Cases Of Craniocerebral Injury Research Articles

Application of channel screw combined with skin-stretching technique in treatment of pelvic fracture with severe Morel-Lavallée lesion

To investigate the effectiveness of channel screw combined with skin-stretching technique in treatment of pelvic fracture with severe Morel-Lavallée lesion. Between January 2017 and May 2020, 11 patients with pelvic fractures complicated with severe Morel-Lavallée lesions were treated with channel screw combined with skin-stretching technique. There were 8 males and 3 females, with an average age of 39.2 years (range, 28-58 years). Causes of injury included traffic accident in 9 cases and falling from hight in 2 cases. The time from injury to hospital admission ranged from 1 to 6 days (mean, 3.7 days). According to the Tile classification, the pelvic fractures were rated as type C1 in 7 cases, type C2 in 3 cases, and type C3 in 1 case. The sites of Morel-Lavallée lesions were buttocks in 8 cases, hips in 2 cases, and thigh in 1 case. There was 1 case of rectal injury, 1 case of splenic rupture, 3 cases of craniocerebral injury, 2 cases of chest injury, 4 cases of spinal fracture, and 6 cases of sacral nerve injury. X-ray films were performed to observe reduction and healing of fracture. The quality of fracture reduction was evaluated by Matta standard at 1 week after operation. Wound healing and complications were observed. Majeed scoring was used to evaluate hip function and Gibbons sacral nerve injury grading was used to evaluate neurological function recovery. The patients underwent 4-7 operations, with an average of 5.8 operations. The time of first operation (pelvic fracture fixation, debridement, and skin distractor installation) was 115-275 minutes, with an average of 186.5 minutes. The amount of intraoperative blood loss was 30-80 mL, with an average of 45.5 mL. All patients were followed up 6-12 months, with an average of 8.3 months. The quality of fracture reduction according to the Matta standard was excellent in 7 cases, good in 2 cases, and fair in 2 cases, with an excellent and good rate of 81.8%. All fractures healed at 3-6 months after operation, with an average of 4.5 months. At last follow-up, the hip functions were excellent in 7 cases and good in 4 cases according to Majeed scoring, with an excellent and good rate of 100%. Among the 6 patients complicated with sacral nerve injury, the Gibbons sacral nerve injury grading reached gradeⅠ for 4 cases, gradeⅡ for 1 case, and grade Ⅲ for 1 case. The wounds of 9 cases were sutured directly after skin-stretching treatment for 25-32 days, with an average of 28 days. The dermal edge necrosis occurred in 1 case, and the defect was repaired by free skin grafting. The skin superficial dry necrosis of the wound occurred in 1 case, and healed by dressing change. In the treatment of pelvic fracture complicated with severe Morel-Lavallée lesion, the channel screw and skin-stretching technique showed their own advantages, which can obtain early fracture fixation and good wound healing.

Clinical application of mobile CT in neurosurgical disorders

Objective To summarize the diagnostic efficiency, application value and safety of CereTom 8-layer mobile CT in neurosurgery. Methods This study retrospectively analyzed the number of cases, number of examinations, location and mode of CereTom's 8-layer mobile CT head bedside scan from August 2010 to July 2017 at Affiliated Bayi Brain Hospital, PLA Army General Hospital. We analyzed the characteristics of brain disorders, diagnostic efficiency and radiation doses. Results (1) Number and pattern of mobile CT examinations: A total of 78, 771 head scans were performed in 49, 068 patients including 44, 433 at outpatient emergency rooms, 4, 549 at ICU (intensive care unit) and 86 at operating rooms. Those consisted of 48, 905 plain scans and 163 enhanced scans, some of which were for 115 cases of intracranial aneurysms with three-dimensional CT angiography. (2) Types of disorders: There were 13, 516 cases of craniocerebral injury and 21, 665 cases of cerebrovascular disorders (including 10, 594 cases of cerebral infarction, 5, 045 cases of cerebral hemorrhage, 6, 026 cases of subarachnoid hemorrhage), 2, 450 cases of brain tumor, 115 cases of intracranial aneurysm, 1, 795 cases of others such as trigeminal neuralgia, hemifacial spasm and skull base depression. There were 37, 160(75.73%) patients with mild to moderate disorders and 11, 908 patients (24.27%) with severe conditions. (3) Diagnostic efficiency: The total positive rate of mobile CT scan was 80.35% (39, 426/49, 068) and positive rate of mobile CT examination at ICU and operating room was 100%. (4) Radiation dose: The volumetric dose index of mobile CT was (76.03±1.54) mGy, the absorbed dose was (8.26±0.50) mSv, and the radiation dose was (82.54±3.13) mGy, which were significantly higher than those of large fixed CT [(63.52±3.72)mGy, (5.46±0.72)mSv, (71.09±2.98)mGy, respectively, P<0.05)]. However, the radiation dose values of mobile CT were within the scope of international radiation standards. Conclusion The volume of mobile CT is small, which is convenient for bedside scan. Its imaging quality is stable with high diagnostic efficiency as well as safety and reliability. Key words: Neurosurgery; Mobile CT; Radiation dosage; Image quality; Safety

G6PC3, ALDOA and CS induction accompanies mir-122 down-regulation in the mechanical asphyxia and can serve as hypoxia biomarkers.

Hypoxia influences different cellular biological processes. To reveal the dynamics of hypoxia's effects on miRNA regulation in vivo, we examined the expression levels of all miRNAs in human brain and heart specimens from cases of mechanical asphyxia compared with those from cases of craniocerebral injury and hemorrhagic shock. We further validated differently expressed miRNAs in another 84 human specimens and rat models. We found that mir-122 was significantly down-regulated and that its putative targets G6PC3, ALDOA and CS were increased in the brain and cardiac tissues in cases of mechanical asphyxia compared with craniocerebral injury and hemorrhagic shock. Our data indicate that mir-122 and its targets G6PC3, ALDOA and CS play roles in the hypoxia responses that regulate glucose and energy metabolism and can serve as hypoxia biomarkers.

A preliminary study on the radiologic findings in the major Wenchuan earthquake

Objective To analyze the injury types and radiologic findings of the wounded in the major Wenchuan earthquake of May 12, 2008. Methods Radiologic results of 1013 victims admitted to MianYang Central Hospital from May 13, 2008 to May 19, 2008 were studied retrospectively, including X-ray of 854 cases (about 2900 local exam positions) and CT scan of 259 cases (about 300 local exam positions). Results 733 cases showed radiologic abnormalities, including 527 cases of single region injury (accounting for 52. 0%) and 206 cases of multi-region injury (accounting for 20. 3%), the overall positive rate was 72. 4%. The results were in the following order on the basis of the incidence, 288 cases of lower extremity injuries (28.4%), 151 cases of thoracic injuries(14. 9%), 136 cases of upper extremity injuries(13.4%), 133 cases of spine fracture(13.1%), 114 cases of pelvic fracture and dislocation(11.3%),88 cases of craniocerebral injuries (8. 7%), 25 cases of maxillofacial fracture (2. 5%) and 8 cases of abdominal tranma(0. 1%). Thoracic injuries included: rib fracture in 136 cases, pulmonary injury in 59 cases, and sternal fracture in 3 cases. Spinal fracture included: cervical vertebrae involved in 12 cases,thoracic vertebrae involved in 43 cases, lumbar vertebrae involved in 93 cases, and Sacrococcygeal vertebraeinvolved in 12 cases. Craniocerebral injuries included: skull fracture in 41 cases, endocranial abnormalities in 72 cases. Abdominal trauma included: intestinal obstruction in 4 cases, renal contusion in 3 cases and abdominal wall hematoma in 1 case. Conclusion Most parts of the body can be injured by earthquake.Bone fracture and dislocation of lower extremity are the most common manifestations. Key words: Natural disasters; injuries and damage; Radiography; Tomography, X-raycomputed

A Case of Craniocerebral Injury Caused by an axe Strike which had a Delayed Spontaneous Acute Subdural Hemorrhage: A Case Report

A Case of Craniocerebral Injury Caused by an axe Strike which had a Delayed Spontaneous Acute Subdural Hemorrhage: A Case Report

Analysis of 204 cases of craniocerebral injuries associated with eye injuries. (Chinese)

Analysis of 204 cases of craniocerebral injuries associated with eye injuries. (Chinese)

Pulmonary changes in cranio-cerebral injuries and respiration with high oxygen concentrations

In 131 cases of craniocerebral trauma it was shown in what respect definite changes in the lungs, demonstrated by clinical course, radiographs and blood gas analyses, occurred in proportion to the severity of the trauma. The causes of these changes were considered and the possibility of complicating the course of the illness by administering oxygen in high concentrations was investigated. In 98 patients was an indication for treatment with a respirator. 41 patients were so treated for longer than 5 days (mean 17.7 days). The need for respirator treatment rose with the increasing severity of the trauma. Frequency and severity of tracheobronchial aspiration increased in proportion to the depth of unconsciousness. It occurred in 50-60% of cases with severe trauma. Minor pulmonary lesions developed in 13% of those patients who only had minor disturbances of consciousness. Patients who had aspirated had lower arterial oxygen tensions than those who had not aspirated. In a high percentage of cases considerable improvement could be achieved, despite lung changes. In patients treated with the respirator mean inspiratory oxygen concentrations of 75% were necessary to achieve arterial oxygen tensions of 150-200 mm Hg. No evidence of oxygen toxicity was found, despite long periods of treatment with high oxygen concentrations. Very often cases of craniocerebral injury are followed both by tracheobronchial aspiration, causing lung damage, hypoxia and acidosis, and by disturbances of coagulation. These disorders are to be considered as most important, each needing specific therapy.