Blunt Head Research Articles

Virtual Reality for Pediatric Trauma Education - A Preliminary Face and Content Validation Study

PurposePediatric trauma education remains expensive and available only to a few providers worldwide. Innovative educational technologies like virtual reality (VR) can be key to decentralizing trauma education. This preliminary validation study evaluates the face and content validity of a VR software designed to enhance pediatric trauma skills. MethodsPhysicians were invited to test a VR software simulating a child with blunt head and truncal trauma. After the simulation, they filled out surveys assessing the face and content validity of the scenario, including the software's realism, interaction, ease of use, and educational content. Additionally, they completed a cybersickness questionnaire. A descriptive statistical analysis was performed. ResultsEleven physicians from eight different countries tested the VR software. Most found it valuable, and realistic and would prefer using it over high-fidelity mannequins for training. The software received more favorable evaluations for non-technical skills training than for technical skills. Regarding cybersickness most participants reported discomfort during the simulation. ConclusionParticipants agreed that a VR platform for pediatric trauma is realistic and immersive, and they endorsed it for enhancing performance, particularly in non-technical skills. Most participants, however, faced some discomfort with the technology, and efforts to minimize cybersickness should be made in future implementation, feasibility, and effectiveness studies. Level of EvidenceIV.

Isolated internal carotid artery dissection after a motorcycle accident: A case report

Extra cranial carotid artery dissection is one of the most important complications associated with blunt head and neck trauma. It is a major cause of ischemic stroke in young adults. We report a case of internal carotid artery dissection which caused transient hemiparesis, horizontal gaze to right and anisocoria in a 19-year-old male motorcyclist involved in a collision. Unenhanced brain computed tomography scan showed well defined infarction in the right frontotemporoparietal area. Digital subtraction angiography showed complete occlusion of the proximal cervical right internal carotid artery. Moreover, intimal dissection was observed in distal cervical left internal carotid artery which did not limit blood flow to the brain. A stent was placed at the site of dissection in the left internal carotid artery. Intravenous heparin was commenced to avoid further thrombosis. He was discharged home 40 days after the accident with oral anticoagulation. Extra cranial carotid artery dissection is a rare condition which may happen after a non-significant neck trauma. Accordingly, the diagnosis of a cervical vascular dissection requires strong clinical suspicion

Head Scarf Pin in the Airway and Challenges in Rigid Bronchoscopy: A Case Series.

Accidental Foreign body aspiration, especially sharp metallic objects may lead to life threatening complications. A metallic object is identified readily on a Xray chest or CT chest and helps us in ascertaining its location. A straight pin with blunt head in the shape of pearl is used in wearing a head scarf also known as hijab to hold it in place. The head scarf pin (hijab pin) if accidentally aspirated into the airway may lead to grave complications. Hence timely intervention with suitable instrumentation is essential to prevent any lethal complications. We have reported four different cases of adolescent females who had accidentally aspirated hijab pin and challenges faced by us during removal.

Risk factors for thromboembolic complications in isolated severe head injury

PurposePatients with traumatic brain injury (TBI) are at high risk for venous thromboembolism (VTE). The aim of the present study is to identify factors independently associated with VTE events. Specifically, we hypothesized that the mechanism of penetrating head trauma might be an independent factor associated with increased VTE events when compared with blunt head trauma.MethodsThe ACS-TQIP database (2013–2019) was queried for all patients with isolated severe head injuries (AIS 3–5) who received VTE prophylaxis with either unfractionated heparin or low-molecular-weight heparin. Transfers, patients who died within 72 h and those with a hospital length of stay < 48 h were excluded. Multivariable analysis was used as the primary analysis to identify independent risk factors for VTE in isolated severe TBI.ResultsA total of 75,570 patients were included in the study, 71,593 (94.7%) with blunt and 3977 (5.3%) with penetrating isolated TBI. Penetrating trauma mechanism (OR 1.49, CI 95% 1.26–1.77), increasing age (age 16–45: reference; age > 45–65: OR 1.65, CI 95% 1.48–1.85; age > 65–75: OR 1.71, CI 95% 1.45–2.02; age > 75: OR 1.73, CI 95% 1.44–2.07), male gender (OR 1.53, CI 95% 1.36–1.72), obesity (OR 1.35, CI 95% 1.22–1.51), tachycardia (OR 1.31, CI 95% 1.13–1.51), increasing head AIS (AIS 3: reference; AIS 4: OR 1.52, CI 95% 1.35–1.72; AIS 5: OR 1.76, CI 95% 1.54–2.01), associated moderate injuries (AIS = 2) of the abdomen (OR 1.31, CI 95% 1.04–1.66), spine (OR 1.35, CI 95% 1.19–1.53), upper extremity (OR 1.16, CI 95% 1.02–1.31), lower extremity (OR 1.46, CI 95% 1.26–1.68), craniectomy/craniotomy or ICP monitoring (OR 2.96, CI 95% 2.65–3.31) and pre-existing hypertension (OR 1.18, CI 95% 1.05–1.32) were identified as independent risk factors for VTE complications in isolated severe head injury. Increasing GCS (OR 0.93, CI 95% 0.92–0.94), early VTE prophylaxis (OR 0.48, CI 95% 0.39–0.60) and LMWH compared to heparin (OR 0.74, CI 95% 0.68–0.82) were identified as protective factors for VTE complications.ConclusionThe identified factors independently associated with VTE events in isolated severe TBI need to be considered in VTE prevention measures. In penetrating TBI, an even more aggressive VTE prophylaxis management may be justified as compared to that in blunt.

A review of the endoparasitic isopods (Epicaridea: Entoniscidae) from hermit crabs, including description of the new subfamily Diogenioninae and a new species of Paguritherium Reinhard, 1945 from the Philippines.

Entoniscid isopods (Entoniscidae) are obligate endoparasites of other crustacean species. They have an indirect lifestyle, usually with two hosts and multiple larval stages; as adults they are found living within decapod hosts. Hermit crabs were previously known to be definitive hosts of only two species of entoniscid parasites: Paguritherium alatum, from the east coast of the United States in Pagurus spp. and Diogenion vermifactus from the Red Sea in Diogenes senex. Little beyond the original descriptions of these species has been reported in the literature. Recently, two species of entoniscids were found parasitizing hermit crabs (mostly Calcinus spp.) collected from shallow water coral reef areas in the Philippines. The goal of this study was to describe the morphology of both the adult and larval stages of these entoniscids through light and scanning electron microscopy and compare them to the previously described species that infest hermit crabs. One of these entoniscids is tentatively identified as D. vermifactus, which infested 0.95% (5 of 527) of the hermit crabs sampled. All specimens of D. cf. vermifactus were found in the abdomens of specimens of Calcinus gaimardii, C. minutus, C. pulcher and Pagurojacquesia polymorpha. Examination of D. vermifactus shows that this taxon belongs in its own subfamily: Diogenioninae n. subfam. The second entoniscid is a new species of the genus Paguritherium and infested 0.94% (7 of 744) of the hermit crabs (C. gaimardii and C. latens) sampled. Females of P. manggagaway n. sp. are characterized by a highly vaulted head, a slender body and long pleopods and males by a blunt head and stump-like pereopods covered in scales; the new species can be distinguished from P. alatum based on the specialized fan-like setae on the first five pereopods of the epicaridium larvae. A key to all entoniscid genera is provided.

Analisis Panjang Bobot dan Faktor Kondisi Ikan Lidah (Cynoglossus lingua) di Sungai Berombang Kabupaten Labuhanbatu

Tongue Fish (C. lingua) is a fish that has a flat body like a tongue, has a non-bilateral symmetrical body, a blunt head, and belongs to the family Cynoglossidae. Tongue fish (C. lingua) usually lives on the bottom of muddy waters or mud mixed with sand and in river estuaries. The purpose of this study was to obtain related information about the analysis of the length and weight of the Tongue Fish (C. lingua) in the Berombang River, Panai Hilir District, Labuhanbatu Regency. This research lasted for 3 months, starting from October-December 2021. The sampling location was based on information from local fishermen. Fish samples were taken using nets, starting at 08.00 WIB - 16.00 WIB. The analysis carried out is the biological aspect of the relationship between length and weight of fish using a linear allometric model (LAM), while the ecological aspect that is measured is the condition factor using the K Fulton equation and the relative weight equation (Wr). In this study, 60 samples of Tongue Fish (C. lingua) were caught, with different lengths and weights. Where the total length ranges from 195-370 mm, with the total length of the dominant tongue fish on average 250 mm. While the weight of the Tongue Fish (C. lingua) ranged from 30-213 grams, and had an average dominant weight of 87 grams. The results of the long-weight relationship explained that the growth of the Tongue Fish (C. lingua) was positive allometric with the b value obtained, namely b &gt; = 3, which was 3.3226.

Mob justice fatalities in South Africa: a forensic mortuary study.

Mob justice fatalities are a gross violation of human rights as they represent extra-legal punishment. There is a paucity of research relating to the demographics of at-risk groups, nature of injuries and the impact to the Forensic Pathology Service at national and provincial levels. This was a retrospective study over 10years (1 April 2006 to 31 March 2016) at Germiston Forensic Pathology Service Medico-legal Mortuary. The objectives were to describe the demographics of the victims of fatal mob justice, describe the trends of the number of fatalities and causes of death over time, assess hospitalization frequency, describe the nature and location of injuries sustained, and to report on ancillary investigations performed. A total of 354 cases were analyzed. All victims were Black (100%), with 99.4% of the sample group being male. The largest proportion was aged between 21-30years (49.2%) with the majority having South African citizenship (68.9%). The majority of deaths were due to blunt force injuries (92.4%) with blunt force head injury being the most prevalent (79.9%). Half of the victims died on the scene (50.6%; n = 175). Hospitalization occurred in 49.4% (n = 175) of cases, of which, 56.3% died within 24h of hospital admittance. Ancillary tests were ordered in 22.6% of cases. Adequate resources should be distributed to appropriate departments to engage with and monitor communities in high incidence areas to curb these killings.

Rudimentary Caudal Peduncle in Bagarius Bagarius (Ham.-Buch.) and Blunt Head, Rudimentary Snout and Abnormal Mouth in Labeo Dero (Ham.-Buch.) From River Tawi, Jammu, J&amp;K UT, India

Rudimentary Caudal Peduncle in Bagarius Bagarius (Ham.-Buch.) and Blunt Head, Rudimentary Snout and Abnormal Mouth in Labeo Dero (Ham.-Buch.) From River Tawi, Jammu, J&amp;K UT, India

Use of Triaging Algorithms to Decrease CT Use Following Blunt Head and Neck Trauma

Use of Triaging Algorithms to Decrease CT Use Following Blunt Head and Neck Trauma

Traumatic rupture of the circle of Willis with closed head injury: Its pathology and possible pathogenesis

Massive and fatal subarachnoid hemorrhage (SAH) with an injury on the circle of Willis may be caused by blunt force to the head; however, it is extremely rare, and the precise mechanism of arterial rupture remains unclear. We investigated the clinicopathologic appearance of four rare autopsy cases of massive SAH associated with the rupture of the circle of Willis. All four cases were men aged 17–75 years who presented with a loss of consciousness within a short interval after the injury. Autopsy revealed that the rupture site was located in the vertebral artery in two cases and in the anterior cerebral artery (ACA) in two cases. During our literature review, we found no previous report on traumatic ACA rupture. Based on the correlation of the autopsy findings and the circumstance of injury, we determined that the accidental excessive stretching of the selected artery by neck anteflexion or rotation after a blunt trauma to the posterior head might have caused this rare lethal injury. These cases demonstrated the diversity of the traumatic rupture site of the circle of Willis after a blunt head and/or neck injury. The topographical features of the circle of Willis, particularly in correlation with the surrounding tissue, might account for the occurrence and site of these rare injuries.

Beer stein blast to the head a rare case of combined blunt and sharp force trauma

Cases of combined blunt and sharp force trauma to the head caused by one striking tool are rare. When beer steins are used as an assault weapon, they can cause blunt traumas upon initial contact phase. If the impact force exceeds the mechanical stability of the beer stein, it breaks into several sharp-edged pieces, which then can cause sharp force trauma injuries due to the interaction between the head and the stein fragments.We present a case of a 43-year old man, who suffered from blunt and sharp force head traumas due to one single blow with a 1-l beer stein. A forensic-biomechanical analysis of the event, together with witness testimony evaluation and experimental comparison helped to reconstruct the most probable chain of events. Based on these findings as well as on the medical diagnoses and treatment, the assault was assessed as a nonacute life-threatening, but potentially fatal offence. The case was indicted as grievous bodily harm.

Clinical outcome of paediatric patients with traumatic brain injury (TBI) receiving 3% hypertonic saline (HTS) in the emergency room of a tertiary care hospital.

To determine the clinical outcome and mean length of hospital stay of paediatric patients with severe blunt traumatic head injury (THI) receiving 3% hypertonic saline (HTS) in the Emergency Department (ED). This case series study was conducted at the Department of Emergency Medicine, Aga Khan University Hospital, Karachi, from 2014 to 2015 via chart review of 105 patients. Detailed history and clinical examination of all paediatric patients aged 2-16 years was recorded which included moderate to severe head injury as classified by the Glasgow Coma Scale (GCS) by the Brain Trauma Foundation. As per routine care after admission of such a patient, for resuscitation 3% HTS was administered. GCS was recorded at 6 hours and at the time of discharge. Of the 105 patients, 76 (72.4%) were male and 29 (27.6%) were female, and the mean age was 61.6+45.9 months. Traumatic brain injury (TBI) was found moderate in 60 (57.1%) cases and severe in 45 (42.9%) of our patients as per the GCS. Six hours after resuscitation with 3% hypertonic saline, 45 (43%) patients normalised as per GCS, 39 (37%) patients had moderate TBI and 21 (20%) had severe TBI. Forty five patients had a hospital stay of 2-3 days. The GCS improved after resuscitation with 3% hypertonic saline in emergency department, with a mean length of stay of 4.6+3.9 and 12.6+10.7 days in moderate and severe head injury respectively with a P value of <0.001, and was normal in 94 (89.5%) patients at the time of discharge. Paediatric patients with TBI receiving 3% hypertonic saline results in improved GCS and a decrease in the length of hospital stay.

Cricetus cricetus (Rodentia: Cricetidae)

AbstractCricetus cricetus (Linnaeus, 1758) is a medium-sized cricetid commonly called the common hamster. A sexually dimorphic rodent of unique coloration with robust body, blunt head, short legs, and rudimentary tail, it is the largest hamster and the only species in the genus Cricetus. It is easily recognizable by a color pattern of contrasting dark and light areas. Because its distribution extends from northwestern Europe to eastern China across 5,500 km of low altitude agricultural land, steppe, and forest steppe, the frequently used term European hamster is misleading. Both geographic range and relative abundance started declining in the 1960s on the western edge of its distribution, and now C. cricetus is protected by the Bern Convention and the Fauna-Flora-Habitats Directives.

Study on the performance of inflatable decelerator under hypersonic aerodynamic load

In order to understand the influence of hypersonic aerodynamic force and aerodynamic heat on the performance of flexible structure of inflatable decelerator, a unidirectional thermal-fluid-structure three field coupling model under the extreme conditions of reentry trajectory is established in this paper. The temperature distribution of thermal protection structure (TPS) and structure response are obtained. The numerical results show that the TPS has a good insulation effect, and the cooling contribution of insulation layer in TPS is up to 80.90%. The stress is concentrated at the contact position between the flexible structure and the blunt head. The stress of TPS layer fluctuates greatly.

Dirofilaria hongkongensis - A first report of potential zoonotic dirofilariosis infection in dogs from Tamil Nadu.

Dirofilariosisis, is a mosquito borne anthropo-zoonotic disease caused by the filarial nematodes of the genus Dirofilaria. The current paper reports a species of Dirofilaria, which has not been recorded in Tamil Nadu, in addition to differentiating it from the existing species of Dirofilaria spp. through morphological and molecular techniques. Micrometry of the microfilaria detected by Knott's technique as well as in Giemsa stained blood smears revealed that the length was on an average 280 μm to 310 μm whereas the width was 5 to 8 μm. The microfilariae were unsheathed with blunt heads and tapering tails. For molecular confirmation, the blood sample was subjected to genomic DNA isolation. PCR amplification using specific primers for D. hongkongensis was carried out using thermal cycler with the isolated genomic DNA as template. Molecular analyses revealed the band size of about 230 bp which confirmed the presence of D. hongkongensis. Phylogenetic analysis was done using UPGMA and MLM method. Dirofilaria is recognized as a zoonotic entity throughout the world, and dirofilariasis should be considered an emerging zoonosis in southern India. The control of ubiquitous mosquito population is essential to prevent the transmission of microfilaria from animals to arthropods and from arthropods to humans.

Skull Fracture and Haemorrhagic Pattern in Cases of Fatal Blunt Trauma Head Injury Autopsied at Tertiary Healthcare Centre in Eastern Nepal

Background: Head injury is regarded as a main health problem that is a common cause of morbidities and mortalities and makes great demand to control and prevent it. For this, policy makers need to see the pattern of head injury and this study is done to describe the pattern.Methods: Hospital based, descriptive cross sectional study done on one year autopsy cases of fatal blunt trauma head injury which was 76 in which proportion of different types of head injuries, their causes and their distribution as per age, sex, and duration of survival were studied.Results: Skull-vault fractures were present in 57 (75%) cases in which most common type of fracture was linear fracture constituting 29(49.12%). 50% of the cases were with skullbase fracture in which the most common was of anterior cranial fossa fracture(60.5%). 56.34% of the victims were with subarachnoid haemorrhage (SAH) followed by subdural haemorrhage (SDH) and extradural haemorrhage (EDH). 6.6% victims were without any intracranial haemorrhage. Road traffic accident alone accounted for 71% of total blunt trauma causations of this fatal head injury. 70% cases were in age group from 11 to 50 years and 78.9% were male. 51.3% died at the spot. Conclusions: The research findings have shown that among the fatal blunt trauma head injury cases, skull vault fracture was present in 75% and skull base fracture was present in 50%. The most common intracranial haemorrhage was subarachnoid haemorrhage (56.34%) followed by subdural and extradural haemorrhage. Med Phoenix. Vol. 3, Issue. 1, 2018, Page: 71-74

Case Report of Multiple Bilobar Hepatic Arterio-Portal Fistulas Post–Liver Transplantation Managed Conservatively

Multiple intrahepatic arterio-portal fistulas are rare. The majority are isolated and occur secondary to liver trauma including iatrogenic interventions such as liver biopsy. Post–liver transplantation 18 cases have been reported, all secondary to an interventional radiological procedure. We report multiple bi-lobar arterio-portal fistulas in a liver transplant recipient recognized 1 year after transplantation. The donor died due to intracerebral bleeding following blunt head and abdominal trauma. In the present case, the etiology is not very clear. The patient was managed conservatively and to date has not required intervention.

Unexpected complications following an occupational injury

Experts in forensic medicine are often requested to give an opinion on bodily damage resulting at work. General hazards in a work environment include electricity, fire, inflammable gases, high pressure gases and liquids, powerful or sharp moving machinery and fall. When an occupational trauma is complicated with an unexpected sequelae the forensic pathologist is in a dilemma. We report a workman who was brought following blunt head and chest trauma complicated with a facial palsy and lobar pneumonia. Case study A 53 year old security officer was brought to the hospital following improperly fixed gate falling on to him while at work. He was recruited by the security company two months back and was appointed to this place without informing the condition of the gate. History revealed that he was unconscious for a few minutes and remained to have dizziness and vertigo. Next day he developed profound left lower motor neurone facial nerve palsy. He had fractures of the right petrous temporal bone, and a left scapula. Two weeks later he developed shortness of breath and fever, which was diagnosed as left sided lobar pneumonia. Conclusion Fracture of the bones and the facial nerve damage could be easily categorized as grievous injuries. Chest trauma may result in localized pulmonary contusion which can be complicated as an infection presenting late. The appreciation of the association between the infection and initial injury needs thorough scientific basis since the category of hurt is crucial in formation of medico legal opinion.

Design and Analysis of Secondary Spike on Blunt Head

The present paper investigates the heat flux and drag reduction techniques on a hypersonic re-entry vehicle. Many researchers have reported a reduction in these parameters by the introduction of an aero spike at the stagnation point of the blunt head of a re-entry vehicle. The effect of introducing a secondary surface (called the secondary spike), along with the aero spike, on the blunt head is discussed in this work. The study has been carried out by varying the location of the secondary spike with respect to the axis of the vehicle for a set of free stream conditions. Also, the effect of variation in free stream conditions on a re-entry vehicle with a primary and secondary spike has been investigated. It has been observed that some configurations work well for some free stream conditions but fail in comparison to a single spiked body for some other conditions.

Homicides in Samoa – a five-year study

A retrospective review of homicide cases was undertaken from the mortuary records at the National Hospital in Apia, Samoa, over a five-year period from June 2011 to May 2016. Thirty-three cases were found consisting of 27 males and six females (one with gender not specified; M:F = 4.5:1) with an age range of 19 to 61 years, average 34.1 years (males – 19–57 years, average 33.8 years; females 23–61 years, average 35.0 years). This gave an approximate rate of 3.5 homicides/100,000 people/year. The cases consisted of deaths due to blunt force head trauma: N = 21 (63.6%; two with drowning); sharp force trauma: N = 8 (24.2%; four stab wounds, four chop/machete wounds); gunshot wounds: N = 2 (6.1%); and neck compression: N = 2 (6.1%). This study has demonstrated a particularly high number of deaths due to blunt force trauma and a relatively low number of firearm-related deaths in Samoa in recent years.