlying linear skull fracture may explain this relationship. This was a secondary analysis of 3,866 patients enrolled in the Canadian Assessment of Tomography of Childhood Head Injury (CATCH) study. Information about scalp hematoma presence (yes/no), location (frontal, temporal/parietal, occipital), and size (small and localized, large and boggy) was collected by emergency physicians using a structured data collection form. ICI was defined as the presence of an acute brain lesion on computed tomography. Logistic regression analyses were adjusted for age, sex, dangerous injury mechanism, irritability on examination, suspected open or depressed skull fracture, and clinical signs of basal skull fracture. ICI was present in 159 (4.1%) patients. The presence of a scalp hematoma (n = 1,189) in any location was associated with significantly greater odds of ICI (odds ratio [OR] = 4.4, 95% confidence interval [CI] = 3.06 to 6.02), particularly for those located in temporal/parietal (OR = 6.0, 95% CI = 3.9 to 9.3) and occipital regions (OR = 5.6, 95% CI = 3.5 to 8.9). Both small and localized and large and boggy hematomas were significantly associated with ICI, although larger hematomas conferred larger odds (OR = 9.9, 95% CI = 6.3 to 15.5). Although the presence of a scalp hematoma was associated with greater odds of ICI in all age groups, odds were greatest in children aged 0 to 6 months (OR = 13.5, 95% CI = 1.5 to 119.3). Linear skull fractures were present in 156 (4.0%) patients. Of the 111 patients with scalp hematoma and ICI, 57 (51%) patients had

  6. Brain CT findings in head injury with skull fracture

    International Nuclear Information System (INIS)

    Jeong, In Tae; Lee, Hae Kyung; Chung, Mi Kyung; Kwon, Kwi Hyang; Kim, Ki Jeong

    1982-01-01

    CT has revolutionized the evaluation and management of patients with head injuries. CT in non-invasion and rapidly provides accurate information regarding the presence, extent and nature of intracranial lesions resulting from trauma. We have reviewed the CT scans of 114 patients, who got head injury with confirmed to skull fracture in plain films. The results were as follows: 1. Of all cases, traffic accident was the most frequent cause and in children fall down was more than 50%. 2. Compound linear fracture was the most frequent type fractures in plain skull film.3. Of all 114 cases, epidural hematoma was 16%, subdural hematoma was 18.4%, intracerebral hematoma was 14.4%, subdural hygroma was 2.4%, normal finding was 50%. 4. Mortality rate was 13.2%. 5. Fracture was detected by CT about 28.9%, depression fracture was more easily detected in CT. 6. Incidence rate of counter coup lesion was 14.9% and mortality rate was higher than same site lesion. 7. The shape of epidural hematoma was biconvex in 75%, planoconvex in 25%. 8. The shape of subdural hematoma was cresentic shape 82.6%, biconvex shape 8.7%, planoconvex shape 8.7%

  7. Workshop for disabled survivors of severe head injury.

    Science.gov (United States)

    London, P S

    1973-08-18

    Existing services for the disabled do not cater for the needs of lame-brain survivors of severe head injury who may be capable of productive work though they may never become employable. A grant from the Nuffield Provincial Hospitals Trust made it possible to set up in 1967 a special workshop in premises provided by the regional hospital board. The hospital management committee assumed financial responsibility for the centre after three years, and after five years the Department of Health and Social Security purchased adjoining premises, which will double the present accommodation for about 35 persons. Though 45% of the 101 patients attending the workshop have returned to work, no financial support has yet been received from the Department of Employment. A suitably staffed hostel is needed for patients who live too far away to travel daily to and from the workshop. This undertaking has shown a need for special facilities for some of the victims of severe head injury, who differ in many important ways from other disabled persons.

  8. Acupuncture therapy related cardiac injury.

    Science.gov (United States)

    Li, Xue-feng; Wang, Xian

    2013-12-01

    Cardiac injury is the most serious adverse event in acupuncture therapy. The causes include needling chest points near the heart, the cardiac enlargement and pericardial effusion that will enlarge the projected area on the body surface and make the proper depth of needling shorter, and the incorrect needling method of the points. Therefore, acupuncture practitioners must be familiar with the points of the heart projected area on the chest and the correct needling methods in order to reduce the risk of acupuncture therapy related cardiac injury.

  9. Geriatric fall-related injuries.

    Science.gov (United States)

    Hefny, Ashraf F; Abbas, Alaa K; Abu-Zidan, Fikri M

    2016-06-01

    Falls are the leading cause of geriatric injury. We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period. We studied 92 patients. Fifty six of them (60.9%) were females. The mean (standard deviation) of age was 72.2 (9.6) years. Seventy three (89%) of all incidents occurred at home. Eighty three patients (90.2%) fell on the same level. The median (range) ISS was 4 (1-16) and the median GCS (range) was 15 (12-15). The lower limb was the most common injured body region (63%). There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively). The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk factors for falls including home hazards is essential for prevention of geriatric fall-related injuries.

  10. Head, Neck, Face, and Shoulder Injuries in Female and Male Rugby Players.

    Science.gov (United States)

    Havkins, Sabina B.

    1986-01-01

    Injuries to 150 players in the Southern California Rugby Football Union were studied in order to compare head, neck, face, and shoulder injury rates for female and male players. While overall rates did not differ significantly, women received fewer disabling injuries. Ways to decrease injuries are recommended. (Author/MT)

  11. Clinical value of computerized tomography scanning in severe head injury

    International Nuclear Information System (INIS)

    Kobayashi, Shiro; Yano, Masami; Otsuka, Toshibumi; Nakazawa, Shozo

    1982-01-01

    Serial computerized tomography (SCT) was performed on 138 patients suffering from severe head injuries (8 or less on the Glasgow Coma Scale). Standard practice called for scans to be done upon admission (within hours of the injury), and after 1, 3, 7 days and 1 month. Subsequent CT's depended on the patient's condition. Clinical results at the time of discharge were graded according to the Glasgow Outcome Scale. Patients who died, were in a persistent vegetative state, or were severely disabled were considered to have a ''bad outcome''. On the other hand, patients who were somewhat disabled or made good recoveries were considered to have a ''good outcome''. During the serial CT scan, there were new findings (not visualized on the initial CT but appearing on subsequent ones) in 91 of the 138 patients. These new findings were classified as follows; 1) decreased density collection in the subdural space (DDC), 2) ventricular dilation (VD), 3) intracerebral hematoma (ICH), 4) intraventricular hemorrhage (IVH), 5) extracerebral hematoma (ECH), 6) edema (E), 7) infarction (I). We defined ICH, IVH, ECH, E and I as new lesions. Of the 60 patients with new lesions 12 had good outcomes and 48 had poor outcomes. There were 78 patients who did not have any new lesions, 60 with good outcomes and 18 with poor outcomes. A significant correlation was found between good outcomes and the absence of new lesions, and between bad outcomes and the development of new lesions (p 2 = 44.038). We conclude that SCT can help predict the outcome with severe head injury patients and may be very important in their examination and care. (J.P.N.)

  12. The epidemiological trends of head injury in the largest Canadian adult trauma center from 1986 to 2007.

    Science.gov (United States)

    Cadotte, David W; Vachhrajani, Shobhan; Pirouzmand, Farhad

    2011-06-01

    This study documents the epidemiology of head injury over the course of 22 years in the largest Level I adult trauma center in Canada. This information defines the current state, changing pattern, and relative distribution of demographic factors in a defined group of trauma patients. It will aid in hypothesis generation to direct etiological research, administrative resource allocation, and preventative strategies. Data on all the trauma patients treated at Sunnybrook Health Sciences Centre (SHSC) from 1986 to 2007 were collected in a consecutive, prospective fashion. The authors reviewed these data from the Sunnybrook Trauma Registry Database in a retrospective fashion. The aggregate data on head injury included demographic data, cause of injury, and Injury Severity Score (ISS). The collected data were analyzed using univariate techniques to depict the trend of variables over years. The authors used the length of stay (LOS) and number of deaths per year (case fatality rate) as crude measures of outcome. A total of 16,678 patients were treated through the Level I trauma center at SHSC from January 1986 to December 2007. Of these, 9315 patients met the inclusion criteria (ISS > 12, head Abbreviated Injury Scale score > 0). The median age of all trauma patients was 36 years, and 69.6% were male. The median ISS of the head-injury patients was 27. The median age of this group of patients increased by 12 years over the study period. Motorized vehicle accidents accounted for the greatest number of head injuries (60.3%) although the relative percentage decreased over the study period. The median transfer time of patients sustaining a head injury was 2.58 hours, and there was an approximately 45 minute improvement over the 22-year study period. The median LOS in our center decreased from 19 to 10 days over the study period. The average case fatality rate was 17.4% over the study period. In multivariate analysis, more severe injuries were associated with increased LOS as

  13. The research into head injury criteria dependence on car speed

    Directory of Open Access Journals (Sweden)

    L. Pelenytė-Vyšniauskienė

    2007-12-01

    Full Text Available There are many ways of car collisions which depend on car motion modes before and after crashes, speed, kinds of baskets, their heights, weights and rigidity. The machinery of the occupant’s movement at the moment of the crash is even more diffi cult. In order to find out precisely the chance of body injury, it is important to measure not only parameters that were mentioned above but also occupant’s height, weight, age, position of sitting, condition of body, whether there was any protection system used. The largest number of car crashes happen at the moment of frontal crash. This article’s aim is to analyse the types of frontal crashes and their repartition, to diagnose what part in occupant’s safety the protection system’s use takes, and also to analyse head injury coefficient dependence on car speed and show critical injuries and fatality limits in cases when driver is driving with no seat-belts in and while the car is without airbag. The research is done at the moment of ideal frontal crash by simulating distance from the occupant body to the wheel in diff erent types of baskets.

  14. Pediatric volleyball-related injuries treated in US emergency departments, 1990-2009.

    Science.gov (United States)

    Pollard, Katherine A; Shields, Brenda J; Smith, Gary A

    2011-09-01

    This study describes the epidemiology of pediatric volleyball-related injuries treated in US hospital emergency departments. Data for children younger than 18 years obtained from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission from 1990 through 2009 were analyzed. An estimated 692 024 volleyball-related injuries to children younger than 18 years occurred during the study period. The annual number of injuries declined significantly by 23% during the study period; however, the annual injury rate remained unchanged, and the number of volleyball-related concussions/closed head injuries increased significantly. Upper (48%) and lower (39%) extremity injuries occurred most frequently, as did strains/sprains (54%). Contact with the net/pole was associated with concussions/closed head injury our findings indicate opportunities for making volleyball an even safer sport for children. Protective padding, complying with US volleyball standards, should cover all volleyball poles and protruding hardware to prevent impact-related injuries.

  15. Significance of focal relaxation times in head injury

    Energy Technology Data Exchange (ETDEWEB)

    Inao, Suguru; Furuse, Masahiro; Saso, Katsuyoshi; Yoshida, Kazuo; Motegi, Yoshimasa; Kaneoke, Yoshiki; Izawa, Akira

    1987-11-01

    Serial examinations by nuclear magnetic resonance-computed tomography were carried out in 35 head-injured patients aged 7 to 77 years. The injuries were classified as cerebral contusion (nine cases), acute epidural hematoma (eight cases), acute cerebral swelling (two cases), and chronic subdural hematoma (16 cases). The results of 92 measurements were divided into two groups: acute stage (within 3 days of injury) and chronic stage (2 weeks or longer after injury). The spin-lattice relaxation times (T/sub 1/) of brain tissue adjacent to chronic subdural hematoma were evaluated pre- and postoperatively. A Fonar QED 80-alpha system was used for magnetic resonance imaging and measurement of focal T/sub 1/. The T/sub 1/ values at the region of interest were measured 3 to 5 times by the field focusing technique (468 gauss in the focused spot), and the mean value was used for evaluation. The standard T/sub 1/ values obtained from healthy subjects were 290 +- 41 msec in the cerebral cortex and 230 +- 34 msec in the white matter. Prolongation of T/sub 1/ in perifocal brain gradually shortened over time and normalized in the chronic stage. The degree of contusional edema may have been reflected in alterations in T/sub 1/. In contrast, parenchymal injury resulted in a progressive T/sub 1/ elevation, which far exceeded 500 msec in the chronic stage. Such time courses of T/sub 1/ may indicate irreversible tissue damage. There were no noticeable changes in tissue T/sub 1/ over time in patients with acute diffuse cerebral swelling or those who underwent evacuation of acute epidural or chronic subdural hematomas. The underlying pathophysiology in such situations seems to be not brain edema but cerebral hyperemia. In the presence of ischemia, the T/sub 1/ value was prolonged in the early stage, reflecting progression of is chemic edema. (Abstract Truncated)

  16. A video analysis of head injuries satisfying the criteria for a head injury assessment in professional Rugby Union: a prospective cohort study.

    Science.gov (United States)

    Tucker, Ross; Raftery, Martin; Fuller, Gordon Ward; Hester, Ben; Kemp, Simon; Cross, Matthew J

    2017-08-01

    Concussion is the most common match injury in professional Rugby Union, accounting for 25% of match injuries. The primary prevention of head injuries requires that the injury mechanism be known so that interventions can be targeted to specifically overall incidence by focusing on characteristics with the greatest propensity to cause a head injury. 611 head injury assessment (HIA) events in professional Rugby Union over a 3-year period were analysed, with specific reference to match events, position, time and nature of head contact. 464 (76%) of HIA events occur during tackles, with the tackler experiencing a significantly greater propensity for an HIA than the ball carrier (1.40 HIAs/1000 tackles for the tackler vs 0.54 HIAs/1000 tackles for the ball carrier, incidence rate ratio (IRR) 2.59). Propensity was significantly greater for backline players than forwards (IRR 1.54, 95% CI 1.28 to 1.84), but did not increase over the course of the match. Head to head contact accounted for the most tackler HIAs, with the greatest propensity. By virtue of its high propensity and frequency, the tackle should be the focus for interventions that may include law change and technique education. A specific investigation of the characteristics of the tackle is warranted to refine the approach to preventative strategies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Head injury predictors in sports trauma--a state-of-the-art review.

    Science.gov (United States)

    Fernandes, Fábio A O; de Sousa, Ricardo J Alves

    2015-08-01

    Head injuries occur in a great variety of sports. Many of these have been associated with neurological injuries, affecting the central nervous system. Some examples are motorsports, cycling, skiing, horse riding, mountaineering and most contact sports such as football, ice and field hockey, soccer, lacrosse, etc. The outcome of head impacts in these sports can be very severe. The worst-case scenarios of permanent disability or even death are possibilities. Over recent decades, many In recent decades, a great number of head injury criteria and respective thresholds have been proposed. However, the available information is much dispersed and a consensus has still not been achieved regarding the best injury criteria or even their thresholds. This review paper gives a thorough overview of the work carried out by the scientific community in the field of impact biomechanics about head injuries sustained during sports activity. The main goal is to review the head injury criteria, as well as their thresholds. Several are reviewed, from the predictors based on kinematics to the ones based on human tissue thresholds. In this work, we start to briefly introduce the head injuries and their mechanisms commonly seen as a result of head trauma in sports. Then, we present and summarize the head injury criteria and their respective thresholds. © IMechE 2015.

  18. Head Injury Secondary to Suspected Child Maltreatment: Results of a Prospective Canadian National Surveillance Program

    Science.gov (United States)

    Bennett, Susan; Ward, Michelle; Moreau, Katherine; Fortin, Gilles; King, Jim; MacKay, Morag; Plint, Amy

    2011-01-01

    Objective: We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries. Methods: From March 1, 2005 to February 28, 2008, an average of 2,545…

  19. ocular complications among cases of head injury seen in a neurosurgi

    African Journals Online (AJOL)

    EZENWUGO CHIEDOZIE OBIORA

    ocular cranial nerves were the most commonly occurring complication among the cases of head injury seen in Memphys. Hospital for Neurosurgery, Enugu. Key words: Ocular complications, head injury, Nigeria. INTRODUCTION. Road traffic accidents have been on the increase in Nigeria. Some studies have attributed this ...

  20. Impact of mandatory motorcycle helmet wearing legislation on head injuries in Viet Nam: results of a preliminary analysis.

    Science.gov (United States)

    Passmore, Jonathon; Tu, Nguyen Thi Hong; Luong, Mai Anh; Chinh, Nguyen Duc; Nam, Nguyen Phuong

    2010-04-01

    To compare estimated prevalence of head injuries among road traffic injury patients admitted to hospitals, before and after the introduction of a mandatory helmet law in the Socialist Republic of Viet Nam. Before and after study of all road traffic injury patients with head injuries admitted to 20 provincial and central hospitals 3 months before and after the new law came into effect on 15 December 2007. Relative risk was computed and comparison made for the periods of 3 months before and after the new law. The study found a 16 percent reduction in the risk of road traffic head injuries (4683 to 3522; relative risk [RR] 0.84; 95% confidence interval [CI] 0.81-0.87) and an 18 percent reduction in the risk of road traffic death (deaths in hospital plus injured patients discharged to die at home; 566 to 417; RR 0.82; 95% CI 0.73-0.93). Over the first 3 months of the comprehensive mandatory helmet legislation there has been a significant reduction in the risk of road traffic head injuries among patients admitted to 20 hospitals. The Viet Nam Government's decision to require all motorcycle riders and passengers to wear helmets is suspected of leading to positive road safety benefits and should be seen as a policy example for other low- and middle-income countries with a high utilization of motorcycles for transport.

  1. The study of lymphocytes glucocorticoid receptor in severe head injury

    International Nuclear Information System (INIS)

    Li Dapei; Wang Haodan; Zhao Qihuang

    1994-01-01

    Glucocorticoid receptors (GCR) of peripheral lymphocytes from 14 patients with severe head injury and 11 normal volunteers are studied by means of single point method of radioligand binding assay. All these patients receive surgical therapy and glucocorticoid of routine dosage. The results show that the GCR level of these patients is lower than that of the normal, while the plasma cortisol level is much higher. These changes correlate closely to the patients' clinical outcome. It is indicated that the GCR level can reflect the degree of stress of these patients and their response to glucocorticoid therapy. Using peripheral lymphocytes instead of the brain biopsy for the measurement of GCR can reflect the GCR changes of brain tissue, it's more convenient to get the sample and more acceptable to the patients

  2. Characteristics of helmet or knit cap use in head injury of snowboarders.

    Science.gov (United States)

    Fukuda, Osamu; Hirashima, Yutaka; Origasa, Hideki; Endo, Shunro

    2007-11-01

    The rate of head injury is 1.86-6 times higher for snowboarding than for skiing. Detailed data about the usefulness of a helmet or knit cap for protecting against serious head injuries have not been reported. The present study evaluated the use of a helmet or knit cap for preventing head injuries. Questionnaire data were collected from 1,190 consecutive patients in a hospital during the 1999/2000-2002/2003 winter seasons at Uonuma ski resort, Niigata, Japan. Patients were divided into the helmet, knit cap, and no cap groups. Upper technical level was highest and jumping as the cause of injury was most frequent in the helmet group. After adjustment for other confounders, there was a significant negative association between the occurrence of serious head injury during snowboarding and female sex (adjusted odds ratio 0.55, 95% confidence interval 0.421-0.718, p jumping (adjusted odds ratio 2.25, 95% confidence interval 1.48-3.43, p = 0.0001). Among snowboarding maneuvers, only jumping showed a significant negative association between wearing of a helmet or knit cap and the occurrence of serious head injury (p = 0.036). Snowboarders who wear helmets might attempt dangerous maneuvers causing injuries. Wearing of a helmet or knit cap protected against serious head injuries on jumping. Every snowboarder should wear a helmet or knit cap on jumping to prevent head injury.

  3. Seizure-related injuries in children and adolescents with epilepsy.

    Science.gov (United States)

    Lagunju, IkeOluwa A; Oyinlade, Alexander O; Babatunde, Olubusayo D

    2016-01-01

    Children with epilepsy are reported to be at a greater risk of injuries compared with their peers who do not have epilepsy. We set out to determine the frequency and pattern of seizure-related injuries in children with epilepsy seen at the University College Hospital (UCH), Ibadan, Nigeria. Consecutive cases of epilepsy seen at the pediatric neurology clinic of the UCH, Ibadan over a period of 6months were evaluated for injuries in the preceding 12months using a structured questionnaire. These were compared with age- and sex-matched controls. A total of 125 children with epilepsy and 125 age- and sex-matched controls were studied. Injuries occurred more frequently in children with epilepsy than in their peers (p=0.01, OR 1.935, 95% CI 1.142-3.280). Epilepsy was generalized in 80 (64.0%), and localization-related in 45 (36.0%). Idiopathic epilepsy accounted for 74 (59.2%), and the remaining 51 (40.8%) had remote symptomatic epilepsy. Fifty-seven (45.6%) children had suffered seizure-related injuries with multiple injuries in 31 (24.8%). The most frequent were skin/soft tissue lacerations (26.4%), injuries to the tongue and soft tissues of the mouth (19.2%), minor head injuries (15.2%), and dental injuries with tooth loss (8.0%). There was a statistically significant association between seizure frequency and seizure-related injuries (p=0.002). Children on polytherapy had a significantly higher frequency of seizure-related injuries (pEpilepsy is a major risk factor for injuries in childhood. High seizure frequency increases the risk of multiple injuries in children with epilepsy. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Assessment of head injury of children due to golf ball impact.

    Science.gov (United States)

    Lee, Heow Pueh; Wang, Fang

    2010-10-01

    Head trauma injury due to impact by a flying golf ball is one of the most severe possible injury accidents on the golf course. Numerical simulations based on the finite element method are presented to investigate head injury in children due to impact by a flying golf ball. The stress and energy flow patterns in a head model during the golf ball impact are computed for various combinations of striking speed, falling angle of the golf ball before impact, and impact location. It is found that a child is more prone to head injury due to golf ball impact on the frontal and side/temporal areas. The simulated results are found to conform to the clinical reports on children's head injuries from flying golf balls.

  5. Biomechanics of Head, Neck, and Chest Injury Prevention for Soldiers: Phase 2 and 3

    Science.gov (United States)

    2016-08-01

    AWARD NUMBER: W81XWH-10-2-0165 TITLE: “ Biomechanics of Head, Neck, and Chest Injury Prevention for Soldiers: Phase 2 & 3”.” PRINCIPAL INVESTIGATOR...27Sep2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-10-2-0165 “ Biomechanics of Head, Neck, and Chest Injury Prevention for Soldiers: Phase 2...Virginia Tech – Wake Forest University, Center for Injury Biomechanics and the U.S. Army entitled “ Biomechanics of Head, Neck, and Chest Injury

  6. Preventing Paraffin-Related Injury

    Directory of Open Access Journals (Sweden)

    Dehran Swart

    2009-07-01

    Full Text Available Paraffin (called kerosene in North America and other parts of the world is the most commonly used fuel in ‎non-electrified dwellings worldwide. It is especially popular in Africa and South Asia. Although paraffin ‎offers many advantages – especially its comparatively low cost to produce – it poses two major risks of ‎injury. First, paraffin poisoning is common, either through ingestion or through inhalation of smoke and ‎fumes. Second, paraffin is highly flammable, and poses fire risk through multiple causes. This commentary ‎discusses strategies to prevent paraffin-related injury. Prevention of paraffin-related injury must be through ‎multiple strategies, and should include policy-oriented change, changes to the safety of home environments, ‎and behavioral changes targeting how individuals store and use paraffin and paraffin appliances. We review ‎successful prevention strategies in each of these domains and discuss appropriate research and community ‎initiatives that should be implemented to improve paraffin safety among at-risk populations.‎

  7. Computer-Related Repetitive Stress Injuries

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Computer-Related Repetitive Stress Injuries KidsHealth / For Parents / Computer-Related Repetitive Stress Injuries What's in this article? ...

  8. Imaging of spinal injury in abusive head trauma: a retrospective study

    International Nuclear Information System (INIS)

    Choudhary, Arabinda K.; Ishak, Ramsay; Zacharia, Thomas T.; Dias, Mark S.

    2014-01-01

    Spinal imaging has been a neglected part of abusive head trauma (AHT) imaging. As most of the radiographs and CT spine are negative in AHT in infants, the cervical spine is assumed to be normal. There is increasing evidence in the role of injury to brainstem and cervical cord in the pathogenesis of AHT. In addition, in courts of law, there is fierce debate about AHT, its mimics and other disparate nontraumatic diagnoses explaining the neuroradiological and skeletal findings. However, this discussion ignores the evidence and significance of spinal injury. We sought to study the cervical spine in an AHT cohort to understand the true prevalence of spinal injuries in AHT and contrast it with cohorts of accidental and nontraumatic groups to give the clinicians a robust diagnostic tool in evaluating AHT. The purpose of this study is to compare the relative incidence of spinal ligamentous and soft-tissue abnormalities on spinal MRI among three groups of children ages < 48 months: (1) those with AHT, (2) those with accidental trauma, and (3) those with nontraumatic conditions. This comparative study included 183 children who underwent spine MRI: 67 with AHT, 46 with accidental trauma and a clinical suspicion of spinal injury, and 70 with nontraumatic conditions. Clinical and radiographic findings were collected in all cases and were analyzed retrospectively to identify MRI evidence of traumatic spinal injuries. The incidence of spinal injuries among the three groups was compared. The incidence of spinal ligamentous injuries was calculated for those with and without radiographic evidence of hypoxic-ischemic encephalopathy. All comparisons were performed using Fisher exact test with P < 0.05 considered statistically significant. Cervical spine ligamentous injuries (predominantly the nuchal, atlanto-occipital and atlanto-axial ligaments) were present in 78% of the AHT group, 46% of the accidental trauma group and 1% of the nontraumatic group; all of these differences were

  9. Imaging of spinal injury in abusive head trauma: a retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Choudhary, Arabinda K. [Nemours A.I. DuPont Children Hospital, Department of Radiology, Wilmington, DE (United States); Ishak, Ramsay; Zacharia, Thomas T. [Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Dias, Mark S. [Hershey Medical Center, Department of Neurosurgery, Hershey, PA (United States)

    2014-09-15

    Spinal imaging has been a neglected part of abusive head trauma (AHT) imaging. As most of the radiographs and CT spine are negative in AHT in infants, the cervical spine is assumed to be normal. There is increasing evidence in the role of injury to brainstem and cervical cord in the pathogenesis of AHT. In addition, in courts of law, there is fierce debate about AHT, its mimics and other disparate nontraumatic diagnoses explaining the neuroradiological and skeletal findings. However, this discussion ignores the evidence and significance of spinal injury. We sought to study the cervical spine in an AHT cohort to understand the true prevalence of spinal injuries in AHT and contrast it with cohorts of accidental and nontraumatic groups to give the clinicians a robust diagnostic tool in evaluating AHT. The purpose of this study is to compare the relative incidence of spinal ligamentous and soft-tissue abnormalities on spinal MRI among three groups of children ages < 48 months: (1) those with AHT, (2) those with accidental trauma, and (3) those with nontraumatic conditions. This comparative study included 183 children who underwent spine MRI: 67 with AHT, 46 with accidental trauma and a clinical suspicion of spinal injury, and 70 with nontraumatic conditions. Clinical and radiographic findings were collected in all cases and were analyzed retrospectively to identify MRI evidence of traumatic spinal injuries. The incidence of spinal injuries among the three groups was compared. The incidence of spinal ligamentous injuries was calculated for those with and without radiographic evidence of hypoxic-ischemic encephalopathy. All comparisons were performed using Fisher exact test with P < 0.05 considered statistically significant. Cervical spine ligamentous injuries (predominantly the nuchal, atlanto-occipital and atlanto-axial ligaments) were present in 78% of the AHT group, 46% of the accidental trauma group and 1% of the nontraumatic group; all of these differences were

  10. A DESCRIPTIVE STUDY OF PATTERN OF FATAL HEAD INJURY IN HELMETED AND NONHELMETED VICTIMS OF TWO WHEELER ACCIDENTS

    Directory of Open Access Journals (Sweden)

    P. A. Sheeju

    2016-07-01

    Full Text Available BACKGROUND Motor vehicle crashes are a major cause of fatality all over the world. By 2020, motor vehicle injury is projected to become the third leading contributor to the global burden of disease in the world. Motor cyclists are about 25 times more likely than car occupants to die in Road Traffic Accidents. Data on the incidence and types of crashes is required to guide safety policy. Knowledge of how injuries are caused and of what type they are of valuable instrument for identifying interventions and monitoring the effectiveness of intervention. The present study was done to find out the factors that contribute for motor cycle crashes and to study the injury pattern seen in helmeted and non-helmeted victims. MATERIAL AND METHODS Victims of two wheeler accidents brought for autopsy in a Govt. Medical College were studied from October 2010 to August 2011. Two wheelers include motor cycles, scooters and mopeds. Bicycles were excluded from the study. Accidents include all types; against all types of vehicles running on the road, collision with any object, surface or any animal or fall from vehicle. The details of the accident were collected in a printed proforma from relative/witnesses and from police officials. The injuries were entered in the specific columns of proforma. Data was analysed with MS Excel. RESULTS Death due to head injury is more in non-helmeted (52.5% compared to helmeted drivers (43.8 % whereas injury to chest and abdomen and limbs are more in helmeted. Combination of injuries (Head+Chest+Abdomen predominated in helmeted drivers (18.8% compared to 5% in non-helmeted drivers. Spinal injuries were more in helmeted than in non-helmeted. CONCLUSION The pattern of head injury was analysed in detail in helmeted and non-helmeted drivers. This will help in detailing of pattern of head injury in both groups.

  11. Head injury causation scenarios for belted, rear-seated children in frontal impacts.

    Science.gov (United States)

    Bohman, Katarina; Arbogast, Kristy B; Bostrom, Ola

    2011-02-01

    Head injuries are the most common serious injuries sustained by children in motor vehicle crashes and are of critical importance with regard to long-term disability. There is a lack of understanding of how seat belt-restrained children sustain head injuries in frontal impacts. The aim of the study was to identify the AIS2+ head injury causation scenarios for rear-seated, belt-restrained children in frontal impacts, including the set of parameters contributing to the injury. In-depth crash investigations from two National Highway Traffic Safety Administration (NHTSA) databases, the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS; 1997-2008) and the Crash Injury Research and Engineering Network (CIREN; 1996-2009), were collected and analyzed in detail. Selection criteria were all frontal impacts with principal direction of force (PDOF) of 11, 12, and 1 o'clock involving rear-seated, three-point belt-restrained, with or without booster cushion, children from 3 to 13 years with an AIS2+ head injury. Cases were analyzed using the BioTab method of injury causation assessment in order to systematically analyze the injury causation scenario for each case. There were 27 cases meeting the inclusion criteria, 19 cases with MAIS2 head injuries and 8 cases with MAIS3+ head injuries, including 2 fatalities. Three major injury causation scenarios were identified, including head contact with seatback (10 cases), head contact with side interior (7 cases,) and no evidence of head contact (9 cases). Head injuries with seatback or side interior contact typically included a PDOF greater than 10 degree (similar to the Insurance Institute for Highway Safety [IIHS] and EuroNCAP offset frontal testing) and vehicle maneuvers. For seatback contact, the vehicle's movements contributed to occupant kinematics inboard the vehicle, causing a less than optimal restraint of the torso and/or torso roll out of the shoulder belt. For side interior contact, the PDOF and

  12. Golf-related injuries treated in United States emergency departments.

    Science.gov (United States)

    Walsh, Brittany A; Chounthirath, Thiphalak; Friedenberg, Laura; Smith, Gary A

    2017-11-01

    This study investigates unintentional non-fatal golf-related injuries in the US using a nationally representative database. This study analyzed golf-related injuries treated in US hospital emergency departments from 1990 through 2011 using the National Electronic Injury Surveillance System database. Injury rates were calculated using golf participation data. During 1990 through 2011, an estimated 663,471 (95% CI: 496,370-830,573) individuals ≥7years old were treated in US emergency departments for golf-related injuries, averaging 30,158 annually or 12.3 individuals per 10,000 golf participants. Patients 18-54years old accounted for 42.2% of injuries, but injury rates per 10,000 golf participants were highest among individuals 7-17years old (22.1) and ≥55years old (21.8) compared with 18-54years old (7.6). Patients ≥55years old had a hospital admission rate that was 5.01 (95% CI: 4.12-6.09) times higher than that of younger patients. Injured by a golf club (23.4%) or struck by a golf ball (16.0%) were the most common specified mechanisms of injury. The head/neck was the most frequently injured body region (36.2%), and sprain/strain (30.6%) was the most common type of injury. Most patients were treated and released (93.7%) and 5.9% required hospitalization. Although golf is a source of injury among all age groups, the frequency and rate of injury were higher at the two ends of the age spectrum. Given the higher injury and hospital admission rates of patients ≥55years, this age group merits the special attention of additional research and injury prevention efforts. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Horse-related injuries in children - unmounted injuries are more severe: A retrospective review.

    Science.gov (United States)

    Wolyncewicz, Grace E L; Palmer, Cameron S; Jowett, Helen E; Hutson, John M; King, Sebastian K; Teague, Warwick J

    2018-05-01

    Horse-related injuries account for one quarter of all paediatric sports fatalities. It is not known whether the pattern of injury spectrum and severity differ between children injured whilst mounted, compared with those injured unmounted around horses. We aimed to identify any distinctions between the demographic features, spectrum and severity of injuries for mounted versus unmounted patients. Trauma registry data were reviewed for 505 consecutive paediatric patients (agedinjuries over a 16-year period. Patients were classified into mounted and unmounted groups, and demographics, injury spectrum, injury severity, and helmet usage compared using odds ratios and Wilcoxon rank-sum tests. More patients (56%) were injured in a private setting than in a sporting or supervised context (23%). Overall, head injuries were the most common horse-related injury. Mounted patients comprised 77% of the cohort. Mounted patients were more likely to sustain upper limb fractures or spinal injuries, and more likely to wear helmets. Unmounted were more likely to be younger males, and more likely to sustain facial or abdominal injuries. Strikingly, unmounted children had significantly more severe and critical Injury Severity Scores (OR 2.6; 95% CI 1.5, 4.6) and longer hospital stay (2.0days vs 1.1days; pinjury. Horse-related injuries in children are serious. Unmounted patients are distinct from mounted patients in terms of gender, age, likelihood of personal protective equipment use, severity of injuries, and requirement for intensive or invasive care. This study highlights the importance of vigilance and other safety behaviours when unmounted and around horses, and proposes specific targets for future injury prevention campaigns, both in setting of organised and private equestrian activity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Epidemiological features of 1 281 patients with head injuries arising from the 2008 Wenchuan earthquake

    Directory of Open Access Journals (Sweden)

    YANG Chao-hua

    2012-04-01

    Full Text Available 【Abstract】Objective: To analyze the epidemiologi-cal features of patients with head injuries in the 2008 Wenchuan earthquake. Methods: Medical records of patients with head inju-ries who were admitted to 14 hospitals in Deyang, Mianyang and Chengdu cities after the earthquake were retrospec-tively analyzed. The patients’ age, gender, cause of injury, diagnosis, and outcome were analyzed retrospectively. Results: A total of 1 281 patients with 807 males and 474 females were included. According to Glasgow Coma Scale score at admission, 1 029 patients presented with mild injury, 161 moderate injury and 91 severe injury. The major cause of injuries (83% was bruise by collapsed buildings. Open head injuries accounted for 60.8%. A total of 720 pa-tients underwent surgical treatment. Good recovery was achieved in 1 056 patients, moderate disability in 106, se-vere disability in 71, coma in 29 and death in 19. Conclusions: In this series, male patients were more than female patients. The main cause of injury was hit by falling objects due to building collapse. Minor and open craniocerebral injuries were most common. The epidemio-logical features of head injuries in Wenchuan earthquake may be helpful to preparation for future rescue. Key words: Brain injuries; Epidemiology; Earthquakes; Rescue work

  15. Epidemiology of Muay Thai fight-related injuries.

    Science.gov (United States)

    Strotmeyer, Stephen; Coben, Jeffrey H; Fabio, Anthony; Songer, Thomas; Brooks, Maria

    2016-12-01

    Muay Thai is a combat sport of Thailand that uses stand-up striking along with various clinching techniques. Currently, little is known about the injuries and risk factors for injuries among Muay Thai fighters. Gaining more insight into the nature and frequency of injury in this sport provides part of the overall sports injury picture, within the larger burden of injury as a public health issue. Generating this information is a critical first step toward the broader goal of improving the health and safety of Muay Thai fighters engaged in competition. This study is based upon a survey of 195 Muay Thai fighters. Participants were asked to complete a retrospective web survey on fight-related injuries. Regression analyses were conducted to determine whether injuries during sanctioned fights were related to factors such as fight experience, use of protective equipment, and injury history. Participants were aged 18 to 47 years old (median 26), predominantly male (85.9%), and white (72.3%). Respondents were professional (n = 96, 49.2%) and amateur (n = 99, 50.8%). Fighters reported a mean fight experience of 15.8 fights. Of the 195 respondents, 108 (55.4%) reported sustaining an injury during the most recent fight. The primary body region injured was the extremities (58%) versus the head, with a lower amount of self-reported concussions (5.4%). Nearly 2/3 (66.7%) of all injured fighters reported that the injury did not interfere with the bout outcome. Nearly 25% reported they missed no training time as a result of the injury. Injuries were related to professional fighter status (OR = 2.5, 95% CI = 1.4-4.5), fight experience (OR = 2.7, 95% CI = 1.5-4.9), weight class (OR = 0.923 heavy versus light, 95% CI = .86-.99), age (OR = 0.90 > 26 versus ≤26, 95% CI = .85-.95), use of protective equipment (OR = .46, 95% CI = .26-.82) and previous injury (OR = 1.81, 95% CI = .98-3.3). Lighter, younger, and more experienced

  16. Frequent mild head injury promotes trigeminal sensitivity concomitant with microglial proliferation, astrocytosis, and increased neuropeptide levels in the trigeminal pain system.

    Science.gov (United States)

    Tyburski, Ashley L; Cheng, Lan; Assari, Soroush; Darvish, Kurosh; Elliott, Melanie B

    2017-12-01

    Frequent mild head injuries or concussion along with the presence of headache may contribute to the persistence of concussion symptoms. In this study, the acute effects of recovery between mild head injuries and the frequency of injuries on a headache behavior, trigeminal allodynia, was assessed using von Frey testing up to one week after injury, while histopathological changes in the trigeminal pain pathway were evaluated using western blot, ELISA and immunohistochemistry.  RESULTS: A decreased recovery time combined with an increased mild closed head injury (CHI) frequency results in reduced trigeminal allodynia thresholds compared to controls. The repetitive CHI group with the highest injury frequency showed the greatest reduction in trigeminal thresholds along with greatest increased levels of calcitonin gene-related peptide (CGRP) in the trigeminal nucleus caudalis. Repetitive CHI resulted in astrogliosis in the central trigeminal system, increased GFAP protein levels in the sensory barrel cortex, and an increased number of microglia cells in the trigeminal nucleus caudalis. Headache behavior in rats is dependent on the injury frequency and recovery interval between mild head injuries. A worsening of headache behavior after repetitive mild head injuries was concomitant with increases in CGRP levels, the presence of astrocytosis, and microglia proliferation in the central trigeminal pathway. Signaling between neurons and proliferating microglia in the trigeminal pain system may contribute to the initiation of acute headache after concussion or other traumatic brain injuries.

  17. Automatic Calculation of Hydrostatic Pressure Gradient in Patients with Head Injury: A Pilot Study.

    Science.gov (United States)

    Moss, Laura; Shaw, Martin; Piper, Ian; Arvind, D K; Hawthorne, Christopher

    2016-01-01

    The non-surgical management of patients with traumatic brain injury is the treatment and prevention of secondary insults, such as low cerebral perfusion pressure (CPP). Most clinical pressure monitoring systems measure pressure relative to atmospheric pressure. If a patient is managed with their head tilted up, relative to their arterial pressure transducer, then a hydrostatic pressure gradient (HPG) can act against arterial pressure and cause significant errors in calculated CPP.To correct for HPG, the arterial pressure transducer should be placed level with the intracranial pressure transducer. However, this is not always achieved. In this chapter, we describe a pilot study investigating the application of speckled computing (or "specks") for the automatic monitoring of the patient's head tilt and subsequent automatic calculation of HPG. In future applications this will allow us to automatically correct CPP to take into account any HPG.

  18. A CLINICAL STUDY OF OCULAR MANIFESTATIONS IN PATIENTS OF HEAD INJURY

    Directory of Open Access Journals (Sweden)

    Suhas Shamrao Sarawade

    2017-04-01

    Full Text Available BACKGROUND This study aims to record the prevalence and pattern of various ophthalmic manifestations in patients of head injury and to attempt a correlation between the ocular signs, neurological signs and final outcome. MATERIALS AND METHODS Hundred and twenty patients with head injury having ocular findings, presenting from December 2014 to July 2016, were taken for study. Detailed ophthalmological examination of the patients was carried out and the results of the study are depicted in the form of percentages, graphs and charts. RESULTS The most common cause of head injury found in our study was road traffic accident. The commonest eye finding was oedema and ecchymosis of eyelids. Prime causal factors affecting visual acuity found in our study were corneal tear, globe rupture, optic nerve injury and avulsion of eyeball. CONCLUSION Head injuries with ocular manifestations occur in younger age group. Road traffic accident was the most common cause. Males have to work outside their home for their jobs more than that of females. So they are more prone to accidents. Oedema and ecchymosis of eyelids constitute the most common ocular finding. Patients with mild ocular injuries pointed towards good visual prognosis. Most of them had mild head injury and hence good prognosis in terms of survival of the patient. The patients with severe ocular injuries like corneal tear, globe rupture and optic nerve injury showed poor visual prognosis.

  19. Concussions and Head Injuries in English Community Rugby Union Match Play.

    Science.gov (United States)

    Roberts, Simon P; Trewartha, Grant; England, Michael; Goodison, William; Stokes, Keith A

    2017-02-01

    Previous research has described general injury patterns in community-level rugby union, but specific information on time-loss head injuries has not been reported. To establish the incidence and nature of significant time-loss head injuries in English community rugby match play, and to identify the injury risk for specific contact events. Descriptive epidemiology study. Over 6 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), 76 (2011-2012), 50 (2012-2013), 67 (2013-2014), and 58 (2014-2015) English community rugby clubs (Rugby Football Union levels 3-9) over a total of 175,940 hours of player match exposure. Club injury management staff reported information for all head injuries sustained during match play whereby the player was absent for 8 days or greater. Clubs were subdivided into semiprofessional (mean player age, 24.6 ± 4.7 years), amateur (24.9 ± 5.1 years), and recreational (25.6 ± 6.1 years) playing levels. Contact events from a sample of 30 matches filmed over seasons 2009-2010, 2010-2011, and 2011-2012 provided mean values for the frequency of contact events. The overall incidence for time-loss head injuries was 2.43 injuries per 1000 player match hours, with a higher incidence for the amateur (2.78; 95% CI, 2.37-3.20) compared with recreational (2.20; 95% CI, 1.86-2.53) ( P = .032) playing level but not different to the semiprofessional (2.31; 95% CI, 1.83-2.79) playing level. Concussion was the most common time-loss head injury, with 1.46 per 1000 player match hours. The tackle event was associated with 64% of all head injuries and 74% of all concussions. There was also a higher risk of injuries per tackle (0.33 per 1000 events; 95% CI, 0.30-0.37) compared with all other contact events. Concussion was the most common head injury diagnosis, although it is likely that this injury was underreported. Continuing education programs for medical staff and players are essential for the improved identification and management of

  20. Clinical analysis of spinal cord injury with or without cervical ossification of the posterior longitudinal ligament, spondylosis, and canal stenosis in elderly head injury patients

    International Nuclear Information System (INIS)

    Nakae, Ryuta; Onda, Hidetaka; Yokobori, Shoji; Araki, Takashi; Fuse, Akira; Toda, Shigeki; Kushimoto, Shigeki; Yokota, Hiroyuki; Teramoto, Akira

    2010-01-01

    Patients with degenerative diseases of the cervical spine, such as ossification of the posterior longitudinal ligament, spondylosis, and canal stenosis, sometimes present with acute spinal cord injury caused by minor trauma. However, the relative risk of cervical cord injury with these diseases is unknown. The clinical and radiological features of 94 elderly patients with head injury, 57 men and 37 women aged from 65 to 98 years (mean 76.6 years), were retrospectively analyzed to assess the association of spinal cord injury with degenerative cervical diseases. Degenerative cervical diseases were present in 25 patients, and spinal cord injury was more common in the patients with degenerative diseases (11/25 patients) than in the patients without such diseases (3/69 patients; relative risk=10.2). The incidence of degenerative cervical diseases seems to be increasing in Japan because life expectancy has increased and the elderly are a rapidly growing part of the population. A fall while walking or cycling is a common mechanism of head injury and/or cervical cord injury in the elderly. To decrease the occurrence of cervical myelopathy, prevention by increasing social awareness and avoiding traffic accidents and falls is important. (author)

  1. Susceptibility of the MMPI-2-RF neurological complaints and cognitive complaints scales to over-reporting in simulated head injury.

    Science.gov (United States)

    Bolinger, Elizabeth; Reese, Caitlin; Suhr, Julie; Larrabee, Glenn J

    2014-02-01

    We examined the effect of simulated head injury on scores on the Neurological Complaints (NUC) and Cognitive Complaints (COG) scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). Young adults with a history of mild head injury were randomly assigned to simulate head injury or give their best effort on a battery of neuropsychological tests, including the MMPI-2-RF. Simulators who also showed poor effort on performance validity tests (PVTs) were compared with controls who showed valid performance on PVTs. Results showed that both scales, but especially NUC, are elevated in individuals simulating head injury, with medium to large effect sizes. Although both scales were highly correlated with all MMPI-2-RF over-reporting validity scales, the relationship of Response Bias Scale to both NUC and COG was much stronger in the simulators than controls. Even accounting for over-reporting on the MMPI-2-RF, NUC was related to general somatic complaints regardless of group membership, whereas COG was related to both psychological distress and somatic complaints in the control group only. Neither scale was related to actual neuropsychological performance, regardless of group membership. Overall, results provide further evidence that self-reported cognitive symptoms can be due to many causes, not necessarily cognitive impairment, and can be exaggerated in a non-credible manner.

  2. Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team

    Science.gov (United States)

    John, Simon; Vincent, Andrea L; Reed, Peter

    2015-01-01

    Aim To describe children referred for suspected abusive head trauma (AHT) to a hospital child protection team in Auckland, New Zealand. Methods Comparative review of demographics, histories, injuries, investigations and diagnostic outcomes for referrals under 15 years old from 1991 to 2010. Results Records were available for 345 children. Referrals increased markedly (88 in the first decade, 257 in the second), but the diagnostic ratio was stable: AHT 60%, accidental or natural 29% and uncertain cause 11%. The probability of AHT was similar regardless of socio-economic status or ethnicity. In children under 2 years old with accidental head injuries (75/255, 29%) or AHT (180/255, 71%), characteristics of particular interest for AHT included no history of trauma (88/98, 90%), no evidence of impact to the head (84/93, 90%), complex skull fractures with intracranial injury (22/28, 79%), subdural haemorrhage (160/179, 89%) and hypoxic ischaemic injury (38/39, 97%). In children over 2 years old, these characteristics did not differ significantly between children with accidental head injuries (21/47, 45%) and AHT (26/47, 55%). The mortality of AHT was higher in children over 2 years old (10/26, 38%) than under 2 years (19/180, 11%). Conclusions The striking increase in referrals for AHT probably represents increasing incidence. The decision to refer a hospitalised child with a head injury for assessment for possible AHT should not be influenced by socio-economic status or ethnicity. Children over 2 years old hospitalised for AHT are usually injured by mechanisms involving impact and should be considered at high risk of death. PMID:26130384

  3. Children and youth with 'unspecified injury to the head': implications for traumatic brain injury research and surveillance.

    Science.gov (United States)

    Chan, Vincy; Mann, Robert E; Pole, Jason D; Colantonio, Angela

    2015-01-01

    The case definition for traumatic brain injury (TBI) often includes 'unspecified injury to the head' diagnostic codes. However, research has shown that the inclusion of these codes leads to false positives. As such, it is important to determine the degree to which inclusion of these codes affect the overall numbers and profiles of the TBI population. The objective of this paper was to profile and compare the demographic and clinical characteristics, intention and mechanism of injury, and discharge disposition of hospitalized children and youth aged 19 years and under using (1) an inclusive TBI case definition that included 'unspecified injury to the head' diagnostic codes, (2) a restricted TBI case definition that excluded 'unspecified injury to the head 'diagnostic codes, and (3) the 'unspecified injury to the head' only case definition. The National Ambulatory Care Reporting System and the Discharge Abstract Database from Ontario, Canada, were used to identify cases between fiscal years 2003/04 and 2009/10. The rate of TBI episodes of care using the inclusive case definition for TBI (2,667.2 per 100,000) was 1.65 times higher than that of the restricted case definition (1,613.3 per 100,000). 'Unspecified injury to the head' diagnostic codes made up of 39.5 % of all cases identified with the inclusive case definition. Exclusion of 'unspecified injury to the head' diagnostic code in the TBI case definition resulted in a significantly higher proportion of patients in the intensive care units (p definition of TBI for the children and youth population is important, as it has implications for the numbers used for policy, resource allocation, prevention, and planning of healthcare services. This paper can inform future work on reaching consensus on the diagnostic codes for defining TBI in children and youth.

  4. Head and neck injuries from the Boston Marathon bombing at four hospitals.

    Science.gov (United States)

    Singh, Ajay K; Buch, Karen; Sung, Edward; Abujudeh, Hani; Sakai, Osamu; Aaron, Sodickson; Lev, Michael

    2015-10-01

    The aim of this study was to evaluate the imaging findings of head and neck injuries in patients from the Boston Marathon bombing. A total of 115 patients from the Boston Marathon bombing presenting to four hospitals who underwent imaging to evaluate for head and neck injuries were included in the study. Twelve patients with positive findings on radiography or cross-sectional imaging were included in the final analysis. The radiographic, computed tomography (CT), and magnetic resonance (MR) imaging features of these patients were evaluated for the presence of shrapnel and morphological abnormality. Head and neck injuries were seen in 12 out of 115 patients presenting to the four hospitals. There were secondary blast injuries to the head and neck in eight patients, indicated by the presence of shrapnel on imaging. In the four patients without shrapnel, there were two with subgaleal hematomas, one with facial contusion and one with mastoid injury. There were two patients with subarachnoid hemorrhage, one with brain contusion, one with cerebral laceration, and one with globe rupture. There was frontal bone, nasal bone, and orbital wall fracture in one patient each. Imaging identified 26 shrapnel fragments, 21 of which were ball bearings. Injuries to the head and neck region identified on imaging from the Boston Marathon bombing were not common. The injuries seen were predominantly secondary blast injuries from shrapnel, and did not result in calvarial penetration of the shrapnel fragments.

  5. Head Injury and Intracranial Pressure Monitor Using Ultrasonic and Low-Frequency Acoustic (ULFA) Detection

    National Research Council Canada - National Science Library

    Vo-Dinh, Tuan

    2001-01-01

    The main objective of this research project is the development of a non-invasive method and instrument for head injury detection and monitoring using a new approach based on ultrasonic and low-frequency acoustic (ULFA...

  6. Head Injury and Intracranial Pressure Monitor Using Ultrasonic and Low-Frequency (ULFA) Detection

    National Research Council Canada - National Science Library

    Vo-Dinh, Tuan

    2000-01-01

    The main objective of this research project is the development of a non-invasive method and instrument for head injury detection and monitoring using a new approach based on ultrasonic and low-frequency acoustic (ULFA...

  7. Head injury as a PTSD predictor among Oklahoma City bombing survivors.

    Science.gov (United States)

    Walilko, Timothy; North, Carol; Young, Lee Ann; Lux, Warren E; Warden, Deborah L; Jaffee, Michael S; Moore, David F

    2009-12-01

    The aim of the Oklahoma City (OKC) bombing retrospective review was to investigate the relationship between physical injury, environmental contributors, and psychiatric disorders such as posttraumatic stress disorder (PTSD) in an event-based, matched design study focused on injury. The 182 selected participants were a random subset of the 1,092 direct survivors from the OKC bombing. Only 124 of these 182 cases had a full complement of medical/clinical data in the OKC database. These 124 cases were assessed to explore relationships among PTSD diagnoses, levels of blast exposure, and physical injuries. Associations among variables were statistically tested using contingency analysis and logistic regression. Comparison of the PTSD cases to symptoms/diagnoses reported in the medical records reveals a statistically significant association between PTSD and head/brain injuries associated with head acceleration. PTSD was not highly correlated with other injuries. Although blast pressure and impulse were highly correlated with head injuries, the correlation with PTSD was not statistically significant. Thus, a correlation between blast pressure and PTSD may exist, but higher fidelity pressure calculations are required to elucidate this potential relationship. This study provides clear evidence that head injury is associated with subsequent PTSD, giving caregivers' information on what physical injuries may suggest the development of psychologic disorders to aid them in developing a profile for the identification of future survivors of terrorist attacks and Warfighters with brain injuries and potential PTSD.

  8. Pseudoaneurysm of the occipital artery: an unusual cause of persisting headache after minor head injury.

    LENUS (Irish Health Repository)

    Aquilina, K

    2012-02-03

    Post-traumatic pseudoaneurysms of the extracranial arteries in the scalp are uncommon sequelae of head injury. We report on a patient who presented four weeks after a minor head injury with a tender, pulsating and enlarging mass in the course of the left occipital artery. There was associated headache radiating to the vertex. Computed tomographic angiography confirmed the lesion to be a pseudoaneurysm of the occipital artery. The lump was resected with complete resolution of symptoms.

  9. Delayed symptoms and death after minor head trauma with occult vertebral artery injury.

    OpenAIRE

    Auer, R N; Krcek, J; Butt, J C

    1994-01-01

    Head injury without loss of consciousness is seldom accompanied by grave complications. We report the case of an 18 year old cyclist who was struck by a car in a minor road traffic accident, suffered minor head injury without loss of consciousness, and died unexpectedly seven weeks later with vomiting and coma. Necropsy revealed an expanding cerebellar infarct and vertebral artery thrombosis, superimposed on an old dissecting intramural haematoma of the right vertebral artery in the atlantoax...

  10. Families, Head Injury, and Cognitive-Communicative Impairments: Issues for Family Counseling.

    Science.gov (United States)

    DePompei, Roberta; Zarski, John J.

    1989-01-01

    This paper calls for the incorporation of family counseling into rehabilitation programs treating cognitive-communicative disorders in head-injured individuals. The paper describes general family responses that may be anticipated when a family system experiences head injury, functional versus dysfunctional family responses to a crisis, and three…

  11. Characteristics of Syntactic Comprehension Deficits Following Closed Head Injury versus Left Cerebrovascular Accident.

    Science.gov (United States)

    Butler-Hinz, Susan; And Others

    1990-01-01

    Two studies examined the ability to assign thematic roles and to coindex referentially dependent noun phrases in closed head injured adults (N=20), adult stroke patients (N=20), and normal adults (N=20). Results suggested that syntactic comprehension disturbances are similar following left cerebral hemisphere infarction and closed head injury.…

  12. Diagnosis of climbing related overuse injuries

    International Nuclear Information System (INIS)

    Klauser, A.; Frauscher, F.; Helweg, G.; Nedden, D. zur; Hochholzer, T.; Kramer, J.

    2002-01-01

    Sport climbing shows an enormous increase in participation, evolving to more popularity, including even school sport activity on high standards. Therefore the number of climbing related injuries is increasing and becomes a more frequently encountered medical problem. Typical climbing associated injuries involve predominantly the upper limb. Overuse injuries are the most common climbing related injuries.The clinical examination is the first line investigation, which is often limited especially in the acute phase. However, an exact diagnosis is desireable for therapeutic management. Imaging modalities have shown to be capable for detection of climbing related injuries. An overview about the current use of x-ray, ultrasound and magnetic resonance imaging in different climbing related overuse injuries is presented. (orig.) [de

  13. Trampoline-related injury in children.

    Science.gov (United States)

    Shankar, Amitabh; Williams, Kim; Ryan, Mary

    2006-09-01

    To quantify and describe trampoline-related injuries in children attending an urban pediatric emergency department. Retrospective cohort study of consecutive patients attending a children's emergency department with trampoline-related injuries over a 3-month period (May-July 2005). One hundred and sixty-eight children were treated for trampoline-related injuries during the period reviewed. Sixty-three percent were girls. Their age ranged between 4 months and 16 years (mean, 10.4 years [SD, 3 years and 10 months]). Lower limb injuries (51%) were more common overall. The most common injuries were to the ankle (31%), followed by foot (9.2%), and neck (8.4%). Sprain or soft tissue injuries (68%) were the most common type of injury, followed by fracture (12.2%). The most common mechanism of injury was inversion of the ankle on a trampoline (18.4%). Trampoline-related injuries represented 2.5% of morbidity from accidental trauma in children presenting to emergency department in our study. The rate and severity of injury has become a significant public health concern. It appears that current preventative strategies are inadequate in making children's carers aware of the potential risks of trampoline use, particularly when used recreationally.

  14. Multi-scale mechanics of traumatic brain injury : predicting axonal strains from head loads

    NARCIS (Netherlands)

    Cloots, R.J.H.; Dommelen, van J.A.W.; Kleiven, S.; Geers, M.G.D.

    2013-01-01

    The length scales involved in the development of diffuse axonal injury typically range from the head level (i.e., mechanical loading) to the cellular level. The parts of the brain that are vulnerable to this type of injury are mainly the brainstem and the corpus callosum, which are regions with

  15. Forensic medical study on morphology and formative mechanism of blunt head injury

    Directory of Open Access Journals (Sweden)

    LI Hong-wei

    2012-12-01

    Full Text Available 【Abstract】 Objective: To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods: The statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries. Results: Among the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant (106, 52.5%, followed by suicide (49, 24.3% and accident (44, 21.8%. The majority of suicide-induced death were by falling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants. Conclusion: Studies on the morphology and its forma-tive rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury. Key words: Brain; Head injuries, closed; Cranioce-rebral trauma; Forensic medicine

  16. Transfusion related acute lung injury

    Directory of Open Access Journals (Sweden)

    Sharma Ratti

    2009-10-01

    Full Text Available Transfusion related acute lung injury (TRALI is an uncommon but potentially fatal adverse reaction to transfusion of plasma containing blood components. We describe a case of 10-year-old male child with aplastic anemia, platelet count of 7800/΅l, B positive blood group who developed fever (39.2΀C, difficulty in breathing and cyanosis within 2 hrs after transfusion of a random platelet concentrate. Despite the best resuscitative efforts, the child died within next 24 hrs. The present case highlights the fact that TRALI should be kept as a differential diagnosis in all patients developing acute respiratory discomfort within 6 hrs of transfusion. Without a ′gold standard′ the diagnosis of TRALI relies on a high index of suspicion and on excluding other types of transfusion reactions. Notification to transfusion services is crucial to ensure that a proper investigation is carried out and at-risk donor and recipients can be identified, and risk reduction measures can be adopted.

  17. A comparison of wakeboard-, water skiing-, and tubing-related injuries in the United States, 2000-2007.

    Science.gov (United States)

    Baker, John I; Griffin, Russell; Brauneis, Paul F; Rue, Loring W; McGwin, Gerald

    2010-01-01

    The purpose of the study was to compare tubing-related injuries to wakeboarding- and water skiing-related injuries. Data was collected from the 2000-2007 National Electronic Injury Surveillance Survey for 1,761 individuals seeking care at an emergency department due to a tubing-, wakeboarding, or water skiing-related injury. Data included patient age and sex, as well as injury characteristics including body region injured (i.e., head and neck, trunk, shoulder and upper extremity, and hip and lower extremity) and diagnosis of injury (e.g., contusion, laceration, or fracture). Case narratives were reviewed to ensure that a tubing-, wakeboarding-, or water skiing-related injury occurred while the individual was being towed behind a boat. Severe injury (defined as an injury resulting in the individual being hospitalized, transferred, held for observation) was compared among the groups using logistic regression. Wakeboard- and tubing-related injuries more commonly involved the head and neck, while water skiing- related injuries were likely to involve the hip and lower extremity. Tubing-related injuries, compared to water skiing-related injuries, were more likely to be severe (OR 2.31, 95% CI 1.23-4. 33). Like wakeboarding and water skiing, tubing has inherent risks that must be understood by the participant. While tubing is generally considered a safer alternative to wakeboarding and water skiing, the results of the current study suggest otherwise. Both the number and severity of tubing- related injuries could be prevented through means such as advocating the use of protective wear such as helmets while riding a tube or having recommended safe towing speeds prominently placed on inner tubes. Key pointsIncrease annual injury rate trend in wakeboard injuries.Wakeboard- and tubing-related injuries more often to head and neck, waterskiing-related injuries more often to hip and lower extremity.Tubing-related injuries over 2-times as likely to be severe compared to

  18. Work-related injuries: injury characteristics, survival, and age effect.

    Science.gov (United States)

    Konstantinidis, Agathoklis; Talving, Peep; Kobayashi, Leslie; Barmparas, Galinos; Plurad, David; Lam, Lydia; Inaba, Kenji; Demetriades, Demetrios

    2011-06-01

    Work-related injuries impose a significant burden on society. The goal of this study was to delineate the epidemiology and the effect of age on type and mortality after occupational injuries. Patients 16 years of age or older sustaining work-related injuries were identified from the National Trauma Databank 12.0. The study population was stratified into four age groups: 16 to 35, 36 to 55, 56 to 65, and older than 65 years old. The demographic characteristics, type of injury, mechanism of injury, setting of injury, use of alcohol or other illicit drugs, and mortality were analyzed and related to age strata. Overall 67,658 patients were identified. There were 27,125 (40.1%) patients in the age group 16 to 35 years, 30,090 (44.5%) in the group 36 to 55 years, 6,618 (9.8%) in the group 56 to 65 years, and 3,825 (5.7%) older than 65 years. The injury severity increased significantly with age. Elderly patients were significantly more likely to sustain intracranial hemorrhages, spinal, and other skeletal injuries. The overall mortality was 2.9 per cent (1938) with the latter increasing significantly in a stepwise fashion with progressing age, becoming sixfold higher in patients older than 65 years (OR, 6.18; 95% CI, 4.78 to 7.80; P < 0.001). Our examination illustrates the associations between occupational injury and significant mortality that warrant intervention for mortality reduction. There is a stepwise-adjusted increase in mortality with progressing age.

  19. Training errors and running related injuries

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Østergaard; Buist, Ida; Sørensen, Henrik

    2012-01-01

    The purpose of this systematic review was to examine the link between training characteristics (volume, duration, frequency, and intensity) and running related injuries.......The purpose of this systematic review was to examine the link between training characteristics (volume, duration, frequency, and intensity) and running related injuries....

  20. Artificial neural networks: Predicting head CT findings in elderly patients presenting with minor head injury after a fall.

    Science.gov (United States)

    Dusenberry, Michael W; Brown, Charles K; Brewer, Kori L

    2017-02-01

    To construct an artificial neural network (ANN) model that can predict the presence of acute CT findings with both high sensitivity and high specificity when applied to the population of patients≥age 65years who have incurred minor head injury after a fall. An ANN was created in the Python programming language using a population of 514 patients ≥ age 65 years presenting to the ED with minor head injury after a fall. The patient dataset was divided into three parts: 60% for "training", 20% for "cross validation", and 20% for "testing". Sensitivity, specificity, positive and negative predictive values, and accuracy were determined by comparing the model's predictions to the actual correct answers for each patient. On the "cross validation" data, the model attained a sensitivity ("recall") of 100.00%, specificity of 78.95%, PPV ("precision") of 78.95%, NPV of 100.00%, and accuracy of 88.24% in detecting the presence of positive head CTs. On the "test" data, the model attained a sensitivity of 97.78%, specificity of 89.47%, PPV of 88.00%, NPV of 98.08%, and accuracy of 93.14% in detecting the presence of positive head CTs. ANNs show great potential for predicting CT findings in the population of patients ≥ 65 years of age presenting with minor head injury after a fall. As a good first step, the ANN showed comparable sensitivity, predictive values, and accuracy, with a much higher specificity than the existing decision rules in clinical usage for predicting head CTs with acute intracranial findings. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Microstructural brain injury in post-concussion syndrome after minor head injury

    International Nuclear Information System (INIS)

    Smits, Marion; Wielopolski, Piotr A.; Vernooij, Meike W.; Lugt, Aad van der; Houston, Gavin C.; Dippel, Diederik W.J.; Koudstaal, Peter J.; Hunink, M.G.M.

    2011-01-01

    After minor head injury (MHI), post-concussive symptoms commonly occur. The purpose of this study was to correlate the severity of post-concussive symptoms in MHI patients with MRI measures of microstructural brain injury, namely mean diffusivity (MD) and fractional anisotropy (FA), as well as the presence of microhaemorrhages. Twenty MHI patients and 12 healthy controls were scanned at 3 T using diffusion tensor imaging (DTI) and high-resolution gradient recalled echo (HRGRE) T2*-weighted sequences. One patient was excluded from the analysis because of bilateral subdural haematomas. DTI data were preprocessed using Tract Based Spatial Statistics. The resulting MD and FA images were correlated with the severity of post-concussive symptoms evaluated with the Rivermead Postconcussion Symptoms Questionnaire. The number and location of microhaemorrhages were assessed on the HRGRE T2*-weighted images. Comparing patients with controls, there were no differences in MD. FA was decreased in the right temporal subcortical white matter. MD was increased in association with the severity of post-concussive symptoms in the inferior fronto-occipital fasciculus (IFO), the inferior longitudinal fasciculus and the superior longitudinal fasciculus. FA was reduced in association with the severity of post-concussive symptoms in the uncinate fasciculus, the IFO, the internal capsule and the corpus callosum, as well as in the parietal and frontal subcortical white matter. Microhaemorrhages were observed in one patient only. The severity of post-concussive symptoms after MHI was significantly correlated with a reduction of white matter integrity, providing evidence of microstructural brain injury as a neuropathological substrate of the post-concussion syndrome. (orig.)

  2. The epidemiology of sports-related injuries in older adults: a central European epidemiologic study.

    Science.gov (United States)

    Kammerlander, Christian; Braito, Matthias; Kates, Stephen; Jeske, Christian; Roth, Tobias; Blauth, Michael; Dallapozza, Christian

    2012-10-01

    The population is rapidly aging and remaining more active over the age of 65. An increasing number of sports related injuries in individuals 65 and older are thus anticipated. The aim of this study is to analyze the epidemiology of sports injuries in the age group aged 65 and older. Data from the medical records of adults aged 65 years and older who were treated for sports-related injuries at a level one trauma center between December 1994 and February 2008 was collected and statistically analyzed. A total of 2635 patients met our inclusion criteria. There were 1647 men (62.5%) and 988 women (37.5%) with a mean age of 70.9 years. The yearly number of injuries doubled during the study period (1996-2007). The most common mechanism of injury was a simple fall from standing height (69%). Nearly 75% of all injuries occurred during alpine skiing, cycling or mountain climbing. The median Injury Severity Score was 4. Minor injuries and wounds (40%) were recorded most commonly followed by fractures (27%), sprains, ligament injuries (19%) and injuries of muscles and tendons (6%). The most frequent diagnoses were minor injuries to the head and ligament injuries around the knee joint. Injuries to the upper extremities occurred in 33.7%, injuries to the lower extremities in 29.4% and injuries to the head occurred in 20% of the patients. Women sustained substantially more fractures than men. Adults aged 65 and older are remaining active in sports, which results in higher numbers of sports related injuries in this age group. Identification of type, mechanism and distribution of the injuries can help with the recognition of risk factors for injury. This may enable us to develop appropriate preventative measures to reduce the incidence, and morbidity of such injuries.

  3. Trampoline-related injuries in childhood.

    Science.gov (United States)

    Eberl, Robert; Schalamon, Johannes; Singer, Georg; Huber, Sarah S; Spitzer, Peter; Höllwarth, Michael E

    2009-10-01

    Recommendations to prevent trampoline injuries were given since the 1970s. However, despite these educational efforts, safety recommendations seem to be ignored and the number of trampoline injuries is increasing. All children referred to our department for injuries related to trampolines over a period of 3 years were included. The patients' records were reviewed and a questionnaire was sent out in order to gain additional information. Injuries were classified as severe and mild. A total of 265 children (46% m, 54% f) with a median age of 8.2 years (range 1 to 14) were included. The injury rate was continuously growing from the year 2005 (10.6%) to 2007 (58.1%). Most of the injuries were recorded between April and September with a peak of injuries in August. Seventy-five percent of all accidents happened in the afternoon; 40% of the injuries were classified as severe, 60% as mild. Nets or equal security devices were used in 56.6%. Trampolining is associated with a significant risk for bodily harm at any age and results in severe injuries in 40% of cases. Though there may be still room for improvement in safety recommendations, all attempts over a period of more than 30 years to reduce the number of trampoline-related backyard injuries failed and the incidence is still increasing. At present, trampolines cannot be made safe for recreational activities and are of an unacceptable risk even under supervision.

  4. Outcomes of a questionnaire survey on intracranial hypotension following minor head injury

    International Nuclear Information System (INIS)

    Dohi, Kenji; Aruga, Tohru; Abe, Toshiaki; Ogawa, Takeki; Onuma, Takehide; Katayama, Yoichi; Sakaki, Toshisuke; Shima, Katsuji; Hirakawa, Kimiyoshi

    2007-01-01

    Intracranial hypotension (IH) is a rare condition caused by leakage of cerebrospinal fluid (CSF). Recently, a small number of clinicians have proposed a new concept about IH following minor head injury. They suggest that many of their patients with IH can be successfully treated with epidural blood patch therapy. They also argue that some patients with post-traumatic cervical syndrome and general fatigue syndrome suffer from IH following minor head injury. Consequently, IH following minor head injury was widely recognized and dealt with as a social problem in Japan. On the other hand, pathophysiological aspects of the condition as well as the provisional criteria to describe this clinical entity remain to be elucidated. In 2006, the Japan Society of Neurotraumatology performed a questionnaire survey asking 44 hospitals belonging to trustees of this society about IH following minor head injury. This paper provides a report of the outcomes of this survey. The response rate to this questionnaire was 57% (25/44). Fifty-six percent of respondents did not have experience of IH following minor head injury. Moreover, respondents' criteria for describing this disease differed greatly, especially in the radiological examinations and symptoms for the diagnosis of this entity which showed significant variation. These problems might originate from the general features of this disease. With the exception of postural headache, the symptoms of this disease varied enormously. This wide range of symptoms confused with the pathophysiolosies of a great many similar conditions. As such, clarifications of the pathophysiological characteristics of IH following minor head injury, together with consensus on specific criteria to describe the condition, are required. In conclusion, the results of this survey revealed many serious scientific and social problems associated with the diagnosis and treatment of intracranial hypotension following minor head injury. Scientific study including the

  5. Intracranial traumatic lesion risk factors in elderly patients with minor head injury

    International Nuclear Information System (INIS)

    Kochi, Masato; Hori, Shigeaki

    2011-01-01

    The authors conducted a retrospective analysis of the risk factors of intracranial traumatic lesions in elderly patients with minor head injury. Sixty-nine elderly patients with Glasgow Coma Scale (GCS) scores of 13-15 after head injury who had presented within 24 hours of trauma and admitted to hospital were included in this study. The indications for admission were a GCS score of 13 or 14 on presentation, loss of consciousness, retrograde or posttraumatic amnesia, local neurological deficit, severe headache and vomiting, dangerous mechanism of injury, skull fracture and abnormal CT findings. The relationship between the clinical findings and intracranial traumatic lesions was analized by univariate and multivariate analysis. The relationship between the clinical findings and surgical intervention was also analized by the same methods in those who had intracranial traumatic lesions. The mean and median age of patients were 81.1 and 83 years, respectively. Of 69 patients, 41 had intracranial traumatic lesions present on their CT scan. Of these, 6 needed surgical intervention. Multivariable logistic regression analysis showed that a Glasgow Coma Scale score of 13 and a loss of consciousness at injury were identified as independent risk factors of intracranial traumatic lesions in elderly patients with minor head injury and a dangerous mechanism of injury was identified as an independent risk factor of surgical intervention in those who had traumatic intracranial lesions. Our results offer useful information for evaluating patients with minor head injury in Japan's aging society. (author)

  6. Clinical features of the head injury caused by child abuse in infants

    International Nuclear Information System (INIS)

    Nishimoto, Hiroshi; Kurihara, Jun

    2007-01-01

    The diagnosis and managements of the head injury in battered children are greatly complicated by medical history and the mechanisms of injury. In the present study, we evaluated the clinical features of the head injury in battered children. Clinical signs and symptoms, the mechanisms of injury, intracranial pathology, and prognosis of 25 battered children with head injury treated between 1984 and 2003 were retrospectively analyzed. The age of 25 children was between 1 month and 2 years old. The average of the ages was 7 months old. In 68% of 25 patients, the age was 6 months or less. The medical history of head injury was unclear in 16 children. The chief complains were disturbance of consciousness, convulsion, vomiting and hypothermia. Retinal hemorrhages were recognized in 88% of the patients and these were bilateral in 68%. Acute subdural hematomas (19 cases) and chronic subdural hematomas (6 cases) were shown on CTs or MRIs. In four cases, cerebral contusions were complicated as intracranial pathology. In 44% of the patients, the hypoxic-ischemic injury was confirmed on CTs or MRIs. Fractures of limbs and ribs were recognized on skeletal survey in 40% of the patients. 71% of 17 survival cases had moderate or severe psychomotor disabilities at the end of follow-up periods. In children under 2 years of age with subdural hematomas, clinical investigations other than CT and MRI, included ophthalmoscopy by ophthalmologist and skeletal survey, are crucial and mandatory for early diagnosis of the child abuse. (author)

  7. Sports Related Injuries: Incidence, Management and Prevention

    OpenAIRE

    Stanger, Michael A.

    1982-01-01

    The incidence of injury related to various sports is reviewed according to sport, area of injury, number of participants and hours per week spent at the sport. Organized sports accounted for fewer injuries than unsupervised recreational activities like tree climbing, skateboarding and running. The knee is the most commonly injured site. Sensitivity to patients' commitment to their sport is necessary: sometimes instead of rest, they can substitute a less hazardous form of exercise. Principles ...

  8. Fatal lawn mower related projectile injury.

    Science.gov (United States)

    Colville-Ebeling, Bonnie; Lynnerup, Niels; Banner, Jytte

    2014-06-01

    Fatal lawn mower related injuries are a relatively rare occurrence. In a forensic setting, the primary aim is to reconstruct the injury mechanism and establish the cause of death. A relatively rare, but characteristic type of injury is a so-called projectile or missile injury. This occurs when the operator or a bystander is impacted by an object mobilized from the grass by the rotating mower blades. This type of injury often leaves only modest external trauma, which increases the risk of overlooking an entry wound. In this paper we present a case of a fatal lawn mower related projectile injury which was initially overlooked, later interpreted as a possible gunshot homicide, and finally identified as a lawn mower related projectile injury when autopsy revealed a piece of metal thread in the main bronchus to the right middle lobe, hemopericardium, and right-sided hemothorax. To our knowledge, this injury mechanism has not previously been reported as a cause of death. This case illustrates the importance of postmortem radiological imaging and interdisciplinary cooperation when establishing manner and cause of death in unusual cases.

  9. Lawn mower-related projectile injury.

    Science.gov (United States)

    McNamara, William F; Yamout, Sani Z; Escobar, Mauricio A; Glick, Philip L

    2009-07-01

    Lawn mower injuries are a potentially devastating, yet preventable cause of morbidity and mortality in the pediatric population. The sequelae to these injuries can become even worse if the initial presentation goes unsuspected by medical staff, leading to a delay in treatment. The authors report the case of a lawn mower-related penetrating missile injury, where the extent of injury was not appreciated by the patient until signs and symptoms of a soft-tissue infection developed, prompting the patient to seek medical attention the next day.

  10. Geriatric fall-related injuries.

    African Journals Online (AJOL)

    (57 injuries in 55 patients). Number. %. Male n = 20. Female n =35. P value. Hip fracture. 7. 12.7. 2. 5 .... Ministry of Health, Preventive Medicine Sector, Unit- ed Arab Emirates, Annual ... J Bone Miner Metab 2010;. 28:485-488 PubMed. doi: ...

  11. Head Injuries in School-Age Children Who Play Golf

    Science.gov (United States)

    Reuter-Rice, Karin; Krebs, Madelyn; Eads, Julia K.

    2016-01-01

    Traumatic brain injury (TBI) is the leading cause of death and disability in children. We conducted a prospective study, which examined injury characteristics and outcomes of school-age children of 5.0-15.0 years (N = 10) who were admitted to hospital for a TBI. This study evaluated the role of age, gender, the Glasgow Coma Scale, mechanisms and…

  12. Fatal lawn mower related projectile injury

    DEFF Research Database (Denmark)

    Colville-Ebeling, Bonnie; Lynnerup, Niels; Banner, Jytte

    2014-01-01

    was initially overlooked, later interpreted as a possible gunshot homicide, and finally identified as a lawn mower related projectile injury when autopsy revealed a piece of metal thread in the main bronchus to the right middle lobe, hemopericardium, and right-sided hemothorax. To our knowledge, this injury...

  13. How children with head injury represent real and deceptive emotion in short narratives.

    Science.gov (United States)

    Dennis, M; Barnes, M A; Wilkinson, M; Humphreys, R P

    1998-02-15

    Narratives are not only about events, but also about the emotions those events elicit. Understanding a narrative involves not just the affective valence of implied emotional states, but the formation of an explicit mental representation of those states. In turn, this representation provides a mechanism that particularizes emotion and modulates its display, which then allows emotional expression to be modified according to particular contexts. This includes understanding that a character may feel an emotion but inhibit its display or even express a deceptive emotion. We studied how 59 school-aged children with head injury and 87 normally-developing age-matched controls understand real and deceptive emotions in brief narratives. Children with head injury showed less sensitivity than controls to how emotions are expressed in narratives. While they understood the real emotions in the text, and could recall what provoked the emotion and the reason for concealing it, they were less able than controls to identify deceptive emotions. Within the head injury group, factors such as an earlier age at head injury and frontal lobe contusions were associated with poor understanding of deceptive emotions. The results are discussed in terms of the distinction between emotions as felt and emotions as a cognitive framework for understanding other people's actions and mental states. We conclude that children with head injury understand emotional communication, the spontaneous externalization of real affect, but not emotive communication, the conscious, strategic modification of affective signals to influence others through deceptive facial expressions.

  14. Role of Postmortem Multislice Computed Tomography Scan in Close Blunt Head Injury

    Directory of Open Access Journals (Sweden)

    Prijo Sidipratomo

    2014-08-01

    Full Text Available BACKGROUND: Conventional autopsy in Indonesia is not well accepted as it is contrary to religion and culture. New radiological imaging method such as multislice computed tomography (MSCT scan has potential to be a diagnostic tool in forensic pathology. The purpose of this study is to determine the ability of MSCT scan in finding abnormalities in close blunt head injury compared with autopsy. METHODS: This study used descriptive qualitative method. Postmortem cases in Department of Forensic Medicine and Radiology of Dr. Cipto Mangunkusumo Hospital were selected based on inclusion criteria. Then MSCT scan and autopsy were conducted. MSCT scan and autopsy results were compared and analyzed. RESULTS: There were 491 postmortem cases of blunt head injury. However, only 10 cases fulfilled inclusion criteria. Subarachnoid haemorrhages were identified 100% with MSCT scan and 80% with autopsy. Cerebral oedemas were identified 100% either with MSCT scan and autopsy. Subdural haemorrhages were identified 100% with MSCT scan, while 50% with autopsy. Multiple fractures were identified 80% with MSCT scan, while 40% with auto. CONCLUSIONS: MSCT scan showed a sensitive detection in finding abnormalities in close blunt head injury. Therefore it could be as an alternative choice of examination in close blunt head injury cases. KEYWORDS: multislice computed tomography scan, postmortem, blunt head injury, autopsy.

  15. Cognitive contributions to theory of mind ability in children with a traumatic head injury.

    Science.gov (United States)

    Levy, Naomi Kahana; Milgram, Noach

    2016-01-01

    The objective of the current study is to examine the contribution of intellectual abilities, executive functions (EF), and facial emotion recognition to difficulties in Theory of Mind (ToM) abilities in children with a traumatic head injury. Israeli children with a traumatic head injury were compared with their non-injured counterparts. Each group included 18 children (12 males) ages 7-13. Measurements included reading the mind in the eyes, facial emotion recognition, reasoning the other's characteristics based on motive and outcome, Raven's Coloured Progressive Matrices, similarities and digit span (Wechsler Intelligence Scale for Children - Revised 95 subscales), verbal fluency, and the Behaviour Rating Inventory of Executive Functions. Non-injured children performed significantly better on ToM, abstract reasoning, and EF measures compared with children with a traumatic head injury. However, differences in ToM abilities between the groups were no longer significant after controlling for abstract reasoning, working memory, verbal fluency, or facial emotion recognition. Impaired ToM recognition and reasoning abilities after a head injury may result from other cognitive impairments. In children with mild and moderate head injury, poorer performance on ToM tasks may reflect poorer abstract reasoning, a general tendency to concretize stimuli, working memory and verbal fluency deficits, and difficulties in facial emotion recognition, rather than deficits in the ability to understand the other's thoughts and emotions. ToM impairments may be secondary to a range of cognitive deficits in determining social outcomes in this population.

  16. Team medicine in head injury. Usefulness of telemedicine in cooperation with medically depopulated areas

    International Nuclear Information System (INIS)

    Takazawa, Hiroki; Morita, Takahiro; Narisawa, Ayumi; Saito, Atsushi; Koyama, Shinya; Sasaki, Tatsuya; Nishijima, Michiharu

    2011-01-01

    Our hospital is located between Tsugaru and Shimokita Peninsulas that are wide medically depopulated areas. The depopulated Tsugaru District has only 2 neurosurgical units, and many patients have to be transferred from the district general hospitals. Since 1989, we have been using an image transfer system that is useful for accurately diagnosing patients with head injury. Between January 2005 and September 2010, 644 patients with head injury were admitted to our hospital. The patients who used and did not use telemedicine were 78 and 566, respectively. In both groups, the background (age, gender, and type of head injury), surgery rate, and time of entry into the operating room were analyzed. There were no significant differences in the age, gender, and type of head injuries between the 2 groups. The surgery rate was 25.6% (28 patients) in the telemedicine group and 12.4% (70 patients) in the direct admission group. The average amount of time between admission and entry into the operating room was 2 h and 13 min in the telemedicine group and 2 h and 57 min in the direct admission group. There were significant differences between the telemedicine and direct admission groups (p<0.05). These results suggest that telemedicine is useful in the treatment of patients with head injuries in a widely depopulated area. (author)

  17. Penetrating Bihemispheric Traumatic Brain Injury: A Collective Review of Gunshot Wounds to the Head.

    Science.gov (United States)

    Turco, Lauren; Cornell, David L; Phillips, Bradley

    2017-08-01

    Head injuries that cross midline structures of the brain are bihemispheric. Other terms have been used to describe such injuries, but bihemispheric is the most accurate and should be standard nomenclature. Bihemispheric head injuries are associated with greater mortality and morbidity than other penetrating traumatic brain injuries (TBIs). Currently, there is a tendency to manage severe gunshot wounds (GSWs) to the head nonoperatively, despite reports of improved outcome in military patients treated aggressively. Thus, controversy exists in the management of civilian TBI. PubMed was searched for query terms, and PRISMA guidelines were used. Studies were selected by relevance and inclusion of data regarding etiology, diagnosis, and management of bihemispheric TBI. Case reports, studies not in English, and records lacking information on mechanism or bihemispheric injuries were excluded. Thirteen studies were included and most contained level IV evidence. The mean mortality rate of all head GSWs was 62% in adults and 32% in children. Bihemispheric GSWs had greater mortality rates of 82% in adults and 60% in children. There was a larger proportion of self-inflicted injury in studies with greater rates of bihemispheric injuries. Bihemispheric injuries have greater mortality rates than other penetrating TBI. Violation of midline brain structures such as the diencephalon and mesencephalon, increased rate of self-inflicted wounds, and lack of a standard management algorithm may increase the lethality of these injuries. Although bihemispheric injuries historically have been considered nonsalvageable, an aggressive surgical approach has been shown to improve outcomes, particularly in the military population. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. A biopsychosocial investigation of changes in self-concept on the Head Injury Semantic Differential Scale.

    Science.gov (United States)

    Reddy, Avneel; Ownsworth, Tamara; King, Joshua; Shields, Cassandra

    2017-12-01

    This study aimed to investigate the influence of the "good-old-days" bias, neuropsychological functioning and cued recall of life events on self-concept change. Forty seven adults with TBI (70% male, 1-5 years post-injury) and 47 matched controls rated their past and present self-concept on the Head Injury Semantic Differential Scale (HISD) III. TBI participants also completed a battery of neuropsychological tests. The matched control group of 47 were from a sample of 78 uninjured participants who were randomised to complete either the Social Readjustment Rating Scale-Revised (cued recall) or HISD (non-cued recall) first. Consistent with the good-old-days bias, participants with TBI rated their pre-injury self-concept as more positive than their present self-concept and the present self-concept of controls (p concept ratings were related to lower estimated premorbid IQ and poorer verbal fluency and delayed memory (p concept change (p concept as significantly more negative than the non-cued group (p concept change by affecting retrospective ratings of past self-concept. Further research is needed to investigate the impact of contextual cues on self-concept change after TBI.

  19. Soccer-Related Injuries Treated in Emergency Departments: 1990-2014.

    Science.gov (United States)

    Smith, Nicholas A; Chounthirath, Thiphalak; Xiang, Huiyun

    2016-10-01

    To investigate the epidemiology of youth soccer-related injuries treated in emergency departments in the United States. A retrospective analysis was conducted of soccer-related injuries among children 7 through 17 years of age from 1990 through 2014 with data from the National Electronic Injury Surveillance System. Injury rates were calculated from soccer participation data. An estimated 2 995 765 (95% confidence interval [CI], 2 309 112-3 682 418) children 7 through 17 years old were treated in US emergency departments for soccer-related injuries during the 25-year study period, averaging 119 831 (95% CI, 92 364-147 297) annually. The annual injury rate per 10 000 soccer participants increased significantly, by 111.4%, from 1990 to 2014. Patients 12 to 17 years old accounted for 72.7% of injuries, 55.5% of patients were male, and most injuries occurred in a place of sport or recreation (68.5%) or school (25.7%). Struck by (38.5%) and fell (28.7%) were the leading mechanisms of injury. Injuries most commonly were diagnosed as sprain or strain (34.6%), fracture (23.2%), and soft tissue injury (21.9%), and occurred to the upper extremity (20.7%), ankle (17.8%), and head or neck (17.7%). Concussions or other closed head injuries accounted for 7.3% of the injuries, but the annual rate of concussions/closed head injuries per 10 000 participants increased significantly, by 1595.6%, from 1990 to 2014. This study is the first to comprehensively investigate soccer-related injuries and calculate injury rates based on soccer participation data among children at the national level. The increasing number and rate of pediatric soccer-related injuries, especially soccer-related concussions/closed head injuries, underscore the need for increased efforts to prevent these injuries. Copyright © 2016 by the American Academy of Pediatrics.

  20. Suspected alcohol and addictive narcotic use were more at risk to severe head injury

    Directory of Open Access Journals (Sweden)

    Woro Riyadina

    2012-07-01

    Full Text Available Latar belakang: Cedera kepala menyebabkan dampak seperti gangguan kognitif, perilaku dan keterbatasan fisik. Tujuan studi ini untuk menentukan faktor utama yang berkontribusi terhadap keparahan cedera kepala pada pasien yang dirawat inap di rumah sakit. Metode: Studi ini merupakan bagian dari penelitian “Pengembangan Database Registri Trauma sebagai Penunjang Sistem Surveilans Cedera”. Data dikumpulkan dengan cara abstraksi dari rekam medis oleh petugas terlatih dengan formulir registri pada pasien cedera yang dirawat inap di 3 rumah sakit dari bulan Januari – Agustus 2010. Keparahan cedera diklasifikasikan berdasarkan Glasgow Coma Scale (GCS dengan batasan nilai 3-9 mengalami cedera kepala berat, 10-12 cedera kepala sedang dan 13-15 cedera kepala ringan. Hasil: Dari 450 pasien cedera rawat inap terdapat 36 pasien (8% yang mengalami cedera kepala berat. Pasien dengan indikasi mengkonsumsi alkohol/narkotik mempunyai risiko hampir 5 kali mengalami cedera kepala berat [rasio odds suaian (ORa = 4,77; 95% interval kepercayaan (CI=1,04–21,75] dibanding tanpa indikasi. Pasien yang tidak dirujuk mempunyai risiko 5,5 kali  mengalami cedera kepala berat (ORa=5,50; 95% CI=2,28–13,27 dibanding pasien yang dirujuk. Pasien cedera karena kecelakaaan lalu lintas dibanding bukan kecelakaan lalu lintas mempunyai risiko 3 kali mengalami cedera kepala berat (ORa=3,43; 95% CI=1,14–10,32. Kesimpulan: Indikasi mengkonsumsi alkohol/narkotik berkontribusi paling besar terhadap keparahan cedera kepala. Kampanye anti alkohol/narkotik dan perlu dilakukan untuk mencegah cedera kepala berat. (Health Science Indones 2011;2:34-40   Abstract Background: The impact of head injuries were cognitive disorder, behavioral disorder and physical limitation. The objective of this study was to identify a major factor that contributes to head injury severity in hospitalized patients. Methods: This study was part of research "Development of Trauma Registry Databases as a

  1. A six year prospective study of the incidence and causes of head and neck injuries in international football.

    Science.gov (United States)

    Fuller, C W; Junge, A; Dvorak, J

    2005-08-01

    To identify those risk factors that have the greatest impact on the incidence of head and neck injuries in international football. A case-control study of players sustaining head and neck injuries during 20 FIFA tournaments (men and women) from 1998 to 2004. Video recordings of incidents were used to identify a range of parameters associated with the incidents. Team physicians provided medical reports describing the nature of each injury. chi2 tests (pvideo sequences. The commonest injuries were contusions (53%), lacerations (20%), and concussions (11%). The incidence of all head and neck injuries was 12.5/1000 player hours (men 12.8, women 11.5) and 3.7 for lost-time injuries (men 3.5, women 4.1). The commonest causes of injury involved aerial challenges (55%) and the use of the upper extremity (33%) or head (30%). The unfair use of the upper extremity was significantly more likely to cause an injury than any other player action. Only one injury (a neck muscle strain) occurred as a result of heading the ball throughout the 20 tournaments equivalent to 0.05 injuries/1000 player hours. Players' actions most likely to cause a head or neck injury were the use of the upper extremity or the head but in the majority of cases these challenges were deemed to be fair and within the laws of the game.

  2. Early insulin resistance in severe trauma without head injury as outcome predictor? A prospective, monocentric pilot study

    Directory of Open Access Journals (Sweden)

    Bonizzoli Manuela

    2012-10-01

    Full Text Available Abstract Background Hyperglycemia following major trauma is a well know phenomenon related to stress-induced systemic reaction. Reports on glucose level management in patients with head trauma have been published, but the development of insulin resistance in trauma patients without head injury has not been extensively studied. The aim of this study was therefore to investigate the prognostic role of acute insulin-resistance, assessed by the HOMA model, in patients with severe trauma without head injury. Methods All patients consecutively admitted to the Intensive Care Unit (ICU of a tertiary referral center (Careggi Teaching Hospital, Florence, IT for major trauma without head injury (Jan-Dec 2010 were enrolled. Patients with a previous diagnosis of diabetes mellitus requiring insulin therapy or metabolism alteration were excluded from the analysis. Patients were divided into “insulin resistant” and “non-insulin resistant” based on the Homeostasis Model Assessment index (HOMA IR. Results are expressed as medians. Results Out of 175 trauma patients admitted to the ICU during the study period, a total of 54 patients without head trauma were considered for the study, 37 of whom met the inclusion criteria. In total, 23 patients (62.2% resulted insulin resistant, whereas 14 patients (37.8% were non-insulin resistant. Groups were comparable in demographic, clinical/laboratory characteristics, and severity of injury. Insulin resistant patients had a significantly higher BMI (P=0.0416, C-reactive protein (P=0.0265, and leukocytes count (0.0301, compared to non-insulin resistant patients. Also ICU length of stay was longer in insulin resistant patients (P=0.0381. Conclusions Our data suggest that admission insulin resistance might be used as an early outcome predictor.

  3. Motorcycle helmet use and the risk of head, neck, and fatal injury: Revisiting the Hurt Study.

    Science.gov (United States)

    Rice, Thomas M; Troszak, Lara; Ouellet, James V; Erhardt, Taryn; Smith, Gordon S; Tsai, Bor-Wen

    2016-06-01

    Most studies find strong evidence that motorcycle helmets protect against injury, but a small number of controversial studies have reported a positive association between helmet use and neck injury. The most commonly cited paper is that of Goldstein (1986). Goldstein obtained and reanalyzed data from the Hurt Study, a prospective, on-scene investigation of 900 motorcycle collisions in the city of Los Angeles. The Goldstein results have been adopted by the anti-helmet community to justify resistance to compulsory motorcycle helmet use on the grounds that helmets may cause neck injuries due to their mass. In the current study, we replicated Goldstein's models to understand how he obtained his unexpected results, and we then applied modern statistical methods to estimate the association of motorcycle helmet use with head injury, fatal injury, and neck injury among collision-involved motorcyclists. We found Goldstein's analysis to be critically flawed due to improper data imputation, modeling of extremely sparse data, and misinterpretation of model coefficients. Our new analysis showed that motorcycle helmets were associated with markedly lower risk of head injury (RR 0.40, 95% CI 0.31-0.52) and fatal injury (RR 0.44, 95% CI 0.26-0.74) and with moderately lower but statistically significant risk of neck injury (RR 0.63, 95% CI 0.40-0.99), after controlling for multiple potential confounders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Pediatric patients with severe head injury in Japan Neurotrauma Data Bank. Analysis of the prognostic factors

    International Nuclear Information System (INIS)

    Miki, Tamotsu; Haraoka, Jo

    2009-01-01

    The purpose of this study is to evaluate the clinical characteristics of the pediatric patients in the Japan Neurotrauma Data Bank: Project 2004. Project 2004 consisted of severe head injury patients with a Glasgow Coma Scale (GCS) score of 8 or less on admission or during course and patients who were operated for traumatic intracranial lesion between 2004-2006. The subjects were 101 pediatric patients aged 15 years old or less (mean: 7.8 y/o). We retrospectively examined the patients' age, GCS, cause of injury, duration and time of patient transfer, pupillary abnormality, body temperature, serum glucose level, Injury Severity Score (ISS) excluding cranio-cervical score, skull fracture, CT classification of the Traumatic Coma Data Bank (TCDB), main lesion of focal brain injury on CT, and traumatic subarachnoid hemorrhage (SAH) on CT. The mortality rate in children is lower than in adults: 18.8% vs. 39.7%. The factors that correlated to the poor outcome in pediatric patients are lower GCS score on admission, pupillary abnormality, hyperglycemia (more than 200 mg/dl), complications of severe other organ injury, diffuse injury III according to classification of CT, acute subdural hematoma and SAH. Pathophysiologically pediatric patients are not miniatures of adult patients. The data of Project 2004 is extremely significant and indicates the profile of one general view of pediatric patients with severe head injury in Japan. However, further collection of data and careful analysis are necessary for standardizing pediatric head trauma care. (author)

  5. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Brors, D. [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Schaefers, M. [Dept. of Neurology, University Hospital Wuerzburg (Germany); Schick, B.; Draf, W. [Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Dazert, S. [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Kahle, G. [Department of Radiology, Hospital Fulda (Germany)

    2001-02-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  6. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Brors, D [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Schaefers, M [Dept. of Neurology, University Hospital Wuerzburg (Germany); Schick, B; Draf, W [Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Dazert, S [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Kahle, G [Department of Radiology, Hospital Fulda (Germany)

    2001-02-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  7. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    International Nuclear Information System (INIS)

    Brors, D.; Schaefers, M.; Schick, B.; Draf, W.; Dazert, S.

    2001-01-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  8. Management of minor head injury in patients receiving oral anticoagulant therapy: a prospective study of a 24-hour observation protocol.

    Science.gov (United States)

    Menditto, Vincenzo G; Lucci, Moira; Polonara, Stefano; Pomponio, Giovanni; Gabrielli, Armando

    2012-06-01

    Patients receiving warfarin who experience minor head injury are at risk of intracranial hemorrhage, and optimal management after a single head computed tomography (CT) scan is unclear. We evaluate a protocol of 24-hour observation followed by a second head CT scan. In this prospective case series, we enrolled consecutive patients receiving warfarin and showing no intracranial lesions on a first CT scan after minor head injury treated at a Level II trauma center. We implemented a structured clinical pathway, including 24-hour observation and a CT scan performed before discharge. We then evaluated the frequency of death, admission, neurosurgery, and delayed intracranial hemorrhage. We enrolled and observed 97 consecutive patients. Ten refused the second CT scan and were well during 30-day follow-up. Repeated CT scanning in the remaining 87 patients revealed a new hemorrhage lesion in 5 (6%), with 3 subsequently hospitalized and 1 receiving craniotomy. Two patients discharged after completing the study protocol with 2 negative CT scan results were admitted 2 and 8 days later with symptomatic subdural hematomas; neither received surgery. Two of the 5 patients with delayed bleeding at 24 hours had an initial international normalized ratio greater than 3.0, as did both patients with delayed bleeding beyond 24 hours. The relative risk of delayed hemorrhage with an initial international normalized ratio greater than 3.0 was 14 (95% confidence interval 4 to 49). For patients receiving warfarin who experience minor head injury and have a negative initial head CT scan result, a protocol of 24-hour observation followed by a second CT scan will identify most occurrences of delayed bleeding. An initial international normalized ratio greater than 3 suggests higher risk. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  9. Characterization of patients with head trauma and traumatic axonal injury

    International Nuclear Information System (INIS)

    Mosquera Betancourt, Dra.C. Gretel; Van Duc, Dr. Hanh; Casares Delgado, Dr. Jorge Alejandro; Hernández González, Dr. Erick Héctor

    2016-01-01

    Background: traumatic axonal injury is characterized by multifocal lesions, consequences of primary, secondary and tertiary damage which is able to cause varying degrees of disability. Objective: to characterize patients with traumatic axonal injury. Methods: a cross-sectional analytical study was conducted from January 2014 to December 2015. The target population was composed of 35 patients over age 18 whose diagnosis was traumatic axonal injury type I and IV of the Marshall computed tomographic (CT) classification. With the data collected from medical records revisions and direct observation, a database was created in SPSS for its processing through univariate and multivariate techniques. Results: male patients between 18 and 30 years old without bad habits prevailed. Most of the patients survived and death was associated with the presence of severe traumatic axonal injury, Marshall computed tomographic (CT) classification degree III, complications and presence of trauma in thorax, abdomen and cervical spine. Conclusions: diagnosis of traumatic axonal injury is based on the clinical radiological correlation based on images from tomography and it is confirmed by Magnetic resonance imaging (MRI). Histological study shows injuries that are not demonstrated in the most advanced radiological studies. Its prevention is the most fundamental base in medical assistance, followed by neurocritical attention oriented by neuromonitoring. (author)

  10. Firework related injury in New Zealand.

    Science.gov (United States)

    Clarke, J A; Langley, J D

    1994-10-26

    In March 1992 a private members Bill was introduced into parliament which sought to place tighter restrictions on the sale of fireworks. The primary purpose of this research was to document the nature and extent of firework related injury in New Zealand for the purpose of preparing a submission on this Bill. Firework related injuries were examined in relation to the legislative history of fireworks control in New Zealand to ascertain if existing regulations had been effective in reducing firework injuries and whether there was justification for greater control. Between 1979 and 1992 (inclusive) 237 persons were admitted to hospital for treatment of injuries related to fireworks. The overall incidence rate for this period was 0.52 per 100,000 persons per year. Eighty five percent of all events involved males. Children (fireworks (as is proposed in the Bill). The current legislation could well be supported though, by extending the ban on the types of fireworks publicly available to include skyrockets.

  11. The Evidence for Brain Injury in Whiplash Injuries

    Directory of Open Access Journals (Sweden)

    Michael P. Alexander

    2003-01-01

    Full Text Available The evidence that brain damage can occur in injuries that produce whiplash is reviewed. The clinical phenomena for the two injuries are the same. Pure whiplash injury implies no, or minimal head contact, but many patients also have head contact against a head rest or the steering wheel or windshield. The relative severity of the neck injury and the head injury distinguishes whiplash from mild closed head injury. If there is brain injury is some patients with whiplash, it, by definition, falls at the mildest end of the concussion spectrum. The relationship between these two injuries is examined.

  12. Holiday ornament-related injuries in children.

    Science.gov (United States)

    Kimia, Amir; Lee, Lois; Shannon, Michael; Capraro, Andrew; Mays, Donald; Johnston, Patrick; Hummel, David; Shuman, Margot

    2009-12-01

    Holiday ornament injuries in children have not been well documented in the medical literature. Our aim was to investigate the patterns of injuries sustained from these ornaments as a first measure toward prevention. This was a retrospective cohort analysis of all patients examined in an urban pediatric emergency department over a 13-year period ending in March 2008 for holiday ornament-related injuries. Cases were identified using a computer-assisted text query followed by a manual chart review. Data collected from each chart included the child's age, sex, injury characteristics, physical examination findings, radiographic imaging, interventions, and disposition. To analyze injury rates over the years, we used a multiplicative Poisson model allowing varying exposures. Over the study period, we identified 76 eligible patients. The median age was 2 years (interquartile range, 1.17-3.3 years); 44.7% were female. Forty-three of the 76 cases (53.9%) involved ingestions: 35 were of holiday ornaments, and 8 were of light bulbs. All but one of these ornaments were made of glass. In 28%, there was an associated bleed either from the mouth or as a delayed gastrointestinal bleed. Other patients experienced lacerations (27.6%), eye injuries (5.1%), and minor electrocution injury (2.5%). Imaging was performed in 85%. A subspecialty consult was obtained in 23%, primarily addressing a foreign body ingestion or removal after skin exploration. The incidence rate has not changed over the years. Holiday ornament-related injuries primarily involve foreign body ingestions and glass-related injuries. Over half of the injuries involved small light bulbs and ornaments made of glass placed at the level a toddler can reach. Pediatricians are advised to discuss these points with families during holiday season.

  13. Fast vigilance decrement in closed head injury patients as reflected by the mismatch negativity (MMN).

    Science.gov (United States)

    Kaipio, M L; Novitski, N; Tervaniemi, M; Alho, K; Ohman, J; Salonen, O; Näätänen, R

    2001-05-25

    Event-related potentials (ERPs) were measured from 24 chronic closed head injury (CHI) patients and 18 age- and education-matched controls. The oddball paradigm was applied while subjects were watching a silent movie. The standard (p=0.8) sound of 75 ms duration had a basic frequency of 500 Hz with harmonic partials of 1000 Hz and 1500 Hz, whereas these frequencies for the pitch deviant were each 10% higher. The frequencies of the duration deviant matched with those of the standard but was 25 ms in duration. The MMN (mismatch negativity), generated by the brain's automatic auditory change-detector mechanism, was elicited by both deviants. No significant differences in the MMN latency or amplitude for either pitch or duration deviants were found between the groups. However, the MMN amplitude for the pitch deviant decreased in the patient group during the experiment considerably faster than in controls, suggesting a faster vigilance decrement in the patients.

  14. Preventing Paraffin-Related Injury

    OpenAIRE

    C. Schwebel, David; Swart, Dehran

    2009-01-01

    Paraffin (called kerosene in North America and other parts of the world) is the most commonly used fuel in ‎non-electrified dwellings worldwide. It is especially popular in Africa and South Asia. Although paraffin ‎offers many advantages – especially its comparatively low cost to produce – it poses two major risks of ‎injury. First, paraffin poisoning is common, either through ingestion or through inhalation of smoke and ‎fumes. Second, paraffin is highly flammable, and poses fire risk t...

  15. Corpus callosum lesions after closed head injury in children: MRI, clinical features and outcome

    International Nuclear Information System (INIS)

    Mendelsohn, D.B.; Bruce, D.

    1992-01-01

    Thirty-four children who sustained moderate to severe closed head injury underwent magnetic resonance imaging (MRI). Eight (24%) had MRI evidence of corpus callosum injury, most commonly within the posterior body and splenium. In contradistinction to reports in adults, there was no definite relationship between callosal injury and lower initial Glasgow Coma Scale scores, nor was there a significantly higher incidence of primary brain-stem lesions, diffuse axonal shear injury or intraventricular hemorrhage. In none of these 8 children did the initial admission computed tomography show evidence of callosal injury. Callosal injuries on MRI are not necessarily a poor prognostic finding, the majority of the 8 children showing good functional recovery. (orig.)

  16. Cow-related trauma: a 10-year review of injuries admitted to a single institution.

    LENUS (Irish Health Repository)

    Murphy, Colin G

    2012-02-01

    INTRODUCTION: Bovine-related injuries to farmers are common in rural communities. Many injuries are significant requiring hospital admission and surgery. We reviewed all cattle-related injuries admitted to a regional trauma centre over 10 years and detail the nature of the injuries. METHOD: A retrospective review was undertaken, using hospital inpatient coding system (HIPE) to identify patients admitted following cow-related trauma for the last 10 years. From retrieved charts mechanism of injury was identified, demographics recorded and Injury Severity Score (ISS) and Trauma Injury Severity Score (TRISS) calculated based on the injuries sustained. RESULTS: 47 patients were identified, with a median age of 53 years. 4 injuries occurred in children, and 12 in patients over 65 years old. Three-quarters of those injured were male. Kicking was the most common mechanism of injury (n=21), but charge\\/head-butt injuries and trampling injuries were associated with more serious injury scores. 72% of patients were admitted under Orthopaedics as their primary care team, 25% under General Surgeons, with one patient admitted medically. Mean ISS score was 6.9 (range 1-50). 41 operative interventions were performed on 30 patients during their admission. 6.3% of patients required admission to Intensive Care with a mean length of stay of 12.3 days (range 2-21 days). There was no mortality. CONCLUSION: Cow-related trauma is a common among farming communities and is a potentially serious mechanism of injury that appears to be under-reported in a hospital context. Bovine-related head-butt and trampling injuries should be considered akin to high-velocity trauma.

  17. Establishment of a head injury by club model in rabbits and experimental conditions

    International Nuclear Information System (INIS)

    Cao Yunxing; Xi Huanjiu; Zhang Jing; Li Hongwei; Yin Zhiyong; Zhao Hui

    2013-01-01

    Objective: To establish an animal model to replicate the injury by club in forensic medicine. Methods: Twenty-four New Zealand white rabbits were divided into control group (n=4), minor injury group (n=10), and severe injury group (n=10). Based on the BIM-Ⅱ Horizontal Bio-impact Machine, a self-designed iron bar was used to produce head injury by club. Six hours after injury, all the rabbits were subjected to a CT examination and dissected to observe the injury morphology and undergo routine pathological examination. Four control, six minor and severe rabbits were given moisture content examination. Results: Varying degrees of positive signs of the nervous system were observed in all the injured rabbits within 6 hours. The mortality rate was 1/10 in the minor injury group and 6/10 in the severe injury group. The morphological changes consisted of different levels of scalp hematoma, skull fracture, epidural hematoma, subdural hematoma, subarachnoid hemorrhage and brain injury. The difference in moisture content between the three groups was of statistical significance. Conclusion: Under the rigidly-controlled experimental condition, this animal model produces good reproducibility and stable results. Meanwhile, it can simulate the morphology of injury by club and be used to study the mechanism of injury by club in forensic medicine. (authors)

  18. Spasm of the near reflex associated with head injury.

    Science.gov (United States)

    Knapp, Christopher; Sachdev, Arun; Gottlob, Irene

    2002-03-01

    Spasm of the near reflex is characterized by intermittent miosis, convergence spasm and pseudomyopia with blurred vision at distance. Usually, it is a functional disorder in young patients with underlying emotional problems. Only rarely is it caused by organic disorder. We report a patient who developed convergent spasm associated with miosis after head trauma at the age of 84 years.

  19. Femoral head injuries: Which treatment strategy can be recommended?

    NARCIS (Netherlands)

    Henle, Philipp; Kloen, Peter; Siebenrock, Klaus A.

    2007-01-01

    Despite different operative and non-operative treatment regimens, the outcome after femoral head fractures has changed little over the past decades. The initial trauma itself as well as secondary changes such as posttraumatic osteoarthritis, avascular necrosis or heterotopic ossification is often

  20. Injuries in recreational curling include head injuries and may be prevented by using proper footwear

    OpenAIRE

    D. K. Ting; R. J. Brison

    2015-01-01

    Introduction: Our study examines a recreational curling population to describe patterns of injury occurrence, estimate risk of injury and to gauge attitudes towards equipment-based prevention strategies. Methods: In a retrospective case series, we queried the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), a national injury surveillance database, for curling injuries entered between 1993 and 2011. Kingston General Hospital and Hotel Dieu Hospital provide the two Kingston,...

  1. Seizure Severity Is Correlated With Severity of Hypoxic-Ischemic Injury in Abusive Head Trauma.

    Science.gov (United States)

    Dingman, Andra L; Stence, Nicholas V; O'Neill, Brent R; Sillau, Stefan H; Chapman, Kevin E

    2017-12-12

    The objective of this study was to characterize hypoxic-ischemic injury and seizures in abusive head trauma. We performed a retrospective study of 58 children with moderate or severe traumatic brain injury due to abusive head trauma. Continuous electroencephalograms and magnetic resonance images were scored. Electrographic seizures (51.2%) and hypoxic-ischemic injury (77.4%) were common in our cohort. Younger age was associated with electrographic seizures (no seizures: median age 13.5 months, interquartile range five to 25 months, versus seizures: 4.5 months, interquartile range 3 to 9.5 months; P = 0.001). Severity of hypoxic-ischemic injury was also associated with seizures (no seizures: median injury score 1.0, interquartile range 0 to 3, versus seizures: 4.5, interquartile range 3 to 8; P = 0.01), but traumatic injury severity was not associated with seizures (no seizures: mean injury score 3.78 ± 1.68 versus seizures: mean injury score 3.83 ± 0.95, P = 0.89). There was a correlation between hypoxic-ischemic injury severity and seizure burden when controlling for patient age (r s =0.61, P interquartile range 0 to 0.23 on magnetic resonance imaging done within two days versus median restricted diffusion ratio 0.13, interquartile range 0.01 to 0.43 on magnetic resonance imaging done after two days, P = 0.03). Electrographic seizures are common in children with moderate to severe traumatic brain injury from abusive head trauma, and therefore children with suspected abusive head trauma should be monitored with continuous electroencephalogram. Severity of hypoxic-ischemic brain injury is correlated with severity of seizures, and evidence of hypoxic-ischemic injury on magnetic resonance imaging may evolve over time. Therefore children with a high seizure burden should be reimaged to evaluate for evolving hypoxic-ischemic injury. Published by Elsevier Inc.

  2. A mouse model of weight-drop closed head injury: emphasis on cognitive and neurological deficiency

    Directory of Open Access Journals (Sweden)

    Igor Khalin

    2016-01-01

    Full Text Available Traumatic brain injury (TBI is a leading cause of death and disability in individuals worldwide. Producing a clinically relevant TBI model in small-sized animals remains fairly challenging. For good screening of potential therapeutics, which are effective in the treatment of TBI, animal models of TBI should be established and standardized. In this study, we established mouse models of closed head injury using the Shohami weight-drop method with some modifications concerning cognitive deficiency assessment and provided a detailed description of the severe TBI animal model. We found that 250 g falling weight from 2 cm height produced severe closed head injury in C57BL/6 male mice. Cognitive disorders in mice with severe closed head injury could be detected using passive avoidance test on day 7 after injury. Findings from this study indicate that weight-drop injury animal models are suitable for further screening of brain neuroprotectants and potentially are similar to those seen in human TBI.

  3. Paediatric head injuries in the Kwazulu-Natal Province of South Africa: a developing country perspective.

    Science.gov (United States)

    Okyere-Dede, Ebenezer K; Nkalakata, Munyaradzi C; Nkomo, Tshepo; Hadley, G P; Madiba, Thandinkosi E

    2013-01-01

    We investigated the causes, management and outcome of head injuries in paediatric patients admitted to the paediatric surgery unit at King Edward VIII Hospital over a 3-year period, from 1999 to 2001. There were 506 patients (331 male; M:F ratio 2:1) and the mean age was 71.99 +36.8 months (2 weeks to 180 months). The injuries were due to: motor vehicle crashes (324); falls (121); assault (30); inadvertent injury (23); and unknown (11). Forty-nine patients (9%) were admitted with a Glasgow Coma Scale ≤8. The most common intracranial pathology on computed tomography was: intracranial haematoma/haemorrhage (44); contusion (16); and brain oedema (10). Nineteen patients (3.4%) underwent neurosurgical intervention and the rest were managed conservatively. Eighteen died in hospital (3.6%). The mean hospital stay was 5 ± 12 days. Twenty-three patients (4.5%) were discharged with neurological sequelae. Few paediatric patients are admitted with severe head injury: the majority from blunt injury caused by motor vehicle crashes. Management mainly requires simple neurological observation in a general ward with a surprisingly good prognosis. Specific protocols for paediatric head injuries have been proposed based on these findings.

  4. Head Injury as a Risk Factor for Dementia and Alzheimer's Disease: A Systematic Review and Meta-Analysis of 32 Observational Studies.

    Directory of Open Access Journals (Sweden)

    Yanjun Li

    Full Text Available Head injury is reported to be associated with increased risks of dementia and Alzheimer's disease (AD in many but not all the epidemiological studies. We conducted a systematic review and meta-analysis to estimate the relative effect of head injury on dementia and AD risks.Relevant cohort and case-control studies published between Jan 1, 1990, and Mar 31, 2015 were searched in PubMed, Web of Science, Scopus, and ScienceDirect. We used the random-effect model in this meta-analysis to take into account heterogeneity among studies.Data from 32 studies, representing 2,013,197 individuals, 13,866 dementia events and 8,166 AD events, were included in the analysis. Overall, the pooled relative risk (RR estimates showed that head injury significantly increased the risks of any dementia (RR = 1.63, 95% CI 1.34-1.99 and AD (RR = 1.51, 95% CI 1.26-1.80, with no evidence of publication bias. However, when considering the status of unconsciousness, head injury with loss of consciousness did not show significant association with dementia (RR = 0.92, 95% CI 0.67-1.27 and AD (RR = 1.49, 95% CI 0.91-2.43. Additionally, this positive association did not reach statistical significance in female participants.The findings from this meta-analysis indicate that head injury is associated with increased risks of dementia and AD.

  5. Head and neck injury patterns in fatal falls: epidemiologic and biomechanical considerations.

    Science.gov (United States)

    Freeman, Michael D; Eriksson, Anders; Leith, Wendy

    2014-01-01

    Fatal falls often involve a head impact, which are in turn associated with a fracture of the skull or cervical spine. Prior authors have noted that the degree of inversion of the victim at the time of impact is an important predictor of the distribution of skull fractures, with skull base fractures more common than skull vault fractures in falls with a high degree of inversion. The majority of fatal fall publications have focused on skull fractures, and no research has described the association between fall circumstances and the distribution of fractures in the skull and neck. In the present study, we accessed data regarding head and neck fractures resulting from fatal falls from a Swedish autopsy database for the years 1992-2010, for the purposes of examining the relationships between skull and cervical spine fracture distribution and the circumstances of the fatal fall. Out of 102,310 medico-legal autopsies performed there were 1008 cases of falls associated with skull or cervical spine fractures. The circumstances of the falls were grouped in 3 statistically homogenous categories; falls occurring at ground level, falls from a height of stairs, and falls from ≥3 m. Only head and neck injuries and fractures that were associated with the fatal CNS injuries were included for study, and categorized as skull vault and skull base fractures, upper cervical injuries (C0-C1 dislocation, C1 and C2 fractures), and lower cervical fractures. Logistic regression modeling revealed increased odds of skull base and lower cervical fracture in the middle and upper fall severity groups, relative to ground level falls (lower cervical <3 m falls, OR = 2.55 [1.32, 4.92]; lower cervical ≥3 m falls, OR = 2.23 [0.98, 5.08]; skull base <3 m falls, OR = 1.82 [1.32, 2.50]; skull base ≥3 m falls, OR = 2.30 [1.55, 3.40]). C0-C1 dislocations were strongly related to fall height, with an OR of 8.3 for ≥3 m falls versus ground level. The findings of increased odds of skull

  6. [Trampoline-related injuries in children: an increasing problem].

    Science.gov (United States)

    Königshausen, M; Gothner, M; Kruppa, C; Dudda, M; Godry, H; Schildhauer, T A; Seybold, D

    2014-06-01

    The sales of recreational trampolines have increased during the past few years. Severe injuries are associated in part with trampoline sport in the domestic setting. Therefore, this study was conducted to confirm the hypothesis of an increase in trampoline-related injuries in conjunction with the increasing sales of recreational trampolines and to find out what kind of injuries are most frequent in this context. Between 01/1999 and 09/2013 all trampoline-related injuries of children (0-16 years of age) were assessed retrospectively. Only those cases were evaluated which described with certainty a trampoline-associated trauma. The fractures were considered separately and assigned to specific localisations. Additionally, accidents at home were differentiated from institutional accidents. Within the past 13 years and 9 months trampoline-related injuries were seen in 195 infants. Fractures were present in 83 cases (42 %). The average age was 10 ± 3.4 years (range: 2-16 years). Within first half of the observed time period (7½ years; 01/1999 to 06/2006) 73 cases were detected with a significantly increasing number of injuries up to 122 cases between 07/2006 and 09/2013 (7 years, 3 months), which corresponds to an increase of 67 % (p = 0,028). The vast majority of these injuries happened in the domestic setting (90 %, n = 175), whereas only 10 % (n = 20) of the traumas occurred in public institutions. In 102 children (52 %) the lower extremity was affected and in 51 patients (26 %) the upper extremity was involved (head/spine/pelvis: n = 42, 22 %). The upper extremity was primarily affected by fractures and dislocations (n = 38, 76 %). At the upper extremity there were more injuries requiring surgery in contrast to the lower extremity (n = 11) or cervical spine (n = 1). The underlying data show a significant increase of trampoline-related injuries within the past years. The upper extremity is the second most affected

  7. The scourge of head injury among commercial motorcycle riders in ...

    African Journals Online (AJOL)

    lated deaths and disability worldwide but more so in low and middle ... industry have been received with mixed feelings, resist- ance by operators ... Efforts to promote road safety especial- ly protective gear use ... of human and non-human resources and inadequate .... nity at large. With the right strategies, these injuries can.

  8. Traumatic Brain Injury and Metabolic Dysfunction Among Head ...

    African Journals Online (AJOL)

    This work was carried out to investigate the relationship between some stress hormones (i.e. prolactin and cortisol) and ... Twenty-five TBI patients were included in the study consecutively. .... pituitary function. ... overwhelmingly a male gender problem with about ... injury, and may continue for the period of acute critical.

  9. Nuclear Medicine Imaging in Concussive Head Injuries in Sports

    NARCIS (Netherlands)

    Vállez Garcia, David; Otte, Andreas; Glaudemans, Andor WJM; Dierckx, Rudi AJO; Gielen, Jan LMA; Zwerver, Johannes

    2015-01-01

    Concussions in sports and during recreational activities are a major source of traumatic brain injury in our society. This is mainly relevant in adolescence and young adulthood, where the annual rate of diagnosed concussions is increasing from year to year. Contact sports (e.g., ice hockey, American

  10. Nursery Product-Related Injuries Treated in United States Emergency Departments.

    Science.gov (United States)

    Gaw, Christopher E; Chounthirath, Thiphalak; Smith, Gary A

    2017-04-01

    The goal of this study was to determine the epidemiology of injuries associated with nursery products among young children treated in US emergency departments. Data from the National Electronic Injury Surveillance System were retrospectively analyzed for patients aged nursery product from 1991 through 2011. An estimated 1 391 844 (95% confidence interval, 1 169 489-1 614 199) nursery product-related injuries among children aged Nursery product-related injuries were most commonly associated with baby carriers (19.5%), cribs/mattresses (18.6%), strollers/carriages (16.5%), or baby walkers/jumpers/exercisers (16.2%). The most common mechanism of injury was a self-precipitated fall (80.0%), and the most frequently injured body region was the head or neck (47.1%). Although successful injury prevention efforts with baby walkers led to a decline in nursery product-related injuries from 1991 to 2003, the number and rate of these injuries have been increasing since 2003. Greater efforts are warranted to prevent injuries associated with other nursery products, especially baby carriers, cribs, and strollers. Prevention of falls and concussions/closed head injuries associated with nursery products also deserves special attention. Copyright © 2017 by the American Academy of Pediatrics.

  11. Delayed life-threatening subdural hematoma after minor head injury in a patient with severe coagulopathy: a case report

    NARCIS (Netherlands)

    Engelen, Marc; Nederkoorn, Paul J.; Smits, Marion; van de Beek, Diederik

    2009-01-01

    Minor head injury is a frequent cause for neurologic consultation and imaging. Most patients with minor head injury will make an uneventful recovery, but in a very small proportion of these patients life threatening intracranial complications occur. We describe a patient on oral anticoagulation

  12. Delayed life-threatening subdural hematoma after minor head injury in a patient with severe coagulopathy: A case report

    NARCIS (Netherlands)

    M. Engelen (Marc); P.J. Nederkoorn (Paul); M. Smits (Marion); D. van de Beek (Diederik)

    2009-01-01

    textabstractMinor head injury is a frequent cause for neurologic consultation and imaging. Most patients with minor head injury will make an uneventful recovery, but in a very small proportion of these patients life threatening intracranial complications occur. We describe a patient on oral

  13. Head and face injuries and helmet use among injured motorcyclists with road accidents in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Azam Dadkhah

    2015-10-01

    Full Text Available BACKGROUND AND AIM: The study aimed to assess the frequency of head and face injuries in motorcyclists who had an accident and to find out the relationship between helmet use and frequency of these injuries. METHODS: A cross-sectional study with multi-stage sampling method provides data on the injured motorcyclists with road accidents. Data came from a registration form which has documented information of each injured person who had a road accident and hospitalized in the biggest hospital of Isfahan University of Medical Sciences, Iran (Al-Zahra. All the registration forms were surveyed for hospitalization period, treatment costs, severity of injury, and date of accident during 2010 (n = 1626. Later, among the list of injured motorcyclists during the last 3 months of the registration form, 125 cases were randomly selected and interviewed by phone regarding occurrence of the head and face injuries and whether wearing helmet during the accident. Confidence intervals (CI, Chi-square, and Phi and Cramer’s correlation coefficient were applied. The ethical approval was provided. RESULTS: Accident by motorcycle was 31.0% of all road accidents. The frequency of motorcycle accidents was higher in the autumn and among 21-25 year olds. The mean period of hospitalization was 4.3 days and the mean of hospital costs was about 9000000 Rials [about 8200 United States dollar (USD, in 2010]. Of motorcyclist, 35.0% reported they were helmeted when they had the accident. The frequency of head and face injuries was 51.0% among all the injured motorcyclists, 22.0% and 78.0% among the helmeted and non-helmeted motorcyclists, respectively (P = 0.009, r = -0.267. CONCLUSION: Motorcycle accidents comprise a large number of road accidents and cause substantial morbidity and financial impact for the community members. Head and face injuries are the most common trauma in motorcyclists, and the injury rate is higher among non-helmeted motorcyclists.

  14. Prevalence of work-related injuries among workers of bottling ...

    African Journals Online (AJOL)

    Prevalence of work-related injuries among workers of bottling industries in Benin city, ... job descriptions and activities which constitute health hazards for the individual. ... with the major work-related injuries and illness being physical injuries.

  15. A new objective method for CT triage after minor head injury--serum S100B

    DEFF Research Database (Denmark)

    Undén, Johan; Rommer, Bertil Roland

    2009-01-01

    The risk of acute intracranial complication after minor head injury (MHI) is low. Despite this, a computed tomography (CT) scan is generally recommended for all patients following MHI. Admission for clinical observation is a secondary management option when a CT scan is unavailable or is judged i...

  16. HYPERTRANSLATION OF THE HEAD BACKWARDS - PART OF THE MECHANISM OF CERVICAL WHIPLASH INJURY

    NARCIS (Netherlands)

    PENNING, L

    Based upon a review of the literature, a theory is developed that in whiplash injury the primary mechanism of the trauma is not hyperretroflexion but hypertranslation of the head backwards. Thus a hyperanteflexion (not hyperretroflexion) of the upper cervical spine, probably especially of the

  17. Divided attention years after severe closed head injury : The effect of dependencies between the subtasks

    NARCIS (Netherlands)

    Brouwer, W; Verzendaal, M; van der Naalt, J; Smit, J; van Zomeren, E

    2001-01-01

    Lesions of white matter which connects distant brain areas are characteristic for closed head injury (CHI). It was predicted that this impairs divided attention only if dependent subtasks are used which require communication between corresponding brain processes. Fourteen chronic severe CHI patients

  18. Clinical Utility of '99mTc-HMPAO Brain SPECT Findings in Chronic Head Injury

    International Nuclear Information System (INIS)

    Chung, Jin ll; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Jong Doo; Park, Chang Yoon; Kim, Young Soo

    1992-01-01

    Minima deterioration of cerebral perfusion or microanatomical changes were undetectable on conventional Brain CT or MRI. So evaluation of focal functional changes of the brain parenchyme is essential in chronic head injury patients, who did not show focal anatomical changes on these radiological studies. However, the patients who had longstanding neurologic sequelae following head injury, there had been no available imaging modalities for evaluating these patients precisely. Therefore we tried to detect the focal functional changes on the brain parenchyme using 99m Tc-HMPAO Brain SPECT on the patients of chronic head injuries. Twenty three patients who had suffered from headache, memory dysfunction, personality change and insomnia lasting more than six months following head injury were included in our cases, which showed no anatomical abnormalities on Brain CT or MRI. At first they underwent psychological test whether the symptoms were organic or not. Also we were able to evaluate the cerebral perfusion changes with 99m Tc-HMPAO Brain SPECT in 22 patients among the 23, which five patients were focal and 17 patients were nonfocally diffuse perfusion changes. Thus we can predict the perfusion changes such as local vascular deterioration or functional defects using 99m Tc-HMPAO Brain SPECT in the patients who had suffered from post-traumatic sequelae, which changes were undetectable on Brain CT or MRI.

  19. Radioimmunoassay of serum creatine kinase BB as index of brain damage after head injury

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, J P; Jones, H M; Hitchcock, R; Adams, N; Thompson, R J [Addenbrooke' s Hospital, Cambridge (UK)

    1980-09-20

    Brain-type creatine kinase isoenzyme (CK-BB) was measured by radioimmunoassay in the serum of 54 patients with head injuries. CK-BB was not detectable in 476 out of 1006 controls, the remaining 530 normal samples containing a mean of 1.5 +- SDO.75 ..mu..g/l. The mean CK-BB concentrations in patients with mild, moderate, and fatal head injuries were all significantly higher than the control value (p<0.01 in each instance). Patients with serious head injury had serum concentrations many times the normal value, in two cases within 30 minutes after impact. Fatally injured patients continued to have high serum concentrations several days after injury. In less serious cases values approached normal within two or three days. Every patient with evidence of cerebral laceration, bruising, or swelling had a serum CK-BB concentration above normal. Raised concentrations were found in 14 out of 22 patients with concussion only. Thus the serum CK-BB concentration appears to be a sensitive index of brain damage and may prove useful in the management and follow-up of head-injured patients.

  20. pattern of referrals of head injury to the university college hospital ...

    African Journals Online (AJOL)

    INTRODUCTION. In the developing countries, also known as low-middle income countries (LMIC), head injury (HI) constitutes a sizeable proportion of the clinical caseloads of most neurosurgical units.1-3 The optimal care of many cases of HI, especially the severe ones, is time bound. The time was put at 4 hours for ...

  1. Radioimmunoassay of serum creatine kinase BB as index of brain damage after head injury

    International Nuclear Information System (INIS)

    Phillips, J.P.; Jones, H.M.; Hitchcock, R.; Adams, N.; Thompson, R.J.

    1980-01-01

    Brain-type creatine kinase isoenzyme (CK-BB) was measured by radioimmunoassay in the serum of 54 patients with head injuries. CK-BB was not detectable in 476 out of 1006 controls, the remaining 530 normal samples containing a mean of 1.5 +- SDO.75 μg/l. The mean CK-BB concentrations in patients with mild, moderate, and fatal head injuries were all significantly higher than the control value (p<0.01 in each instance). Patients with serious head injury had serum concentrations many times the normal value, in two cases within 30 minutes after impact. Fatally injured patients continued to have high serum concentrations several days after injury. In less serious cases values approached normal within two or three days. Every patient with evidence of cerebral laceration, bruising, or swelling had a serum CK-BB concentration above normal. Raised concentrations were found in 14 out of 22 patients with concussion only. Thus the serum CK-BB concentration appears to be a sensitive index of brain damage and may prove useful in the management and follow-up of head-injured patients. (author)

  2. Proposed diagnosis criteria for inflicted head injury of children younger than two years of age

    International Nuclear Information System (INIS)

    Fujiwara, Takeo; Okuyama, Makiko; Matsumoto, Tsutomu; Aritaki, Kentarou; Yotani, Nobuyuki; Miyasaka, Mikiko; Nishina, Sachiko

    2008-01-01

    It is difficult to distinguish whether children's head injuries are due to physical abuse or unintentional accidents. However, in the literature, medical findings specific to infant physical abuse were identified. Thus, we developed diagnostic criteria for inflicted head injury (IHI) and assessed its validity. Subjects were collected from all patients who were less than two years old when they visited National Center for Child Health (NCCHD) and Development and underwent head CT scan to assess head trauma from March 1, 2002 to December 31, 2005. Diagnostic criteria for IHI were developed based on definitions of Duhaime et al (1992) and Reece et al (2001). Validity of diagnosis criteria was assessed by comparing the official report to the Child Guidance Center (CGC) from NCCHD to the disposition decided by the CGC. Two-hundred and sixty cases were collected and diagnosed. There was a 86.5% match of the number of cases which were diagnosed as IHI or non-IHI using the IHI diagnostic criteria with official reports to CGC from NCCHD. Among the cases which were diagnosed as presumptive IHI and also reported to the CGC, 20 cases (83.3%) were regarded as abused cases by the CGC. The diagnostic criteria for IHI were valid and would be useful for pediatricians not to condone inflicted head injury. (author)

  3. Relatives of patients with severe brain injury

    DEFF Research Database (Denmark)

    Norup, Anne; Petersen, Janne; Lykke Mortensen, Erik

    2015-01-01

    PRIMARY OBJECTIVE: To investigate trajectories and predictors of trajectories of anxiety and depression in relatives of patients with a severe brain injury during the first year after injury. RESEARCH DESIGN: A prospective longitudinal study with four repeated measurements. SUBJECTS: Ninety...... relatives of patients with severe brain injury. METHODS: The relatives were assessed on the anxiety and depression scales from the Symptom Checklist-90-Revised and latent variable growth curve models were used to model the trajectories. The effects of patient's age, patient's Glasgow Coma Score, level...... should focus not only on specific deficits in the patient, but also on how the emotional state and well-being of the relatives evolve, while trying to adjust and cope with a new life-situation....

  4. Fatal head injury: a sequelae to electric shock - a case report.

    Science.gov (United States)

    Jayanth, S H; Hugar, Basappa S; Chandra, Y P Girish; Krishnan, A Gokula

    2015-03-01

    Deaths due to electric shock are increasing despite stringent laws and preventive measures. These shocks are a leading cause of death amongst construction workers. In about 20% of the cases, no visible injury due to electricity can be seen. In some cases, non-electrical injuries are present and at times there are no eyewitnesses to provide a detailed account of events. In such circumstances, examination of scene of death, autopsy and accident reconstruction with the help of an electrical expert are all necessary to determine the cause of death. Here, we report one such case where a mason working on the second floor of a building under construction sustained an electrical injury, following which he was thrown to the ground sustaining a fatal traumatic injury. After careful consideration, his death was attributed to the head injury. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. Swordfish Attack—Death by Penetrating Head Injury

    Directory of Open Access Journals (Sweden)

    Boon Hui Gooi

    2007-04-01

    Full Text Available There have been very few reports of swordfish attacks on humans and none have resulted in death. Although there are no reports of unprovoked attacks on humans, swordfish can be very dangerous when provoked and they can jump and use their swords to pierce their target. We describe here an unusual case of death that resulted from intracranial penetrating injury caused by a swordfish.

  6. Nintendo related injuries and other problems: review.

    Science.gov (United States)

    Jalink, Maarten B; Heineman, Erik; Pierie, Jean-Pierre E N; ten Cate Hoedemaker, Henk O

    2014-12-16

    To identify all reported cases of injury and other problems caused by using a Nintendo video gaming system. Review. Search of PubMed and Embase in June 2014 for reports on injuries and other problems caused by using a Nintendo gaming system. Most of the 38 articles identified were case reports or case series. Injuries and problems ranged from neurological and psychological to surgical. Traditional controllers with buttons were associated with tendinitis of the extensor of the thumb. The joystick on the Nintendo 64 controller was linked to palmar ulceration. The motion sensitive Wii remote was associated with musculoskeletal problems and various traumas. Most problems are mild and prevalence is low. The described injuries were related to the way the games are controlled, which varies according to the video game console. © Jalink et al 2014.

  7. Experience on treatment of acute head injury combined with optic nerve damage

    International Nuclear Information System (INIS)

    Gao Heng; Feng Dongxia; Ma Yuanpin; Chen Jinqing

    2000-01-01

    Objective: To investigate the therapeutic principle for the management of acute head injury combined with optic nerve damage. Method: the clinical data of treatment and prognosis from 24 patients, in which 15 received operative and 9 conservative measures were collected and analyzed. Results: In 15 operated cases, the vision of 10 cases including one with blindness before operation was improved obviously, while those of other 5 did not get any improvement. In 9 conservatively treated cases, the vision was improved in 4 cases, deteriorated in 4 case and no change in 1 case with blindness after injury. Conclusion: One the optic nerve damage has been manifested by clinical or radiological evidences in acute head injury patients, despite it was primary or secondary reason, surgical optic nerve bone canal decompression should be done as soon as possible

  8. Influence of prayer and prayer habits on outcome in patients with severe head injury.

    Science.gov (United States)

    Vannemreddy, Prasad; Bryan, Kris; Nanda, Anil

    2009-01-01

    The objective of the study is to evaluate the effect of prayers on the recovery of the unconscious patients admitted after traumatic brain injury. A retrospective study of patients with severe head injury was conducted. The Glasgow Coma Scale and Glasgow Outcome Scale scores were examined along with age, gender, smoking, and alcohol intake. There were 13 patients who received prayer and 13 who did not receive prayer during the hospital stay with almost identical mean Glasgow Coma Scale score. The prayer group stayed in the hospital for more days (P = .03). On multivariate analysis, patients' age (P = .01), admission Glasgow Coma Scale score (P = .009), and prayer habits (P = .007) were significant factors. Patients with prayers habits recovered better following severe head injury. The role of intercessory prayer needs further studies in larger groups.

  9. Head Injury in the Elderly: What Are the Outcomes of Neurosurgical Care?

    Science.gov (United States)

    Whitehouse, Kathrin Joanna; Jeyaretna, Deva Sanjeeva; Enki, Doyo Gragn; Whitfield, Peter C

    2016-10-01

    Epidemiologic studies show that an increasing proportion of those presenting with head trauma are elderly. This study details the outcomes of elderly patients with head trauma admitted to a regional United Kingdom neurosurgical unit. The notes and imaging were reviewed of all patients with head injury aged ≥75 years, admitted from 1 January 2007 to 31 December 2010, including mortality data up to at least 2 years after discharge. Outcomes comprised death as an inpatient, by 30 days and 1 year after discharge; Glasgow Outcome Score; discharge Glasgow Coma Scale (GCS) score; recurrence; readmission; reoperation; and complication. A total of 263 patients were admitted: 26 with acute subdural hematoma (ASDH); 175 with chronic subdural hematoma (CSDH); and 46 with mixed subdural collections (ACSDH). Sixteen patients had other head injury diagnoses. Patients with ASDH had a significantly lower survival rate than did those with CSDH or ACSDH: the odds of inpatient death for patients with ASDH was 15.38 (vs. those with CSDH). For all subdural hematomas (SDHs), low American Society of Anesthesiologists score was an independent predictor of early death. Death at 1 year was predicted by head injury severity measured by admission GCS score (P = 0.028), long anesthetic (P = 0.002), and the presence of bilateral SDH (P = 0.002). Unfavorable Glasgow Outcome Scale score (1-3) was predicted by age greater than 85 years (P = 0.029); larger depth of subdural (P neurosurgery after head injury have SDHs. Our results are better than many previously reported; however, the rate of death for those with ASDH is still high. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  10. Are Men With a History of Head Injury Less Responsive to Cognitive Behavioral Therapy for Intimate Partner Violence?

    Science.gov (United States)

    Akerele, Felicia A; Murphy, Christopher M; Williams, Megan R

    2017-06-01

    Head injury is highly prevalent among intimate partner violence (IPV) offenders. This study investigates responsiveness to cognitive behavioral therapy (CBT) for partnerviolent men with and without a history of head injury using archival data on 310 males seeking IPV counseling at a community domestic violence agency. Participants reported on their history of head injury, age at injury, and length of time unconscious in a structured interview at program intake. Criminal justice outcomes were assessed for the 2-year period after scheduled completion of treatment using a publicly available state database. A significantly greater percentage of men with a history of head injury (N = 84) than those without (N = 226) had criminal involvement for incidents of partner abuse during the follow-up period. In addition, men with a history of moderate-to-severe head injury (n = 25) had more criminal involvement for general violence than those with no history of head injury. The findings highlight the need to screen partner-violent men for head injury and to develop and investigate intervention enhancements for those individuals.

  11. Ten Years of Equine-related Injuries: Severity and Implications for Emergency Physicians.

    Science.gov (United States)

    Davidson, Scott B; Blostein, Paul A; Schrotenboer, Andrew; Sloffer, Chris A; VandenBerg, Sheri L

    2015-11-01

    The size, speed, and unpredictable nature of horses present a significant risk for injury in all equine-related activities. We sought to examine the mechanism, severity, frequency, body regions affected, surgical requirements, rehabilitation needs, safety equipment utilization, and outcomes of equine-related injured patients. Records of inpatients who sustained an equine-related injury from 2002-2011 with International Classification of Diseases, Ninth Revision codes E828 and E906 were retrospectively reviewed for pertinent data. Ninety patients, 70% female, age (mean ± SD) 37.3 ± 19.4 years, length of stay 3.7 ± 4.5 days, Injury Severity Score 12.9 ± 8.4. Predominant mechanism of injury was fall from horse (46.7%). The chest (23%) was most frequently injured, followed by brain/head (21.5%). Thirty patients (33%) required 57 surgical procedures. Twenty percent of patients required occupational therapy and 33.3% required physical therapy while hospitalized. Only 3% required rehabilitation, with 90% discharged directly home. Safety equipment was not used in 91.9% of patients. One patient sustained a cord injury. Six patients expired, all from extensive head injuries. The majority of equine-related injuries occur while pursuing recreational activities and are due to falls. Our patients experienced more severe injuries to the trunk and head and required more surgical intervention for pelvic, facial, and brain injuries than previously reported. Failure to use safety equipment contributes to the risk of severe injury. Education and injury prevention is essential. The need for complex surgical intervention by multiple specialties supports transfer to Level I trauma centers. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Changes in motorcycle-related injuries and deaths after mandatory motorcycle helmet law in a district of Vietnam.

    Science.gov (United States)

    Ha, Ninh Thi; Ederer, David; Vo, Van Anh Ha; Pham, An Van; Mounts, Anthony; Nolen, Leisha D; Sugerman, David

    2018-01-02

    Our study measured the change in head injuries and deaths among motorcycle users in Cu Chi district, a suburban district of Ho Chi Minh City. Hospital records for road traffic injuries (RTIs) were collected from the Cu Chi Trauma Centre and motorcycle-related death records were obtained from mortality registries in commune health offices. Head injury severity was categorized using the Abbreviated Injury Score (AIS). Rate ratios (RRs) were used to compare rates pre- and post-law (2005/2006-2009/2010). Cu Chi's population, stratified by year, age, and sex, was used as the denominator. Of records identifying the transportation mode at the time of injury, motorcyclists accounted for most injuries (3,035, 87%) and deaths (238, 90%). Head injuries accounted for 70% of motorcycle-related hospitalizations. Helmet use was not recorded in any death records and not in 97% of medical records. Males accounted for most injuries (73%) and deaths (88%). The median age was 28 years and 32 years for injuries and deaths, respectively. Compared to the pre-law period, rates of motorcycle injuries (RR = 0.53; 95% confidence interval [CI], 0.49-0.58), head injuries (RR = 0.35; 95% CI, 0.31-0.39), severe head injuries (RR = 0.47; 95% CI, 0.34-0.63), and deaths (RR = 0.69; 95% CI, 0.53-0.89) significantly decreased in the post-law period. Rates of head injuries and deaths among motorcycle riders decreased significantly after implementation of the mandatory helmet law in Vietnam. To further examine the impact of the motorcycle helmet law, including compliance and helmet quality, further emphasis should be placed on gathering helmet use data from injured motorcyclists.

  13. Prevention of Blast-Related Injuries

    Science.gov (United States)

    2016-07-01

    posterior of the head to the lambda . Its location is shown in Figure 2 which also shows the approximate locations of the six ICP transducers. The X-axis...cell bodies that may be related to impaired axoplasmic transport and its ultimate release into the surrounding extracellular matrix , which in turn

  14. [Epidemiology of work-related eye injuries].

    Science.gov (United States)

    Zghal-Mokni, Imen; Nacef, Leila; Kaoueche, Mourad; Letaief, Imen; Bouguila, Hedi; Jeddi, Amel; Ayed, Saida

    2007-07-01

    Occupational injury represents 7,7 at 69,9% of the total ocular traumatisms. They can be a major source of visuel loss and blindness. The aim is to study the epidemiology of work-related ocular injuries: objects frequencies,works most exposed. We performed a prospective study that interest 78 patients having a work-related ocular traumatism during a 4 months period. They were admitted at ocular emergeney All patients underwent an ophtalmologic examination completed with orbital radiography and echography. A medical and/or chirurgical appropriate treatment was institued. Occupationnal injury frequency was 9% of the whole ocular traumatisms in the same period. The mean age was 31 years. 55% of cases were under 30 years. 91% were male. Most exposed works were industrial and mecanical sectors In 70,5% of cases work-related eye injuries were caused by projectile objects. Most common lesion was corneal superficial foreign body (58%). Open globe injury was noted in 8%. 95% of patients had no eye protection at the time of the accident. 13% were blind or unilateral partially sighted (according to the OMS classification). The authors discussed the importance and different prevention strategies to prevent the risk of blindness and socio-economical cost of occupationnal accidents. There is a need for systematic periodic sensibilization to reduce these accidents and blindness.

  15. Study of cerebral circulation for patients with head injury

    International Nuclear Information System (INIS)

    Honda, Mitsuru; Aoki, Yoshinori; Noguchi, Yoshitaka; Haga, Daisuke; Seiki, Yoshikatsu; Machida, Keiichi

    2004-01-01

    Severe traumatic brain injury is widely known to cause a dynamic cerebral blood flow (CBF). Especially, decrease of CBF has been reported. In the present study we measured the CBF, the mean transit time (MTT) and the cerebral blood volume (CBV). Our purpose was to investigate the possibility to estimate the outcome with use of these physiological parameters, and the relationship between the clinical condition of the patients and these parameters. In 24 patients with traumatic brain injury, Xe-CT and Perfusion CT were performed at the same time in the phase II (Day 1-3). We measured CBF by using Xe-CT and MTT by using Perfusion CT and calculated CBV by using AZ-7000W98 computer system. We evaluated the relationship between these values and outcome, grading on admission and discussed the usefulness of deciding on courses of treatment. The results were correlated with the outcome and values of CBF and MTT. Significant differences in CBF and MTT were found between favorable outcome group (good recovery (GR) and moderate disability (MD)) and poor outcome group (severe disability (SD), vegetative state (VS) and dead (D)). We could estimate the outcome of patients with subarachnoid hemorrhage (SAH) by analyzing values of CBF and MTT. The probability was 78%. (authors)

  16. Unilateral hypoxic-ischemic injury in young children from abusive head trauma, lacking craniocervical vascular dissection or cord injury

    International Nuclear Information System (INIS)

    McKinney, Alexander M.; Thompson, Linda R.; Truwit, Charles L.; Velders, Scott; Karagulle, Ayse; Kiragu, Andrew

    2008-01-01

    Abusive head trauma (AHT) in young children usually has a severe outcome when associated with hypoxic-ischemic encephalopathy (HIE), which is best characterized by MRI in the acute or subacute phase utilizing diffusion-weighted imaging (DWI). HIE in this setting has been hypothesized to result from stretching of the spinal cord, brainstem, or vasculature. To provide clinical correlation in patients with unilateral HIE and to postulate a mechanism in the setting of suspected AHT. IRB approval was obtained. Over a 5-year period, the medical records and images were reviewed of the 53 children ≤3 years of age who presented with acute head trauma according to the hospital registry. The children were subselected in order to determine how many suffered either HIE or AHT, and to detect those with unilateral HIE. In 11 of the 53 children, the etiology of the head trauma was highly suspicious for abuse. In 38 the head trauma was accidental and in 4 the trauma was of unknown etiology and at the time of this report was unresolved legally. Of the 53, 4 suffered HIE confirmed by CT or MRI. In three of these four with HIE the trauma was considered highly suspicious for AHT. Two of these three were the only patients with unilateral HIE, and both (7 months and 14 months of age) presented with early subacute phase HIE seen on DW MRI (range 4-7 days) and are described in detail with clinical correlation. The third child with AHT and HIE had bilateral findings. In the fourth patient the HIE was bilateral and was considered accidental. The work-up for both patients with unilateral HIE included head CT, craniocervical MRI, and craniocervical MR angiography (MRA). In both, there was mostly unilateral, deep white matter restricted diffusion, with subdural hematomas that were small compared to the extent of hypoxic-ischemic insult, and no skull fracture. Craniocervical MRA and axial thin-section fat-saturation images were negative for dissection, brainstem, or cord injury. Legal

  17. Unilateral hypoxic-ischemic injury in young children from abusive head trauma, lacking craniocervical vascular dissection or cord injury

    Energy Technology Data Exchange (ETDEWEB)

    McKinney, Alexander M.; Thompson, Linda R.; Truwit, Charles L.; Velders, Scott; Karagulle, Ayse; Kiragu, Andrew [University of Minnesota Medical School, Department of Radiology, Hennepin County Medical Center, Minneapolis, MN (United States)

    2008-02-15

    Abusive head trauma (AHT) in young children usually has a severe outcome when associated with hypoxic-ischemic encephalopathy (HIE), which is best characterized by MRI in the acute or subacute phase utilizing diffusion-weighted imaging (DWI). HIE in this setting has been hypothesized to result from stretching of the spinal cord, brainstem, or vasculature. To provide clinical correlation in patients with unilateral HIE and to postulate a mechanism in the setting of suspected AHT. IRB approval was obtained. Over a 5-year period, the medical records and images were reviewed of the 53 children {<=}3 years of age who presented with acute head trauma according to the hospital registry. The children were subselected in order to determine how many suffered either HIE or AHT, and to detect those with unilateral HIE. In 11 of the 53 children, the etiology of the head trauma was highly suspicious for abuse. In 38 the head trauma was accidental and in 4 the trauma was of unknown etiology and at the time of this report was unresolved legally. Of the 53, 4 suffered HIE confirmed by CT or MRI. In three of these four with HIE the trauma was considered highly suspicious for AHT. Two of these three were the only patients with unilateral HIE, and both (7 months and 14 months of age) presented with early subacute phase HIE seen on DW MRI (range 4-7 days) and are described in detail with clinical correlation. The third child with AHT and HIE had bilateral findings. In the fourth patient the HIE was bilateral and was considered accidental. The work-up for both patients with unilateral HIE included head CT, craniocervical MRI, and craniocervical MR angiography (MRA). In both, there was mostly unilateral, deep white matter restricted diffusion, with subdural hematomas that were small compared to the extent of hypoxic-ischemic insult, and no skull fracture. Craniocervical MRA and axial thin-section fat-saturation images were negative for dissection, brainstem, or cord injury. Legal

  18. Head injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and football.

    Science.gov (United States)

    Delaney, J Scott

    2004-03-01

    To examine the number and rates of head injuries occurring in the community as a whole for the team sports of ice hockey, soccer, and football by analyzing data from patients presenting to US emergency departments (EDs) from 1990 to 1999. Retrospective analysis. Data compiled for the US Consumer Product Safety Commission using the National Electronic Injury Surveillance System were used to generate estimates for the total number of head injuries, concussions, internal head injuries, and skull fractures occurring on a national level from the years 1990 to 1999. These data were combined with yearly participation figures to generate rates of injuries presenting to the ED for each sport. There were an estimated 17,008 head injuries from ice hockey, 86,697 from soccer, and 204,802 from football that presented to US EDs from 1990 to 1999. The total number of concussions presenting to EDs in the United States over the same period was estimated to be 4820 from ice hockey, 21,715 from soccer, and 68,861 from football. While the rates of head injuries, concussions, and combined concussions/internal head injuries/skull fractures presenting to EDs per 10,000 players were not always statistically similar for all 3 sports in each year data were available, they were usually comparable. While the total numbers of head injuries, concussions, and combined concussions/skull fractures/internal head injuries presenting to EDs in the United States are different for ice hockey, soccer, and football for the years studied, the yearly rates for these injuries are comparable among all 3 sports.

  19. Epidemiology of terror-related versus non-terror-related traumatic injury in children.

    Science.gov (United States)

    Aharonson-Daniel, Limor; Waisman, Yehezkel; Dannon, Yehuda L; Peleg, Kobi

    2003-10-01

    In the past 2 years hundreds of children in Israel have been injured in terrorist attacks. There is a paucity of data on the epidemiology of terror-related trauma in the pediatric population and its effect on the health care system. The objective of this study was to review the accumulated Israeli experience with medical care to young victims of terrorism and to use the knowledge obtained to contribute to the preparedness of medical personnel for future events. Data on all patients who were younger than 18 years and were hospitalized from October 1, 2000, to December 31, 2001, for injuries sustained in a terrorist attack were obtained from the Israel National Trauma Registry. The parameters evaluated were patient age and sex, diagnosis, type, mechanism and severity of injury, interhospital transfer, stay in intensive care unit, duration of hospitalization, and need for rehabilitation. Findings were compared with the general pediatric population hospitalized for non-terror-related trauma within the same time period. During the study period, 138 children were hospitalized for a terror-related injury and 8363 for a non-terror-related injury. The study group was significantly older (mean age: 12.3 years [standard deviation: 5.1] v 6.9 years [standard deviation: 5.3]) and sustained proportionately more penetrating injuries (54% [n = 74] vs 9% [n = 725]). Differences were also noted in the proportion of internal injuries to the torso (11% in the patients with terror-related trauma vs 4% in those with non-terror-related injuries), open wounds to the head (13% vs 6%), and critical injuries (Injury Severity Score of 25+; 25% vs 3%). The study group showed greater use of intensive care unit facilities (33% vs 8% in the comparison group), longer median hospitalization time (5 days vs 2 days), and greater need for rehabilitative care (17% vs 1%). Terror-related injuries are more severe than non-terror-related injuries and increase the demand for acute care in children.

  20. Retrospective Analysis of Mosh-Pit-Related Injuries.

    Science.gov (United States)

    Milsten, Andrew M; Tennyson, Joseph; Weisberg, Stacy

    2017-12-01

    Moshing is a violent form of dancing found world-wide at rock concerts, festivals, and electronic dance music events. It involves crowd surfing, shoving, and moving in a circular rotation. Moshing is a source of increased morbidity and mortality. The goal of this study was to report epidemiologic information on patient presentation rate (PPR), transport to hospital rate (TTHR), and injury patterns from patients who participated in mosh-pits. Materials and Methods Subjects were patrons from mosh-pits seeking medical care at a single venue. The events reviewed were two national concert tours which visited this venue during their tour. The eight distinct events studied occurred between 2011 and 2014. Data were collected retrospectively from prehospital patient care reports (PCRs). A single Emergency Medical Service (EMS) provided medical care at this venue. The following information was gathered from each PCR: type of injury, location of injury, treatment received, alcohol or drug use, Advanced Life Support/ALS interventions required, age and gender, disposition, minor or parent issues, as well as type of activity engaged in when injured. Attendance for the eight events ranged from 5,100 to 16,000. Total patient presentations ranged from 50 to 206 per event. Patient presentations per ten thousand (PPTT) ranged from 56 to 130. The TTHR per 10,000 ranged from seven to 20. The mean PPTT was 99 (95% CI, 77-122) and the median was 98. The mean TTHR was 16 (95% CI, 12-29) and the median TTHR was 17. Patients presenting from mosh-pits were more frequently male (57.6%; Psurfing was the next most significant, accounting for 20% of presentations. The most common body part injured was the head (64% of injuries). This retrospective review of mosh-pit-associated injury patterns demonstrates a high rate of injuries and presentations for medical aid at the evaluated events. General moshing was the most commonly associated activity and the head was the most common body part injured

  1. [Therapy of head injuries caused by animal slaughter guns].

    Science.gov (United States)

    Crevenna, Richard; Klintschar, Michael; Weger, Martin; Weger, Wolfgang; Quittan, Michael; Fialka-Moser, Veronika; Homann, Carl N

    2003-01-01

    Slaughterer's guns ("humane killers") are powder-activated cattle skull impacting tools. Today mechanical stunning is typical for country like regions, because in the municipal slaughter-houses electrical stunning of pigs and ruminants is preferred. In rare cases these weapons are used for suicide. They then cause penetrating brain lesions and if the victim survives the brain-damage, an encephalitis caused by the impacted material results. The neurosurgical treatment is to revise the gunshot canal and to remove impacted fragments of bone and contaminated skin (imprimat) under antibiotic cover. A psychiatric treatment of the mostly underlying depression and a rehabilitative treatment should complete therapy. So treatment of slaughterer's gun injury should have a multidisciplinary approach.

  2. Role of skull radiography in the initial evaluation of minor head injury: a retrospective study

    International Nuclear Information System (INIS)

    Murshid, W.R.

    1994-01-01

    The use of skull radiography in the initial evaluation of minor head injured patients is controversial. In an attempt to evaluate its benefits, a retrospective study of 566 cases subjected to skull radiography following close minor head trauma (Glasgow Coma Scale 13-15), is presented. A skull fracture (linear vault, depressed or base of skull) was present in 64 (11%) cases. Only three (5%) who were found to have a skull fracture on skull radiography developed an intracranial injury which required surgery. Intracranial injuries developed in 19 (3%) cases and were followed by surgery in six (32%). All, except for one case, had a decreased level of consciousness and a Glasgow Coma Scale less than 15, few had focal neurological deficits. Management had not been altered by the results of skull radiography in any of the cases. We concluded that skull radiographs are unnecessary for the decision process in closed minor head injury because management decisions are based primarily on a careful neurological examination. When intracranial injuries are a concern, a CT scan should be obtained. (author)

  3. The CRASH trial protocol (Corticosteroid randomisation after significant head injury [ISRCTN74459797

    Directory of Open Access Journals (Sweden)

    2001-06-01

    Full Text Available Abstract Background Worldwide, millions of people are treated each year for significant head injury. A substantial proportion die, and many more are disabled. If short term corticosteroid infusion could be reliably shown to reduce these risks by just a few percent then this might affect the treatment of a few hundred thousand patients a year, protecting thousands from death or long term disability. Study design CRASH is a large simple, placebo-controlled trial of the effects of a 48-hour infusion of corticosteroids on death and on neurological disability, among adults with head injury and some impairment of consciousness. Head injured patients with impaired consciousness who are judged to be 16 years or older are eligible if the responsible doctor is, for any reason, substantially uncertain whether or not to use corticosteroids. Organisation The CRASH trial will determine reliably the effects on death and disability of a short corticosteroid infusion following significant head injury. To detect or refute improvements of only a few percent in outcome, many thousands of acute head injury patients must be randomised between control and steroid infusions. Such large numbers will be possible only if hundreds of doctors and nurses can collaborate in the participating emergency departments. Since they are busy, and working in emergency situations, the trial involves them in almost no extra work: no special investigations or changes to usual management are required, and data collection is absolutely minimal. The trial is on-going and new collaborators are welcome. Further information about the trial is available at http://www.crash.lshtm.ac.uk

  4. Prevalence and impact of diffuse axonal injury in patients with moderate and severe head injury: a cohort study of early magnetic resonance imaging findings and 1-year outcome.

    Science.gov (United States)

    Skandsen, Toril; Kvistad, Kjell Arne; Solheim, Ole; Strand, Ingrid Haavde; Folvik, Mari; Vik, Anne

    2010-09-01

    In this prospective cohort study the authors examined patients with moderate to severe head injuries using MR imaging in the early phase. The objective was to explore the occurrence of diffuse axonal injury (DAI) and determine whether DAI was related to level of consciousness and patient outcome. One hundred and fifty-nine patients (age range 5-65 years) with traumatic brain injury, who survived the acute phase, and who had a Glasgow Coma Scale (GCS) score of 3-13 were admitted between October 2004 and August 2008. Of these 159 patients, 106 were examined using MR imaging within 4 weeks postinjury. Patients were classified into 1 of 3 stages of DAI: Stage 1, in which lesions were confined to the lobar white matter; Stage 2, in which there were callosal lesions; and Stage 3, in which lesions occurred in the dorsolateral brainstem. The outcome measure used 12 months postinjury was the Glasgow Outcome Scale-Extended (GOSE). Diffuse axonal injury was detected in 72% of the patients and a combination of DAI and contusions or hematomas was found in 50%. The GCS score was significantly lower in patients with "pure DAI" (median GCS Score 9) than in patients without DAI (median GCS Score 12; p GOSE score of 7, and patients without DAI had a median GOSE score of 8 (p = 0.10). Outcome was better in patients with DAI Stage 1 (median GOSE Score 8) and DAI Stage 2 (median GOSE Score 7.5) than in patients with DAI Stage 3 (median GOSE Score 4; p < 0.001). Thus, in patients without any brainstem injury, there was no difference in good recovery between patients with DAI (67%) and patients without DAI (66%). Diffuse axonal injury was found in almost three-quarters of the patients with moderate and severe head injury who survived the acute phase. Diffuse axonal injury influenced the level of consciousness, and only in patients with DAI was GCS score related to outcome. Finally, DAI was a negative prognostic sign only when located in the brainstem.

  5. CO2 reactivity and brain oxygen pressure monitoring in severe head injury.

    Science.gov (United States)

    Carmona Suazo, J A; Maas, A I; van den Brink, W A; van Santbrink, H; Steyerberg, E W; Avezaat, C J

    2000-09-01

    To investigate the effect of hyperventilation on cerebral oxygenation after severe head injury. A prospective, observational study. Neurointensive care unit at a university hospital. A total of 90 patients with severe head injury (Glasgow Coma Scale score brain tissue oxygen pressure (PbrO2) was performed as a measure of cerebral oxygenation. Arterial PCO2 was decreased each day over a 5-day period for 15 mins by increasing minute volume on the ventilator setting to 20% above baseline. Arterial blood gas analysis was performed before and after changing ventilator settings. Multimodality monitoring, including PbrO2, was performed in all patients. Absolute and relative PbrO2/PaCO2 reactivity was calculated. Outcome at 6 months was evaluated according to the Glasgow Outcome Scale. Effective hyperventilation, defined by a decrease of PaCO2 > or =2 torr (0.27 kPa), was obtained in 218 (84%) of 272 tests performed. Baseline PaCO2 averaged 32.3 +/- 4.5 torr (4.31 +/- 0.60 kPa). Average reduction in PaCO2 was 3.8 +/- 1.7 torr (0.51 +/- 0.23 kPa). PbrO2 decreased by 2.8 +/- 3.7 torr (0.37 +/- 0.49 kPa; p < .001) from a baseline value of 26.5 +/- 11.6 torr (3.53 +/- 1.55 kPa). PbrO2/PaCO2 reactivity was low on day 1 (0.8 +/- 2.3 torr [0.11 +/- 0.31 kPa]), increasing on subsequent days to 6.1 +/- 4.4 torr (0.81 +/- 0.59 kPa) on day 5. PbrO2/PaCO2 reactivity on days 1 and 2 was not related to outcome. In later phases in patients with unfavorable outcome, relative reactivity was increased more markedly, reaching statistical significance on day 5. Increased hyperventilation causes a significant reduction in PbrO2, providing further evidence for possible increased risk of secondary ischemic damage during hyperventilation. The low PbrO2/PaCO2 reactivity on day 1 indicates the decreased responsiveness of cerebral microvascular vessels to PaCO2 changes, caused by generalized vascular narrowing. The increasing PbrO2/PaCO2 reactivity from days 2 to 5 suggests that the risk of

  6. Head and Maxillofacial Injuries in Child and Adolescent Victims of Automotive Accidents

    Directory of Open Access Journals (Sweden)

    Alessandro Leite Cavalcanti

    2014-01-01

    Full Text Available Background. Victims of motor vehicle accidents may suffer multiple lesions, including maxillofacial injuries. The aim of this study was to evaluate the prevalence and factors associated with head, facial, and maxillofacial injuries in child and adolescent victims of automobile accidents. A cross-sectional study was carried out with analysis of forensic medical reports from the Legal Medical Institute of Campina Grande, Brazil, between January 2008 and December 2011. Descriptive and inferential statistical analysis was conducted using the chi-square test (α = 0.05. From 1613 medical reports analyzed, the sample is composed 232 (14.4% reports referring to child and adolescent victims of automobile accidents aged 0–19 years of both sexes. Victims were mostly adolescents aged from 15 to 19 years (64.2%, males (73.7%, and motorcyclists (51.3%. More than half of the victims had single lesions (54.3% located in the head (20.7% and face (21.6%. Head injuries occurred more frequently in children aged 0–4 years (53.8%, PR = 5.065, 95% CI = 1.617–5.870 and pedestrians (30.4%, PR = 2.039, 95% CI = 1.024–4.061, while facial and maxillofacial injuries occurred in higher proportion among females (31.1%, PR = 0.489, 95% CI = 0.251–0.954. Our findings suggest that accidents involving motorcyclists are the most prevalent, affecting male adolescents aged from 15 to 19 years, resulting in a high frequency of injuries in the head and face regions.

  7. Paediatric mild head injury: is routine admission to a tertiary trauma hospital necessary?

    Science.gov (United States)

    Tallapragada, Krishna; Peddada, Ratna Soundarya; Dexter, Mark

    2018-03-01

    Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014. Data were collected regarding demographics, clinical findings, mechanism of injury, head computed tomography scan findings, neurosurgical intervention, outcome and length of admission. Wilcoxon paired test was used with P value <0.05 considered significant. Four hundred and ten children were analysed. Three hundred and eighty-one (93%) children were managed conservatively, 18 (4%) underwent evacuation of extradural haematoma (TBI surgery) and 11 (3%) needed fracture repair surgery. Two children evolved a surgical lesion 24 h post-admission. Only 17 of 214 children transferred from peripheral hospitals needed neurosurgery. Overall outcomes: zero deaths, one needed brain injury rehabilitation and 63 needed child protection unit intervention. Seventy-five percentage of children with non-surgical lesions were discharged within 2 days. Eighty-three percentage of road transfers were discharged within 3 days. Children with small intracranial haematomas and/or skull fractures who need no surgery only require brief inpatient symptomatic treatment and could be safely managed in primary hospitals. Improved tertiary hospital transfer guidelines with protocols to manage clinical deterioration could have cost benefit without risking patient safety. © 2017 Royal Australasian College of Surgeons.

  8. Head and neck control varies with perturbation acceleration but not jerk: implications for whiplash injuries.

    Science.gov (United States)

    Siegmund, Gunter P; Blouin, Jean-Sébastien

    2009-04-15

    Recent studies have proposed that a high rate of acceleration onset, i.e. high jerk, during a low-speed vehicle collision increases the risk of whiplash injury by triggering inappropriate muscle responses and/or increasing peak head acceleration. Our goal was to test these proposed mechanisms at realistic jerk levels and then to determine how collision jerk affects the potential for whiplash injuries. Twenty-three seated volunteers (8 F, 15 M) were exposed to multiple experiments involving perturbations simulating the onset of a vehicle collision in eyes open and eyes closed conditions. In the first experiment, subjects experienced five forward and five rearward perturbations to look for the inappropriate muscle responses and 'floppy' head kinematics previously attributed to high jerk perturbations. In the second experiment, we independently varied the jerk ( approximately 125 to 3 000 m s(-3)) and acceleration ( approximately 0.65 to 2.6 g) of the perturbation to assess their effect on the electromyographic (EMG) responses of the sternocleidomastoid (SCM), scalene (SCAL) and cervical paraspinal (PARA) muscles and the kinematic responses of the head and neck. In the first experiment, we found neither inappropriate muscle responses nor floppy head kinematics when subjects had their eyes open, but observed two subjects with floppy head kinematics with eyes closed. In the second experiment, we found that about 70% of the variations in the SCM and SCAL responses and about 95% of the variations in head/neck kinematics were explained by changes in perturbation acceleration in both the eyes open and eyes closed conditions. Less than 2% of the variation in the muscle and kinematic responses was explained by changes in perturbation jerk and, where significant, response amplitudes diminished with increasing jerk. Based on these findings, collision jerk appears to have little or no role in the genesis of whiplash injuries in low-speed vehicle crashes.

  9. The Current State of Head and Neck Injuries in Extreme Sports

    Science.gov (United States)

    Sharma, Vinay K.; Rango, Juan; Connaughton, Alexander J.; Lombardo, Daniel J.; Sabesan, Vani J.

    2015-01-01

    Background: Since their conception during the mid-1970s, international participation in extreme sports has grown rapidly. The recent death of extreme snowmobiler Caleb Moore at the 2013 Winter X Games has demonstrated the serious risks associated with these sports. Purpose: To examine the incidence and prevalence of head and neck injuries (HNIs) in extreme sports. Study Design: Descriptive epidemiological study. Methods: The National Electronic Injury Surveillance System (NEISS) was used to acquire data from 7 sports (2000-2011) that were included in the Winter and Summer X Games. Data from the NEISS database were collected for each individual sport per year and type of HNI. Cumulative data for overall incidence and injuries over the entire 11-year period were calculated. National estimates were determined using NEISS-weighted calculations. Incidence rates were calculated for extreme sports using data from Outdoor Foundation Participation Reports. Results: Over 4 million injuries were reported between 2000 and 2011, of which 11.3% were HNIs. Of all HNIs, 83% were head injuries and 17% neck injuries. The 4 sports with the highest total incidence of HNI were skateboarding (129,600), snowboarding (97,527), skiing (83,313), and motocross (78,236). Severe HNI (cervical or skull fracture) accounted for 2.5% of extreme sports HNIs. Of these, skateboarding had the highest percentage of severe HNIs. Conclusion: The number of serious injuries suffered in extreme sports has increased as participation in the sports continues to grow. A greater awareness of the dangers associated with these sports offers an opportunity for sports medicine and orthopaedic physicians to advocate for safer equipment, improved on-site medical care, and further research regarding extreme sports injuries. PMID:26535369

  10. Characteristics of associated craniofacial trauma in patients with head injuries: An experience with 100 cases

    Directory of Open Access Journals (Sweden)

    Rajendra Prasad

    2009-01-01

    Full Text Available Background: Facial fractures and concomitant cranial injuries carry the significant potential for mortality and neurological morbidity mainly in young adults. Aims and Objectives: To analyze the characteristics of head injuries and associated facial injuries, the management options and outcome following cranio-facial trauma. Methods: This retrospective review was performed at Justice K. S. Hegde Charitable Hospital, and associated A. B. Shetty Memorial Institute of Dental sciences, Deralakatte, Mangalore. Following Ethical Committee approval, hospital charts and radiographs of 100 consecutive patients of cranio-facial trauma managed at the Department of Oral and Maxillofacial Surgery and Neurosurgery between January 2004 and December 2004 were reviewed. Results: Majority of the patients were in the 2nd to 4th decade (79% with a male to female ratio of -8.09:1. Road traffic accidents were the common cause of craniofacial trauma in present study (54% followed by fall from height (30%. Loss of consciousness was the most common clinical symptom (62% followed by headache (33%. Zygoma was the most commonly fractured facial bone 48.2% (alone 21.2%, in combination 27.2%. Majority of patients had mild head injury and managed conservatively in present series. Causes of surgical intervention for intracranial lesions were compound depressed fracture, contusion and intracranial hematoma. Operative indications for facial fractures were displaced facial bone fractures. Major causes of mortality were associated systemic injuries. Conclusion: Adult males are the most common victims in craniofacial trauma, and road traffic accidents were responsible for the majority. Most of the patients sustained mild head injuries and were managed conservatively. Open reduction and internal fixation with miniplates was used for displaced facial bone fractures.

  11. Interactive eBooks in educating patients and their families about head injury regardless of age.

    Science.gov (United States)

    Sahyouni, Ronald; Mahmoodi, Amin; Mahmoodi, Amir; Huang, Melissa; Tran, Diem Kieu; Chen, Jefferson W

    2017-05-01

    Traumatic Brain Injury (TBI) is a common and debilitating injury that is particularly prevalent in patients over 60. Given the influence of head injury on dementia (and vice versa), and the increased likelihood of ground-level falls, elderly patients are vulnerable to TBI. Educational interventions can increase knowledge and influence preventative activity to decrease the likelihood of further TBI. We sought to determine the efficacy of interactive tablet-based educational interventions in elderly patients on self-reported knowledge. Patients and family members, ages 20-90, presenting to a NeuroTrauma clinic completed a pre-survey to assess baseline TBI or concussion knowledge, depending on their diagnosis. Participants then received an interactive electronic book (eBook), or a text-based pamphlet with identical information, and completed a post-survey to test interim knowledge improvement. All participants (n=180), regardless of age, had significantly higher post-survey scores (peBook (n=39) scored lower than their younger counterparts despite higher pre-survey scores (peBook (n=20, 90) significantly improved on the post-survey (peBook (p<0.01, 95% CI). We demonstrated that interactive educational interventions are effective in the elderly TBI population. Enhanced educational awareness in the elderly population, especially patients at risk or with prior TBI, may prevent further head injury by educating patients on the importance of avoiding further head injury and taking precautionary measures to decrease the likelihood of further injury. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Prediction of time trends in recovery of cognitive function after mild head injury

    DEFF Research Database (Denmark)

    Müller, Kay; Ingebrigtsen, Tor; Wilsgaard, Tom

    2009-01-01

    . There was significant improvement of performance after 6 months. APOE-epsilon4 genotype was the only independent factor significantly predicting less improvement. CONCLUSION: The presence of the APOE-epsilon4 allele predicts less recovery of cognitive function after mild head injury....... change. RESULTS: A Glasgow Coma Scale score of less than 15, traumatic brain injury demonstrated with computed tomography, magnetic resonance imaging, and serum S-100B greater than 0.14 microg/L predicted impaired cognitive performance both at baseline and after 6 months; APOE genotype did not...

  13. Penetrating head injury with bilateral eye avulsion due to Himalayan bear bite.

    Science.gov (United States)

    Roka, Yam B; Roka, Narayani; Shrestha, Manzil; Puri, Puspa R; Adhikari, Hari B

    2012-12-01

    The Himalayan black bear (Ursus thibetanus or Selenarctos thibetanus), although an omnivore, is more carnivorous than its American counterpart. It is also more aggressive towards humans and is a threatened species because of the deforestation in the Himalayas. Furthermore, poverty, encroachment of the forest, extensive deforestation, lack of education and living near the forest are factors that increase the probability of such animal injuries. We report the case of a 35-year-old woman who suffered a severe penetrating head injury with scalp and bilateral eye avulsion, which was managed successfully. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  14. Pediatric gunshot penetrating head injury: a case report with 2-year follow-up

    OpenAIRE

    Steven Tandean; Marsal Risfandi; Iskandar Japardi

    2018-01-01

    Gunshot is a rare subset of penetrating head injury, and generally the victim dies before arriving at the hospital. This paper reported a case of an intracranial gunshot injury in a 12 year-old boy that was shot by his friend, whose primary intention was to play around, using a revolver. A missile projectile penetrated from mid frontal and came out from right occipital. Vital signs were stable with GCS 8 from physical examination. A rational management strategy should permit a good outcome. T...

  15. Heading Frequency Is More Strongly Related to Cognitive Performance Than Unintentional Head Impacts in Amateur Soccer Players

    Directory of Open Access Journals (Sweden)

    Walter F. Stewart

    2018-04-01

    Full Text Available ObjectiveCompared to heading, unintentional head impacts (e.g., elbow to head, head to head, head to goalpost in soccer are more strongly related to risk of moderate to very severe Central Nervous System (CNS symptoms. But, most head impacts associated with CNS symptoms that occur in soccer are mild and are more strongly related to heading. We tested for a differential relation of heading and unintentional head impacts with neuropsychological (NP test performance.MethodActive adult amateur soccer players were recruited in New York City and the surrounding areas for this repeated measures longitudinal study of individuals who were enrolled if they had 5+ years of soccer play and were active playing soccer 6+ months/year. All participants completed a baseline validated questionnaire (“HeadCount-2w”, reporting 2-week recall of soccer activity, heading and unintentional head impacts. In addition, participants also completed NP tests of verbal learning, verbal memory, psychomotor speed, attention, and working memory. Most participants also completed one or more identical follow-up protocols (i.e., HeadCount-2w and NP tests at 3- to 6-month intervals over a 2-year period. Repeated measures General Estimating Equations (GEE linear models were used to determine if variation in NP tests at each visit was related to variation in either heading or unintentional head impacts in the 2-week period before testing.Results308 players (78% male completed 741 HeadCount-2w. Mean (median heading/2-weeks was 50 (17 for men and 26 (7 for women. Heading was significantly associated with poorer performance on psychomotor speed (p < 0.001 and attention (p = 0.02 tasks and was borderline significant with poorer performance on the working memory (p = 0.06 task. Unintentional head impacts were not significantly associated with any NP test. Results did not differ after excluding 22 HeadCount-2w with reported concussive or borderline concussive symptoms

  16. ROLE OF MELATONIN IN EXPRESSION OF MALONDIALDEHYDE ON MICROGLIA CELLS OF RAT INDUCED HEAD INJURY

    Directory of Open Access Journals (Sweden)

    K. I. Nasution

    2015-08-01

    Full Text Available Background: brain injury is condition that harm human life. This study examines the application of melatonin in reducing oxidant status and barriers to the formation of cerebral edema in a rat brain injury model. The main purpose of this study is to prove the role of melatonin on the expression of Malondialdehyde (MDA and histological injury in a rat head injury model. Methods: This study was a randomized experimental posttest only control group design. This experimental was carried out on male Sprague Dawley strain Rattus novergicus, aged of 10-12 weeks, and weight of 300 g. Rat brain injury model was performed based on Marmarou (1994.1 Histology were observed using hematoxilen-eosin staining and immunohistochemistry, MDA was assessed using antibodies specific to each MDA protein. Observation and calculation of immunohistochemistry studies were also performed. Results: In this study, histological observation area covers an area of bleeding, number of immune-competent cells and the diameter of the arteries. Histology observation results showed that there is a significant reduction in diameter of arterial blood vessels of the brain injury tissue. Immunohisto-chemistry results showed that there is a significant reduction of MDA expression amount microglia cells of brain injury tissue. Conclusion: From this study, it can be concluded that Melatonin is a potent hydrogen peroxide scavenger that reduce the production of MDA. 

  17. Assessment of cognitive recovery following sports related head trauma in boxers.

    Science.gov (United States)

    Ravdin, Lisa D; Barr, William B; Jordan, Barry; Lathan, William E; Relkin, Norman R

    2003-01-01

    To prospectively examine recovery of cognitive function within one month following subconcussive sports related head trauma. A prospective study of New York State licensed professional boxers who underwent testing of cognitive functioning before and after (within days, one week, and one month) a professional bout. Male professional athletes recruited from the New York State Athletic Commission and local boxing gyms. Twenty-six licensed professional boxers were enrolled in the protocol. Data is presented on the 18 participants who completed testing on at least three of the four time points. Serial neuropsychological assessment before and after the athletes engaged in competition. Neuropsychological measures of cognitive functioning, including new learning and memory, information processing speed, and mental flexibility. A series of repeated measures MANOVAS revealed significant within subject differences across testing on complex information processing and verbal fluency. Post hoc analyses indicated significant differences between time 1 (baseline) and time 4 (one month post), with scores one month following the bout indicating significantly improved performance. Memory scores did not change significantly across testing; however, prior boxing exposure measured by total number of professional bouts was associated with poorer memory performance. Cognitive testing one month following participation in a professional boxing bout yielded scores suggestive of recovery to a level above the baseline. We conclude that baseline assessment taken during periods of intense training are likely confounded by other pre-bout conditions (i.e., sparring, rapid weight loss, pre-bout anxiety) and do not represent true baseline abilities. Instability of performance associated with mild head injury may complicate the interpretation of post-injury assessments. Practice effects may also confound the interpretation of serial assessments, leading to underestimation of the effects of sports

  18. Blind estimation of a ship's relative wave heading

    DEFF Research Database (Denmark)

    Nielsen, Ulrik Dam; Iseki, Toshio

    2012-01-01

    This article proposes a method to estimate a ship’s relative heading against the waves. The procedure relies purely on ship- board measurements of global responses such as motion components, accelerations and the bending moment amidships. There is no particular (mathematical) model connected to t...... to the estimate, and therefore it is called a ’blind estimate’. The approach is in this introductory study tested by analysing simulated data. The analysis reveals that it is possible to estimate a ship’s relative heading on the basis of shipboard measurements only....

  19. Quetiapine Induced Acute Dystonia in a patient with History of severe Head Injury

    Directory of Open Access Journals (Sweden)

    Robert G. Bota

    2010-01-01

    Full Text Available A patient with a history of severe head injury 10 years ago regained ability to walk after years of being bound to a wheelchair. During the last psychiatric hospitalization, quetiapine was increased to therapeutic dose using a normal titration. As a result the patient developed dystonia of multiple muscle groups requiring 4 days of hospitalization for remittance of symptoms. In this paper, we take a close look at the literature concerning extrapiramidal symptoms (EPS in this context, and we suggest that in patients with a history of head injury, it is warranted to consider a slower titration of antipsychotic medications, including ones that are considered having a lower risk of EPS such as quetiapine.

  20. Comparison of External and Internal Injury in Cases of Fatal Blunt Trauma Head Injury Autopsied at Tertiary Care Centre in Eastern Nepal

    Directory of Open Access Journals (Sweden)

    Bikash Sah

    2017-07-01

    Full Text Available Background & Objectives: Blunt trauma is more likely to be missed because clinical signs are less obvious in many regions of the body. This study was done with an objective to compare external and internal injuries of autopsy cases with fatal blunt trauma head injuries.Materials & Methods: This was a hospital based, cross sectional and analytical study done on the autopsy cases at B. P. Koirala Institute of Health Sciences, Dharan, Nepal (tertiary hospital in eastern Nepal from 13th April 2012 to 13th April 2013 with Head injuries by blunt trauma with or without concomitant non-head injuries. The decomposed bodies and the bodies where cause of trauma could not be differentiated were excluded. Postmortem examination was conducted on all the cases and the injuries present on all the body parts were noted. Abbreviated Injury Scale (AIS score was given for each injury. Appropriate statistical tool was used to compare the AIS scores of external and internal injuries. The test of significance was fixed at p < 0.01. Results: The correlation of scalp injuries with that of skull fracture, intracranial hemorrhage, cerebral injury and overall internal head injury were 0.591, 0.772, 0.439 and 0.600 respectively and all these correlations were statistically significant whereas the correlation between concomitant external and internal non-head injuries is -0.092 which is statistically not significant.Conclusion: Within the limits of this study it is possible to conclude that there was significant association between periodontitis and anxiety, and depression.

  1. Head injury in asylum seekers and refugees referred with psychological trauma

    OpenAIRE

    Doherty, S.M.; Craig, R.; Gardani, M.; McMillan, T.M.

    2016-01-01

    Objective. Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service. Method. Participants were 115 adult ASR referred ...

  2. Pontomedullary lacerations and concomitant head and neck injuries: their underlying mechanism. A prospective autopsy study.

    Science.gov (United States)

    Živković, Vladimir; Nikolić, Slobodan; Strajina, Veljko; Babić, Dragan; Djonić, Danijela; Djurić, Marija

    2012-09-01

    It is a well-documented fact that pontomedullary lacerations (PML) occur as a result of severe craniocervical injury, but their underlying mechanism has yet to be fully clarified. The aim of this prospective study has been to give greater insight into the underlying mechanism of PML through determining the site of blunt head-impact, as well as the presence of concomitant head and neck injuries in cases of brainstem PML. A total of 56 cases with partial PML have been analysed for this study. The case group was composed of 40 men and 16 women, averaging in age 44.2 ± 19.2 years and consisting of 7 motorcyclists, 4 bicyclists, 18 car occupants, 16 pedestrians, and 10 victims of falls from a height, as well as 1 victim of a fall from standing height. The presented study has shown that there are several possible mechanisms of PML. Impact to the chin, with or without a skull base fracture, most often leads to this fatal injury, due to the impact force transmission either through the jawbone or vertebral column; most likely in combination with a fronto-posterior hyperextension of the head. Additionally, lateral head-impacts with subsequent hinge fractures and PML may also be a possible mechanism. The jawbone and other facial bones are able to act as shock absorbers, and their fracture may diminish the energy transfer towards the skull and protect the brain and brainstem from injury. The upper cervical spine can act as damper and energy absorber as well, and may prevent any occurrence of fracture to the base of the skull.

  3. Role of Postmortem Multislice Computed Tomography Scan in Close Blunt Head Injury

    OpenAIRE

    Sidipratomo, Prijo; Prija, Trijono Karmawan Sukana; Murtala, Bachtiar; Purwadianto, Agus; Lawrence, Gatot Susilo

    2014-01-01

    BACKGROUND: Conventional autopsy in Indonesia is not well accepted as it is contrary to religion and culture. New radiological imaging method such as multislice computed tomography (MSCT) scan has potential to be a diagnostic tool in forensic pathology. The purpose of this study is to determine the ability of MSCT scan in finding abnormalities in close blunt head injury compared with autopsy. METHODS: This study used descriptive qualitative method. Postmortem cases in Department of Forensic M...

  4. Quetiapine Induced Acute Dystonia in a patient with History of severe Head Injury

    OpenAIRE

    Robert G. Bota; Joanne W. Witkowski

    2010-01-01

    A patient with a history of severe head injury 10 years ago regained ability to walk after years of being bound to a wheelchair. During the last psychiatric hospitalization, quetiapine was increased to therapeutic dose using a normal titration. As a result the patient developed dystonia of multiple muscle groups requiring 4 days of hospitalization for remittance of symptoms. In this paper, we take a close look at the literature concerning extrapiramidal symptoms (EPS) in this context, and we ...

  5. The influence of severe malnutrition on rehabilitation in patients with severe head injury.

    Science.gov (United States)

    Dénes, Zoltán

    2004-10-07

    The purpose of the study was to evaluate the consequences of severe malnutrition in patients with severe head injury during rehabilitation. The data were collected from medical records of patients admitted to the neurorehabilitation unit over the last 5 years. Twenty of 1850 patients had severe malnutrition, the body mass index (BMI) of these patients were under 15 (10-14) kg/m2. The majority of patients suffered traumatic brain damage (17/20). Thirteen patients arrived with percutaneous endoscopic gastrotomy /PEG, three nasogastric tube in 3 cases we placed PEG. The nutritional strategy included a high-calorie diet, by means of bolus feeding five times during the day, continuous feeding during the night; the daily intake target being more than 2500 kcal. During rehabilitation treatment the majority of patients (13/20) revealed weight gain with a rate of 0.5-2 kg/week. The following complications were treated during the rehabilitation phase: 20 pressure sores, 20 contractures, 11 urinal infections, 6 cases of pneumonia, 2 of purulent bronchitis, 6 of sepsis, 1 penoscrotal abscess, epidydymitis, and 1 case of purulent arthritis. The patients required total assistance at the time of admission. At discharge 10 patients remained completely dependent, 6 patients needed minimal assistance, and 4 patients could perform daily activities independently. The average length of stay in our unit was 78/6-150/days. Patients with head injury suffering from severe malnutrition exhibit serious complications at the time of admission as well as during rehabilitation treatment. The patients were very difficult to mobilize. The length of stay at the rehabilitation unit was 28 days longer when complicated by malnutrition, than head injuries showing normal nutritional status. These findings underline the importance of adequate nutrition in patients with head injury in both the acute ward and in the rehabilitation unit.

  6. Safety and efficacy of pharmacologic thromboprophylaxis following blunt head injury: a systematic review.

    Science.gov (United States)

    Reeves, Fairleigh; Batty, Lachlan; Pitt, Veronica; Chau, Marisa; Pattuwage, Loyal; Gruen, Russell L

    2013-10-01

    Patients with blunt head injury are at high risk of venous thromboembolism. However, pharmacologic thromboprophylaxis (PTP) may cause progression of intracranial hemorrhage, and clinicians must often weigh up the risks and benefits. This review aimed to determine whether adding PTP to mechanical prophylaxis confers net benefit or harm and the optimal timing, dose, and agent for PTP in patients with blunt head injury. We searched MEDLINE, EMBASE, The Cochrane Library Central Register of Controlled Trials (CENTRAL), and www.clinicaltrials.gov on April 24, 2013, to identify controlled studies and ongoing trials that assessed the efficacy or safety of thromboprophylaxis interventions in the early management of head-injured patients. Studies were classified based on types of interventions and comparisons, and the quality of included studies was assessed using Cochrane risk-of-bias tool and the Newcastle-Ottawa Quality Assessment Scale. We intended to undertake a meta-analysis if studies were sufficiently similar. Sixteen studies met the inclusion criteria, including four randomized controlled trials. At least two randomized controlled trials were at high risk of bias owing to inadequate randomization and concealment of allocation, and observational studies were potentially confounded by substantial differences between comparison groups. Heterogeneity of included studies precluded meta-analysis. Results were mixed, with some studies supporting and others refuting addition of PTP to mechanical interventions. Little evidence was available about dose or choice of agent. The safety and efficacy of early PTP in patients without early progression of hemorrhage is unclear. There is currently insufficient evidence to guide thromboprophylaxis in patients with blunt head injury. Standardized definitions and outcome measurements would facilitate comparison of outcomes across future studies. Studies in mixed populations should report head-injured specific subgroup data. Future

  7. Heading Frequency Is More Strongly Related to Cognitive Performance Than Unintentional Head Impacts in Amateur Soccer Players.

    Science.gov (United States)

    Stewart, Walter F; Kim, Namhee; Ifrah, Chloe; Sliwinski, Martin; Zimmerman, Molly E; Kim, Mimi; Lipton, Richard B; Lipton, Michael L

    2018-01-01

    Compared to heading, unintentional head impacts (e.g., elbow to head, head to head, head to goalpost) in soccer are more strongly related to risk of moderate to very severe Central Nervous System (CNS) symptoms. But, most head impacts associated with CNS symptoms that occur in soccer are mild and are more strongly related to heading. We tested for a differential relation of heading and unintentional head impacts with neuropsychological (NP) test performance. Active adult amateur soccer players were recruited in New York City and the surrounding areas for this repeated measures longitudinal study of individuals who were enrolled if they had 5+ years of soccer play and were active playing soccer 6+ months/year. All participants completed a baseline validated questionnaire ("HeadCount-2w"), reporting 2-week recall of soccer activity, heading and unintentional head impacts. In addition, participants also completed NP tests of verbal learning, verbal memory, psychomotor speed, attention, and working memory. Most participants also completed one or more identical follow-up protocols (i.e., HeadCount-2w and NP tests) at 3- to 6-month intervals over a 2-year period. Repeated measures General Estimating Equations (GEE) linear models were used to determine if variation in NP tests at each visit was related to variation in either heading or unintentional head impacts in the 2-week period before testing. 308 players (78% male) completed 741 HeadCount-2w. Mean (median) heading/2-weeks was 50 (17) for men and 26 (7) for women. Heading was significantly associated with poorer performance on psychomotor speed ( p  impacts were not significantly associated with any NP test. Results did not differ after excluding 22 HeadCount-2w with reported concussive or borderline concussive symptoms. Poorer NP test performance was consistently related to frequent heading during soccer practice and competition in the 2 weeks before testing. In contrast, unintentional head impacts incurred

  8. Computed tomography and magnetic resonance imaging of mild head injury - is it appropriate to classify patients with glasgow coma scale score of 13 to 15 as 'mild injury'?

    International Nuclear Information System (INIS)

    Uchino, Y.; Saeki, N.; Yamaura, A.; Okimura, Y.; Tanaka, M.

    2001-01-01

    Objective. The purpose of this study is to examine the relation between Glasgow coma scale (GCS) score and findings on computed tomography (CT) and magnetic resonance (MR) imaging of patients with mild head injury presenting GCS Scores between 13 and 15. Methods. Data were collected from all consecutive patients with mild head injury who were referred to our hospital between July 1 and October 31, 1999. All patients were recommended to undergo CT and MR imaging examinations. Patients younger than 14 years of age were excluded. Results. Ninety patients were recruited into this study. CT scans were obtained in 88 patients and MR imaging were obtained in 65 patients. Of those 90 patients, 2 patients scored 13 points, 5 scored 14 points and 83 (92.2 %) 15 points. Patients with GCS score of 13 points demonstrated parenchymal lesions an both CT and MR imaging. Those with 14 points revealed absence of parenchymal abnormality an CT, but presence of parenchymal lesions an MR imaging. Patients in advanced age (chi square test, p < 0.0001), and those with amnesia (p = 0005, not significant), although scoring 15 points, revealed a tendency to abnormal intracranial lesions on CT scans. Conclusion. It is doubtful whether patients with GCS score 13 should be included in the mild head injury category, due to obvious brain damage on CT scans. MR imaging should be performed on patients with GCS score 14, since the parenchymal lesions are not clearly demonstrated an CT scans. Even if patients scored GCS 15, patients which amnesia or of advanced age should undergo CT scans at minimum, and MR imaging when available. (author)

  9. Injuries to children in the United States related to trampolines, 1990-1995: a national epidemic.

    Science.gov (United States)

    Smith, G A

    1998-03-01

    To describe the epidemiology of trampoline-related injuries among children in the United States. A retrospective analysis of data for children 18 years old and younger from the National Electronic Injury Surveillance System of the United States Consumer Product Safety Commission for 1990 through 1995. There were an estimated 249 400 trampoline-related injuries [95% confidence interval (CI), 166 300-332 500] to children 18 years old and younger treated in hospital emergency departments in the United States during the 6-year study period. The number of injuries increased by 98% from 29 600 in 1990 to 58 400 in 1995, with an average of 41 600 (95% CI, 27 700-55 500) injuries per year, or 59.4 injuries per 100 000 United States children per year (95% CI, 39.6-79.3). The median age of injured children was 10 years, and 50% were males. Ninety-three percent of injuries occurred at home. Injuries to the extremities predominated among children of all ages and accounted for more than 70% of all injuries. This study identified several age-specific injury patterns. There was an inverse relationship between age versus the relative frequency of upper extremity injuries, and fractures and dislocations; and there was a direct relationship between age versus lower extremity injuries and soft tissue injury. There was also an inverse relationship between age versus facial injuries, head and neck injuries, and lacerations. Annually, an estimated 1400 children (95% CI, 800-2000), or 2.0 per 100 000 United States children (95% CI, 1. 1-2.9), required hospital admission or interhospital transfer because of a trampoline-related injury. This represented 3.3% of all children with a trampoline-associated injury. Fractures or dislocations accounted for 83% of injuries among admitted or transferred children, and children with a fracture or dislocation were more likely to be admitted or transferred to another hospital (8.4%) than children with other types of injury (relative risk, 10.80; 95% CI

  10. Nationwide time trends and risk factors for in-hospital falls-related major injuries

    DEFF Research Database (Denmark)

    Jorgensen, T. S. H.; Hansen, A. H.; Sahlberg, M.

    2015-01-01

    BackgroundAccidental falls during hospitalisation have a range of complications and more information is needed to improve prevention. We investigated patterns of in-hospital fall-related major injuries in the period 2000-2012 and the association between chronic conditions and in-hospital fall......-related major injuries. MethodsUsing administrative databases, patients aged 65+ years with in-hospital falls causing fractures or head injuries with need for surgery or intensive observation were identified as cases and were individually matched with five controls. Joinpoint regression was used to examine time...... trends and conditional logistic regression was used to analyse odds ratio (OR) for in-hospital falls-related major injuries according to a range of comorbidities. ResultsFour thousand seven hundred and fifty-four cases were identified from 2000 to 2012 and the most common injury was femur fracture (61...

  11. Pathophysiological changes detected by MRI within 24 hours after head injury

    International Nuclear Information System (INIS)

    Nagaoka, Tsukasa; Wakabayashi, Shinichi; Nariai, Tadashi; Ohno, Kikuo; Hirakawa, Kimiyoshi; Fukui, Shinsuke; Takei, Hidenori.

    1995-01-01

    This report concerns the evaluation of the usefulness of high-field magnetic resonance imaging (MRI) for the diagnosis and prognosis of patients with head injuries. For this purpose we compared the CT and MRI results obtained on 48 such patients. MRI of all cases was taken within 24 hours after head injury using a 1.5-Tesla unit. The sensitivity of the two modalities in the detection of small traumatic lesions was compared. Traumatic lesions of 23 patients (47.9%) were not detected by CT, but they were demonstrated on MRI. Overall, MRI was significantly more sensitive than CT in detecting early and/or subtle traumatic changes of the brain parenchyma (P 1 -WI and T 2 -WI. (B) Corpus callosum lesions with hyperintensity on T 2 -WI were in fact hemorrhagic contusions by signal changes on sequential MRI. The follow-up of chronological changes of a given corpus callosum lesion was essential for confirmation of its pathology. (C) In one case, scratch-like lesions with strong hypointensity on T 1 -WI and hyperintensity on T 2 -WI were clearly demonstrated in the white matter. These observations appeared to indicate axonal damages. (D) Even if initial GCS score is low ( 2 -WI and subsequently disappeared completely. We conclude that performing MRI in the early stage of a head injury is of utility for the understanding of pertinent pathophysiological changes and for predicting outcome. (author)

  12. Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Kadom, Nadja [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Boston University Medical Center, Boston, MA (United States); Khademian, Zarir; Vezina, Gilbert; Shalaby-Rana, Eglal [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Rice, Amy [Independent Consultant (Biostatistics), Chevy Chase, MD (United States); Hinds, Tanya [Children' s National Medical Center, Child and Adolescent Protection Center, Washington, DC (United States)

    2014-07-15

    In the evaluation of children younger than 3 years with intracranial hemorrhage it can be difficult to determine whether the cause of hemorrhage was traumatic, and if so, whether abusive head trauma (AHT) is a possibility. Cervical spine MRI is not a routine part of the nationally recommended imaging workup for children with suspected abusive head trauma. There is increasing evidence that spinal injuries are found at autopsy or MRI in abused children. However the prevalence of cervical spine injuries in children evaluated for abusive head trauma is unknown. We sought to determine both the incidence and the spectrum of cervical spine and brain injuries in children being evaluated for possible abusive head trauma. We also examined the relationship between cervical and brain MRI findings and selected study outcome categories. This study is a 3-year retrospective review of children evaluated for abusive head trauma. Inclusion criteria were: children with head trauma seen at our institution between 2008 and 2010, age younger than 36 months, availability of diagnostic-quality brain and cervical spine MRI, and child abuse team involvement because abusive head trauma was a possibility. A child abuse pediatrician and pediatric radiologists, all with board certification, were involved in data collection, image interpretation and data analysis. Statistical analysis was performed using Stata v12.1. The study included 74 children (43 boys, 31 girls) with a mean age of 164 days (range, 20-679 days). Study outcomes were categorized as: n = 26 children with accidental head trauma, n = 38 with abusive head trauma (n = 18 presumptive AHT, n = 20 suspicious for AHT), and n = 10 with undefined head trauma. We found cervical spine injuries in 27/74 (36%) children. Most cervical spine injuries were ligamentous injuries. One child had intrathecal spinal blood and two had spinal cord edema; all three of these children had ligamentous injury. MRI signs of cervical injury did not show a

  13. Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma

    International Nuclear Information System (INIS)

    Kadom, Nadja; Khademian, Zarir; Vezina, Gilbert; Shalaby-Rana, Eglal; Rice, Amy; Hinds, Tanya

    2014-01-01

    In the evaluation of children younger than 3 years with intracranial hemorrhage it can be difficult to determine whether the cause of hemorrhage was traumatic, and if so, whether abusive head trauma (AHT) is a possibility. Cervical spine MRI is not a routine part of the nationally recommended imaging workup for children with suspected abusive head trauma. There is increasing evidence that spinal injuries are found at autopsy or MRI in abused children. However the prevalence of cervical spine injuries in children evaluated for abusive head trauma is unknown. We sought to determine both the incidence and the spectrum of cervical spine and brain injuries in children being evaluated for possible abusive head trauma. We also examined the relationship between cervical and brain MRI findings and selected study outcome categories. This study is a 3-year retrospective review of children evaluated for abusive head trauma. Inclusion criteria were: children with head trauma seen at our institution between 2008 and 2010, age younger than 36 months, availability of diagnostic-quality brain and cervical spine MRI, and child abuse team involvement because abusive head trauma was a possibility. A child abuse pediatrician and pediatric radiologists, all with board certification, were involved in data collection, image interpretation and data analysis. Statistical analysis was performed using Stata v12.1. The study included 74 children (43 boys, 31 girls) with a mean age of 164 days (range, 20-679 days). Study outcomes were categorized as: n = 26 children with accidental head trauma, n = 38 with abusive head trauma (n = 18 presumptive AHT, n = 20 suspicious for AHT), and n = 10 with undefined head trauma. We found cervical spine injuries in 27/74 (36%) children. Most cervical spine injuries were ligamentous injuries. One child had intrathecal spinal blood and two had spinal cord edema; all three of these children had ligamentous injury. MRI signs of cervical injury did not show a

  14. Examination and Treatment of Hamstring Related Injuries

    Science.gov (United States)

    2012-01-01

    Context: There is a wide spectrum of hamstring-related injuries that can occur in the athlete. Accurate diagnosis is imperative to prevent delayed return to sport, injury recurrence, and accurate clinical decision making regarding the most efficacious treatment. Evidence Acquisition: This review highlights current evidence related to the diagnosis and treatment of hamstring-related injuries in athletes. Data sources were limited to peer-reviewed publications indexed in MEDLINE from 1988 through May 2011. Results: An accurate diagnostic process for athletes with posterior thigh–related complaints should include a detailed and discriminative history, followed by a thorough clinical examination. Diagnostic imaging should be utilized when considering hamstring avulsion or ischial apophyseal avulsion. Diagnostic imaging may also be needed to further define the cause of referred posterior thigh pain. Conclusions: Differentiating acute hamstring strains, hamstring tendon avulsions, ischial apophyseal avulsions, proximal hamstring tendinopathies, and referred posterior thigh pain is critical in determining the most appropriate treatment and expediting safe return to play. PMID:23016076

  15. Sports-related injuries of the spine

    International Nuclear Information System (INIS)

    Hochmuth, K.; Mack, M.G.; Vogl, T.J.; Kurth, A.A.; Zichner, L.

    2002-01-01

    Different sports show different patterns and frequencies of injuries, which are discussed in this paper. About 3% of all sports accidents relate to the spine. These injuries often have far-reaching consequences for the patients. A very early and extensive diagnosis of all changes is decisive for the start of an adequate therapy and thus for the prognosis of the injury. Radiological diagnosis is also of decisive importance for the documentation of late injuries and in the question of rehabilitation. Here special focus is put on MRT and CT diagnostics.A healthy spine of humans is normally able to resist all static and dynamic strains of the usual sports. However, anomalies and dysfunctions of the spine can reduce its capacity to resist strain. The recommendations of sporting activities are given according to the extent of deflection and the expected growth. The importance of radiology in primary diagnosis and in the follow-up due to typical changes like scoliosis, Morbus Scheuerman, spondylolysis and spondylolisthesis is discussed here as well. (orig.) [de

  16. Development of Medical Adjunctive Treatment for Acute Penetrating Head Injury

    Science.gov (United States)

    1988-04-01

    a bird) 22. Pyramid .................................................. (found in Egypt) 23. Unicorn ...Eat 2. Care 2. Mile 2. Rose 3. Rice 3. Cake 3. Meat 4. Storm 4. Skate 4. Cream 5. Market 5. Almost 5. Relate 6. Closet 6. Sailor 6. Strike 7. Mistake 7

  17. Effectiveness of rugby headgear in preventing soft tissue injuries to the head: a case-control and video cohort study.

    Science.gov (United States)

    Jones, S J; Lyons, R A; Evans, R; Newcombe, R G; Nash, P; McCabe, M; Palmer, S R

    2004-04-01

    To determine if headgear use by rugby players was associated with a reduced risk of head or facial laceration, abrasion, or fracture. An emergency department based case-control study in South Wales, UK, with cases being rugby players treated for superficial head and facial injuries and controls being their matched opponents during the game. A review of videos of the 41 games in the 1999 Rugby World Cup was also carried out to compare with the case-control study. Odds ratios (OR) and 95% confidence intervals (95% CI) were used to measure association between exposure (headgear wearing) and outcome (head and facial injuries). In the case-control study, 164 pairs were analysed, with headgear worn by 12.8% of cases and 21.3% of controls. Headgear use was associated with substantial but non-significant reductions in superficial head (OR = 0.43, 95% CI 0.13 to 1.19) and facial (OR = 0.57, 95% CI 0.21 to 1.46) injuries. The video study followed 547 players over 41 games, during which there were 47 bleeding injuries to the head. Headgear use significantly reduced the risk of bleeding head injury in forwards (OR = 0.14, 95% CI 0.01 to 0.99, p = 0.02), but not in backs. There was also a higher risk of facial injury among forwards, but this was not significant. The combined results suggest that headgear can prevent certain types of superficial head injuries in players at all levels of the game, but the evidence is strongest for superficial head injury in elite forwards. A randomised controlled trial would be the best way to study this further.

  18. Equestrian sport-related injuries: a review of current literature.

    Science.gov (United States)

    Havlik, Heather S

    2010-01-01

    Equestrian sports continue to grow in popularity in the Unites States and abroad, with an estimated 30 million people riding horses annually in the United States alone. Approximately one in five of these riders will suffer a serious injury during their riding career, requiring medical care and potentially hospitalization. Riding carries with it an implicit risk of injury associated with the unpredictability of the animals, the rider's head being positioned approximately 9 feet off the ground, and traveling unrestrained at speeds up to 40 mph. This article reviews common equestrian injuries, epidemiology, mechanism of injury, risk factors, and prevention strategies, with an emphasis on the more dangerous aspects of the sport.

  19. Television-related injuries in children--the British Columbia experience.

    Science.gov (United States)

    Mills, Jessica; Grushka, Jeremy; Butterworth, Sonia

    2012-05-01

    In Canada, mortality from falling televisions (TVs) is the 15th leading cause of childhood death owing to injury. Frequency, characteristics, and outcomes of TV childhood injuries were examined to determine any at risk populations. All TV-related traumas at a tertiary children's hospital from 1997 to 2011 were identified using the Canadian Hospitals Injury Reporting and Prevention Program database and the hospital's trauma database. Charts of admitted patients were reviewed. Analysis of 179 injuries (10-24 per year) revealed a high frequency of injury in the home and a preponderance of head and neck injuries. Toddlers were the most commonly injured age group. Eleven admitted patients were identified; 6 were admitted to intensive care unit with significant head injuries, 2 of whom required surgery. More than half of admitted patients were First Nations or recent immigrants. The length of stay for a ward vs intensive care unit admission was 1.3 days (range, Television injury would likely have been prevented by a securing device or support. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Alcohol consumption, blood alcohol concentration level and guideline compliance in hospital referred patients with minimal, mild and moderate head injuries

    DEFF Research Database (Denmark)

    Harr, Marianne Efskind; Heskestad, Ben; Ingebrigtsen, Tor

    2011-01-01

    In 2000 the Scandinavian Neurotrauma Committee published guidelines for safe and cost-effective management of minimal, mild and moderate head injured patients.The aims of this study were to investigate to what extent the head injury population is under the influence of alcohol, and to evaluate...... whether the physicians' compliance to the guidelines is affected when patients are influenced by alcohol....

  1. Expression of S100A6 in Rat Hippocampus after Traumatic Brain Injury Due to Lateral Head Acceleration

    Directory of Open Access Journals (Sweden)

    Bo Fang

    2014-04-01

    Full Text Available In a rat model of traumatic brain injury (TBI, we investigated changes in cognitive function and S100A6 expression in the hippocampus. TBI-associated changes in this protein have not previously been reported. Rat S100A6 was studied via immunohistochemical staining, Western blot, and reverse transcription-polymerase chain reaction (RT-PCR after either lateral head acceleration or sham. Reduced levels of S100A6 protein and mRNA were observed 1 h after TBI, followed by gradual increases over 6, 12, 24, and 72 h, and then a return to sham level at 14 day. Morris water maze (MWM test was used to evaluate animal spatial cognition. TBI- and sham-rats showed an apparent learning curve, expressed as escape latency. Although TBI-rats displayed a relatively poorer cognitive ability than sham-rats, the disparity was not significant early post-injury. Marked cognitive deficits in TBI-rats were observed at 72 h post-injury compared with sham animals. TBI-rats showed decreased times in platform crossing in the daily MWM test; the performance at 72 h post-injury was the worst. In conclusion, a reduction in S100A6 may be one of the early events that lead to secondary cognitive decline after TBI, and its subsequent elevation is tightly linked with cognitive improvement. S100A6 may play important roles in neuronal degeneration and regeneration in TBI.

  2. Management and outcome of low velocity penetrating head injury caused by impacted foreign bodies.

    Science.gov (United States)

    Moussa, Wael Mohamed Mohamed; Abbas, Mohamed

    2016-05-01

    Penetrating head injuries with impacted foreign bodies are rare, associated with a high incidence of morbidity and potentially life-threatening. In this study, we aimed at investigating the outcome of these cases as well as analyzing the factors affecting the prognosis. A retrospective study in which the records of 16 patients who had penetrating head injuries caused by low-velocity impacted foreign bodies were revised. All patients were males with a mean age of 28.9 years (range, 18 to 50 years). The follow-up period ranged from 4 to 13 months with a mean of 8.1 months. Causes of injury were construction accidents in 6 (37.5 %) patients, assault in 6 (37.5 %) and road traffic accidents in 4 (25 %). The impacted objects included a bar of iron, a piece of wood, a nail, a sickle and a piece of glass. Diagnostic computerized tomography (CT) of the brain was carried out on admission in all patients. Thirteen (81.3 %) patients were submitted to surgery, and all had the appropriate management in the form of antibiotics and dehydrating measures as required. The primary outcome measure was the Glasgow Outcome Scale (GOS) at the end of follow-up. At the end of follow-up, ten (62.5 %) patients had a GOS score of 5, two (12.5 %) patients had a score of 4, and four (25 %) patients had a score of 1. Low-velocity penetrating head injuries are most common in young adult males. With the appropriate management, a majority of even the most severe cases can have a favorable outcome.

  3. Computed Tomography Profile and its Utilization in Head Injury Patients in Emergency Department: A Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Archana Waganekar

    2018-01-01

    Full Text Available Context: Based on Glasgow Coma Scale (GCS, head injury can be classified as minor (GCS 13–15, moderate (GCS 9–12, and severe (GCS 3–8. There is a lot of controversy in the use of computed tomography (CT in head injury patients. Aims: This study was intended to estimate the rate of CT positivity in head injury patients and to define the criteria for doing CT in head injury patients. Settings and Design: This was a prospective observational study in the emergency department (ED over a 12-month period. Subjects and Methods: Study involved all head injury patients attending ED. Risk factors studied were a loss of consciousness (LOC, vomiting, seizures, ear bleed, nosebleed, external injuries, and alcohol intoxication. Statistical Analysis Used: Comparison of CT positivity with the patient's demographics and clinical characteristics was carried out using Chi-square. Results: A total of 1782 patients were included in this study. Overall CT positivity was 50.9%. In minor head injury (MHI, CT positivity rate was 38%. The study showed significant association of CT positivity with five variables: LOC >5 min, vomiting, seizures, ear bleed, and nosebleed. Conclusions: From the study, we recommend following: CT is indicated in all patients with moderate and severe head injury (GCS ≤12. Low threshold for taking CT is advisable in elderly and alcohol-intoxicated patients. In MHI, CT is indicated if any one of the following risk factors are present: LOC >5 min, history of vomiting, history of seizures, history of ear bleed, and history of nosebleed.

  4. A COMPARISON OF WAKEBOARD-, WATER SKIING-, AND TUBING-RELATED INJURIES IN THE UNITED STATES, 2000-2007

    Directory of Open Access Journals (Sweden)

    John I. Baker

    2010-03-01

    Full Text Available The purpose of the study was to compare tubing-related injuries to wakeboarding- and water skiing-related injuries. Data was collected from the 2000-2007 National Electronic Injury Surveillance Survey for 1,761 individuals seeking care at an emergency department due to a tubing-, wakeboarding, or water skiing-related injury. Data included patient age and sex, as well as injury characteristics including body region injured (i.e., head and neck, trunk, shoulder and upper extremity, and hip and lower extremity and diagnosis of injury (e.g., contusion, laceration, or fracture. Case narratives were reviewed to ensure that a tubing-, wakeboarding-, or water skiing-related injury occurred while the individual was being towed behind a boat. Severe injury (defined as an injury resulting in the individual being hospitalized, transferred, held for observation was compared among the groups using logistic regression. Wakeboard- and tubing-related injuries more commonly involved the head and neck, while water skiing- related injuries were likely to involve the hip and lower extremity. Tubing-related injuries, compared to water skiing-related injuries, were more likely to be severe (OR 2.31, 95% CI 1.23-4. 33. Like wakeboarding and water skiing, tubing has inherent risks that must be understood by the participant. While tubing is generally considered a safer alternative to wakeboarding and water skiing, the results of the current study suggest otherwise. Both the number and severity of tubing- related injuries could be prevented through means such as advocating the use of protective wear such as helmets while riding a tube or having recommended safe towing speeds prominently placed on inner tubes

  5. Traumatic brain injuries in illustrated literature: experience from a series of over 700 head injuries in the Asterix comic books.

    Science.gov (United States)

    Kamp, Marcel A; Slotty, Philipp; Sarikaya-Seiwert, Sevgi; Steiger, Hans-Jakob; Hänggi, Daniel

    2011-06-01

    The goal of the present study was to analyze the epidemiology and specific risk factors of traumatic brain injury (TBI) in the Asterix illustrated comic books. Among the illustrated literature, TBI is a predominating injury pattern. A retrospective analysis of TBI in all 34 Asterix comic books was performed by examining the initial neurological status and signs of TBI. Clinical data were correlated to information regarding the trauma mechanism, the sociocultural background of victims and offenders, and the circumstances of the traumata, to identify specific risk factors. Seven hundred and four TBIs were identified. The majority of persons involved were adult and male. The major cause of trauma was assault (98.8%). Traumata were classified to be severe in over 50% (GCS 3-8). Different neurological deficits and signs of basal skull fractures were identified. Although over half of head-injury victims had a severe initial impairment of consciousness, no case of death or permanent neurological deficit was found. The largest group of head-injured characters was constituted by Romans (63.9%), while Gauls caused nearly 90% of the TBIs. A helmet had been worn by 70.5% of victims but had been lost in the vast majority of cases (87.7%). In 83% of cases, TBIs were caused under the influence of a doping agent called "the magic potion". Although over half of patients had an initially severe impairment of consciousness after TBI, no permanent deficit could be found. Roman nationality, hypoglossal paresis, lost helmet, and ingestion of the magic potion were significantly correlated with severe initial impairment of consciousness (p ≤ 0.05).

  6. Mild closed head traumatic brain injury-induced changes in monoamine neurotransmitters in the trigeminal subnuclei of a rat model: mechanisms underlying orofacial allodynias and headache

    Directory of Open Access Journals (Sweden)

    Golam Mustafa

    2017-01-01

    Full Text Available Our recent findings have demonstrated that rodent models of closed head traumatic brain injury exhibit comprehensive evidence of progressive and enduring orofacial allodynias, a hypersensitive pain response induced by non-painful stimulation. These allodynias, tested using thermal hyperalgesia, correlated with changes in several known pain signaling receptors and molecules along the trigeminal pain pathway, especially in the trigeminal nucleus caudalis. This study focused to extend our previous work to investigate the changes in monoamine neurotransmitter immunoreactivity changes in spinal trigeminal nucleus oralis, pars interpolaris and nucleus tractus solitaries following mild to moderate closed head traumatic brain injury, which are related to tactile allodynia, touch-pressure sensitivity, and visceral pain. Our results exhibited significant alterations in the excitatory monoamine, serotonin, in spinal trigeminal nucleus oralis and pars interpolaris which usually modulate tactile and mechanical sensitivity in addition to the thermal sensitivity. Moreover, we also detected a robust alteration in the expression of serotonin, and inhibitory molecule norepinephrine in the nucleus tractus solitaries, which might indicate the possibility of an alteration in visceral pain, and existence of other morbidities related to solitary nucleus dysfunction in this rodent model of mild to moderate closed head traumatic brain injury. Collectively, widespread changes in monoamine neurotransmitter may be related to orofacial allodynhias and headache after traumatic brain injury.

  7. Head injury in asylum seekers and refugees referred with psychological trauma.

    Science.gov (United States)

    Doherty, S M; Craig, R; Gardani, M; McMillan, T M

    2016-01-01

    Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service. Participants were 115 adult ASR referred to a community psychological trauma service with moderate to severe mental health problems associated with psychological trauma. They were screened for a history of HI using a questionnaire developed for the study. Interpreters were used when required. The overall prevalence of HI was 51%. At least 38% of those with HI had a moderate-severe HI that could cause persisting disability. In 53% of those with HI, the cause was torture, human trafficking or domestic violence. Repeat HI can have cumulative effects on function; it was common, and was reported in 68% of those with HI. An injury to the head was not known to mental health clinicians prior to screening in 64% of cases. The emotional and cognitive consequences of HI in ASR may increase the vulnerability of this disadvantaged group, and can be associated with neurobehavioural problems affecting daily life and may compromise asylum outcomes. Routine screening for HI in ASR is needed, as are links to neuropsychology and brain injury services for advice, assessment and intervention.

  8. Radiological diagnosis in patients with head injury alone or in combination with multiple trauma

    International Nuclear Information System (INIS)

    Rieger, J.; Linsenmaier, U.; Pfeifer, K.J.; Reiser, M.

    2002-01-01

    Purpose. Head injury alone or in combination with multiple trauma is the main cause of death and severe disability in individuals under 45 years old. This review is intended to describe the relevant imaging modalities, to analyze their specific value and limitations and to illustrate the most important radiologic findings. The indications for diagnostic imaging within the context of an interdisciplinary linkage of diagnostic and therapeutic measures are discussed.Material and methods. Recent publications are analyzed and compared to the experiences of our own hospital. In terms of a critical synoptic assessment the currently best standard of care is described in consideration of an interdisciplinary care concept.Results. Radiologic imaging modalities crucially contribute to the complete injury assessment and provide an indispensable basis for any therapeutic decision. Comprehensive neuromonitoring and reliable demonstration of delayed or secondary brain damage is impossible without modern imaging technology. Computed tomography (CT) further continues to be the most important imaging modality, while magnetic resonance imaging despite it's partly superior diagnostic informations remains reserved to particular diagnostic problems.Conclusions. Suitable constructive prerequisites, an interdisciplinary care concept and integration of the radiologist in hospital-adapted diagnostic and therapeutic algorithms significantly improves the outcome of patients with acute head injury. Beside the correct diagnosis itself the time to establish a diagnosis above all has a crucial impact on successful management and good outcome of these patients. (orig.) [de

  9. Clinical manifestations that predict abnormal brain computed tomography (CT in children with minor head injury

    Directory of Open Access Journals (Sweden)

    Nesrin Alharthy

    2015-01-01

    Full Text Available Background: Computed tomography (CT used in pediatric pediatrics brain injury (TBI to ascertain neurological manifestations. Nevertheless, this practice is associated with adverse effects. Reports in the literature suggest incidents of morbidity and mortality in children due to exposure to radiation. Hence, it is found imperative to search for a reliable alternative. Objectives: The aim of this study is to find a reliable clinical alternative to detect an intracranial injury without resorting to the CT. Materials and Methods: Retrospective cross-sectional study was undertaken in patients (1-14 years with blunt head injury and having a Glasgow Coma Scale (GCS of 13-15 who had CT performed on them. Using statistical analysis, the correlation between clinical examination and positive CT manifestation is analyzed for different age-groups and various mechanisms of injury. Results: No statistically significant association between parameteres such as Loss of Consciousness, ′fall′ as mechanism of injury, motor vehicle accidents (MVA, more than two discrete episodes of vomiting and the CT finding of intracranial injury could be noted. Analyzed data have led to believe that GCS of 13 at presentation is the only important clinical predictor of intracranial injury. Conclusion: Retrospective data, small sample size and limited number of factors for assessing clinical manifestation might present constraints on the predictive rule that was derived from this review. Such limitations notwithstanding, the decision to determine which patients should undergo neuroimaging is encouraged to be based on clinical judgments. Further analysis with higher sample sizes may be required to authenticate and validate findings.

  10. The scourge of head injury among commercial motorcycle riders in Kampala; a preventable clinical and public health menace.

    Science.gov (United States)

    Kamulegeya, Louis H; Kizito, Mark; Nassali, Rosemary; Bagayana, Shiela; Elobu, Alex E

    2015-09-01

    Trauma is an increasingly important cause of disease globally. Half of this trauma is from road traffic injuries with motorcycles contributing 21-58%. Low protective gear use, lack of regulation and weak traffic law enforcement contribute to unsafe nature of commercial motorcycles also known as "boda boda" in Uganda. To determine the prevalence of protective gear use, the occurrence of head injury and the relationship between the two among commercial motorcycle riders in Kampala. Following ethical approval we recruited consecutive consenting participants to this analytical cross-sectional study. Data was collected using pretested interviewer administered questionnaires, double entered in Epidata and analyzed with STATA. Proportions and means were used to summarize data. Odds ratios were calculated for association between wearing helmets and occurrence and severity of head injury. All 328 participants recruited were male. Of these, 18.6% used Protective gear and 71.1 % sustained head injury. Helmets protected users from head injury (OR 0.43, 95% CI, 0.23-0.8) and significantly reduced its severity when it occurred. Protective gear use was low, with high occurrence of head injury among commercial motorcycle riders in Uganda. More effective strategies are needed to promote protective gear use among Uganda's commercial motorcycle riders.

  11. Injuries and helmet use related to non-motorized wheeled activities among pediatric patients.

    Science.gov (United States)

    Lindsay, H; Brussoni, M

    2014-07-01

    Patients presenting to emergency departments (ED) for injuries resulting from recreational activities represent a unique source of information on important directions for injury prevention efforts. We describe the epidemiology of non-motorized wheeled activity-related injury in pediatric patients presenting to Canadian EDs as well as patients' helmet use. Data for the years 2004 to 2009 were abstracted from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), a national ED injury surveillance program in fifteen hospitals. Most of the 28 618 children aged 1 to 16 years injured during non-motorized wheeled activities were injured while cycling, followed by skateboarding. Most injuries occurred among boys. Children injured on scooters tended to be younger whereas skateboarders were the oldest. On average, the number of all injuries decreased by 6% over the time period. Falls were the most common mechanism of injury; 8.3% of patients had head injuries, which were seen more often among cyclists than other wheeled-activity users. Helmet use was greatest among cyclists (62.2%) and lowest among skateboarders (32.9%). Injured patients presenting to EDs in jurisdictions with legislation mandating helmet use had 2.12 greater odds of helmet use and 0.86 lesser odds of head injury compared with those presenting in jurisdictions without helmet laws. These results provide further evidence that legislation mandating helmet use may be an effective way of reducing injury among all wheeled-activity users. The small number of patients who presented with helmet use and protective gear (59.4% overall) suggests that this remains an area for intervention.

  12. Playground slide-related injuries in preschool children: increased risk of lower extremity injuries when riding on laps.

    Science.gov (United States)

    Jennissen, Charles A; Koos, Maggie; Denning, Gerene

    2018-04-10

    The purpose of this study was to better understand the factors associated with playground slide-related injuries in preschool children and to test the hypothesis that riding on laps increases the likelihood of lower extremity injuries. Playground slide-related injuries (product code 1242) in children ≤5 years of age treated in emergency departments from 2002 to 2015 were identified (N = 12,686) using the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS). Descriptive and comparative analyses, including chi-square testing and binary logistic regression, were performed. Based on NEISS stratified national sampling estimates, over 350,000 children ≤5 years of age were injured on slides from 2002 to 2015. Overall, 59% of the children were male, and 65% were white. Almost 60% of injuries occurred in parks or other public areas. The most frequent diagnosis was a fracture (36%); lacerations were 19% of the injuries. A higher proportion of musculoskeletal injuries were seen in toddlers < 3 years old as compared to those 3-5 years of age (p < 0.001). Injuries to the lower extremities increased in frequency as age decreased, whereas injuries to the upper extremities and head/neck/face were more common in older preschoolers. Children < 3 years of age were 12 times more likely to be identified from narratives as being on another person's lap at the time of injury. Children identified as being on a lap had an increased odds of injury to the lower extremity than to other body parts (OR 43.0, 95% confidence interval (CI) 32.0-58.0), and of lower leg/ankle fracture than fractures elsewhere (OR 49.5, 95% CI 31.7-77.4). Decreasing age was associated with a higher likelihood of being identified as sliding down on another person's lap and a higher likelihood of lower extremity injuries. Healthcare providers should be mindful of the potential for these slide-related injuries as they can result in a toddler's fracture of

  13. Medieval times' influencing figure Rhaze's approach to head injuries in Liber Almansoris.

    Science.gov (United States)

    Acıduman, Ahmet; Aşkit, Cağatay; Belen, Deniz

    2014-12-01

    To present the chapter "On wound of the head and fracture of the head bone" of Kitāb al-Manṣūrī / Liber Almansoris, which was one of the early works of Rhazes. Both Arabic (Süleymaniye Manuscript Library, Ayasofya collection, Nr. 3751 and Millet Library, Feyzullah Efendi collection, Nr. 1327) and the Latin (Basileae, 1544) texts of Kitāb al-Manṣūrī / Liber Almansoris were studied, and the 26th section of the 7th chapter, entitled "Fī al-shajja kasr al-'aẓm al-ra's / De plagis capitis et fractura cranei / On wound of the head and fracture of the head bone" was translated into English and English text created. Rhazes underlined removing bone fragments in depressed and separated fractures of cranium along with protection of the dura, but he did not describe any surgical technique in this chapter. Galen's contemplation for the care of the dura with its integrity and as well his proposal to remove the bone fragments for preventing the dura from injury were the golden standards at the time that Rhazes also followed in the treatment of skull fractures. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Intraventricular catheter placement by electromagnetic navigation safely applied in a paediatric major head injury patient.

    Science.gov (United States)

    Aufdenblatten, Christoph Alexander; Altermatt, Stefan

    2008-09-01

    In the management of severe head injuries, the use of intraventricular catheters for intracranial pressure (ICP) monitoring and the option of cerebrospinal fluid drainage is gold standard. In children and adolescents, the insertion of a cannula in a compressed ventricle in case of elevated intracranial pressure is difficult; therefore, a pressure sensor is placed more often intraparenchymal as an alternative option. In cases of persistent elevated ICP despite maximal brain pressure management, the use of an intraventricular monitoring device with the possibility of cerebrospinal fluid drainage is favourable. We present the method of intracranial catheter placement by means of an electromagnetic navigation technique.

  15. The outcome after head injury in patients with radiologically demonstrated brain contusion

    International Nuclear Information System (INIS)

    Eide, P.K.; Tysnes, O.B.

    1993-01-01

    The early and late outcome was evaluated in head injury patients who presented brain contusion(s) on the cranial CT scan and in patients hospitalized for concussion. There was a high degree of concurrence between mortality and CT findings. Late complaints were common among cases of concussion of the brain. However, the frequency of impaired memory and concentration, speech problems, paresis and epileptic seizures was increased in cases where the CT scan showed brain contusion. Adaptive and social functioning was most impaired in cases with multifocal contusions in both hemispheres. 16 refs., 5 tabs

  16. Therapeutic effectiveness of epicranial nerve blocks on post-traumatic syndrome from head injury

    Directory of Open Access Journals (Sweden)

    C. A. Caputi

    2011-03-01

    Full Text Available The autor describes the case of a 53-year-old woman suffering from headache and dizziness, sometimes nausea, tinnitus in the right ear, and diffuse scalp allodynia following an occupational accident involving a head injury. Hyposensitizing treatment by anesthetic blockade at the emergence points of the epicranial nerves, which were hyperalgesic to fi nger pressure, rapidly controlled the allodynia and eventually the headache. Unexpectedly, the patient also reported reduced dizziness and resolution of the tinnitus. The unforeseen outcome highlights the unpredictable therapeutic potential of a simple and modestly invasive procedure. The neuropathophysiological interpretation is consequently very interesting.

  17. Injuries of the head from backface deformation of ballistic protective helmets under ballistic impact.

    Science.gov (United States)

    Rafaels, Karin A; Cutcliffe, Hattie C; Salzar, Robert S; Davis, Martin; Boggess, Brian; Bush, Bryan; Harris, Robert; Rountree, Mark Steve; Sanderson, Ellory; Campman, Steven; Koch, Spencer; Dale Bass, Cameron R

    2015-01-01

    Modern ballistic helmets defeat penetrating bullets by energy transfer from the projectile to the helmet, producing helmet deformation. This deformation may cause severe injuries without completely perforating the helmet, termed "behind armor blunt trauma" (BABT). As helmets become lighter, the likelihood of larger helmet backface deformation under ballistic impact increases. To characterize the potential for BABT, seven postmortem human head/neck specimens wearing a ballistic protective helmet were exposed to nonperforating impact, using a 9 mm, full metal jacket, 124 grain bullet with velocities of 400-460 m/s. An increasing trend of injury severity was observed, ranging from simple linear fractures to combinations of linear and depressed fractures. Overall, the ability to identify skull fractures resulting from BABT can be used in forensic investigations. Our results demonstrate a high risk of skull fracture due to BABT and necessitate the prevention of BABT as a design factor in future generations of protective gear. © 2014 American Academy of Forensic Sciences.

  18. Primary oculomotor nerve palsy due to mild head injury. Report of two cases

    International Nuclear Information System (INIS)

    Katsuno, Makoto; Kobayashi, Shiro; Yokota, Hiroyuki; Teramoto, Akira

    2008-01-01

    Two patients with primary oculomotor nerve palsy due to direct mild head injury are reported. They presented with internal ophthalmoplegia, dilated nonreactive pupils, and very mild disturbance in consciousness. Except for the persistent oculomotor nerve palsy, both the patients recovered fully within one week. Neither demonstrated a history that was suggestive of a cause for their oculomotor nerve palsy. Initial CT scans demonstrated localized subarachnoid hemorrhage around the brain stem. One of the patients had sustained a fracture of the anterior clinoid process. As the underlying pathophysiologic mechanism underlying the oculomotor nerve palsy we suspected mild injury to the pupillomotor fibers at the anterior petroclinoidal ligament and that of the pupillary fibers at the posterior petroclinoidal ligament. We speculate that these perforating fibers at the anterior petroclinoidal ligament acted as a fulcrum due to downward displacement of the brainstem at the time of impact. (author)

  19. Cognitive dysfunction in young men following head injury in childhood and adolescence: a population study

    DEFF Research Database (Denmark)

    Teasdale, T W; Engberg, A W

    2003-01-01

    admissions and the draft board, 3091 young men were identified who had been injured before age 18 and tested at age 18 or shortly thereafter: 970 had suffered a single concussion and were in hospital for one day only; 521 had two concussions at separate times and were in hospital for one day only on each...... Danish men appearing before the draft board had a score classified as dysfunctional). RESULTS: For young men who had suffered a single concussion, cranial fracture, or cerebral lesion before 12 years of age, resulting in less than 12 days of hospital admission (n = 376), rates of cognitive dysfunction.......0, irrespective of age at injury. For cases of two concussions, all odds ratios were > 1.4 but were not significant for all age groupings. CONCLUSIONS: For milder forms of single head injury before age 12 there is no evidence of enduring cognitive dysfunction. The apparent effect at later ages may reflect...

  20. Ultrasound imaging of sports-related musculoskeletal injuries

    International Nuclear Information System (INIS)

    Craig, J.G.; Holsbeek, M.T. van; Gauthier, T.P.; Cook, W.J.

    2006-01-01

    Sports-related injuries of the musculoskeletal system affect millions of individuals every year. Integrating high-frequency Tissue Harmonic Imaging ultrasound with MRI and CT gives the greatest opportunity for diagnosing specific injuries. (orig.)

  1. Most common sports-related injuries in a pediatric emergency department.

    Science.gov (United States)

    Monroe, Kathy W; Thrash, Chris; Sorrentino, Annalise; King, William D

    2011-01-01

    Participation in sports is a popular activity for children across the country. Prevention of sports-related injuries can be improved if details of injuries are documented and studied. A retrospective medical record review of injuries that occurred as a direct result of sports participation (both organized and non-organized play) from November 2006 to November 2007. Because the vast majority of injuries were a result of participation in football or basketball, these injuries were focused upon. The injuries specifically examined were closed head injury (CHI), lacerations and fractures. There were 350 football and 196 basketball injuries (total 546). Comparing injuries between the two groups fractures were found to be more prevalent in football compared to basketball (z = 2.14; p = 0.03; 95%CI (0.01, 0.16)). Lacerations were found to be less prevalent among helmeted patients than those without helmets. (z = 2.39; p = 0.02; 95%CI (-0.17,-0.03)). CHI was more prevalent among organized play compared to non-organized (z = 3.9; pfootball related visits, organized play had a higher prevalence of injury compared to non-organized play (z = 2.87; p = 0.004; 95%CI (0.04.0.21)). No differences in fracture or laceration prevalence were found between organized and non-organized play. Football and basketball related injuries are common complaints in a pediatric Emergency Department. Frequently seen injuries include CHI, fractures and lacerations. In our institution, fractures were more prevalent among football players and CHI was more prevalent among organized sports participants.

  2. Recent trends in television tip over-related injuries among children aged 0-9 years.

    Science.gov (United States)

    Murray, K J; Griffin, R; Rue, L W; McGwin, G

    2009-08-01

    To describe recent trends in television tip over-related injuries among children aged 0-9 years, and to compare injury rates with sales of newer digital televisions. Digital television sales data were obtained from marketing data provided by the Television Bureau of Advertising. Data regarding television tip over-related injuries among children aged 0-9 years were obtained from the 1998-2007 National Electronic Injury Surveillance System. A Wald chi(2) test, estimated from logistic analysis, was used to determine whether the distribution of injury types differed by age group. Pearson's correlation was used to estimate the association between digital television sales and television tip over-related injuries. An estimated 42 122 (95% CI 35 199 to 49 122) injuries from television tip-overs were treated in US emergency departments from 1998 to 2007. The injury rate was highest for children aged 1-4 years (18.6/100 000). A majority of injuries (63.9%) involved the head and neck for children under 1 year of age, while a higher proportion of injuries among children aged 1-4 involved the hip and lower extremity (42.9% and 31.0%, respectively), and shoulder and upper extremity (16.8%) for children aged 5-9. A strong, positive correlation was observed between television sales and annual injury rates (r = 0.89, pdigital television sales were strongly correlated with increased injury rates, the lack of information regarding the type of television involved prevents inference regarding causation.

  3. Comparison of Indiana High School Football Injury Rates by Inclusion of the USA Football "Heads Up Football" Player Safety Coach.

    Science.gov (United States)

    Kerr, Zachary Y; Dalton, Sara L; Roos, Karen G; Djoko, Aristarque; Phelps, Jennifer; Dompier, Thomas P

    2016-05-01

    In Indiana, high school football coaches are required to complete a coaching education course with material related to concussion awareness, equipment fitting, heat emergency preparedness, and proper technique. Some high schools have also opted to implement a player safety coach (PSC). The PSC, an integral component of USA Football's Heads Up Football (HUF) program, is a coach whose primary responsibility is to ensure that other coaches are implementing proper tackling and blocking techniques alongside other components of the HUF program. To compare injury rates in Indiana high school football teams by their usage of a PSC or online coaching education only. Cohort study; Level of evidence, 2. Athletic trainers (ATs) evaluated and tracked injuries at each practice and game during the 2015 high school football season. Players were drawn from 6 teams in Indiana. The PSC group, which used the PSC component, was comprised of 204 players from 3 teams. The "education only" group (EDU), which utilized coaching education only, was composed of 186 players from 3 teams. Injury rates and injury rate ratios (IRRs) were reported with 95% confidence intervals (CIs). During 25,938 athlete-exposures (AEs), a total of 149 injuries were reported, of which 54 (36.2%) and 95 (63.8%) originated from the PSC and EDU groups, respectively. The practice injury rate was lower in the PSC group than the EDU group (2.99 vs 4.83/1000 AEs; IRR, 0.62; 95% CI, 0.40-0.95). The game injury rate was also lower in the PSC group than the EDU group (11.37 vs 26.37/1000 AEs; IRR, 0.43; 95% CI, 0.25-0.74). When restricted to concussions only, the rate was lower in the PSC group (0.09 vs 0.73/1000 AEs; IRR, 0.12; 95% CI, 0.01-0.94), although only 1 concussion was reported in the PSC group. No differences were found in game concussion rates (0.60 vs 4.39/1000 AEs; IRR, 0.14; 95% CI, 0.02-1.11). Findings support the PSC as an effective method of injury mitigation in high school football. Future research

  4. Isolated Post-Traumatic Radial Head Dislocation, A Rare and Easily Missed Injury-A Case Report

    Directory of Open Access Journals (Sweden)

    V Gupta

    2013-03-01

    Full Text Available Dislocation of the head of the radius may be either congenital, an isolated injury or more commonly part of a complex injury to the elbow such as the Monteggia fracturedislocation. Isolated traumatic radial head dislocation without associated injuries in children is a rare and easily missed condition. We report such a case in a 7-year-old boy without any associated injuries or co-morbid conditions. Initially the diagnosis was missed, and 6 weeks later open reduction was performed with annular ligament reconstruction surgery. At the one-year follow up, the patient had returned to most normal activities, showing only slight terminal restriction of pronation. We discuss the injury mechanism and management for the Monteggia fracturedislocation and review the available literature.

  5. A heads up on concussions: are there sex-related differences?

    Science.gov (United States)

    Brook, Emily M; Luo, Xuan; Curry, Emily J; Matzkin, Elizabeth G

    2016-01-01

    Head injuries are a major concern for physicians in athletes of all ages. Specifically, sports-related concussions are becoming an all-too-common injury among female athletes. The incidence of concussions among female athletes has likely increased over the past few decades because of an increase in sports participation afforded by Title IX. It would be useful for physicians to have general knowledge of concussions and their potential sex-related differences. This review article summarizes the current body of research concerning sex-related differences in concussion epidemiology and outcomes. A literature search was performed using PubMed and included all articles published from 1993 to present, with a predominant focus on research conducted over the past fifteen years. Additional articles were found using the bibliography from articles found through the PubMed search. Several articles have compared incidence, severity of neurological deficit, constellation of symptoms, and length of recovery post-concussion in males and females. However, the literature does not unanimously support a significant sex-related difference in concussions. Lack of consensus in the literature can be attributed to differences between patient populations, different tools used to study concussions, including subjective or objective measures, and differences in mechanisms of injury. We conclude that concussions are a serious injury in both male and female athletes, and physicians should have a very high index of suspicion regardless of sex, because there currently is not sufficient consensus in the literature to institute sex-related changes to concussion management. Current research may suggest a sex-related difference pertaining to sports-related concussions, but further evaluation is needed on this topic.

  6. Beware of the dog? An observational study of dog-related musculoskeletal injury in the UK.

    Science.gov (United States)

    Willmott, H; Greenheld, N; Goddard, R

    2012-05-01

    Although owning a dog confers numerous health benefits, dogs can cause falls resulting in musculoskeletal injury and fractures. We conducted a prospective observational study over a two-month period to investigate the incidence and epidemiology of dog-related musculoskeletal injury. All patients attending the Emergency Department, trauma ward or fracture clinic were asked whether their injury was caused by a dog. Thirty-seven patients were identified. There were 26 fractures, 10 soft-tissue injuries and one head injury. Seventeen patients were admitted to the hospital and sixteen cases required an operation. Older people were statistically more likely to sustain a fracture (p=0.0003) or require hospital admission (p=0.02). Mechanisms of injury are discussed and can be classified into direct or indirectly caused by the dog. The most common injury mechanism was being pulled over by a dog on a lead. Injury avoidance strategies are discussed. We conclude that dogs are a potential hazard, particularly to the elderly and the morbidity associated with these injuries may offset the health benefits conferred by dog ownership. Copyright © 2012. Published by Elsevier Ltd.

  7. Burden of motorcycle-related injury in Malaysia

    OpenAIRE

    Rahman, Nik Hisamuddin NA; Baharuddin, Kamarul A; Mohamad, Syarifah Mastura S

    2015-01-01

    Background Road traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycle crash. We attempted to conduct a short survey to determine the magnitude of burden related to motorcycle-related RTIs in Malaysia. We hypothesize that motorcycle-related RTI in Malaysia contributes significantly to the health burden in the country. Methods The cross-sectiona...

  8. Firework-related childhood injuries in Greece: a national problem.

    Science.gov (United States)

    Vassilia, Konte; Eleni, Petridou; Dimitrios, Trichopoulos

    2004-03-01

    During a 5-year period, out of 110066 children with injuries recorded in the Greek Emergency Department Injury Surveillance System (EDISS), 91 had firework-related injuries. Descriptive analyses and the Barrell matrix were used to determine risk factors and extrapolated national firework childhood injury figures were calculated. The estimated annual incidence of childhood firework injuries treated in the emergency departments of hospitals countrywide, was 7 per 100000 children years. Seventy percent of injuries concerned older children (10-14 years), mostly boys with self-inflicted injuries, whereas girls suffered injuries as bystanders. A sharp peak in spring was noted, when the Greek Orthodox Easter is celebrated. Illicitly sold fireworks caused most injuries, but in eight instances homemade firecrackers were responsible.

  9. Clinical Epidemiology of Head Injury from Road-Traffic Trauma in a Developing Country in the Current Era

    Directory of Open Access Journals (Sweden)

    Amos O. Adeleye

    2017-12-01

    Full Text Available ObjectivesAfrica and other Asian low middle-income countries account for the greatest burden of the global road-traffic injury (RTI-related head injury (HI. This study set out to describe the incidence, causation, and severity of RTI-related HI and associated injuries in a Nigerian academic neurosurgical practice.MethodsThis is a retrospective cross-sectional analysis of RTI-related HI from a prospective HI registry in an academic neurosurgery practice in Nigeria.ResultsAll-terrain RTI accounted for 80.6% (833/1,034 of HI over a 7-year study period. All age groups were involved, mean 33.06 years (SD 18.30, mode 21–30, 231/833 (27.7%. The male:female ratio was 631:202, ≈3:1. The road trauma occurred exclusively from motorcycle-and motor-vehicle crash (MCC/MVC, MCC caused 56.8% (473/833 of these; the victims were vulnerable road users (VRU in 74%, and >90% belong in the low socioeconomic class. Using the Glasgow Coma Scale grading, the HI was moderate/severe in 52%; loss of consciousness occurred in 93%, the Abbreviated Injury Severity-head > 3 in 74%, and computed tomography (CT Rotterdam score > 3 in 52%. Significant extracranial injuries occurred in many organ systems, 421/833 (50.5% having Injury Severity Score (ISS > 25. Surgical lesions included extensive brain contusions in 157 (18.8%; acute extradural hematoma in 34 (4.1%; acute subdural hematoma in 32 (3.8%; and traumatic intracerebral hemorrhage in 27 (3.2%, but only 97 (11.6% received operative care for various logistic reasons. The in-hospital outcome was good in 71.3% and poor in 28.7%; the statistically significant (p < 0.001 determinants of this outcome profile were the severity of the HI, the CT Rotterdam score, and the ISS.ConclusionIn this study from Nigeria, RTI-related HI emanates from significant trauma to vulnerable road users and are caused exclusively by motorcycles and motor vehicles.

  10. Plasma aldosterone and CT findings in head injury, especially in acute subdural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Hideaki

    1988-12-01

    As we have already reported, an increase in the plasma aldosterone level was regulary found after severe head injury. And the values of plasma aldosterone in unconscious patients with increased intracranial pressure were significantly higher than those in patients without unconsciousness. Thus, plasma aldosterone in acute phase of head injury seems to be a sensitive index of increased intracranial pressure. In the present study, we measured plasma aldosterone levels in three groups ; subdural hematoma with mid-line shift (group A), cerebral contusion without mid-line shift (group B) and cerebral conceussion (group C). In group A, the peak value of aldosterone was markedly high (283.9 +- 142.5). In B, the peak value (143.7 +- 27.8) was higher than in C (116.3 +- 35.0). And, correlation between the serum aldosterone levels and CT findings, especially the mid-line shift was found. As a conclusion, the serum levels of aldosterone seems to be associated with intracranial pressure.

  11. Head injury in childhood: comparison of sonography with the conventional X-ray and CT

    International Nuclear Information System (INIS)

    Steiner, S.; Riebel, T.; Nazarenko, O.; Bassir, C.; Steger, W.; Vogl, T.; Felix, R.

    1996-01-01

    Purpose: The purpose of our study was to compare the value of ultrasound, conventional X-ray diagnosis and CT in detecting skull fractures and intracranial haemorrhage in children suffering from a head injury. Material and methods: We examined 210 children who had a head injury. In all cases the calvarium was investigated by ultrasound using a 7.0 MHz linear transducer. In children with an open fontanel (n=190) the cerebrum was screened additionally by ultrasound following a standard protocol. The sonographic findings were correlated to the X-ray examination (n=21) and CT (n=13). Results: Ultrasound enabled diagnosis of linear calvarial fractures (n=29), depressed fratures (n=6) and intracranial haemorrhage (n=8). X-Ray and XT examination confirmed the diagnosis of linear calvarial fractures in 16 cases, of depressed fractures in 6 cases. CT confirmed the sonographic diagnosis of intracranial haemorrhage in 8 cases. Conclusion: Ultrasound as a primary method can replace the conventional X-ray in detecting calvarial fracture and posttraumatic sequelae. Additional CT examination depends on the sonographic and neurological status. (orig.) [de

  12. The autopsy-correlation of computed tomography in acute severe head injuries

    International Nuclear Information System (INIS)

    Tomita, Shin; Kim, Hong; Mikabe, Toshio; Karasawa, Hideharu; Watanabe, Saburo

    1981-01-01

    We discuss the importance of Contrast-Enhanced CT (C.E.CT) in establishing the variety of the intracranial pathological process in acute severe head injuries. During a two-and-a-half-year period (June, 1977 - December, 1979) thirty-three patients with acute severe head injuries were autopsied, all of whom had been scanned on admission. Among them, 14 patients had undergone both plain CT and C.E.CT on admission. Brain slices were examined macroscopically in three categories; brain contusion, subarachnoid hemorrhage, and intracerebral hemorrhage. Each category was then compared retrospectively with the plain CT and C.E.CT findings. C.E.CT was found to correspond much better to the autopsy finding than plain CT in the following three points: (1) C.E.CT clearly enhances the contusion areas and reveals occult contusion areas. (2) C.E.CT enhances the areas corresponding to the subarachnoid space due to the breakdown of brain-surface blood vessels. (3) C.E.CT reveals the enlargement and formation of the intracerebral hematoma by the extravasation of the intravenous contrast material from injured arterial vessels. (author)

  13. Demographic, medical, and psychiatric factors in work and marital status after mild head injury.

    Science.gov (United States)

    Vanderploeg, Rodney D; Curtiss, Glenn; Duchnick, Jennifer J; Luis, Cheryl A

    2003-01-01

    To explore factors associated with long-term outcomes of work and marital status in individuals who had experienced a mild head injury (MHI), as well as those who had not. Population-based study using logistical regression analyses to investigate the impact of preinjury characteristics on work and marital status. Two groups of Vietnam-era Army veterans: 626 who had experienced a MHI an average of 8 years before examination, and 3,896 who had not. Demographic characteristics, concurrent medical conditions, early life psychiatric problems, loss of consciousness (LOC), and interactions among these variables were used to predict current work and marital status. Multiple variables were associated with work and marital status in the sample with MHI, accounting for approximately 23% and 17% of the variance in these two outcome variables, respectively. In contrast, the same factors accounted for significantly less variance in outcome in the sample without a head injury-13.3% and 9.4% for work and marital status, respectively. These findings suggest a more potent role for and increased vulnerability to the influence of demographic, medical, and psychiatric factors on outcomes after a MHI. That is, MHI itself moderates the influence of preinjury characteristics on work and marital status. In addition, in those who had a MHI, moderator relationships were found between education and LOC for both work and marital status. Similarly, complex moderator relationships among race, region of residence, and LOC were found for both work and marital status outcomes.

  14. Children should wear helmets while ice-skating: a comparison of skating-related injuries.

    Science.gov (United States)

    McGeehan, Jennifer; Shields, Brenda J; Smith, Gary A

    2004-07-01

    This study compares injuries, especially head injuries, among ice-skaters with those among skateboarders, rollerskaters, and in-line skaters, to determine the need for helmet use during recreational ice-skating by children. A comparative study of a consecutive series of patients. The emergency department of a large, urban, academic, children's hospital. Children treated for injuries related to recreational ice-skating, skateboarding, rollerskating, and in-line skating. During a 31-month period, 419 consecutive children were evaluated in the emergency department for skating-related injuries. Children were predominantly male (53.9%), with a mean age of 10.0 years (SD: 3.0 years; median: 10.0 years; range: 1-18 years). The most frequent mechanism of injury was a fall. Overall, 76.5% of children (215 of 281 children) were reported to be wearing no protective equipment, such as a helmet or padding on the elbows or knees, at the time of injury. Ice-skaters were more likely to have adult supervision than were skateboarders (relative risk [RR]: 5.16; 95% confidence interval [CI]: 2.13-12.46), rollerskaters (RR: 1.21; 95% CI: 1.09-1.35), and in-line skaters (RR: 2.08; 95% CI: 1.72-2.51). Ice-skaters were at greater risk of injury to the head (20.0%) than were in-line skaters (4.9%) (RR: 4.09; 95% CI: 1.81-9.23); a weak difference was noted between ice-skaters and rollerskaters (9.9%) (RR: 2.18; 95% CI: 1.04-4.57), with no significant difference in head injuries between ice-skaters and skateboarders (15.9%) (RR: 1.60; 95% CI: 0.54-2.93). Ice-skaters demonstrated lacerations to the head in 68.8% of abnormal head examinations, compared with 37.0% for rollerskaters (RR: 1.86; 95% CI: 1.08-3.20) and 50.0% for in-line skaters (RR: 2.06; 95% CI: 1.35-3.16); however, there was no significant difference in lacerations to the head between ice-skaters and skateboarders (53.3%) (RR: 1.29; 95% CI: 0.76-2.19). Injuries to ice-skaters occurred more often in an indoor skating facility (92

  15. Hospitalization due to horse-related injuries: has anything changed? A 25 year survey.

    Science.gov (United States)

    Abu-Kishk, Ibrahim; Klin, Baruch; Gilady-Doron, Nataly; Jeroukhimov, Igor; Eshel, Gideon

    2013-04-01

    Horse riding and horse handling are dangerous. There is a lack of knowledge concerning the incidence of hospitalization due to horse-related injuries and types of injuries in Israel. During the last two decades we have observed an increasing incidence of hospitalizations due to horse-related injuries at our medical center as well as the frequent involvement of pediatric patients. To investigate these injuries with respect to type, incidence and modes of prevention. We conducted a retrospective study of medical records for all patients admitted to Assaf Harofeh Medical Center due to horse-related injury between January 1984 and December 2008. A telephone questionnaire was used to complete the data. Eighty-nine subjects (267 injuries) were included in the study. Most of them were not professional horse riders or horse handlers. Helmet use was reported in only 28% of the participants. The number of subjects with horse-related injuries and the percentage of pediatric involvement increased during the study period. Falling from a horse was the most frequent cause of injury (60.67%), followed by being kicked (13.4%). Head and extremities were the most affected areas. On admission, 33.7% had a potential severe injury score. Forty-two participants (47%) had underlying fractures, mostly in the upper extremities. In the pediatric population, 16.2% (vs. 0% adults) rode horses for therapeutic reasons. Seventeen subjects reported having long-term consequences. The findings are similar to those described in other parts of the world. Horseback riding-related injuries are increasing, which emphasizes the need for safety education programs in Israel.

  16. Audibility of spectral differences in head-related transfer functions

    DEFF Research Database (Denmark)

    Hoffmann, Pablo F.F.; Møller, Henrik

    2006-01-01

    The spatial resolution at which head-related transfer functions (HRTFs) are available is an important aspect in the implementation of three-dimensional sound. Specifically, synthesis of moving sound requires that HRTFs are sufficiently close so the simulated sound is perceived as moving smoothly....... How close they must be, depends directly on how much the characteristics of neighboring HRTFs differ, and, most important, when these differences become audible. Differences between HRTFs exist in the interaural delay (ITD) and in the spectral characteristics, i.e. the magnitude spectrum of the HRTFs...

  17. Risk of mild head injury in preschool children: relationship to attention deficit hyperactivity disorder symptoms.

    Science.gov (United States)

    Altun, Hatice; Altun, İdiris

    2018-04-25

    To investigate whether there is an association between mild head injury (MHI) and attention deficit hyperactivity disorder (ADHD) symptoms in preschool children. The study included a patient group of 30 children aged 3-6 years with mild head trauma and a control group of 30 healthy and age- and sex-matched children. The symptoms of ADHD were evaluated using the Conners' Parent Rating Scale-Revised Long (CPRS-RL) form. The mean age was 4.73 ± 1.13 years in the patient group and 4.65 ± 0.99 years in the control group. No significant differences were determined between the groups in terms of age, gender, parents' age and education (p > 0.05). The total subscale points as reported by the parents of the children with MHI were significantly higher than those for the control group in terms of the following subscales: oppositional, cognitive problems/inattention, hyperactivity, social problems, ADHD index, Conners' Global Index (CGI)-Irritability-Impulsiveness, CGI-Emotional Lability, CGI-Total and DSM-IV ADHD symptoms (p < 0.05). A history of previous trauma treated in emergency services was determined in eight of the 30 patients (26.7%). The findings of this study suggest that preschool children with MHI have more pre-injury ADHD symptoms and oppositional and emotional-behavioural symptoms than healthy children without trauma. Clinicians should screen children with MHI for ADHD symptoms and refer them for treatment when necessary. Evaluation of children presenting with MHI by a child psychiatrist may prevent repetition of injuries.

  18. One Stage Emergency Pancreatoduodenectomy  for Isolated Injury to Pancreatic Head Following Blunt Abdominal Trauma: Case Report and Review of Literature.

    Science.gov (United States)

    Ghosh, Sumanta Kumar

    2013-07-01

    Major pancreatic injury following blunt abdominal trauma by itself is a relatively rare occurrence, and in vast majority of cases (95%) it is associated with injury to adjacent major vessels and organs; thus making isolated major pancreatic injury even rarer. While most pancreatic injuries are managed by simple measures like debridement and drainage, complex proximal injury poses surgical challenge regarding surgical skill and judgement. Disproportionate approach at any stage of management can contribute  to high mortality and morbidity. Emergency pancreatoduodenectomy plays a limited but important role in managing serious trauma to proximal pancreas and duodenum. Author presents a case where isolated injury to head of pancreas required emergency pancreatoduodenectomy. After a bizarre road accident, a middle aged male underwent emergency laparotomy for intraperitoneal bleeding and during exploration a deep transverse laceration with ampullary disruption was found in the head of the organ. Duodenum in all its part was intact and there was no other injury. The nature and site of injury made emergency pancreatoduodenectomy the only viable option. Leaking pancreatojejunostomy enhances infective complications that lead to late mortality. To circumvent this problem there is enthusiasm for staged surgery with resection and tube pancreatostomy in first stage, leaving the difficult anastomosis for a later date, However, if the patient is haemodynamically stable and operated reasonably early, one stage pancreatoduodenectomy gives good result and avoids repeating surgery with inherent problems and reduces hospital stay. For successful management of pancreatic trauma it is essential to make early diagnosis of duct disruption, with sound application of operative skill and judgement by treating surgeon.

  19. Neuroimaging for non-accidental head injury in childhood: A proposed protocol

    International Nuclear Information System (INIS)

    Jaspan, T.; Griffiths, P.D.; McConachie, N.S.; Punt, J.A.G.

    2003-01-01

    Non-accidental head injury (NAHI) is a major cause of neurological disability and death during infancy. Radiological imaging plays a crucial role in evaluating craniospinal injury, both for guiding medical management and the forensic aspects of abusive trauma. The damage sustained is varied, complex and may be accompanied by an evolving pattern of brain injury secondary to a cascade of metabolic and physiological derangements. Regrettably, many cases are poorly or incompletely evaluated leading to diagnostic errors and difficulties in executing subsequent child care or criminal proceedings. It is evident, from cases referred to the authors, that imaging protocols for NAHI are lacking (or only loosely adhered to, if present) in many centres throughout the U.K. Future research in this field will also be hampered if there is a lack of consistent and reliable radiological data. There is no nationally agreed protocol for imaging NAHI. We propose such a protocol, based upon a wide experience in the medical management of child abuse and extensive involvement in the medicolegal aspects of NAHI. Jaspan, T., et al. (2003). Clinical Radiology58, 44--53

  20. Dislocation of the fibular head in an unusual sports injury: a case report

    Directory of Open Access Journals (Sweden)

    Ahmad Riaz

    2008-05-01

    Full Text Available Abstract Introduction One of the primary functions of the proximal tibiofibular joint is slight rotation to accommodate rotational stress at the ankle. Proximal tibiofibular joint dislocation is a rare injury and accounts for less than 1% of all knee injuries. This dislocation has been reported in patients who had been engaged in football, ballet dancing, equestrian jumping, parachuting and snowboarding. Case presentation A 20-year-old man was injured whilst playing football. He felt a pop in the right knee and was subsequently unable to bear weight on it. The range of movement in his knee joint was limited. Anterior-posterior and lateral X-rays of the knee revealed anterolateral dislocation of the proximal tibiofibular joint. Comparison views confirmed the anterolateral dislocation. He had a failed manipulation under anaesthesia and the joint needed an open reduction in which the fibular head was levered back into place. Operative findings revealed a horizontal type of joint. Conclusion An exceedingly rare dislocation of a horizontal type of proximal tibiofibular joint was presented following a football injury. This dislocation was irreducible by a closed method.

  1. Neuroimaging for non-accidental head injury in childhood: A proposed protocol

    Energy Technology Data Exchange (ETDEWEB)

    Jaspan, T.; Griffiths, P.D.; McConachie, N.S.; Punt, J.A.G

    2003-01-01

    Non-accidental head injury (NAHI) is a major cause of neurological disability and death during infancy. Radiological imaging plays a crucial role in evaluating craniospinal injury, both for guiding medical management and the forensic aspects of abusive trauma. The damage sustained is varied, complex and may be accompanied by an evolving pattern of brain injury secondary to a cascade of metabolic and physiological derangements. Regrettably, many cases are poorly or incompletely evaluated leading to diagnostic errors and difficulties in executing subsequent child care or criminal proceedings. It is evident, from cases referred to the authors, that imaging protocols for NAHI are lacking (or only loosely adhered to, if present) in many centres throughout the U.K. Future research in this field will also be hampered if there is a lack of consistent and reliable radiological data. There is no nationally agreed protocol for imaging NAHI. We propose such a protocol, based upon a wide experience in the medical management of child abuse and extensive involvement in the medicolegal aspects of NAHI. Jaspan, T., et al. (2003). Clinical Radiology58, 44--53.

  2. An observational study of compliance with the Scandinavian guidelines for management of minimal, mild and moderate head injury

    DEFF Research Database (Denmark)

    Heskestad, Ben; Waterloo, Knut; Ingebrigtsen, Tor

    2012-01-01

    The Scandinavian guidelines for management of minimal, mild and moderate head injuries were developed to provide safe and cost effective assessment of head injured patients. In a previous study conducted one year after publication and implementation of the guidelines (2003), we showed low...... compliance, involving over-triage with computed tomography (CT) and hospital admissions. The aim of the present study was to investigate guideline compliance after an educational intervention....

  3. Exploring the mechanisms of vehicle front-end shape on pedestrian head injuries caused by ground impact.

    Science.gov (United States)

    Yin, Sha; Li, Jiani; Xu, Jun

    2017-09-01

    In pedestrian-vehicle accidents, pedestrians typically suffer from secondary impact with the ground after the primary contact with vehicles. However, information about the fundamental mechanism of pedestrian head injury from ground impact remains minimal, thereby hindering further improvement in pedestrian safety. This study addresses this issue by using multi-body modeling and computation to investigate the influence of vehicle front-end shape on pedestrian safety. Accordingly, a simulation matrix is constructed to vary bonnet leading-edge height, bonnet length, bonnet angle, and windshield angle. Subsequently, a set of 315 pedestrian-vehicle crash simulations are conducted using the multi-body simulation software MADYMO. Three vehicle velocities, i.e., 20, 30, and 40km/h, are set as the scenarios. Results show that the top governing factor is bonnet leading-edge height. The posture and head injury at the instant of head ground impact vary dramatically with increasing height because of the significant rise of the body bending point and the movement of the collision point. The bonnet angle is the second dominant factor that affects head-ground injury, followed by bonnet length and windshield angle. The results may elucidate one of the critical barriers to understanding head injury caused by ground impact and provide a solid theoretical guideline for considering pedestrian safety in vehicle design. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Influence of impact speed on head and brain injury outcome in vulnerable road user impacts to the car hood.

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    Fredriksson, Rikard; Zhang, Liying; Boström, Ola; Yang, King

    2007-10-01

    EuroNCAP and regulations in Europe and Japan evaluate the pedestrian protection performance of cars. The test methods are similar and they all have requirements for the passive protection of the hood area at a pedestrian to car impact speed of 40 km/h. In Europe, a proposal for a second phase of the regulation mandates a brake-assist system along with passive requirements. The system assists the driver in optimizing the braking performance during panic braking, resulting in activation only when the driver brakes sufficiently. In a European study this was estimated to occur in about 50% of pedestrian accidents. A future system for brake assistance will likely include automatic braking, in response to a pre-crash sensor, to avoid or mitigate injuries of vulnerable road users. An important question is whether these systems will provide sufficient protection, or if a parallel, passive pedestrian protection system will be necessary. This study investigated the influence of impact speed on head and brain injury risk, in impacts to the carhood. One car model was chosen and a rigid adjustable plate was mounted under the hood. Free-flying headform impacts were carried out at 20 and 30 km/h head impact velocities at different under-hood distances, 20 to 100 mm; and were compared to earlier tests at 40 km/h. The EEVC WG17 adult pedestrian headform was used for non-rotating tests and a Hybrid III adult 50th percentile head was used for rotational tests where linear and rotational acceleration was measured. Data from the rotational tests was used as input to a validated finite element model of the human head, the Wayne State University Head Injury Model (WSUHIM). The model was utilized to assess brain injury risk and potential injury mechanism in a pedestrian-hood impact. Although this study showed that it was not necessarily true that a lower HIC value reduced the risk for brain injury, it appeared, for the tested car model, under-hood distances of 60 mm in 20 km/h and 80 mm

  5. Individual and occupational factors related to fatal occupational injuries: a case-control study.

    Science.gov (United States)

    Villanueva, Vicent; Garcia, Ana M

    2011-01-01

    This study has been designed in order to identify factors increasing the risk of a fatal outcome when occupational accidents occur. The aim is to provide further evidence for the design and implementation of preventive measures in occupational settings. The Spanish Ministry of Labour registry of occupational injuries causing absence from work includes information on individual and occupational characteristics of injured workers and events. Registered fatal occupational injuries in 2001 (n=539) were compared to a sample of non-fatal injuries in the same year (n=3493). Risks for a fatal result of occupational injuries, adjusted by individual and occupational factors significantly associated, were obtained through logistic regression models. Compared to non-fatal injuries, fatal occupational injuries were mostly produced by trapping or by natural causes, mostly related to elevation and transport devices and power generators, and injured parts of body more frequently affected were head, multiple parts or internal organs. Adjusted analyses showed increased risk of fatality after an occupational injury for males (adjusted odds ratio aOR=10.92; 95%CI 4.80-24.84) and temporary workers (aOR=5.18; 95%CI 2.63-10.18), and the risk increased with age and with advancing hour of the work shift (p for trends accidents in agricultural or construction companies. These data can help to select and define priorities for programmes aimed to prevent fatal consequences of occupational injuries. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Vestibular and stabilometric findings in whiplash injury and minor head trauma.

    Science.gov (United States)

    Nacci, A; Ferrazzi, M; Berrettini, S; Panicucci, E; Matteucci, J; Bruschini, L; Ursino, F; Fattori, B

    2011-12-01

    Vertigo and postural instability following whiplash and/or minor head injuries is very frequent. According to some authors, post-whiplash vertigo cannot be caused by real injury to vestibular structures; other authors maintain that vestibular damage is possible even in the case of isolated whiplash, with vascular or post-traumatic involvement. Furthermore, many of the balance disorders reported after trauma can be justified by post-traumatic modification to the cervical proprioceptive input, with consequent damage to the vestibular spinal reflex. The aim of this study was to evaluate the vestibular condition and postural status in a group of patients (Group A, n = 90) affected with balance disorders following whiplash, and in a second group (Group B, n = 20) with balance disorders after minor head injury associated with whiplash. Both groups were submitted to videonystagmography (VNG) and stabilometric investigation (open eyes - O E, closed eyes - CE, closed eyes with head retroflexed - CER) within 15 days of their injuries and repeated within 10 days after conclusion of cervical physiotherapy treatment. The VNG tests revealed vestibulopathy in 19% of cases in Group A (11% peripheral, 5% central, 3% in an undefined site) and in 60% of subjects in Group B (50% peripheral, 10% central). At the follow-up examination, all cases of non-compensated labyrinth deficit showed signs of compensation, while there were two cases (2%) in Group A and one case (5%) in Group B of PPV. As far as the altered posturographic recordings are concerned, while there was no specific pattern in the two groups, they were clearly pathologic, especially during CER. Both in OE and in CE there was an increase in the surface values and in those pertaining to shifting of the gravity centre on the sagittal plane, which was even more evident during CER. In Group A, the pre-post-physiotherapy comparison of CER results showed that there was a statistically significant improvement in the majority of the

  7. One Stage Emergency Pancreatoduodenectomy for Isolated Injury to Pancreatic Head Following Blunt Abdominal Trauma: Case Report and Review of Literature

    OpenAIRE

    Sumanta Kumar Ghosh

    2013-01-01

    Major pancreatic injury following blunt abdominal trauma by itself is a relatively rare occurrence, and in vast majority of cases (95%) it is associated with injury to adjacent major vessels and organs; thus making isolated major pancreatic injury even rarer. While most pancreatic injuries are managed by simple measures like debridement and drainage, complex proximal injury poses surgical challenge regarding surgical skill and judgement. Disproportionate approach at any stage of management ...

  8. EFFECT OF CEREBROPROTEIN HYDROLYSATE WITH CITICOLINE VERSUS CITICOLINE ALONE IN THE INITIAL MANAGEMENT OF HEAD INJURY AND ITS CLINICAL OUTCOME “A PROSPECTIVE RANDOMISED COMPARATIVE STUDY”

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    Varadaraju D. N

    2017-06-01

    Full Text Available BACKGROUND Traumatic brain injury is an important cause of morbidity. It also represents the most frequent reason for neurological illness after headache. Compared with other types of brain insult, traumatic brain injury produces more diffuse injury causing more cognitive and neuropsychiatric disturbances. Various drugs have been used in an attempt to improve the clinical outcome, citicoline and Cerebrolysin hydrolysate have been used to improve the clinical outcome in traumatic brain injury. The evidence thus far has been conflicting with reports in favour and against the use of these drugs in the clinical benefit of the patients with traumatic brain injury. We attempt to determine the benefits and advantages of using these drugs in the management of traumatic brain injury. MATERIALS AND METHODS This is a prospective study comprising 60 patients of head injury admitted in the Department of Neurosurgery at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. The purpose of the current study is to evaluate the effect of cerebroprotein hydrolysate with citicoline compared to citicoline alone in the initial management of head injury and its clinical outcome and to assess the improvement. RESULTS Sixty patients with head injury were recruited and divided into group A and group B randomly. The mean age was 43.5 years with 43 male patients and 17 female patients. The GCS at admission of 27 patients was mild head injury and of 33 patients was moderate head injury. Group A had 13 patients with mild head injury and 17 patients with moderate head injury. Group B had 14 patients with mild and 16 patients with moderate head injury at the time of admission. The GCS was assessed at 1 week and 3 weeks. On assessing the patients at 1 week, group A had 14 patients with mild head injury and 16 patients with moderate head injury, whereas group B had 14 patients with mild and 16 patients with moderate head injury. The extended Glasgow Outcome Scale

  9. Prevention of Blast-Related Injuries

    Science.gov (United States)

    2013-07-01

    influence of cerebrospinal fluid (CSF) on the shock wave response 3. Development of the geometric model for the head of a 23 55-kg Yucatan pig 4...of Tissue-Tek® optimum cutting compound and 20% sucrose (w/v) and frozen in a stream of liquid nitrogen (Saljo et al, 2008). The frozen blocks will...review of current models of the pig head under air blast loading 2. Development of a 2-D pig head FE model to study the influence of cerebrospinal fluid

  10. Mechanisms and Factors Associated With Tackle-Related Injuries in South African Youth Rugby Union Players.

    Science.gov (United States)

    Burger, Nicholas; Lambert, Mike Ian; Viljoen, Wayne; Brown, James Craig; Readhead, Clint; den Hollander, Steve; Hendricks, Sharief

    2017-02-01

    The majority of injuries in rugby union occur during tackle events. The mechanisms and causes of these injuries are well established in senior rugby union. To use information from an injury database and assess video footage of tackle-related injuries in youth rugby union matches to identify environmental factors and mechanisms that are potentially confounding to these injuries. Descriptive epidemiological study. Injury surveillance was conducted at the under-18 Craven Week rugby tournament. Tackle-related injury information was used to identify injury events in match video footage (role-matched noninjury tackle events were identified for the cohort of injured players). Events were coded using match situational variables (precontact, contact, and postcontact). Relative risk ratio (RRR; ratio of probability of an injury or noninjury outcome occurring when a characteristic was observed) was reported by use of logistic regression. In comparison with the first quarter, injury risk was greater in the third (RRR = 9.75 [95% CI, 1.71-55.64]; P = .010) and fourth quarters (RRR = 6.97 [95% CI, 1.09-44.57]; P = .040) for ball carriers and in the fourth quarter (RRR = 9.63 [95% CI, 1.94-47.79]; P = .006) for tacklers. Ball carriers were less likely to be injured when they were aware of impending contact (RRR = 0.14 [95% CI, 0.03-0.66]; P = .012) or when they executed a moderate fend (hand-off) (RRR = 0.22 [95% CI, 0.06-0.84]; P = .026). Tacklers were less likely to be injured when performing shoulder tackles (same side as leading leg) in comparison to an arm-only tackle (RRR = 0.02 [95% CI, 0.001-0.79]; P = .037). Ball carriers (RRR = 0.09 [95% CI, 0.01-0.89]; P = .040) and tacklers (RRR = 0.02 [95% CI, 0.001-0.32]; P =.006) were less likely to be injured when initial contact was made with the tackler's shoulder/arm instead of his head/neck. The relative risk of tackle-related injury was higher toward the end of matches. Incorrect technique may contribute to increased injury

  11. Heavy drinking and alcohol-related injuries in college students

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    Lucía Moure-Rodríguez

    2014-09-01

    Conclusion: We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern.

  12. Pediatric Firework-Related Injuries Presenting to United States Emergency Departments, 1990-2014.

    Science.gov (United States)

    Billock, Rachael M; Chounthirath, Thiphalak; Smith, Gary A

    2017-06-01

    This study characterizes the epidemiology of nonfatal pediatric firework-related injuries in the United States among children and adolescents by analyzing data from the National Electronic Injury Surveillance System from 1990 through 2014. During this 25-year period, an estimated 136 991 (95% CI = 113 574-160 408) children firework-related injuries. The annual injury rate decreased significantly by 30.4% during this period. Most of those injured were male (75.7%), mean patient age was 10.6 years, and 7.6% required hospital admission. The hands (30.0%) were the most commonly injured body region, followed by head and neck (22.2%), and eyes (21.5%). Sixty percent of injuries were burns. Injuries were most commonly associated with firecrackers (26.2%), aerial devices (16.3%), and sparklers (14.3%). Consumer fireworks pose a serious injury risk to pediatric users and bystanders, and families should be encouraged to attend public firework displays rather than use consumer fireworks.

  13. Relative brain displacement and deformation during constrained mild frontal head impact.

    Science.gov (United States)

    Feng, Y; Abney, T M; Okamoto, R J; Pless, R B; Genin, G M; Bayly, P V

    2010-12-06

    This study describes the measurement of fields of relative displacement between the brain and the skull in vivo by tagged magnetic resonance imaging and digital image analysis. Motion of the brain relative to the skull occurs during normal activity, but if the head undergoes high accelerations, the resulting large and rapid deformation of neuronal and axonal tissue can lead to long-term disability or death. Mathematical modelling and computer simulation of acceleration-induced traumatic brain injury promise to illuminate the mechanisms of axonal and neuronal pathology, but numerical studies require knowledge of boundary conditions at the brain-skull interface, material properties and experimental data for validation. The current study provides a dense set of displacement measurements in the human brain during mild frontal skull impact constrained to the sagittal plane. Although head motion is dominated by translation, these data show that the brain rotates relative to the skull. For these mild events, characterized by linear decelerations near 1.5g (g = 9.81 m s⁻²) and angular accelerations of 120-140 rad s⁻², relative brain-skull displacements of 2-3 mm are typical; regions of smaller displacements reflect the tethering effects of brain-skull connections. Strain fields exhibit significant areas with maximal principal strains of 5 per cent or greater. These displacement and strain fields illuminate the skull-brain boundary conditions, and can be used to validate simulations of brain biomechanics.

  14. The Head Injury Retrieval Trial (HIRT): a single-centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics only

    Science.gov (United States)

    Garner, Alan A; Mann, Kristy P; Fearnside, Michael; Poynter, Elwyn; Gebski, Val

    2015-01-01

    Background Advanced prehospital interventions for severe brain injury remains controversial. No previous randomised trial has been conducted to evaluate additional physician intervention compared with paramedic only care. Methods Participants in this prospective, randomised controlled trial were adult patients with blunt trauma with either a scene GCS score <9 (original definition), or GCS<13 and an Abbreviated Injury Scale score for the head region ≥3 (modified definition). Patients were randomised to either standard ground paramedic treatment or standard treatment plus a physician arriving by helicopter. Patients were evaluated by 30-day mortality and 6-month Glasgow Outcome Scale (GOS) scores. Due to high non-compliance rates, both intention-to-treat and as-treated analyses were preplanned. Results 375 patients met the original definition, of which 197 was allocated to physician care. Differences in the 6-month GOS scores were not significant on intention-to-treat analysis (OR 1.11, 95% CI 0.74 to 1.66, p=0.62) nor was the 30-day mortality (OR 0.91, 95% CI 0.60 to 1.38, p=0.66). As-treated analysis showed a 16% reduction in 30-day mortality in those receiving additional physician care; 60/195 (29%) versus 81/180 (45%), p<0.01, Number needed to treat =6. 338 patients met the modified definition, of which 182 were allocated to physician care. The 6-month GOS scores were not significantly different on intention-to-treat analysis (OR 1.14, 95% CI 0.73 to 1.75, p=0.56) nor was the 30-day mortality (OR 1.05, 95% CI 0.66 to 1.66, p=0.84). As-treated analyses were also not significantly different. Conclusions This trial suggests a potential mortality reduction in patients with blunt trauma with GCS<9 receiving additional physician care (original definition only). Confirmatory studies which also address non-compliance issues are needed. Trial registration number NCT00112398. PMID:25795741

  15. Vietnam Head Injury Study - Phase III: A 30-Year Post-Injury Follow-Up Study

    Science.gov (United States)

    2007-08-01

    from PHI. GAD - 19 - Glutamic acid decarboxylase (GAD) is the rate-limiting enzyme for the production of gamma-amino butyric acid ( GABA ) in the...brain. The adenosine triphosphate (ATP)- mediated control of GABA synthesis gradually declines with age and AD-related neurodegeneration (Marczynski...function and risk for schizophrenia . Proc Natl Acad Sci USA. 2001; 5;98(12):6917-22. Esposito L, Raber J, Kekonius L, Yan F, Yu G-Q, Bien-Ly N

  16. Clinical factors associated with intracranial complications after pediatric traumatic head injury: an observational study of children submitted to a neurosurgical referral unit

    DEFF Research Database (Denmark)

    Åstrand, Ramona Alice; Undén, Johan; Hesselgard, Karin

    2010-01-01

    Clinically validated guidelines for the management of head injury in children do not exist, and the treatment is often based upon adult management routines. In order to examine the safety of this procedure, an analysis of clinical factors associated with complications after pediatric head injury ...

  17. Clinical factors associated with intracranial complications after pediatric traumatic head injury: an observational study of children submitted to a neurosurgical referral unit

    DEFF Research Database (Denmark)

    Åstrand, Ramona Alice; Undén, Johan; Hesselgard, Karin

    2010-01-01

    Clinically validated guidelines for the management of head injury in children do not exist, and the treatment is often based upon adult management routines. In order to examine the safety of this procedure, an analysis of clinical factors associated with complications after pediatric head injury...

  18. Sports related injuries in Scottish adolescents aged 11-15

    OpenAIRE

    Williams, J. M.; Wright, P.; Currie, C. E.; Beattie, T. F.

    1998-01-01

    OBJECTIVES: To measure the age and sex distribution of self reported sports and leisure injuries in a 12 month retrospective recall period among a representative national sample of Scottish adolescents, and to examine the characteristics (gender, age, handedness, and level of sports participation) of sports related injuries in relation to injuries sustained during other activities. DESIGN/SETTING: Self completion questionnaire survey administered in schools during April- June 1994. SUBJ...

  19. Famous head injuries of the first aerial war: deaths of the "Knights of the Air".

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    Koul, Prateeka; Mau, Christine; Sabourin, Victor M; Gandhi, Chirag D; Prestigiacomo, Charles J

    2015-07-01

    World War I advanced the development of aviation from the concept of flight to the use of aircraft on the battlefield. Fighter planes advanced technologically as the war progressed. Fighter pilot aces Francesco Baracca and Manfred von Richthofen (the Red Baron) were two of the most famous pilots of this time period. These courageous fighter aces skillfully maneuvered their SPAD and Albatros planes, respectively, while battling enemies and scoring aerial victories that contributed to the course of the war. The media thrilled the public with their depictions of the heroic feats of fighter pilots such as Baracca and the Red Baron. Despite their aerial prowess, both pilots would eventually be shot down in combat. Although the accounts of their deaths are debated, it is undeniable that both were victims of traumatic head injury.

  20. Work-related injuries in minors.

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    Schober, S E; Handke, J L; Halperin, W E; Moll, M B; Thun, M J

    1988-01-01

    Since 1938, federal child labor laws have restricted employment of persons under 18 years old, in part to protect them from hazardous occupations. Workers' compensation claims reported to the Supplementary Data System of the Bureau of Labor Statistics were examined to define the current status of occupational injuries among minors. Data tapes from 1980 to 1983 were searched to identify all current claims for injuries and illnesses occurring in 1980 in persons under age 18. Injury rates were calculated using information about employment in 1979 available from the 1980 census. In the 24 states included in this study, 23,823 claims were reported for persons less than 18 years old. Of these claims, approximately 10% were from persons under age 16. Rates of injuries in 16- and 17 year olds were 12.6 per 100 full-time male workers and 6.6 per 100 full-time female workers. Serious injuries included fractures, dislocations, and amputations, accounting for 5.8%, 0.7%, and 0.6% of cases, respectively. California, the only state that coded whether injuries resulted in fatalities, reported 12 deaths in this age group. Machines and vehicles, many of which are restricted under child labor laws, accounted for 8.3% and 5.8% of claims. These data suggest that persons under age 18 years are not adequately protected from occupational injury. Further attention and, possibly, new preventive strategies are needed.

  1. Does head CT scan pathology predict outcome after mild traumatic brain injury?

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    Lannsjö, M; Backheden, M; Johansson, U; Af Geijerstam, J L; Borg, J

    2013-01-01

    More evidence is needed to forward our understanding of the key determinants of poor outcome after mild traumatic brain injury (MTBI). A large, prospective, national cohort of patients was studied to analyse the effect of head CT scan pathology on the outcome. One-thousand two-hundred and sixty-two patients with MTBI (Glasgow Coma Scale score 15) at 39 emergency departments completed a study protocol including acute head CT scan examination and follow-up by the Rivermead Post Concussion Symptoms Questionnaire and the Glasgow Outcome Scale Extended (GOSE) at 3 months after MTBI. Binary logistic regression was used for the assessment of prediction ability. In 751 men (60%) and 511 women (40%), with a mean age of 30 years (median 21, range 6-94), we observed relevant or suspect relevant pathologic findings on acute CT scan in 52 patients (4%). Patients aged below 30 years reported better outcome both with respect to symptoms and GOSE as compared to patients in older age groups. Men reported better outcome than women as regards symptoms (OR 0.64, CI 0.49-0.85 for ≥3 symptoms) and global function (OR 0.60, CI 0.39-0.92 for GOSE 1-6). Pathology on acute CT scan examination had no effect on self-reported symptoms or global function at 3 months after MTBI. Female gender and older age predicted a less favourable outcome. The findings support the view that other factors than brain injury deserve attention to minimize long-term complaints after MTBI. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

  2. Epidemiology and management of head injury in paediatric age group in North-Eastern Nigeria

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    J Y Chinda

    2013-01-01

    Full Text Available Background: Paediatric head injury (HI is the single most common cause of death and permanent disability in children world over, and this is increasingly becoming worrisome in our society because of increased risks and proneness to road traffic accidents on our highways and streets. The study set to determine causes and management of HI among children in our society. Patients and Methods: A retrospective review of all children aged 0-15 years with traumatic head injury (THIs who were managed at the University of Maiduguri Teaching Hospital between July, 2006 and August, 2008. Results: A total of 45 children with THIs presented to the casualty unit of the hospital; 30 (66.7% were boys and 15 (33.3% were girls. Three (6.7% children were less than 1 year of age, 21 (46.7% were between 1 years and 6 years while 16 (35.6% and 5 (11.0% were aged 7-11 years and 12-15 years respectively. Thirty six (80.0% of the children were pedestrians, 6 (13.4% fell from a height, while 2 (4.4% and 1 (2.2% were as a result of home accident and assault, respectively. Twenty one patients (46.7% had mild HI, while 53.3% had moderate to severe category. Forty one (91.1% of children were managed as in-patients, mostly (95.1% by conservative non-operative management, while 4 (8.9% were treated on the out-patient basis. The mortality rate was 17.8%. Conclusion: H1 among children is of a great concern, because of its incremental magnitude, due to increasing child labour and interstate religious discipleship among children, with attendant high mortality and permanent disabilities. Necessary laws and legislations should be formulated and implemented with organized campaigns and public enlightenment to prevent and mitigate this menace.

  3. Seat belt-related injuries: A surgical perspective

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    Tahir Masudi

    2017-01-01

    Full Text Available Introduction: Legislation making seatbelt use mandatory is considered to have reduced fatal and serious injuries by 25%, with UK government estimates predicting more than 50,000 lives saved since its introduction. However, whilst the widespread use of seatbelts has reduced the incidence of major traumatic injury and death from road-traffic collisions (RTCs, their use has also heralded a range of different injuries. The first ever seatbelt related injury was described in 1956, and since then clear patterns of seatbelt-related injuries have been recognised. Methodology and Findings: This review of the published literature demonstrates that the combination of airbags and three-point seatbelts renders no part of the body free from injury. Serious injuries can, and do, occur even when passengers are properly restrained and attending clinicians should have a high index of suspicion for overt or covert intra-abdominal injuries when patients involved in RTCs attend the Emergency Department. Bruising to the trunk and abdomen in a seatbelt distribution is an obvious sign that suggests an increased risk of abdominal and thoracic injury, but bruising may not be apparent and its absence should not be falsely reassuring. A high index of suspicion should be retained for other subtler signs of injury. Children and pregnant women represent high-risk groups who are particularly vulnerable to injuries. Conclusion: In this review we highlight the common patterns of seatbelt-related injuries. A greater awareness of the type of injuries caused by seatbelt use will help clinicians to identify and treat overt and covert injuries earlier, and help reduce the rates of morbidity and mortality following RTCs.

  4. Admissions for isolated nonoperative mild head injuries: Sharing the burden among trauma surgery, neurosurgery, and neurology.

    Science.gov (United States)

    Zhao, Ting; Mejaddam, Ali Y; Chang, Yuchiao; DeMoya, Marc A; King, David R; Yeh, Daniel D; Kaafarani, Haytham M A; Alam, Hasan B; Velmahos, George C

    2016-10-01

    Isolated nonoperative mild head injuries (INOMHI) occur with increasing frequency in an aging population. These patients often have multiple social, discharge, and rehabilitation issues, which far exceed the acute component of their care. This study was aimed to compare the outcomes of patients with INOMHI admitted to three services: trauma surgery, neurosurgery, and neurology. Retrospective case series (January 1, 2009 to August 31, 2013) at an academic Level I trauma center. According to an institutional protocol, INOMHI patients with Glasgow Coma Scale (GCS) of 13 to 15 were admitted on a weekly rotational basis to trauma surgery, neurosurgery, and neurology. The three populations were compared, and the primary outcomes were survival rate to discharge, neurological status at hospital discharge as measured by the Glasgow Outcome Score (GOS), and discharge disposition. Four hundred eighty-eight INOMHI patients were admitted (trauma surgery, 172; neurosurgery, 131; neurology, 185). The mean age of the study population was 65.3 years, and 58.8% of patients were male. Seventy-seven percent of patients has a GCS score of 15. Age, sex, mechanism of injury, Charlson Comorbidity Index, Injury Severity Score, Abbreviated Injury Scale in head and neck, and GCS were similar among the three groups. Patients who were admitted to trauma surgery, neurosurgery and neurology services had similar proportions of survivors (98.8% vs 95.7% vs 94.7%), and discharge disposition (home, 57.0% vs 61.6% vs 55.7%). The proportion of patients with GOS of 4 or 5 on discharge was slightly higher among patients admitted to trauma (97.7% vs 93.0% vs 92.4%). In a logistic regression model adjusting for Charlson Comorbidity Index CCI and Abbreviated Injury Scale head and neck scores, patients who were admitted to neurology or neurosurgery had significantly lower odds being discharged with GOS 4 or 5. While the trauma group had the lowest proportion of repeats of brain computed tomography (61

  5. HEAD INJURIES IN FULL CONTACT KARATE COMPETITION! IS THE PREJUDICE IN MANAGEMENT MINIMISING THE REQUIRED INVESTIGATION?

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    Michael R. Graham

    2007-10-01

    Full Text Available A 33 year old male karate practitioner presented himself for a full-contact national karate competition. This individual competed for approximately 2 minutes and received a kick to the head. He collapsed in the competitive arena, and suffered a tonic-clonic seizure, lasting for 3 minutes 25 seconds. Examination in the competitive arena revealed an individual who was unconscious. First aid, and paramedic support was provided immediately. Medical assessment identified the presence of vital signs. Glasgow coma scale (GCS, post trauma was recorded as 3/15 until the fifth minute. A patent airway was established and a neck brace was applied. Blood pressure within 1 minute of trauma was 195/98 mm.Hg, heart rate was 185 bpm and respiratory rate was 40 breaths·min-1. Oxygen was administered via a ventimask. The patient was conveyed to the medical area. The patient regained consciousness one minute after the seizure had resolved, but had amnesia concerning the event. GCS at five minutes was recorded as 13/15. The patient was transferred by ambulance to the nearest Hospital. The patient was discharged, following examination without further investigation. The finding of this study suggests that an individual with a history of head injury should have received computerised tomography as a minimum investigation. This may help eleviate the risk of further medical complications

  6. Nursing care of service members with head injury during the Vietnam war.

    Science.gov (United States)

    Yost, Terri L

    2012-06-01

    The purpose of this article was to describe and analyze the nursing management of head-injured soldiers by military nurses serving in the Vietnam War. This study used traditional historical methods and a military history framework. Primary sources included original military reports, letters, and policies from the Vietnam War period (located in the archives of the Army Medical Department, Office of Medical History in Falls Church, VA); journal articles of the time period; and autobiographical texts. Secondary sources consisted of biographical and historical texts and Web sites of historical societies. Findings supported that advances in medicine, nursing, and technology throughout the 1960s have an overall positive impact on patient care in a combat zone. The Vietnam War was a time when new theories in the management of head injuries led directly to overall improvements in survival. In conclusion, nurses were professionally and emotionally challenged on a near daily basis but were able to directly apply new nursing science in a combat environment to help improve survivability for those who may not have previously survived off the battlefield.

  7. Intraparenchymal hemorrhage segmentation from clinical head CT of patients with traumatic brain injury

    Science.gov (United States)

    Roy, Snehashis; Wilkes, Sean; Diaz-Arrastia, Ramon; Butman, John A.; Pham, Dzung L.

    2015-03-01

    Quantification of hemorrhages in head computed tomography (CT) images from patients with traumatic brain injury (TBI) has potential applications in monitoring disease progression and better understanding of the patho-physiology of TBI. Although manual segmentations can provide accurate measures of hemorrhages, the processing time and inter-rater variability make it infeasible for large studies. In this paper, we propose a fully automatic novel pipeline for segmenting intraparenchymal hemorrhages (IPH) from clinical head CT images. Unlike previous methods of model based segmentation or active contour techniques, we rely on relevant and matching examples from already segmented images by trained raters. The CT images are first skull-stripped. Then example patches from an "atlas" CT and its manual segmentation are used to learn a two-class sparse dictionary for hemorrhage and normal tissue. Next, for a given "subject" CT, a subject patch is modeled as a sparse convex combination of a few atlas patches from the dictionary. The same convex combination is applied to the atlas segmentation patches to generate a membership for the hemorrhages at each voxel. Hemorrhages are segmented from 25 subjects with various degrees of TBI. Results are compared with segmentations obtained from an expert rater. A median Dice coefficient of 0.85 between automated and manual segmentations is achieved. A linear fit between automated and manual volumes show a slope of 1.0047, indicating a negligible bias in volume estimation.

  8. Clinical Utility of '9{sup 9m}Tc-HMPAO Brain SPECT Findings in Chronic Head Injury

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jin ll; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Jong Doo; Park, Chang Yoon; Kim, Young Soo [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1992-03-15

    Minima deterioration of cerebral perfusion or microanatomical changes were undetectable on conventional Brain CT or MRI. So evaluation of focal functional changes of the brain parenchyme is essential in chronic head injury patients, who did not show focal anatomical changes on these radiological studies. However, the patients who had longstanding neurologic sequelae following head injury, there had been no available imaging modalities for evaluating these patients precisely. Therefore we tried to detect the focal functional changes on the brain parenchyme using {sup 99m}Tc-HMPAO Brain SPECT on the patients of chronic head injuries. Twenty three patients who had suffered from headache, memory dysfunction, personality change and insomnia lasting more than six months following head injury were included in our cases, which showed no anatomical abnormalities on Brain CT or MRI. At first they underwent psychological test whether the symptoms were organic or not. Also we were able to evaluate the cerebral perfusion changes with {sup 99m}Tc-HMPAO Brain SPECT in 22 patients among the 23, which five patients were focal and 17 patients were nonfocally diffuse perfusion changes. Thus we can predict the perfusion changes such as local vascular deterioration or functional defects using {sup 99m}Tc-HMPAO Brain SPECT in the patients who had suffered from post-traumatic sequelae, which changes were undetectable on Brain CT or MRI.

  9. The influence of headform orientation and flooring systems on impact dynamics during simulated fall-related head impacts.

    Science.gov (United States)

    Wright, Alexander D; Laing, Andrew C

    2012-10-01

    Novel compliant flooring systems are a promising approach for reducing fall-related injuries in seniors, as they may provide up to 50% attenuation in peak force during simulated hip impacts while eliciting only minimal influences on balance. This study aimed to determine the protective capacity of novel compliant floors during simulated 'high severity' head impacts compared to common flooring systems. A headform was impacted onto a common Commercial-Carpet at 1.5, 2.5, and 3.5 m/s in front, back, and side orientations using a mechanical drop tower. Peak impact force applied to the headform (F(max)), peak linear acceleration of the headform (g(max)) and Head Injury Criterion (HIC) were determined. For the 3.5 m/s trials, backwards-oriented impacts were associated with the highest F(max) and HIC values (pfloors (Resilient Rubber, Residential-Loop Carpet, Berber Carpet) and six novel compliant floors at each impact velocity. ANOVAs indicated that flooring type was associated with all parameters at each impact velocity (pfloors (pfloors can substantially reduce the forces and accelerations applied to a headform compared to common floors including carpet and resilient rubber. In combination with reports of minimal balance impairments, these findings support the promise of novel compliant floors as a biomechanically effective strategy for reducing fall-related injuries including traumatic brain injuries and skull fractures. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  10. Imaging of sports-related hip and groin injuries.

    Science.gov (United States)

    Lischuk, Andrew W; Dorantes, Thomas M; Wong, William; Haims, Andrew H

    2010-05-01

    A normally functioning hip joint is imperative for athletes who use their lower extremities with running, jumping, or kicking activities. Sports-related injuries of the hip and groin are far less frequent than injuries to the more distal aspect of the extremity, accounting for less than 10% of lower extremity injuries. Despite the lower incidence, hip and groin injuries can lead to significant clinical and diagnostic challenges related to the complex anatomy and biomechanical considerations of this region. Loads up to 8 times normal body weight have been documented in the joint in common daily activities, such as jogging, with significantly greater force expected during competitive athletics. Additionally, treatment for hip and groin injuries can obviate the participation of medical and surgical specialties, with a multidisciplinary approach frequently required. Delay in diagnosis and triage of these injuries may cause loss of time from competition and, potentially, early onset of degenerative changes. Magnetic resonance imaging (MRI) of the hip has proven to be the gold standard for the diagnosis of sports-related hip and groin injuries in the setting of negative radiographs. With its exquisite soft tissue contrast, multiplanar capabilities, and lack of ionizing radiation, MRI is unmatched in the noninvasive diagnosis of intra-articular and extra-articular pathology, as well as intraosseous processes. This review focuses on MRI of common athletic injuries of the hip and groin, including acetabular labral tears, femoral acetabular impingement syndrome, muscle injuries around the hip and groin (including athletic pubalgia), and athletic osseous injuries.

  11. Detection and monitoring of cerebral hemodynamic disturbances with transcranial color-coded duplex sonography in patients after head injury

    International Nuclear Information System (INIS)

    Kochanowicz, J.; Mariak, Z.; Lyson, T.; Lewko, J.; Krejza, J.; Bilello, M.

    2006-01-01

    Reduced cerebral blood flow after severe head injury results in an increased risk of ischemic brain damage. Blood flow should therefore be monitored with a simple, reliable method. Transcranial color-coded Doppler sonography (TCCS) is an accepted tool for the diagnosis of cerebral vasospasm; however, its usefulness in evaluating patients with head injury has not been proven. Cerebral blood-flow velocity in the middle, anterior, and posterior cerebral arteries was measured with a 2.5 MHz probe (Aplio SSA 770A, Toshiba, Japan) in 36 subjects with moderate or severe head injury. Serial measurements of resistance index (RI), peak-systolic, end-diastolic, and mean velocity in the middle cerebral arteries were performed 2-24 h after head trauma and in the subsequent days during hospitalization. Immediately after head trauma, increased RI values, and unusually decreased blood-flow velocity (mainly in MCA) were observed. Microcirculation disturbances were suspected because the end-diastolic velocity had substantially diminished. Changes in blood-flow parameters correlated with the clinical state, and in most cases, a poor prognosis. In some patients, blood-flow velocity increased above the normal reference limit and this implied poor prognosis. Transcranial color-coded Doppler sonography is a reliable, repeatable, and accessible tool that provides information about cerebral blood-flow disturbances and may hold diagnostic and prognostic importance. (orig.)

  12. Prevention of Blast-Related Injuries

    Science.gov (United States)

    2015-07-14

    raised against β-APP (Cat # 51- 2700, Life Technologies , Grand Island, NY) and processed by routine avidin biotin peroxidase method. The presence of...pathology of traumatic axonal injury involves distinct injury processes, neurofilament compaction ( NFC ) and impaired axoplasmic transport (IAT)1. In rat...blunt trauma studies NFC was evidenced by immunoreactive axons that were thin, elongated and sometimes with vacuolations as revealed by RMO14

  13. From conception to evaluation of mobile services for people with head injury: A participatory design perspective.

    Science.gov (United States)

    Groussard, Pierre-Yves; Pigot, Hélène; Giroux, Sylvain

    2018-07-01

    Adults with cognitive impairments lack the means to organise their daily life, plan their appointments, cope with fatigue, and manage their budget. They manifest interest in using new technologies to be part of society. Unfortunately, the applications offered on smart phones are often beyond their cognitive abilities. The goal of this study was to design a mobile cognitive assistant to enhance autonomy of people living with acquired traumatic brain injury. Participatory design methodologies guided this research by involving adults with cognitive impairments (CI) and their caregivers in the early stages of the design process. The population of the study is composed of four male adults who present cognitive impairments (three with head injury and one with stroke) and three caregivers. The first phase of this research was to design the Services Assistance Mobile and Intelligent (SAMI) application based on the needs expressed by the participants. During three focus groups, needs emerged concerning planning, health monitoring and money management and led to the implementation of assistive solutions on an Android mobile phone. During the second phase, the participants evaluated the mobile assistant SAMI at home for eight weeks. The results demonstrate that the participants were able to participate actively in the conception of SAMI and to use it successfully. People with CI showed a slight improvement in their life satisfaction. Due to the small number of participants, these promising results need to be confirmed by a larger-scale study.

  14. The contribution of alcohol to fatal traumatic head injuries in the forensic setting.

    LENUS (Irish Health Repository)

    Cryan, J

    2010-11-01

    Excessive drinking increases the risk of dying unnaturally. In the Republic of Ireland such deaths are referred to the State Pathologist. Blood alcohol concentration (BAC) is routinely measured. We created a database of cases presenting to the State Pathologist over a nine year period (2000-2008 inclusive) to evaluate the relationship between alcohol and fatal traumatic brain injuries (FTBI). Of a total of 1778 cases, 332 (275 Male [M]; 57 Female [F]) died of head injuries. Fatalities were highest in males aged 36-50 (N = 97) and 26-35 (N = 73). Assaults (N = 147), falls (N = 95), road traffic accidents (RTA) (N = 50) and suicide (N = 15) were the commonest modes of presentation. A positive blood alcohol concentration (BAC) was found in 36% of assaults, 41% of falls and 40% of suicides. In the RTA group BAC was positive in 59% of pedestrians, 33% of drivers and 14% of passengers. Alcohol clearly plays a significant role in FTBI in the forensic setting.

  15. Translational Research in Enteral and Parenteral Nutrition Support for Patients with Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Fa-liang LIN

    2015-12-01

    Full Text Available Abstract Objective: To explore the key points of the translational research in enteral and pareenteral nutrition support for patients with severe head injury (SHI, and to analyze the influence of different nutritional support routes on the prognosis of SHI patients. Methods: Totally 141 patients with severe craniocerebral injury were selected as study subjects, 47 cases for each group, and were given early enteral nutrition (EEN, delayed enteral nutrition (DEN, and parenteral nutrition (PN, respectively. The effect of different nutritional support routes on SHI patients was observed. Results: After 14 d of treatment, Glasgow coma scale (GCS scores of 3 groups were higher than treatment before (P<0.01, and with statistical differences among groups (P<0.05, or P<0.01. The levels of serum albumin, total serum protein and hemoglobin were higher in EEN group than the other groups (P<0.01. The level of serum albumin was lower in PN group than in DEN group (P<0.05. There were statistical differences in the incidence of complications among three groups (χ2=9.2487, P=0.0098. Conclusion: EEN support is more conductive to the improvement of the nutrition status, reduction of the incidence of complications, and promotion of the prognosis of SHI patients than DEN and PN.

  16. A combined microdialysis and FDG-PET study of glucose metabolism in head injury.

    Science.gov (United States)

    Hutchinson, Peter J; O'Connell, Mark T; Seal, Alex; Nortje, Jurgens; Timofeev, Ivan; Al-Rawi, Pippa G; Coles, Jonathan P; Fryer, Timothy D; Menon, David K; Pickard, John D; Carpenter, Keri L H

    2009-01-01

    Microdialysis continuously monitors the chemistry of a small focal volume of the cerebral extracellular space. Positron emission tomography (PET) establishes metabolism of the whole brain but only for the scan's duration. This study's objective was to apply these techniques together, in patients with traumatic brain injury, to assess the relationship between microdialysis (extracellular glucose, lactate, pyruvate, and the lactate/pyruvate (L/P) ratio as a marker of anaerobic metabolism) and PET parameters of glucose metabolism using the glucose analogue [(18)F]-fluorodeoxyglucose (FDG). In particular, we aimed to determine the fate of glucose in terms of differential metabolism to pyruvate and lactate. Microdialysis catheters (CMA70 or CMA71) were inserted into the cerebral cortex of 17 patients with major head injury. Microdialysis was performed during FDG-PET scans with regions of interest for PET analysis defined by the location of the gold-tipped microdialysis catheter. Microdialysate analysis was performed on a CMA600 analyser. There was significant linear relationship between the PET-derived parameter of glucose metabolism (regional cerebral metabolic rate of glucose; CMRglc) and levels of lactate (r = 0.778, p glucose was metabolised to both lactate and pyruvate, but was not associated with an increase in the L/P ratio. This suggests an increase in glucose metabolism to both lactate and pyruvate, as opposed to a shift towards anaerobic metabolism.

  17. Fall-related injuries among initially 75- and 80-year old people during a 10-year follow-up.

    Science.gov (United States)

    Saari, Päivi; Heikkinen, Eino; Sakari-Rantala, Ritva; Rantanen, Taina

    2007-01-01

    The aim of this study was to investigate the occurrence, type, scene and seasonal variation of fall related injuries, and the impact of socio-economic factors, mobility limitation, and the most common diseases on the risk of injurious falls over a 10-year follow-up. Elderly residents of Jyväskylä, Finland, aged initially 75 and 80 years, took part in the study in 1989-1990. The health and functional capacity assessments were carried out at the baseline. Injurious falls were monitored over a 10-year period. The rate of injurious falls per thousand person-years was 188 among women and 78 among men. Of all fall-related diagnoses, head injuries comprised 32%, upper limb injuries 27% and hip injuries 19%. Majority of injurious falls took place indoors and no seasonal variation in fall occurrence was observed. Recurring falls were more likely to take place in institutions. Osteoarthritis increased the risk of injurious falls but no effect was observed for coronary heart diseases or mobility limitation. All in all, intrinsic factors, such as chronic diseases and mobility limitation had only minor effect on risk of injurious falls among older people. The current results suggest that preventive interventions for injurious falls among older people should pay attention to the risk factors present indoors.

  18. Withholding and withdrawing of life support from patients with severe head injury.

    Science.gov (United States)

    O'Callahan, J G; Fink, C; Pitts, L H; Luce, J M

    1995-09-01

    To characterize the withholding or withdrawing of life support from patients with severe head injury. San Francisco General Hospital, a city and county hospital with a Level I trauma center. A standardized questionnaire was used to collect data on demographics and functional outcome of severely head-injured (Glasgow Coma Score of family members. Forty-seven patients who were admitted to a medical-surgical intensive care unit over a 1-yr period. Twenty-four patients had life support withheld or withdrawn, and 23 patients did not. Physician and family separately assessed patient's probable functional outcome, degree of communication between them, reasons important in recommending or deciding on discontinuation of life support, and the result of action taken. Six months later, the families reviewed the process of their decision, how well physician(s) had communicated, and what might have improved communication. Of 24 patients with life support discontinued, 22 died; two were discharged from the hospital. Twenty-three of the 24 patients had a poor prognosis on admission. Of the 23 patients who were continued on life support for the duration of their hospitalization, ten had a poor (p Family's assessment of prognosis agreed with physician's assessment in 22 of the 24 patients from whom life support was discontinued (p families' assessments. Physicians' considerations in recommending limitation of care and families' considerations in making decisions were the same, primarily an inevitably poor prognosis. Neither physician nor families cited cost or availability of care as a deciding factor. Two families disagreed with the recommendation to limit care after initial agreement because the patients' prognosis improved from "likely death" to "vegetative." Care was therefore continued, and both patients remained vegetative 6 months after admission to the hospital and discharge to chronic care facilities. Life support is commonly withheld or withdrawn from patients with severe

  19. Analysis of sports injuries related with shooting.

    Science.gov (United States)

    Kabak, Banu; Karanfilci, Muharrem; Ersöz, Taner; Kabak, Mehmet

    2016-06-01

    Athletes typically maintain rigorous training and work programs to be able to participate in competitions. An injury that occurs during the competition that causes withdrawal from the competition and a possible departure from sports, can render results athletes' and their support staff's efforts as meaningless. The early detection of injuries in the competition and developing preventive training programs can help ensure that participating in competitions and the associated preparatory efforts are not wasted. In this study, the sports injuries discussed occurred during training and competition events of the Turkish Shooting Sportive group. Body parts of injuries are determined and exercise programs focused on the affected body parts are developed. A total of 729 athletes (285 female, 444 male) who participated in Turkish Shooting Sports Championship during the 2010-2011 competition period participated in the study. Athletes were given a questionnaire that was developed prior to the event, and the questionnaire was filled in during interviews conducted one-on-one. Data was collected from the questionnaire and SPSS v.16.0 was used to analyze the results. The study was completed in six months. The results showed that the most of the injuries that occurred during training were strain and muscle tears whereas most of the injuries occurred during the actual competition were strain, muscle tears, tendinitis, and sprain. The results also indicated that during training, the most frequently-occurring injuries were in shoulder, calf-thigh, hand and wrist; whereas during the competition, it was manifested in the shoulder, foot and ankle. Muscle strengthening, stretching and proprioception exercises for these body parts should be included as part of the athletic training program.

  20. Weather warnings predict fall-related injuries among older adults.

    Science.gov (United States)

    Mondor, Luke; Charland, Katia; Verma, Aman; Buckeridge, David L

    2015-05-01

    weather predictions are a useful tool for informing public health planning and prevention strategies for non-injury health outcomes, but the association between winter weather warnings and fall-related injuries has not been assessed previously. to examine the association between fall-related injuries among older adults and government-issued winter weather warnings. using a dynamic cohort of individuals ≥65 years of age who lived in Montreal between 1998 and 2006, we identified all fall-related injuries from administrative data using a validated set of diagnostic and procedure codes. We compared rates of injuries on days with freezing rain or snowstorm warnings to rates observed on days without warnings. We also compared the incidence of injuries on winter days to non-winter days. All analyses were performed overall and stratified by age and sex. freezing rain alerts were associated with an increase in fall-related injuries (incidence rate ratio [IRR] = 1.20, 95% confidence interval [CI]: 1.08-1.32), particularly among males (IRR = 1.31, 95% CI: 1.10-1.56), and lower rates of injuries were associated with snowstorm alerts (IRR = 0.89, 95% CI: 0.80-0.99). The rate of fall-related injuries did not differ seasonally (IRR = 1.00, 95% CI: 0.97-1.03). official weather warnings are predictive of increases in fall-related injuries among older adults. Public health agencies should consider using these warnings to trigger initiation of injury prevention strategies in advance of inclement weather. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Further Reductions in Road-Related Deaths and Injuries in Irish Children

    LENUS (Irish Health Repository)

    Garry, E

    2018-04-01

    The aim was to study road-related injuries and fatalities in under 15-year-olds in three time periods (1996-2000, 2004-2008 and 2009 -2013 respectively) to assess whether progress has been made via cross-sectoral efforts (legislation, public awareness campaigns and police enforcement) to reduce this injury toll in Ireland. For road traffic collisions where an injury has occurred, police assistance is required and at the time a detailed CT 68 form is completed by the attending police officer and sent to the Road Safety Authority for analysis. Details regarding the severity of injury, light and road conditions and safety measures such as seat belt or car restraint use, seat position and helmet use if a cyclist is involved are recorded. Injuries were sub-classified as fatalities, serious (detained in hospital, fractures, severe head injury, severe internal injuries or shock requiring treatment) or minor. All data for the three time periods was entered onto an SPSS database. A concerted national campaign re road safety media campaign allied to random breath testing, penalty points for driving offences, on the spot fines for speeding and greater police enforcement took place over the 17-year timeframe and continues to this day. When results were compared between the three cohorts, total injuries dropped from 5928 (1996-2000) to 3903 (2009-2013).Fatal injuries dropped from 163 to 43 with car occupant fatalities fell from 69 to 17 between 1996-2000 and 2009-2013. Serious injuries dropped from 347 in the first cohort to 201 in the third cohort. Minor injuries fell from 5,063 to 3,659 between first and last cohort. Pedestrian injuries dropped from 1719 to 1258 with pedestrian fatalities decreased from 61 (1996-2000) to 21 (2009-2013) and serious pedestrian injuries decreased from 261 down to 129. Cyclist fatalities saw the most significant fall (76%) with a dramatic reduction in fatalities from 25 down to 6. A national road safety campaign, greater police enforcement and a

  2. Sports-related injuries in athletes with disabilities.

    Science.gov (United States)

    Fagher, K; Lexell, J

    2014-10-01

    The number of athletes with disabilities participating in organized sports and the popularity of the Paralympic Games is steadily increasing around the world. Despite this growing interest and the fact that participation in sports places the athlete at risk for injury, there are few studies concerning injury patterns, risk factors, and prevention strategies of injuries in disabled athletes. In this systematic literature search and critical review, we summarize current knowledge of the epidemiology of sports-related injuries in disabled athletes and describe their characteristics, incidence, prevalence, and prevention strategies. The outcomes of interest were any injury, either an acute trauma or an overuse event. PubMed, EMBASE, CINAHL, and Google Scholar were systematically searched and 25 of 605 identified studies met the inclusion criteria. Lower extremity injuries were more common in walking athletes, whereas upper extremity injuries were more prevalent in wheelchair athletes. The methodologies and populations varied widely between the studies. Few studies were sports or disability specific, which makes it difficult to determine specific risk factors, and few studies reported injury severity and prevention of injuries. Further longitudinal, systematic sports and disability specific studies are needed in order to identify and prevent injuries in athletes with disabilities. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Computerized tomography(CT) in patients with head injuries, assessment of outcome based upon initial clinical findings and initial CT scans

    International Nuclear Information System (INIS)

    Espersen, J.O.; Petersen, O.F.

    1982-01-01

    In this study, which comprises 144 consecutive head injuries, the initial clinical assessment and the findings of the initial CT scan are relatd to the outcome. The mortality is related to the patient's level of consiousness and pupillary light reflex on admission. The disability rate (= number of disabled/number of survivors) was independent of the level of consiousness but closely related to pupillary light reaction. Diminished and obliterated basal cisterns were bad prognostic signs, with a mortality rate of 66% in the latter group. Both disability and mortality increase with the number of different lesion types. (Author)

  4. Prevention, Evaluation, and Rehabilitation of Cycling-Related Injury.

    Science.gov (United States)

    Kotler, Dana H; Babu, Ashwin N; Robidoux, Greg

    2016-01-01

    The unique quality of the bicycle is its ability to accommodate a wide variety of injuries and disabilities. Cycling for recreation, transportation, and competition is growing nationwide, and has proven health and societal benefits. The demands of each type of cycling dictate the necessary equipment, as well as potential for injury. Prevention of cycling-related injury in both the athlete and the recreational cyclist involves understanding the common mechanisms for both traumatic and overuse injury, and early correction of strength and flexibility imbalances, technique errors, and bicycle fit.

  5. Work-related ocular injuries in Johor Bahru, Malaysia

    Directory of Open Access Journals (Sweden)

    Nyo Nyo Min

    2016-03-01

    Full Text Available AIM:To describe the epidemiology of work-related ocular injuries and its visual outcome in tertiary hospital in southern Malaysia. METHODS:Retrospective review of medical records of patients diagnosed as work-related ocular injuries who attended to the eye casualty of Hospital Sultan Ismail in Johor Bahru, Malaysia from Jan. 2011 to Dec. 2013. Data for clinical presentation, types of injuries, use of eye protective device(EPDand visual outcome were collected using a standardized proforma.RESULTS: A total of 935 ocular injuries attended to Hospital Sultan Ismail during 3y period. Among them 440 cases were work-related ocular injuries and included in the study. There was significant male preponderance(98.19%and commonest age group affected was 21 to 30y(45%. The most common type of injury was superficial injuries(70.91%, followed by chemical(11.13%, open globe(8.41%, closed globe(6.83%and thermal(2.72%. Although Malays are commonly involved in work-related ocular injury accounted for 78.47%, two-thirds of open globe injuries were seen in foreign workers. Only 59 patients(13.41%reported that they wore EPD at the time of incident. Generally, 89.86%(n=399had good vision, 5.45%(n=24had moderate vision and 3.86%(n=17poor vision. Visual outcome related to specific types of injuries showed that poor outcome was higher in open globe injuries groups compared with closed globe injuries \\〖odd ratio(OR=3.33, 95% confidence interval(CI=0.68 to 16.33\\〗. Overall hospital attendance rate of work-related ocular trauma ranged from 20.7 to 51.9 per 1000 new cases and decline of approximately 1.5% per year(PCONCLUSION: Work-related ocular trauma is important cause of ocular morbidity in working forces particularly young men. Malay males between 21 to 40y have higher risk. Majority of work-related ocular trauma seen in our hospital are generally of superficial injuries and potentially preventable. This study indicates they need to improve safety measures to

  6. Geriatric fall-related injuries | Hefny | African Health Sciences

    African Journals Online (AJOL)

    Background: Falls are the leading cause of geriatric injury. ... and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. Methods: All injured patients with an age ≥ 60 years who were admitted to ...

  7. Work related spinal cord injury, Australia 1986–97

    OpenAIRE

    O'Connor, P

    2001-01-01

    Objectives—Little has been published before on the epidemiology and prevention of work related spinal cord injury (SCI). This study is the first national population based epidemiological analysis of this type of injury. It presents that largest case series ever reported.

  8. Development of a human head FE model for the impact analysis using VOXEL approach and simulation for the assessment on the focal brain injury

    International Nuclear Information System (INIS)

    Watanabe, Dai; Yuge, Kohei; Nishimoto, Tetsuya; Murakami, Shigeyuki; Takao, Hiroyuki

    2008-01-01

    In this paper, a three-dimensional digital human-head model was developed and several dynamic analyses on the head trauma were conducted. This model was built up by the VOXEL approach using 433 slice CT images (512 x 512 pixels) and made of 1.22 million parallelepiped finite elements with 10 anatomical tissue properties such as scalp, cerebrospinal fluid (CSF), skull, brain, dura mater and so on. The numerical analyses were conducted using a finite element code the authors have developed. The main features of the code are it is based on the explicit time integration method and it uses the one point integration method to evaluate the equivalent nodal forces with the hourglass control proposed by Flanagan and Belythcko and it utilizes the parallel computation with the Massage Passing Interface (MPI). In order to verify the developed model, the head impact experiment for a cadaver by Nahum et al. was simulated. The calculated results showed good agreement with experimental ones. A front and rear impact analyses were also performed investigate the relation between the impact direction and the positions of the high measurement of pressure and stresses in brain. The obtained results represent that brain injury has a closer relation with the Mises equivalent stress rather than the pressure. At this time, the large deformation of a frontal cranial base was observed in both frontal and occipital impact analyses. We expect that it induces the brain injury in a frontal lobe regardless of the impact positions. (author)

  9. Impact of CrossFit-Related Spinal Injuries.

    Science.gov (United States)

    Hopkins, Benjamin S; Cloney, Michael B; Kesavabhotla, Kartik; Yamaguchi, Jonathon; Smith, Zachary A; Koski, Tyler R; Hsu, Wellington K; Dahdaleh, Nader S

    2017-11-16

    Exercise-related injuries (ERIs) are a common cause of nonfatal emergency department and hospital visits. CrossFit is a high-intensity workout regimen whose popularity has grown rapidly. However, ERIs due to CrossFit remained under investigated. All patients who presented to the main hospital at a major academic center complaining of an injury sustained performing CrossFit between June 2010 and June 2016 were identified. Injuries were classified by anatomical location (eg, knee, spine). For patients with spinal injuries, data were collected including age, sex, body mass index (BMI), CrossFit experience level, symptom duration, type of symptoms, type of clinic presentation, cause of injury, objective neurological examination findings, imaging type, number of clinic visits, and treatments prescribed. Four hundred ninety-eight patients with 523 CrossFit-related injuries were identified. Spine injuries were the most common injuries identified, accounting for 20.9%. Among spine injuries, the most common location of injury was the lumbar spine (83.1%). Average symptom duration was 6.4 months ± 15.1, and radicular complaints were the most common symptom (53%). A total of 30 (32%) patients had positive findings on neurologic examination. Six patients (6.7%) required surgical intervention for treatment after failing an average of 9.66 months of conservative treatment. There was no difference in age, sex, BMI, or duration of symptoms of patients requiring surgery with those who did not. CrossFit is a popular, high-intensity style workout with the potential to injure its participants. Spine injuries were the most common type of injury observed and frequently required surgical intervention.

  10. Prevention of Blast-Related Injuries

    Science.gov (United States)

    2017-09-01

    in a canvas harness. The harness was further supported by a steel frame which was suspended from a metal beam (3.7 m off the ground) mounted on...direction of the wave propagation (Figure 5). After proper alignment of the head with respect to the center of the C4 charge, the steel frame was...further tied to four hooks cemented to the concrete ground with straps to prevent excessive motion during the blast exposure. The intensity of the two

  11. The Role of Negative Affect on Headache-Related Disability Following Traumatic Physical Injury.

    Science.gov (United States)

    Pacella, Maria L; Hruska, Bryce; George, Richard L; Delahanty, Douglas L

    2018-03-01

    Acute postinjury negative affect (NA) may contribute to headache pain following physical injury. Early psychiatric-headache comorbidity conveys increased vulnerability to chronic headache-related disability and impairment. Yet, it is unknown whether NA is involved in the transition to chronic headache related-disability after injury. This prospective observational study examined the role of acute postinjury NA on subacute and chronic headache-related disability above and beyond nonpsychiatric factors. Eighty adult survivors of single-incident traumatic physical injury were assessed for negative affect (NA): a composite of depression and anxiety symptoms, and symptoms of posttraumatic stress disorder (PTSS) during the acute 2-week postinjury phase. NA was examined as the primary predictor of subacute (6-week) and chronic (3-month) headache-related disability; secondary analyses examined whether the individual NA components differentially impacted the outcomes. Hierarchical linear regression confirmed NA as a unique predictor of subacute (Cohen's f  2  = 0.130; P = .005) and chronic headache related-disability (Cohen's f  2  = 0.160; P = .004) beyond demographic and injury-related factors (sex, prior headaches, and closed head injury). Upon further analysis, PTSS uniquely predicted greater subacute (Cohen's f  2  = 0.105; P = .012) and chronic headache-related disability (Cohen's f  2  = 0.103; P = .022) above and beyond demographic and injury-related factors, depression, and anxiety. Avoidance was a robust predictor of subacute headache impairment (explaining 15% of the variance) and hyperarousal was a robust predictor of chronic headache impairment (10% of the variance). Although NA consistently predicted headache-related disability, PTSS alone was a unique predictor above and beyond nonpsychiatric factors, depression, and anxiety. These results are suggestive that early treatment of acute postinjury PTSS may correlate with

  12. The rockets' red glare, the bombs bursting in air: fireworks-related injuries to children.

    Science.gov (United States)

    Smith, G A; Knapp, J F; Barnett, T M; Shields, B J

    1996-07-01

    To describe the epidemiology of fireworks-related injuries to children treated in a pediatric emergency department. A descriptive study of a consecutive series of patients. The emergency department of a large urban children's hospital. Children treated for injuries associated with fireworks during the 22-year period from 1972 through 1993. Three hundred sixteen children were treated for fireworks-related injuries. Ninety-five percent of patients were injured during the 3-week period of June 22 to July 14 during the study years. Seventy-one percent of patients were male, and the average age was 8.5 years, with a range of 1 month to 17 years. The child was a bystander in 26% of cases, and adult supervision was present in 54% of cases. One patient died, and 11% of children required admission to the hospital, with an average length of stay of 7.8 days (range, 1 to 37 days). Fifteen children (5%) went to the operating room for treatment of injuries. Thirty-three patients (10%) had permanent sequelae from their injuries, including 7 children (2%) with complete or partial loss of vision in one eye. The eyes were injured in 29% of cases, followed by hands and fingers (22%), other head and face sites (18%), and lower extremities (16%). The primary injury was a burn in 72% of cases. Firecrackers were associated with 42% of injuries, followed by bottle rockets (12%), other types of rockets (7%), Roman candles (11%), sparklers (7%), fountains (5%), jumping jacks (4%), and class B (illegal) fireworks (4%). Sixty-seven percent of sparkler-related injuries occurred among children 5 years and younger (Fisher's exact test, P = .000002; odds ratio [OR] = 10.00, 95% confidence interval 3.52 rockets than eye injuries caused by other types of fireworks (Fisher's exact test, P = .03; OR = 6.72, 95% confidence interval 1.18 < OR < 38.18). Charges for medical care of a fireworks-related injury averaged $1385 per patient (range, $44 to $15 071). Fireworks are associated with serious

  13. Adherence to Head Computed Tomography Guidelines for Mild Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Landon A. Jones

    2014-07-01

    Full Text Available Introduction: Traumatic brain injury (TBI is a significant health concern. While 70-90% of TBI cases are considered mild, decision-making regarding imaging can be difficult. This survey aimed to assess whether clinicians’ decision-making was consistent with the most recent American College of Emergency Physicians (ACEP clinical recommendations regarding indications for a non-contrast head computed tomography (CT in patients with mild TBI. Methods: We surveyed 2 academic emergency medicine departments. Six realistic clinical vignettes were created. The survey software randomly varied 2 factors: age (30, 59, or 61 years old and presence or absence of visible trauma above the clavicles. A single important question was asked: “Would you perform a non-contrast head CT on this patient?” Results: Physician decision-making was consistent with the guidelines in only 62.8% of total vignettes. By age group (30, 59, and 61, decision-making was consistent with the guidelines in 66.7%, 47.4%, and 72.7% of cases, respectively. This was a statistically-significant difference when comparing the 59- and 61-year-old age groups. In the setting of presence/absence of trauma above the clavicles, respondents were consistent with the guidelines in 57.1% of cases. Decision-making consistent with the guidelines was significantly better in the absence of trauma above the clavicles. Conclusion: Respondents poorly differentiated the “older” patients from one another, suggesting that respondents either inappropriately apply the guidelines or are unaware of the recommendations in this setting. No particular cause for inconsistency could be determined, and respondents similarly under-scanned and over-scanned in incorrect vignettes. Improved dissemination of the ACEP clinical policy and recommendations is a potential solution to this problem.

  14. Exploring the King’s outcome scale for childhood head injury in children attending a rehabilitation hospital

    DEFF Research Database (Denmark)

    Rumney, Peter; Hung, Ryan; McAdam, Laura

    2014-01-01

    Objective: Few tools exist to assess and monitor impairment and disability in children with acquired brain injury. The King’s Outcome Scale for Childhood Head Injury (KOSCHI) was developed as an alternative to the Glasgow Outcome Scale. However, limited information is available to support its...... reliability, validity and responsiveness. A pilot study was designed to (1) develop a KOSCHI data collection form; and (2) determine the feasibility of studying its intra-rater and inter-rater reliability in children with acquired brain injury. Methods: A KOSCHI data collection form was developed after...... reviewing the literature. Two paediatricians and one paediatric neurologist tested its use in a clinical setting and the form was modified. As a pilot study, a rehabilitation paediatrician then assessed 10 children (aged 5–18 years) with acquired brain injuries (six traumatic, four non...

  15. Plantar talar head contusions and osteochondral fractures: associated findings on ankle MRI and proposed mechanism of injury

    Energy Technology Data Exchange (ETDEWEB)

    Gorbachova, Tetyana; Wang, Peter S.; Hu, Bing [Einstein Medical Center Philadelphia, Department of Radiology, Philadelphia, PA (United States); Horrow, Jay C. [Drexel University, Department of Anesthesiology and Perioperative Medicine, Philadelphia, PA (United States)

    2016-06-15

    To evaluate the significance of plantar talar head injury (PTHI) in predicting osseous and soft tissue injuries on ankle MRI. The IRB approved this HIPAA-compliant retrospective study. The study group consisted of 41 ankle MRIs with PTHI that occurred at our institution over a 5 1/2 year period. Eighty MRIs with bone injuries in other locations matched for age, time interval since injury, and gender formed a control group. Injuries to the following structures were recorded: medial malleolus, lateral malleolus/distal fibula, posterior malleolus, talus, calcaneus, navicular, cuboid, lateral, medial and syndesmotic ligaments, spring ligament complex, and extensor digitorum brevis (EDB) muscle. Twenty separate logistic regressions determined which injuries PTHI predicted, using the Holm procedure to control for family-wise alpha at 0.05. PTHI strongly predicted the occurrence of injuries involving the anterior process of the calcaneus [24 % of cases, odds ratio (OR) 12.66], plantar components of the spring ligament (27 %, OR 9.43), calcaneal origin of the EDB and attachment of the dorsolateral calcaneocuboid ligament (22 %, OR 7.22), cuboid (51 %, OR 6.58), EDB (27 %, OR 5.49), anteromedial talus (66 %, OR 4.78), and posteromedial talus (49 %, OR 4.48). PTHI strongly predicted lack of occurrence of syndesmotic ligament injury (OR 19.6). The PTHI group had a high incidence of lateral ligamentous injury (78 %), but not significantly different from the control group (53 %). PTHI is strongly associated with injury involving the transverse tarsal joint complex. We hypothesize it results from talo-cuboid and/or talo-calcaneal impaction from a supination injury of the foot and ankle. (orig.)

  16. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... by the interpreting radiologist. Frequently, the differentiation of abnormal (diseased) tissue from normal tissues is better with ... Tumor Treatment Magnetic Resonance Imaging (MRI) Safety Alzheimer's Disease Head Injury Brain Tumors Images related to Magnetic ...

  17. Repeated mild closed head injury impairs short-term visuospatial memory and complex learning.

    Science.gov (United States)

    Hylin, Michael J; Orsi, Sara A; Rozas, Natalia S; Hill, Julia L; Zhao, Jing; Redell, John B; Moore, Anthony N; Dash, Pramod K

    2013-05-01

    Concussive force can cause neurocognitive and neurobehavioral dysfunction by inducing functional, electrophysiological, and/or ultrastructural changes within the brain. Although concussion-triggered symptoms typically subside within days to weeks in most people, in 15%-20% of the cases, symptomology can continue beyond this time point. Problems with memory, attention, processing speed, and cognitive flexibility (e.g., problem solving, conflict resolution) are some of the prominent post-concussive cognitive symptoms. Repeated concussions (with loss or altered consciousness), which are common to many contact sports, can exacerbate these symptoms. The pathophysiology of repeated concussions is not well understood, nor is an effective treatment available. In order to facilitate drug discovery to treat post-concussive symptoms (PCSs), there is a need to determine if animal models of repeated mild closed head injury (mCHI) can mimic the neurocognitive and histopathological consequences of repeated concussions. To this end, we employed a controlled cortical impact (CCI) device to deliver a mCHI directly to the skull of mice daily for 4 days, and examined the ensuing neurological and neurocognitive functions using beam balance, foot-fault, an abbreviated Morris water maze test, context discrimination, and active place avoidance tasks. Repeated mCHI exacerbated vestibulomotor, motor, short-term memory and conflict learning impairments as compared to a single mCHI. Learning and memory impairments were still observed in repeated mCHI mice when tested 3 months post-injury. Repeated mCHI also reduced cerebral perfusion, prolonged the inflammatory response, and in some animals, caused hippocampal neuronal loss. Our results show that repeated mCHI can reproduce some of the deficits seen after repeated concussions in humans and may be suitable for drug discovery studies and translational research.

  18. Computed tomography findings in young children with minor head injury presenting to the emergency department greater than 24h post injury.

    Science.gov (United States)

    Gelernter, Renana; Weiser, Giora; Kozer, Eran

    2018-01-01

    Large studies which developed decision rules for the use of Computed tomography (CT) in children with minor head trauma excluded children with late presentation (more than 24h). To assess the prevalence of significant traumatic brain injury (TBI) on CT in infants with head trauma presenting to the emergency department (ED) more than 24h from the injury. A retrospective chart review of infants less than 24 months old referred for head CT because of traumatic brain injury from January 2004 to December 2014 in Assaf-Harofeh medical center was conducted. We used the PECARN definitions of TBI on CT to define significant CT findings. 344 cases were analyzed, 68 with late presentation. There was no significant difference in the age between children with late and early presentation (mean 11.4 (SD 5.6) month vs 10. 5 (SD 7.0) month, P=0.27). There was no significant difference between the groups in the incidence of significant TBI (22% vs 19%, p=0.61). Any TBI on CT (e.g. fracture) was found in 43 (63%) patients with late presentation compared with 116 (42%) patients with early presentation (p=0.002, OR 2.37, 95% CI 1.37-4.1). A similar rate of CT-identified traumatic brain injury was detected in both groups.‏ There was no significant difference in the incidence of significant TBI on CT between the groups.‏ Young children presenting to the ED more than 24 hours after the injury may have abnormal findings on CT. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Diagnostic imaging of sport related musculoskeletal system injuries

    International Nuclear Information System (INIS)

    Fernandes, Artur da Rocha Correa; Schivartche, Vivian

    1998-01-01

    The authors review the literature about musculoskeletal injuries related to sports, emphasizing the main findings with different imaging methods. They also present the specific characteristics of each method. (author)

  20. Frequency of cerebral infarction secondary to head injury and the underlying mechanisms: CT study

    International Nuclear Information System (INIS)

    Fernande-Fresno, L.; Manzanares, R.; Caniego, J.L.; Velasco, M.; Parra, M.L.; Monasterio, F.

    1997-01-01

    To study the frequency of and possible mechanisms producing severe head injury (HI) by serial CT studies. We reviewed brain CT results in 154 HI patients examined over the past 31 months. All of them were hospitalized in the Intensive Care Unit (ICU) presenting coma with Glosgow Coma Scale scores of 9 or under. A first CT scan was performed when the patients arrived in the emergency room and at a least one more was carried out over the following 1 to 6 days. Sixteen of the 154 patients presented ischemic areas of low attenuation in a territory of defined vascular distribution that did not exist in the CT done at admission; the majority of them also had extensive extraaxial or intraaxial hematomas causing a considerable mass effect and cerebral displacement inducing different types of herniation. The vascular territories involved were anterior cerebral artery in five cases, middle cerebral artery in two, posterior cerebral artery in seven lenticulostriate arteries in six, anterior choroidal artery in five, perforating thalamus in six, recurrent artery in one case and superior cerebellar artery in another. In our series, there was a high prevalence (10.4%) of infarcts associated with severe HI; the most common etiopathogenic mechanisms are cerebral displacement accompanied by compression and vessel strain. (Author) 13 refs

  1. Technical report: lawn mower-related injuries to children.

    Science.gov (United States)

    Smith, G A

    2001-06-01

    In the United States, approximately 9400 children younger than 18 years receive emergency treatment annually for lawn mower-related injuries. More than 7% of these children require hospitalization, and power mowers cause a large proportion of the amputations during childhood. Prevention of lawn mower-related injuries can be achieved by design changes of lawn mowers, guidelines for mower operation, and education of parents, child caregivers, and children. Pediatricians have an important role as advocates and educators to promote the prevention of these injuries.

  2. Elderly Taiwanese's Intrinsic Risk Factors for Fall-related Injuries

    OpenAIRE

    In-Fun Li; Yvonne Hsiung; Hui-Fen Hsing; Mei-Yu Lee; Te-Hsin Chang; Ming-Yuan Huang

    2016-01-01

    Background: As a vital issue in geriatric research, risk factors for falls were concluded to be multifactorial, and prevention has been mostly aimed at decreasing situational and environmental risks that cause and aggravate fall-related injuries, particularly within the institutions. While knowledge is limited about older patients' intrinsic determinants, the purpose of this study was to explore elderly Taiwanese's intrinsic risk factors associated with severe fall-related injuries. Method...

  3. Eletrencefalograma nos traumatismos cranio-encefalicos The value of electroencephalogram in head injuries

    Directory of Open Access Journals (Sweden)

    Lineu Corrêa Fonseca

    1975-12-01

    Full Text Available São analisados 551 eletrencefalogramas de 387 pacientes com traumatismo crânio-encefálico. Os achados eletrencefalográficos são correlacionados aos seguintes dados clínicos: idade, tempo após o trauma, duração da perda de consciência, presença de sinais focais ao exame neurológico, existência de traumatismo crânio-encefálico aberto ou hematoma, líquido cefalorraqueano hemorrágico ou fratura de crânio e aparecimento de convulsões. O autor chega às seguintes conclusões: 1 — há nítida correlação entre as anormalidades eletrencefalográficas e o grau de lesão cerebral, caracterizado pelo tempo de perda de consciência, presença de sinais focais ao exame neurológico, presença de líquido cefalorraqueano hemorrágico e epilepsia pós-traumática; 2 — as anormalidades lentas contínuas focais parietoccipitais são mais freqüentes na faixa etária com menos de 10 anos; 3 — há uma queda de proporção de eletrencefalogramas anormais particularmente entre o 6.° e o 12.° mês após o trauma; 4 — as anormalidades lentas contínuas difusas ou focais têm sua proporção diminuída particularmente após o primeiro mês depois do trauma; 5 — as anormalidades paroxísticas aumentam, em proporção, de modo nítido, após o 6.° mês depois do trauma; 6 — os pacientes com hematoma intracraniano apresentam grande proporção de anormalidades, particularmente as depressões. Todos esses dados mostram a importância do eletrencefalograma na complementação do estudo clínico dos pacientes com traumatismo crânio-encefálico, principalmente quando é feita seqüência eletrencefalográfica, desde os primeiros dias após o trauma.The 551 electroencephalograms of 387 patients with head injury are analysed. The electroencephalographic findings are correlated to the following clinical data: age, time after the trauma, duration of unconsciousness, presence of localizing neurological signs, existence of open wounds or hematoma

  4. Adult sports-related traumatic brain injury in United States trauma centers.

    Science.gov (United States)

    Winkler, Ethan A; Yue, John K; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E

    2016-04-01

    OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories-fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to

  5. Common injuries related to weightlifting: MR imaging perspective.

    Science.gov (United States)

    Yu, Joseph S; Habib, Paula A

    2005-12-01

    Weightlifting has evolved to become a ubiquitous form of exercise. Resistance training has been shown to have beneficial effects on both muscle and osseous maintenance and development. Competitive weightlifting sports continue to enjoy tremendous popularity, with participants striving to establish new standards in performance and more demanding personal goals. Thus, it is not surprising that we have also seen an increase in injuries related to weightlifting. Many of these injuries are radiographically occult and are best suited for evaluation by magnetic resonance (MR) imaging because many involve the soft tissues. In this article, we discuss some of the factors that contribute to these injuries and address the mechanisms of injury and the MR imaging manifestations of the more common injuries.

  6. Trauma patient adverse outcomes are independently associated with rib cage fracture burden and severity of lung, head, and abdominal injuries.

    Science.gov (United States)

    Dunham, C Michael; Hileman, Barbara M; Ransom, Kenneth J; Malik, Rema J

    2015-01-01

    We hypothesized that lung injury and rib cage fracture quantification would be associated with adverse outcomes. Consecutive admissions to a trauma center with Injury Severity Score ≥ 9, age 18-75, and blunt trauma. CT scans were reviewed to score rib and sternal fractures and lung infiltrates. Sternum and each anterior, lateral, and posterior rib fracture was scored 1 = non-displaced and 2 = displaced. Rib cage fracture score (RCFS) = total rib fracture score + sternal fracture score + thoracic spine Abbreviated Injury Score (AIS). Four lung regions (right upper/middle, right lower, left upper, and left lower lobes) were each scored for % of infiltrate: 0% = 0; ≤ 20% = 1, ≤ 50% = 2, > 50% = 3; total of 4 scores = lung infiltrate score (LIS). Of 599 patients, 193 (32%) had 854 rib fractures. Rib fracture patients had more abdominal injuries (p fractures (p = 0.0028) and death or need for mechanical ventilation ≥ 3 days (Death/Vdays ≥ 3) (p rib fracture patients, Glasgow Coma Score 3-12 or head AIS ≥ 2 occurred in 43%. A lung infiltrate or hemo/pneumothorax occurred in 55%. Thoracic spine injury occurred in 23%. RCFS was 6.3 ± 4.4 and Death/Vdays ≥ 3 occurred in 31%. Death/Vdays ≥ 3 rates correlated with RCFS values: 19% for 1-3; 24% for 4-6; 42% for 7-12 and 65% for ≥ 13 (p rib fracture score (p = 0.08) or number of fractured ribs (p = 0.80). Rib fracture patients have increased risk for truncal injuries and adverse outcomes. Adverse outcomes are independently associated with rib cage fracture burden. Severity of head, abdominal, and lung injuries also influence rib fracture outcomes.

  7. Does trauma team activation associate with the time to CT scan for those suspected of serious head injuries?

    Science.gov (United States)

    Rados, Alma; Tiruta, Corina; Xiao, Zhengwen; Kortbeek, John B; Tourigny, Paul; Ball, Chad G; Kirkpatrick, Andrew W

    2013-11-18

    Traumatic brain injury (TBI) constitutes the leading cause of posttraumatic mortality. Practically, the major interventions required to treat TBI predicate expedited transfer to CT after excluding other immediately life-threatening conditions. At our center, trauma responses variably consist of either full trauma activation (FTA) including an attending trauma surgeon or a non-trauma team response (NTTR). We sought to explore whether FTAs expedited the time to CT head (TTCTH). Retrospective review of augmented demographics of 88 serious head injuries identified from a Regional Trauma Registry within one year at a level I trauma center. The inclusion criteria consisted of a diagnosis of head injury recorded as intubated or GCS FTA (median 50 vs. 26 minutes, p FTA). Without FTA, most delays (69%) were for emergency intubation. TTCTH after securing the airway was longer for NTTR group (median 38 vs. 26 minutes, p =0.0013). Even with no requirements for ED interventions, TTCTH for FTA was less than half versus NTTR (25 vs. 61 minutes, p =0.0013). Multivariate regression analysis indicated age and FTA with an attending surgeon as significant predictors of TTCTH, although the majority of variability in TTCTH was not explained by these two variables (R² = 0.33). Full trauma activations involving attending trauma surgeons were quicker at transferring serious head injury patients to CT. Patients with FTA were younger and more seriously injured. Discerning the reasons for delays to CT should be used to refine protocols aimed at minimizing unnecessary delays and enhancing workforce efficiency and clinical outcome.

  8. An Unusual Case of Cerebral Penetrating Injury by a Driven Bone Fragment Secondary to Blunt Head Trauma

    OpenAIRE

    Lee, Jae Il; Ko, Jun Kyeung; Cha, Seung Heon; Han, In Ho

    2011-01-01

    Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right t...

  9. Post-traumatic stress disorder and head injury as a dual diagnosis: "islands" of memory as a mechanism.

    Science.gov (United States)

    King, N S

    1997-01-01

    This case study describes post-traumatic stress disorder (PTSD) and head injury after a road traffic accident involving a pedestrian. Previous studies have proposed two mechanisms by which this dual diagnosis may occur: (1) when post-traumatic amnesia and retrograde amnesia are small or non-existent and (2) when non-declarative memory systems for the traumatic event are in operation. This case study demonstrates a third mechanism--"islands" of memory within post-traumatic amnesia.

  10. Functional survival after acute care for severe head injury at a designated trauma center in Hong Kong.

    Science.gov (United States)

    Taw, Benedict B T; Lam, Alan C S; Ho, Faith L Y; Hung, K N; Lui, W M; Leung, Gilberto K K

    2012-07-01

    Severe head injury is known to be a major cause of early mortalities and morbidities. Patients' long-term outcome after acute care, however, has not been widely studied. We aim to review the outcome of severely head-injured patients after discharge from acute care at a designated trauma center in Hong Kong. This is a retrospective study of prospectively collected data of patients admitted with severe head injuries between 2004 and 2008. Patients' functional status post-discharge was assessed using the Extended Glasgow Outcome Score (GOSE). Of a total of 1565 trauma patients, 116 had severe head injuries and 41 of them survived acute hospital care. Upon the last follow-up, 23 (56.1%) of the acute-care survivors had improvements in their GOSE, six (11.8%) experienced deteriorations, and 12 (23.5%) did not exhibit any change. The greatest improvement was observed in patients with GOSE of 5 and 6 upon discharge, but two of the 16 patients with GOSE 2 or 3 also had a good recovery. On logistic regression analysis, old age and prolonged acute hospital stay were found to be independent predictors of poor functional outcome after a mean follow-up duration of 42 months. Multidisciplinary neurorehabilitation service is an important component of comprehensive trauma care. Despite significant early mortalities, a proportion of severely head-injured patients who survive acute care may achieve good long-term functional recovery. Copyright © 2012, Asian Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved.

  11. Successful renal transplantation from a brain-dead deceased donor with head injury, disseminated intravascular coagulation and deranged renal functions

    Directory of Open Access Journals (Sweden)

    P P Ghuge

    2013-01-01

    Full Text Available Deceased donors (DDs with the brain death due to head injury are the major source of organs for transplantation. The incidence of post-head injury disseminated intravascular coagulation (DIC ranges from 24% to 50%. Many centers do not accept organs from donors with DIC due to increased risk of primary graft non-function and/or high chances of morbidity/mortality. We performed two successful renal transplants from a DD with head injury with DIC and deranged renal function. One of the recipients developed transient thrombocytopenia, but there was no evidence of DIC or delayed graft functions in either of the recipients. Over a follow-up of 1 month, both are doing well with stable graft function and hematological profile. Thus, a carefully selected DD with severe DIC even with deranged renal function is not a contraindication for organ donation if other risk factors for primary non-function are excluded. This approach will also help in overcoming organ shortage.

  12. Diagnostic efficacy and pitfalls of a 64-raw multislice computed tomography scan for mild head injuries in children

    International Nuclear Information System (INIS)

    Matsumoto, Yoshihisa; Nawashiro, Hiroshi; Uozumi, Youichi

    2010-01-01

    The aim of this study is to analyze the usefulness of 64-raw multislice computed tomography (CT) scans and bone images of three-dimensional CT (3D-CT) scans for evaluation of mild head injuries in children. Thirteen children (9 boys and 4 girls, less than or equal to 15 years old) with mild head injury were included in the study. Head CT scans obtained within 24 hours after injury. All children had no episodes of loss of consciousness, amnesia, epilepsy, vomiting, and no neurological abnormality on arrival at hospital. We detected 9 positive findings on CT scans, which looked like fracture lines at the frontal bone in 7 cases. The bone images of CT axial views revealed a true fracture in one case in which a skull X-ray could not demonstrate a fracture line, but, other positive findings turned out to be a diploic vein surrounded by a thin bone cortex. All false positive findings were detected in the patients under the age of 6. By the 3D-reconstructive CT scan, it is easier to detect not only the intracranial lesions but also the cranial fracture. But, the diploic vein is apt to be misdiagnosed as the fracture line, especially in patients under the age of 6. (author)

  13. A prototype for a mammographic head and related developments

    Energy Technology Data Exchange (ETDEWEB)

    Amendolia, S.R.; Annovazzi, A.; Bigongiari, A.; Bisogni, M.G.; Catarsi, F.; Cesqui, F.; Cetronio, A.; Chianella, M.; Delogu, P.; Fantacci, M.E.; Galimberti, D.; Lanzieri, C.; Lavanga, S.; Novelli, M.; Passuello, G.; Stefanini, A.; Testa, A.; Venturelli, L

    2004-02-01

    The Integrated Mammographic Imaging (IMI) project aims to realize innovative instrumentations for morphological and functional mammography, in particular, one of the research topics is the design and development of a prototype of a mammographic head. Innovative industrial processes for the production of GaAs pixel detectors and for their bump-bonding to the read-out VLSI electronics have been developed by AMS. The data acquisition and processing have been developed by LABEN; the power supply and distribution system has been realized by CAEN; while the integration of the head in a standard mammograph has been carried on by the Laboratori di Ricerca Gilardoni.

  14. A prototype for a mammographic head and related developments

    International Nuclear Information System (INIS)

    Amendolia, S.R.; Annovazzi, A.; Bigongiari, A.; Bisogni, M.G.; Catarsi, F.; Cesqui, F.; Cetronio, A.; Chianella, M.; Delogu, P.; Fantacci, M.E.; Galimberti, D.; Lanzieri, C.; Lavanga, S.; Novelli, M.; Passuello, G.; Stefanini, A.; Testa, A.; Venturelli, L.

    2004-01-01

    The Integrated Mammographic Imaging (IMI) project aims to realize innovative instrumentations for morphological and functional mammography, in particular, one of the research topics is the design and development of a prototype of a mammographic head. Innovative industrial processes for the production of GaAs pixel detectors and for their bump-bonding to the read-out VLSI electronics have been developed by AMS. The data acquisition and processing have been developed by LABEN; the power supply and distribution system has been realized by CAEN; while the integration of the head in a standard mammograph has been carried on by the Laboratori di Ricerca Gilardoni

  15. Protection against head injuries should not be optional: a case for mandatory installation of side-curtain air bags.

    Science.gov (United States)

    Stuke, Lance E; Nirula, Raminder; Gentilello, Larry M; Shafi, Shahid

    2010-10-01

    More than 9,000 vehicle occupants die each year in side-impact vehicle collisions, primarily from head injuries. The authors hypothesized that side-curtain air bags significantly improve head and neck safety in side-impact crash testing. Side-impact crash-test data were obtained from the Insurance Institute for Highway Safety, which ranks occupant protection as good, acceptable, marginal, or poor. Vehicles of the same make and model that underwent side-impact crash testing both with and without side-curtain air bags were compared, as well as the protective effect of these air bags on occupants' risk for head and neck injury. Of all the passenger vehicles, 25 models have undergone side-impact crash testing with and without side-curtain air bags by the Insurance Institute for Highway Safety. Only 3 models without side-curtain air bags (12%) provided good head and neck protection for drivers, while 21 cars with side-curtain air bags (84%) provided good protection (P bags was less dramatic but significant (84% without vs 100% with side-curtain air bags, P = .04). Side-curtain air bags significantly improve vehicle occupant safety in side-impact crash tests. Installation of these air bags should be federally mandated in all passenger vehicles. Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Welding related occupational eye injuries: a narrative analysis.

    Science.gov (United States)

    Lombardi, D A; Pannala, R; Sorock, G S; Wellman, H; Courtney, T K; Verma, S; Smith, G S

    2005-06-01

    To determine the activities and circumstances proximal to a welding related occupational eye injury, a hybrid narrative coding approach derived from two well developed classification systems was developed to categorize and describe the activity, initiating process, mechanism of injury, object and/or substance, and the use of protective eyewear from the narrative text data reported for each injury. Routinely collected workers' compensation claims over a one year period (2000) were analyzed from a large US insurance provider. An index term search algorithm of occupation, incident, and injury description fields identified 2209 potential welding related eye injury claims. After detailed review of these claims, 1353 welders and 822 non-welders were analyzed. During 2000, eye(s) as the primary injured body part accounted for 5% (n = 26 413) of all compensation claims. Eye injuries accounted for 25% of all claims for welders. Subjects were mainly male (97.1%) and from manufacturing (70.4%), service (11.8%), or construction (8.4%) related industries. Most injuries were foreign body (71.7%) or burn (22.2%) and 17.6% were bilateral. Common activities include welding (31.9%) and/or grinding (22.5%). Being struck by an airborne object occurred in 56.3% of cases. Non-welders showed similar patterns except that burns (43.8%) were more frequent and more often initiated by another worker (13.9%). Narrative injury text provides valuable data to supplement traditional epidemiologic analyses. Workers performing welding tasks or working nearby welders should be trained to recognize potential hazards and the effective use of proper safety equipment to prevent ocular injury.

  17. Gymnastic Formation-related Injury to Children in Physical Education.

    Science.gov (United States)

    Araki, Takashi; Miyauchi, Masato; Suzaki, Makoto; Wakakuri, Taro; Kirinoki, Sonoko; Onodera, Naoko; Saigusa, Taro; Takana, Akihiro; Hyodo, Hideya; Ohara, Toshihiko; Kawai, Makoto; Yasutake, Masahiro; Yokota, Hiroyuki

    2015-01-01

    Current data indicate that the rate of trauma in children during gymnastic formation is increasing, especially while creating a structure with a certain height, such as the human pyramid. The goal of the present study was to clarify the clinical characteristics of these injuries. In this single-institution review, all children treated for a gymnastic formation-related injury at Nippon Medical School Hospital from 2013 through 2015 were identified through the institution's registry. The injury mechanism was classified, and injury severity, interventions, and outcome were examined. Eight children were treated for a gymnastic formation-related injury. They were 7 boys and 1 girl aged 10 to 15 years (mean age, 13.1±1.8 years). Neurotrauma ranging from concussion to spinal cord injury without radiographic abnormality occurred in 6 patients (75%). No intracranial hemorrhagic lesions were detected. The Glasgow Coma Scale score on arrival was 15 in all 8 patients, and neurological deficits were present in 1 patient. No patient required surgical intervention. All patients made a full recovery after discharge from the hospital. No patients died. The average follow-up period was 2.1±0.9 weeks. Neurotrauma is a frequent result of gymnastic formation accidents in children. Healthcare workers and teachers should recognize this type of injury, and public education that targets parents should be introduced.

  18. Neuroimaging in pediatric traumatic head injury: diagnostic considerations and relationships to neurobehavioral outcome.

    Science.gov (United States)

    Bigler, E D

    1999-08-01

    Contemporary neuorimaging techniques in child traumatic brain injury are reviewed, with an emphasis on computerized tomography (CT) and magnetic resonance (MR) imaging. A brief overview of MR spectroscopy (MRS), functional MR imaging (fMRI), single-photon emission computed tomography (SPECT), and magnetoencephalography (MEG) is also provided because these techniques will likely constitute important neuroimaging techniques of the future. Numerous figures are provided to illustrate the multifaceted manner in which traumatic deficits can be imaged and the role of neuroimaging information as it relates to TBI outcome.

  19. A theoretical perspective on running-related injuries.

    Science.gov (United States)

    Gallant, Jodi Lynn; Pierrynowski, Michael Raymond

    2014-03-01

    The etiology of running-related injuries remains unknown; however, an implicit theory underlies much of the conventional research and practice in the prevention of these injuries. This theory posits that the cause of running-related injuries lies in the high-impact forces experienced when the foot contacts the ground and the subsequent abnormal movement of the subtalar joint. The application of this theory is seen in the design of the modern running shoe, with cushioning, support, and motion control. However, a new theory is emerging that suggests that it is the use of these modern running shoes that has caused a maladaptive running style, which contributes to a high incidence of injury among runners. The suggested application of this theory is to cease use of the modern running shoe and transition to barefoot or minimalist running. This new running paradigm, which is at present inadequately defined, is proposed to avoid the adverse biomechanical effects of the modern running shoe. Future research should rigorously define and then test both theories regarding their ability to discover the etiology of running-related injury. Once discovered, the putative cause of running-related injury will then provide an evidence-based rationale for clinical prevention and treatment.

  20. EmptyHeaded: A Relational Engine for Graph Processing.

    Science.gov (United States)

    Aberger, Christopher R; Tu, Susan; Olukotun, Kunle; Ré, Christopher

    2016-01-01

    There are two types of high-performance graph processing engines: low- and high-level engines. Low-level engines (Galois, PowerGraph, Snap) provide optimized data structures and computation models but require users to write low-level imperative code, hence ensuring that efficiency is the burden of the user. In high-level engines, users write in query languages like datalog (SociaLite) or SQL (Grail). High-level engines are easier to use but are orders of magnitude slower than the low-level graph engines. We present EmptyHeaded, a high-level engine that supports a rich datalog-like query language and achieves performance comparable to that of low-level engines. At the core of EmptyHeaded's design is a new class of join algorithms that satisfy strong theoretical guarantees but have thus far not achieved performance comparable to that of specialized graph processing engines. To achieve high performance, EmptyHeaded introduces a new join engine architecture, including a novel query optimizer and data layouts that leverage single-instruction multiple data (SIMD) parallelism. With this architecture, EmptyHeaded outperforms high-level approaches by up to three orders of magnitude on graph pattern queries, PageRank, and Single-Source Shortest Paths (SSSP) and is an order of magnitude faster than many low-level baselines. We validate that EmptyHeaded competes with the best-of-breed low-level engine (Galois), achieving comparable performance on PageRank and at most 3× worse performance on SSSP.

  1. Attrition tendinitis of long head of biceps brachii in relation to humeral head osteonecrosis: case report.

    Science.gov (United States)

    Wiesler, Ethan R; Sarlikiotis, Thomas; Mavrogenis, Andreas F; Kokkalis, Zinon T

    2013-01-01

    This case report identifies a 41-year-old male patient who developed anterior shoulder pain in the setting of humeral head osteonecrosis. As a consequence of the cartilage degeneration, multiple loose bodies formed and migrated into the bicipital tendon sheath, causing attrition tendinitis, which was a feature of the clinical presentation. The patient was treated by a combination of arthroscopic glenohumeral joint debridement and open tenodesis of the biceps using a suture anchor. Follow-up revealed asymptomatic shoulder function by 18 months. This is the first report in the literature of bicipital tendinitis in the context of avascular necrosis of the shoulder.

  2. Epidemiology of livestock-related injuries in a major trauma center in Kashan, Iran

    Directory of Open Access Journals (Sweden)

    Mohammadzadeh Mahdi

    2013-02-01

    Full Text Available 【Abstract】Objective: Livestock-related injuries are one of the important factors causing morbidity and mor-tality in patients admitted to hospital. Treatment of these patients is still a major problem in health care system. The aim of current study was to assess the epidemiology of livestock-related injuries in a major trauma center in Iran from 2006 to 2011. Methods: In a prospective study, patients with live-stock-related injuries who were consecutively admitted to the trauma center in Kashan, Iran between 2006 and 2011 were evaluated. The data collected included patient’s demographics, place and nature of accident, damaged organ, educational level, transport and outcome. Data were ex-pressed as mean±standard deviation. Results: A total of 129 patients were included in this study, accounting for 0.3% of all trauma admission (40 273 cases. The mean age was (55.27±14.45 years. Men were affected four times more than women. Falling down from livestock is the main mechanism of trauma in all groups. Upper and lower extremities were most frequently injured (n=72, followed by the head, neck and spine (n=33 for each. There was one death resulting from livestock-related injury in this study. Conclusion: Despite the low incidence, livestock-re-lated injuries can damage major organs of human body and therefore appropriate training program to increase the safety awareness in home and outdoor is very important. Key words: Epidemiology; Livestock; Iran; Wounds and injuries

  3. Range dependent characteristics in the head-related transfer functions of a bat-head cast: part 1. Monaural characteristics

    International Nuclear Information System (INIS)

    Kim, S; Allen, R; Rowan, D

    2012-01-01

    Knowledge of biological sonar systems has revolutionized many aspects of sonar engineering and further advances will benefit from more detailed understanding of their underlying acoustical processes. The anatomically diverse, complex and dynamic heads and ears of bats are known to be important for echolocation although their range-dependent properties are not well understood, particularly across the wide frequency range of some bats' vocalizations. The aim of this and a companion paper Kim et al (2012 Bioinspir. Biomim.) is to investigate bat-head acoustics as a function of bat-target distance, based on measurements up to 100 kHz and more robust examination of hardware characteristics in measurements than previously reported, using a cast of a bat head. In this first paper, we consider the spectral features at either ear (i.e. monaural head-related transfer functions). The results show, for example, that there is both higher magnitude and a stronger effect of distance at close range at relatively low frequencies. This might explain, at least in part, why bats adopt a strategy of changing the frequency range of their vocalizations while approaching a target. There is also potential advantage in the design of bio-inspired receivers of using range-dependent HRTFs and utilizing their distinguished frequency characteristics over the distance. (paper)

  4. Fishing gear-related injury in California marine wildlife.

    Science.gov (United States)

    Dau, Brynie Kaplan; Gilardi, Kirsten V K; Gulland, Frances M; Higgins, Ali; Holcomb, Jay B; Leger, Judy St; Ziccardi, Michael H

    2009-04-01

    We reviewed medical records from select wildlife rehabilitation facilities in California to determine the prevalence of injury in California Brown Pelicans (Pelecanus occidentalis), gulls (Larus spp.), and pinniped species (Zalophus californianus, Mirounga angustirostris, and Phoca vitulina) due to fishing gear entanglement and ingestion from 2001 to 2006. Of 9,668 Brown Pelican, gull, and pinniped cases described during the 6-yr study period (2001-06), 1,090 (11.3%) were fishing gear-related. Pelican injuries caused by fishing gear were most common in the Monterey Bay region, where 59.6% of the pelicans rescued in this area and admitted to a rehabilitation center were injured by fishing gear over the 6-yr period. The highest prevalence of fishing gear-related injury in gulls was documented in the Los Angeles/Orange County region (16.1%), whereas the highest prevalences in pinnipeds were seen in the San Diego region (3.7%). Despite these higher prevalences of gull and pinniped fishing gear-related injuries in these specific regions, there was no statistical significance in these trends. Juvenile gulls and pinnipeds were more commonly injured by fishing gear than adults (gulls: P = 0.03, odds ratio = 1.29; pinnipeds: P = 0.01, odds ratio = 2.07). Male pinnipeds were twice as likely to be injured by fishing gear as females (P gear-related injury cases that were successfully rehabilitated and released (percentage of cases successfully rehabilitated to the point of release out of the total number of fishing gear-related injury cases) was high in all three species groups (pelicans: 63%; gulls: 54%; pinnipeds: 70%). Fishing gear-related injuries in Brown Pelicans and gulls were highest in the fall, but there was only a significant difference between seasons for fishing gear-related injuries in pelicans. Fishing gear-related injuries in pinnipeds most commonly occurred in summer; however, a statistical difference was not detected between seasons for pinnipeds. Derelict

  5. Head Impact Laboratory (HIL)

    Data.gov (United States)

    Federal Laboratory Consortium — The HIL uses testing devices to evaluate vehicle interior energy attenuating (EA) technologies for mitigating head injuries resulting from head impacts during mine/...

  6. Minor head injury in anticoagulated patients: a 6-year retrospective analysis in an emergency department

    Directory of Open Access Journals (Sweden)

    Alessandro Riccardi

    2014-05-01

    Full Text Available The appropriate management of minor head injury (MHI in patients receiving oral anticoagulant (OAC is unclear. In this retrospective study, we focused on elderly patients (>65 years treated with OAC, presented to our emergency department with MHI between 2004 and 2010. Three hundred and six patients with MHI were taking OAC: we documented 7.19% hemorrhages at the first computed tomography (C; 18.19% deaths; 50.1% spontaneous reabsorptions; 22.73% deteriorations of intracranial bleeding without surgical intervention (for clinical comorbidity, and 4.55% neurosurgical interventions. We documented a second positive CT scan in 2 patients (1.51% who had no symptoms and remained asymptomatic during observation. In both cases, intracranial bleeding resolved spontaneously. The mean international normalized ratio (INR value was 2.26, higher in the group of patients with bleeding (2.74 than in the group without bleeding (2.19. We found a significant increased risk in patients with posttraumatic loss of consciousness [odds ratio (OR 28.3], diffuse headache (OR 14.79, vomiting (OR 14.2 and neurological signs (OR 5.27. We did not reach significance in patients with post-traumatic amnesia. Our data confirm the need for a CT scan of any patients on OAC with MHI. None of our patients developed any symptoms or signs during observation, and only 2 patients developed an intracranial hemorrhage in the second CT scan with a favorable evolution. Our data need to be confirmed with an observational study, but we suggest that the second CT could be reserved for patients developing symptoms and signs during observation. We also underline the role of the INR in the stratification of risk.

  7. Progress in reducing road-related deaths and injuries in Irish children.

    LENUS (Irish Health Repository)

    Donnelly, J

    2012-04-01

    The aim was to study road-related injuries and fatalities in under 15 year olds in two time periods (1996-2000 and 2004-2008 inclusive) to assess whether progress has been made via cross-sectoral efforts to reduce this injury toll in Ireland. For pedestrian and car-related accidents, police assistance is required and at the time a detailed CT 68 form is completed by the attending officer and sent to the Road Safety Authority for analysis. Details re the severity of injury, light and road conditions and safety measures such as seat belt or car restraint use, seat position and helmet use if a cyclist were recorded. Injuries were sub-classified as fatalities, serious (detained in hospital, fractures, severe head injury, severe internal injuries or shock requiring treatment) or minor. All data for the two time periods was entered onto an SPSS database. A concerted national campaign re road safety media campaign allied to random breath testing, penalty points for driving offences, on the spot fines for speeding and far greater police enforcement took place between the two time frames and continues to this day. When looked at as most likely estimates of death ratios the results were found to be statistically significant with an overall p value of < 0.0001 CI [0.39, 0.69]. When broken down into specific age ranges all were significant apart from the 0-3 age range with a p value of 0.69 CI [0.26, 1.1]. The most significant changes were found in the 7-9 years, 10-12 and 13-15 year age ranges with p values of < 0.0001, 0.0002 and 0.0007 respectively. When results were compared between the two cohorts, car occupant fatalities between both groups dropped by 36%. Pedestrian injuries dropped from 1719 to 1232, pedestrian fatalities decreased by almost 50% as did serious pedestrian injuries from 261 down to 129. Cyclist fatalities saw the most significant fall (76%) with a dramatic reduction in cyclist injuries from 25 down to 6 (63%). The 13-15 year old age group had the highest

  8. Epidemiology of golf related musculo-skeletal injuries

    Directory of Open Access Journals (Sweden)

    Dhillon Mandeep

    2006-01-01

    Full Text Available Background : Golfing has become an increasingly popular sport enjoyed by both men and women. Although the game is not viewed as hazardous, golfers do sustain injuries connected with the game. However, golf injuries have received little attention in the literature and there is no study from Asia. Methods : A prospective study was undertaken to analyze the incidence, cause and type of injury among amateur golfers. Open ended questionnaires were sent to 1000 golfers; 240 responded (Av age 51 years, 200 males and 40 females. The respondents played an average of 2 rounds per week. Results : One hundered and ten (46% responders had sustained one or more orthopaedic injuries. Both among men and women, the lower back was the most common site of injury followed by shoulder and dorsal spine. There was a difference in the injury pattern in skilled and relatively unskilled players. Lack of warm up, excessive practice and improper swing mechanics were the most common causes. Conclusion : Golf injuries perhaps could be prevented or reduced by proper technique, controlled practice routines, physical conditioning and pre-play stretching exercises. The most important factor in this playing population seems to be prevention.

  9. Effect of built environment on tsunami related injuries

    Directory of Open Access Journals (Sweden)

    SD Dharmarathne

    2013-10-01

    Full Text Available Background Built environment is a major determinant in injuries and deaths during natural disasters. Purpose of the present paper was to study the effect of built environment on tsunami injuries.Methods A retrospective residential cohort was constructed one month after the tsunami, based on the cross sectional household survey. Household structure was categorised as a binary variable based on the definition used department of census and statistics for the census.Results The constructed cohort consisted of 4178 individuals, 2143 (51.3% males and 2034 (48.7% females from 1047 households. Mean age of the study sample was 25 years with a standard deviation of 17 years. Out of the 4178 study units studied, 43 (1.1% died during the acute incidence and 19(0.5% died later due to complications. Twenty eight (0.7% people were reported missing at the time of data collection. Moderate to severe injuries were reported by 508 individuals (12.5%. To investigate the injury incidence all tsunami related deaths, missing personals and injuries were classified in to a single group as injuries. Reported number of injuries were 302 (14.4%, and 296 (14.9% among males and females respectively. In multivariate analysis, living in a temporary shelter (OR=0.259, 95% CI 0.351-0.797 shown a protective effect on injuries whereas, residing within the 100 meter boundary from sea (OR 1.43, 95% CI 1.1-1.8 and destruction of house (OR 1.53 95% CI 1.14-2.07 were predictors of injuries.Conclusion Policies on building construction in coastal areas should be done considering these findings to mitigate the effect of future disasters.

  10. Range dependent characteristics in the head-related transfer functions of a bat-head cast: part 2. Binaural characteristics

    International Nuclear Information System (INIS)

    Kim, S; Allen, R; Rowan, D

    2012-01-01

    Further innovations in bio-inspired engineering based on biosonar systems, such as bats, may arise from more detailed understanding of the underlying acoustic processes. This includes the range-dependent properties of bat heads and ears, particularly at the higher frequencies of bat vocalizations. In a companion paper Kim et al (2012 Bioinspir. Biomim.), range-dependent head-related transfer functions of a bat head cast were investigated up to 100 kHz at either ear (i.e. monaural features). The current paper extends this to consider range-dependent spectral and temporal disparities between the two ears (i.e. binaural features), using experimental data and a spherical model of a bat head to provide insights into the physical basis for these features. It was found that binaural temporal and high-frequency binaural spectral features are approximately independent of distance, having the effect of decreasing their angular resolution at close range. In contrast, low-frequency binaural spectral features are strongly distance-dependent, such that angular sensitivity can be maintained by lowering the frequency of the echolocation emission at close range. Together with the companion paper Kim et al, we speculate that distance-dependent low-frequency monaural and binaural features at short range might help explain why some species of bats that drop the frequency of their calls on target approach while approaching a target. This also provides an impetus for the design of effective emissions in sonar engineering applied to similar tasks. (paper)

  11. What are the main risk factors for running-related injuries?

    Science.gov (United States)

    Saragiotto, Bruno Tirotti; Yamato, Tiê Parma; Hespanhol Junior, Luiz Carlos; Rainbow, Michael J; Davis, Irene S; Lopes, Alexandre Dias

    2014-08-01

    Despite several studies that have been conducted on running injuries, the risk factors for running-related injuries are still not clear in the literature. The aim of this study was to systematically review prospective cohort studies that investigated the risk factors for running injuries in general. We conducted electronic searches without restriction of language on EMBASE (1980 to Dec 2012), PUBMED (1946 to Dec 2012), CINAHL (1988 to Dec 2012) SPORTDiscus (1977 to Dec 2012), Latin American and Caribbean Centre on Health Sciences Information (1985 to Dec 2012) and Scientific Electronic Library Online (1998 to Dec 2012) databases, using subject headings, synonyms, relevant terms and variant spellings for each database. Only prospective cohort studies investigating the risk factors for running-related musculoskeletal injuries were included in this review. Two independent reviewers screened each article and, if they did not reach a consensus, a third reviewer decided whether or not the article should be included. Year of publication, type of runners, sample size, definition of running-related musculoskeletal injury, baseline characteristics, reported risk factors and the statistical measurement of risk or protection association were extracted from the articles. A scale adapted by the authors evaluated the risk of bias of the articles. A total of 11 articles were considered eligible in this systematic review. A total of 4,671 pooled participants were analysed and 60 different predictive factors were investigated. The main risk factor reported was previous injury (last 12 months), reported in 5 of the 8 studies that investigated previous injuries as a risk factor. Only one article met the criteria for random selection of the sample and only six articles included a follow-up of 6 months or more. There was no association between gender and running injuries in most of the studies. It is possible that eligible articles for this review were published in journals that were

  12. Higher education does not protect against firework-related injuries: a review of the economic burden and the risk factors of firework-related injuries in the capital of Iran.

    Science.gov (United States)

    Saadat, S; Mafi, M; Smith, G A

    2012-01-01

    To examine the incidence and risk factors of firework-related injuries during the Last Wednesday Eve Festival in Tehran, Iran, with a focus on the association of socio-economic status and educational level with the use of fireworks and the incidence of firework-related injury. Cross-sectional household survey. Using a random cluster sampling approach, a household survey was conducted in Greater Tehran in April 2008. During a structured interview with an adult member of the household, questions were asked about the use of fireworks and any firework-related injuries sustained by household members during the preceding festival. Data were gathered on expenditure on fireworks, medical treatment of firework-related injuries, length of hospital stay for the treatment of these injuries, and damage to personal property by fireworks. The survey included 2456 households in Greater Tehran. At least one member of 18% of these households had used fireworks during the Last Wednesday Eve Festival in 2008. The overall incidence of firework-related injuries was 100 per 100,000 population (95% confidence interval 37-163). The use of fireworks was less common among parents and more common among male children. Individuals who used fireworks were younger than non-users. Younger age and use of fireworks were associated with firework-related injuries (P fireworks was US$1.62. Among the households that had bought fireworks, the mean expenditure was US$9.40 (standard deviation US$16.34). Thirty-two households (1.3%) reported damage to personal property due to fireworks during the festival costing US$3.30-167.20. The regional price of housing in the study area was correlated with the educational level of the head of the household. Higher educational level of the head of the household was associated with participation in firework activities by household members, expenditure on fireworks, and the amount of financial loss due to fireworks (all P Fireworks are associated with serious injuries

  13. Civil engineering airman at increased risk for injuries and injury-related musculoskeletal disorders.

    Science.gov (United States)

    Webb, Timothy S; Wells, Timothy S

    2011-03-01

    With the advent of electronic records, the opportunity to conduct research on workplace-related injuries and musculoskeletal disorders has increased dramatically. The purpose of this study was to examine the United States Air Force Civil Engineering career field to determine if they are negatively impacted by their work environment. Specifically, the objective of this study was to determine if enlisted Civil Engineering Airmen (n = 25,385) were at increased risk for injury or injury-related musculoskeletal disorders compared to enlisted Information Management/Communications Airmen (n = 28,947). Using an historical prospective design, electronic data were assembled and analyzed using Cox's proportional hazards modeling. Models were stratified by gender and adjusted for race/ethnicity, marital status, birth year, and deployment status. Male Civil Engineers were observed to be at greater risk for both inpatient injury-related musculoskeletal disorders (HR = 1.86; 95% CI = 1.54-2.26) and injuries (HR = 1.77; 95% CI = 1.48-2.11), while female Civil Engineers were more than double the risk for both inpatient injury-related musculoskeletal disorders (HR = 2.18; 95% CI = 1.28-3.73) and injuries (HR = 2.22; 95% CI = 1.27-3.88) compared to Information Management/Communications Airmen. Although analyses do not allow exploration of specific causes, they highlight the utility of using electronic data to identify occupations for further evaluation. Based on these results, additional resources were allocated to survey Civil Engineers on their physical work demands and job requirements to identify key problem areas for further study and mitigation. Copyright © 2010 Wiley-Liss, Inc.

  14. Bicycling-related accidents and factors contributing to injury

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez Perez, L.M.; Wideberg, J.; Gonzalez Perez-Somarriba, B.

    2016-07-01

    Objective: This study was conducted to find the epidemiological characteristics of bicycling-related maxillofacial fractures in a defined population, and identify factors contributing to injury. Methodology: A prospective study was carried out involving patients presenting with maxillofacial fractures sustained in bicycling-related accidents. Results: Between 908 of all cycling accidents attending for medical treatment, 122 patients (13% of all cycling accidents) were admitted with facial fractures between 2007 and 2014. Male and female ratio was 2.6:1, and the mean age was 29.4 years (standard deviation: 12.8, range: 12-79 years). Causes of injury included collisions (63%) and accidental falls (37%). The fracture patterns seen were mandibular (49%), zygomatic (32%), orbital (13%), nasal (7%), maxillary (2%), and frontal (2%). Condylar fractures were the most common of the mandibular fractures (63%). The most frequently observed concomitant lesions were orthopedic injuries. Conclusions: Bicycling-related maxillofacial injuries are common and therefore important to identify in order to design a sustainable transport system and for units that provide assistance to traffic accident victims. Missed diagnosis or delayed treatment can lead to facial deformities and functional problems. Wearing protective helmets and the improvement of the helmets design is one aspect that would be of interest for the prevention of injuries. Keywords: Cycling; bicycle-related trauma; maxillofacial fractures; risk factors; helmets. (Author)

  15. Transfusion-related acute lung injury: a change of perspective

    NARCIS (Netherlands)

    Vlaar, A. P.; Schultz, M. J.; Juffermans, N. P.

    2009-01-01

    Two decades ago, transfusion-related acute lung injury (TRALI) was considered a rare complication of transfusion medicine. Nowadays, TRALI has emerged as the leading cause of transfusion-related mortality, presumably as a consequence of reaching international agreement on defining TRALI with

  16. A framework for the etiology of running-related injuries.

    Science.gov (United States)

    Bertelsen, M L; Hulme, A; Petersen, J; Brund, R K; Sørensen, H; Finch, C F; Parner, E T; Nielsen, R O

    2017-11-01

    The etiology of running-related injury is important to consider as the effectiveness of a given running-related injury prevention intervention is dependent on whether etiologic factors are readily modifiable and consistent with a biologically plausible causal mechanism. Therefore, the purpose of the present article was to present an evidence-informed conceptual framework outlining the multifactorial nature of running-related injury etiology. In the framework, four mutually exclusive parts are presented: (a) Structure-specific capacity when entering a running session; (b) structure-specific cumulative load per running session; (c) reduction in the structure-specific capacity during a running session; and (d) exceeding the structure-specific capacity. The framework can then be used to inform the design of future running-related injury prevention studies, including the formation of research questions and hypotheses, as well as the monitoring of participation-related and non-participation-related exposures. In addition, future research applications should focus on addressing how changes in one or more exposures influence the risk of running-related injury. This necessitates the investigation of how different factors affect the structure-specific load and/or the load capacity, and the dose-response relationship between running participation and injury risk. Ultimately, this direction allows researchers to move beyond traditional risk factor identification to produce research findings that are not only reliably reported in terms of the observed cause-effect association, but also translatable in practice. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. A Study of the Effect of the Front-End Styling of Sport Utility Vehicles on Pedestrian Head Injuries

    Directory of Open Access Journals (Sweden)

    Guanjun Zhang

    2018-01-01

    Full Text Available Background. The number of sport utility vehicles (SUVs on China market is continuously increasing. It is necessary to investigate the relationships between the front-end styling features of SUVs and head injuries at the styling design stage for improving the pedestrian protection performance and product development efficiency. Methods. Styling feature parameters were extracted from the SUV side contour line. And simplified finite element models were established based on the 78 SUV side contour lines. Pedestrian headform impact simulations were performed and validated. The head injury criterion of 15 ms (HIC15 at four wrap-around distances was obtained. A multiple linear regression analysis method was employed to describe the relationships between the styling feature parameters and the HIC15 at each impact point. Results. The relationship between the selected styling features and the HIC15 showed reasonable correlations, and the regression models and the selected independent variables showed statistical significance. Conclusions. The regression equations obtained by multiple linear regression can be used to assess the performance of SUV styling in protecting pedestrians’ heads and provide styling designers with technical guidance regarding their artistic creations.

  18. Pediatric sports-related traumatic brain injury in United States trauma centers.

    Science.gov (United States)

    Yue, John K; Winkler, Ethan A; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E

    2016-04-01

    OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the authors characterize the demographics of sports-related TBI in the pediatric population and identify predictors of prolonged hospitalization and of increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from children (age 0-17 years) across 5 sports categories: fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged length of stay (LOS) in the hospital or intensive care unit (ICU), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were recorded in the NTDB, and these injuries represented 11,614 incidents nationally after sample weighting. Fall or interpersonal contact events were the greatest contributors to sports-related TBI (47.4%). Mild TBI represented 87.1% of the injuries overall. Mean (± SEM) LOSs in the hospital and ICU were 2.68 ± 0.07 days and 2.73 ± 0.12 days, respectively. The overall mortality rate was 0.8%, and the prevalence of medical complications was 2.1% across all patients. Severities of head and extracranial injuries were significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Hypotension on admission to the ED was a significant predictor of failure to discharge to home (OR 0.05, 95% CI 0.03-0.07, p sports was independently associated with prolonged hospital LOS compared with FIC events (mean increase

  19. Continuous infusion of small-volume fluid resuscitation in the treatment of combined uncontrolled hemorrhagic shock and head injury

    International Nuclear Information System (INIS)

    Hayrettin, O.; Yagmur, Y.; Tas, A.; Topcu, S.; Orak, M.

    2007-01-01

    To determine the effect of continuous limited fluid resuscitation on the hemodynamic response and survival in rats in a model of uncontrolled hemorrhage shock due to Massive Splenic Injury (MSI) and Head Injury (HI). Seventy Sprague-Dawley rats were used in this study. Group 1 rats (n=10) was sham-operated. In group 2 (n=10), only Massive Splenic Injury (MSI) was performed and untreated. In group 3 (n=10), only head injury (HI) was performed and untreated. In group 4 (n=10), HI and MSI were performed and were untreated. In group 5 (n=10), HI and MSI were performed and 15 minutes later treated with 7.5% NaCl. In group 6 (n=10), HI and MSI were performed, and rats were treated with Ringer's Lactate (RL) solution. In group 7 (n=10), HI and MSI were performed, rats were treated with 0.9 % NaCl. In groups 2,4,5,6 and 7 midline incision was reopened and splenectomy was performed at 45 minutes. In group 4 rats, Mean Arterial Pressure (MAP) was decreased from 104 +- 6.1 mmHg to 75 +- 19.5 mmHg at 15 minutes; heart rate decreased from 357+- 24.9 beats/min to 321 +- 62.1 beats/min and hematocrit decreased from 46 +- 1.3 % to 43 +- 2.5 % (p<0.01). Similar early changes in MAP, heart rate and hematocrit were observed in groups 5, 6, and 7, at 15 minutes. At 45,60 and 120 minutes, in fluid resuscitated rats (group 5,6,7) MAP, heart rate and hematocrit values were measured higher than group 2 and 4 (p<0.01 for all). At 120 min. in group 6, hematocrit was higher than group 4, 5 and 7, in group 6, total blood loss after splenectomy was calculated at 20 +- 2.4% of blood volume and was the best value compared to other fluid resuscitated group 5 and 7 (28% and 27% of blood volume) (p<0.01). Mortality was lower in all fluid resuscitated groups when compared to group 3 and 4 (p< 0.05). The median survival time was again higher in fluid resuscitated groups. Continuous infusion of 7.5% NaCl, RL and 0.9 % NaCl following uncontrolled hemorrhagic shock with massive splenic injury and

  20. The first concussion crisis: head injury and evidence in early American football.

    Science.gov (United States)

    Harrison, Emily A

    2014-05-01

    In the early 21st century, sports concussion has become a prominent public health problem, popularly labeled "The Concussion Crisis." Football-related concussion contributes much of the epidemiological burden and inspires much of the public awareness. Though often cast as a recent phenomenon, the crisis in fact began more than a century ago, as concussions were identified among footballers in the game's first decades. This early concussion crisis subsided-allowing the problem to proliferate-because work was done by football's supporters to reshape public acceptance of risk. They appealed to an American culture that permitted violence, shifted attention to reforms addressing more visible injuries, and legitimized football within morally reputable institutions. Meanwhile, changing demands on the medical profession made practitioners reluctant to take a definitive stance. Drawing on scientific journals, public newspapers, and personal letters of players and coaches, this history of the early crisis raises critical questions about solutions being negotiated at present.

  1. Development and Validation of an Older Occupant Finite Element Model of a Mid-Sized Male for Investigation of Age-related Injury Risk.

    Science.gov (United States)

    Schoell, Samantha L; Weaver, Ashley A; Urban, Jillian E; Jones, Derek A; Stitzel, Joel D; Hwang, Eunjoo; Reed, Matthew P; Rupp, Jonathan D; Hu, Jingwen

    2015-11-01

    The aging population is a growing concern as the increased fragility and frailty of the elderly results in an elevated incidence of injury as well as an increased risk of mortality and morbidity. To assess elderly injury risk, age-specific computational models can be developed to directly calculate biomechanical metrics for injury. The first objective was to develop an older occupant Global Human Body Models Consortium (GHBMC) average male model (M50) representative of a 65 year old (YO) and to perform regional validation tests to investigate predicted fractures and injury severity with age. Development of the GHBMC M50 65 YO model involved implementing geometric, cortical thickness, and material property changes with age. Regional validation tests included a chest impact, a lateral impact, a shoulder impact, a thoracoabdominal impact, an abdominal bar impact, a pelvic impact, and a lateral sled test. The second objective was to investigate age-related injury risks by performing a frontal US NCAP simulation test with the GHBMC M50 65 YO and the GHBMC M50 v4.2 models. Simulation results were compared to the GHBMC M50 v4.2 to evaluate the effect of age on occupant response and risk for head injury, neck injury, thoracic injury, and lower extremity injury. Overall, the GHBMC M50 65 YO model predicted higher probabilities of AIS 3+ injury for the head and thorax.

  2. Three-dimensional biomimetic head model as a platform for thermal testing of protective goggles for prevention of eye injuries.

    Science.gov (United States)

    Friedman, Rinat; Haimy, Ayelet; Gefen, Amit; Epstein, Yoram

    2018-04-22

    The rate of eye injury is steadily rising during military conflicts of the century, with thermal burns being the most common type of injury to the eyes. The present study focuses on assessing the heat resistance properties of military protective goggles using three-dimensional (3D) finite element head modeling fitted with the tested protective gear. A computational thermal impact was applied onto a 3D biomimetic human head model fitted with two goggle models - sports (Type 1) and square (Type 2). The resultant temperature of the eye tissues and the thermal injury thresholds were calculated by using the modeling, hence allowing to determine the protective efficacy of the goggles objectively, in a standardized, quantitative and cost-effective manner. Both types of goggles had a dramatic protective effect on the eyes. The specific goggle geometry had no notable effect on the level of protection to the inner tissues against the thermal insult. At the skin level goggles reduced temperatures by ~64% under the impact zone, with only a mild difference (10 °C) between the goggles. Little limitations on the shape and geometry of goggles were observed and any structure of goggles can provide an adequate protection against a thermal insult (per se) to inner cranial tissues, assuming the lenses are wide and thick enough to block direct skin contact of the heat insult. It was shown that our 3D biomimetic human head model provides a practical and cost-effective tool for determining the performance level of goggles with different attributed (i.e., shapes and thermal properties). Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Swedish dairy farmers' perceptions of animal-related injuries.

    Science.gov (United States)

    Lindahl, Cecilia; Lundqvist, Peter; Norberg, Annika Lindahl

    2012-01-01

    Animal-related injuries are among the most common occupational injuries in agriculture. Despite the large number of documented animal-related injuries in dairy farming, the issue has received relatively limited attention in the scientific literature. The farmers' own perspectives and views on risks and safety during livestock handling and what they think are effective ways of preventing injuries are valuable for the future design of effective interventions. This paper presents results from a qualitative study with the aim to investigate Swedish dairy farmers' own experience of animal-related occupational injuries, as well as their perceptions of and attitudes towards them, including risk and safety issues, and prevention measures. A total of 12 dairy farmers with loose housing systems participated in the study. Data collection was conducted by means of semistructured in-depth interviews. Three main themes with an impact on risks and safety when handling cattle were identified: the handler, the cattle, and the facilities. They all interact with each other, influencing the potential risks of any work task. Most of the farmers believed that a majority of the injuries can be prevented, but there are always some incidents that are impossible to foresee. In conclusion, this study indicates that Swedish dairy farmers are aware of the dangers from working with cattle. However, even though safety is acknowledged by the farmers as an important and relevant issue, in the end safety is often forgotten or not prioritized. One concern is that farmers are willing to take calculated risks to save money or time. In situations where they work alone with high stress levels and under economic distress, safety issues are easily given low priority.

  4. Effect of midazolam versus propofol sedation on markers of neurological injury and outcome after isolated severe head injury: a pilot study.

    LENUS (Irish Health Repository)

    Ghori, Kamran A

    2012-02-03

    BACKGROUND: Midazolam and propofol are sedative agents commonly administered to patients with brain injury. We compared plasma concentrations of glial cell S100beta protein and nitric oxide (NO) between patients who received midazolam and those who received propofol sedation after severe brain injury, and investigated the association between S100beta and NO concentrations and neurological outcome. DESIGN: 28 patients with severe head injury (Glasgow Coma Score <9) who required sedation and ventilation were randomly assigned to receive midazolam (n =15) or propofol (n = 13) based sedation. Blood samples were drawn daily for 5 days for estimation of S100beta and NO concentrations. Neurological outcome was assessed 3 months later as good (Glasgow Outcome Score [GOS], 4-5) or poor (GOS, 1-3). RESULTS: A good neurological outcome was observed in 8\\/15 patients (53%) in the midazolam group and 7\\/13 patients (54%) in the propofol group. Patients with a poor outcome had higher serum S100beta concentrations on ICU admission and on Days 1-4 in the ICU than those with a good outcome (mean [SD] on Day 1, 0.99 [0.81] v 0.41 [0.4] microg\\/L; Day 2, 0.80 [0.81] v 0.41 [0.24] microg\\/L; Day 3, 0.52 [0.55] v 0.24 [0.25] microg\\/L; and Day 4, 0.54 [0.43] v 0.24 [0.35] microg\\/L; P<0.05). There was no significant difference on Day 5. Plasma NO concentrations were not associated with outcome. In subgroup analysis, there was no difference in S100beta and NO concentrations between patients with a good outcome versus those with a poor outcome in either the midazolam or propofol group. CONCLUSIONS: Plasma concentrations of markers of neurological injury in patients with severe head injury were similar in those who received midazolam sedation and those who received propofol. Patients who had a poor neurological outcome at 3 months had consistently higher serum S100beta concentrations during the initial 4 days after injury than patients who had a good outcome.

  5. Current controversies in the interpretation of non-accidental head injury

    International Nuclear Information System (INIS)

    Jaspan, Tim

    The field of non-accidental injury (NAI) has been the subject of a number of theories and hypotheses of variable merit. Concerning injuries that occur within the intracranial compartment, much research has been undertaken to investigate the cause of SDH and parenchymal brain injury. Much, however, remains contentious, particularly regarding the medicolegal aspects of suspected child abuse. Issues that present the greatest challenges will be addressed. (orig.)

  6. Current controversies in the interpretation of non-accidental head injury

    Energy Technology Data Exchange (ETDEWEB)

    Jaspan, Tim [Imaging Centre, University Hospital, Nottingham (United Kingdom)

    2008-06-15

    The field of non-accidental injury (NAI) has been the subject of a number of theories and hypotheses of variable merit. Concerning injuries that occur within the intracranial compartment, much research has been undertaken to investigate the cause of SDH and parenchymal brain injury. Much, however, remains contentious, particularly regarding the medicolegal aspects of suspected child abuse. Issues that present the greatest challenges will be addressed. (orig.)

  7. Implementation of adapted PECARN decision rule for children with minor head injury in the pediatric emergency department.

    Science.gov (United States)

    Bressan, Silvia; Romanato, Sabrina; Mion, Teresa; Zanconato, Stefania; Da Dalt, Liviana

    2012-07-01

    Of the currently published clinical decision rules for the management of minor head injury (MHI) in children, the Pediatric Emergency Care Applied Research Network (PECARN) rule, derived and validated in a large multicenter prospective study cohort, with high methodologic standards, appears to be the best clinical decision rule to accurately identify children at very low risk of clinically important traumatic brain injuries (ciTBI) in the pediatric emergency department (PED). This study describes the implementation of an adapted version of the PECARN rule in a tertiary care academic PED in Italy and evaluates implementation success, in terms of medical staff adherence and satisfaction, as well as its effects on clinical practice. The adapted PECARN decision rule algorithms for children (one for those younger than 2 years and one for those older than 2 years) were actively implemented in the PED of Padova, Italy, for a 6-month testing period. Adherence and satisfaction of medical staff to the new rule were calculated. Data from 356 visits for MHI during PECARN rule implementation and those of 288 patients attending the PED for MHI in the previous 6 months were compared for changes in computed tomography (CT) scan rate, ciTBI rate (defined as death, neurosurgery, intubation for longer than 24 hours, or hospital admission at least for two nights associated with TBI) and return visits for symptoms or signs potentially related