Craniocerebral Injuries Research Articles

IMMUNOLOGIC REACTIVITY IN THE FIRST DAYS AFTER THE CRANIOCEREBRAL TRAUMA

The proportion of the craniocerebral injuries (CI) is 25-40 % of all kinds of injuries in the world. The mortality rate due to ChMT is 30 persons per 100 thousand of the population, and over a third of victims die in medical institutions in the first three days after entering. The research of immune system condition and its role in formation of clinical implications, possible complications in victims with ChMT remains a poorly studied problem. Few literary data reflect results of surgical interventions in a brain or fighting (explosive) injuries for 3-5 days. Reactions of adaptive immunity and compensatory immune reactions in the first days after a trauma represent a class of the protective and adaptive phenomena which develop only in extreme conditions, show response to damage and can be reactions of cascade type and can compensate a neurologic injury. The complex immunologic research of victims in the first days after a trauma will allow to determine parameters which will help to prognosticate character of possible complications, to lower disability percent. The increased values of immunologic indicators are marked in 25,0-66,7 % of persons with moderate trauma severity (CD10+, CD16+, IL-2, CD8+, IgE, IL-6) and in 16,7-100 % of victims with serious degree of ChMT (CD8+, CD16+, CD71+, CD95+, CD25+, IL-6, -10, IgE, IgM, HLA-DR+), at the same time a wider range of indicators involve in the adaptive immune response. In the first days after getting injured rising of values of cytokine and cytotoxic activity testifies to the expressed tension in the immune system that promotes reduction of spare capacities of immune homeostasis in victims and development of secondary ecologically dependent immune imbalances in the form of complications.

Denied Suicide Attempt: Penetrating Cranial Cerebral Injury with a Nail Gun

AbstractPenetrating craniocerebral injuries with a nail gun are uncommon. In this article, we describe a highly unusual delayed presentation of a 49-year-old man after an initially unnoticed penetrating head injury with an air-powered nail gun. The nail was successfully surgically removed, and the postoperative course was uneventful. Further evaluation revealed that the penetrating craniocerebral nail gun injury was a suicide attempt and not an accident. Possible reasons for the initial unrecognition of the injury and denial of the suicide attempt were discussed.

Management of War-Related Ballistic Craniocerebral Injuries in a French Role 3 Hospital During the Afghan Campaign.

France deployed to Afghanistan from 2001 to 2014 within the International Security and Assistance Force. A French role 3 hospital was built in 2009 in the vicinity of Kabul International Airport (KaIA). The objectives of this study were to describe the epidemiology, management, and outcome of war-related craniocerebral injuries during the Afghan campaign in a French role 3 hospital. From March 1, 2010 to September 30, 2012, we conducted a retrospective descriptive study in Kabul, Afghanistan. All patients presenting with a ballistic craniocerebral injury to the KaIA role 3 hospital were included. We analyzed 48 records. Mean age was 21.9 years (1-46 years) with a 37:11 (male:female) sex ratio and a majority Afghan population (n= 41). Civilians represented 64.6% (n= 31) of casualties. On the battlefield, mean Glasgow Coma Scale score was 9.4 [3-15]. On arrival at the KaIA field hospital, 20 of the 48 patients were hemodynamically unstable. All patients underwent a full-body computed tomography scan. The majority of our casualties had associated injuries. Neurosurgery was indicated for 42 (87.5%) patients. The surgery consisted of wound debridement plane by plane associated with decompressive craniectomy (n= 11), debridement craniectomy (n= 19), and craniotomy (n= 12). A total of 32.4% wounded died at the point of injury, 8.4% at the emergency department, and 16.9% after surgery. War casualties with ballistic head injuries were predominantly multitraumatized patients with hemodynamic compromise requiring neurosurgical damage control management and multidisciplinary care. The neurosurgeon has thus an essential role to play.

Autopsy study of Cranio-Cerebral Injuries in Vehicular Accidents

Head injury is one of the most important regional injuries known to human beings since time immemorial. Head injury is a morbid state, resulting from gross or subtle structural changes in the scalp, skull and or the contents of the skull, produced by mechanical forces. Vehicular accident can be defined as, ‘An event that occurs on a way or street open to public traffic; resulting in one or more persons being injured or killed, where at least one moving vehicle is involved. They involve high human suffering and socioeconomic costs in terms of premature deaths, injuries, loss of productivity, and so on.

Study of Patterns of Cranio-cerebral Injuries in Road Traffic Accidents Involving Two Wheelers in Gulbarga Area

Study of Patterns of Cranio-cerebral Injuries in Road Traffic Accidents Involving Two Wheelers in Gulbarga Area

Pattern of Craniocerebral Injuries among Homicidal Deaths in Hubballi Dharwad Region-One Year Retrospective Study

Pattern of Craniocerebral Injuries among Homicidal Deaths in Hubballi Dharwad Region-One Year Retrospective Study

The experience of application of gel preparations containing bacteriophages in the complex therapy of nosocomial rhinosinusitises

The authors conducted a study of application of gel preparations containing bacteriophages in the complex therapy of nosocomial rhinosinusitises. The preparation was administered at the acute period of the process in the paranasal sinuses in the patients with craniocerebral injuries undergoing artificial pulmonary ventilation. The results of bacteriological studies were assessed all over the supervision period, they made it possible to reveal the trend in the change of the nasal cavity microbial landscape due to reduction of specific weight of the gram-negative flora. The results of preliminary analyses of the clinical observation of the patients with nosocomial rhinosinusitises and the data of X-ray examination suggest the anti-inflammatory effect of the preparation and allow recommending its application in therapeutic and preventive activities.

Study of Patterns of Fatal Cranio-Cerebral Injuries in Deaths due to Road Traffic Accidents

Study of Patterns of Fatal Cranio-Cerebral Injuries in Deaths due to Road Traffic Accidents

A study of injury characteristics in road traffic accidents by different road user category

Background:Trauma is one of the oldest subjects in medical science because it appeared just as early as human being came to the earth. At the same time trauma is also a novel subject, because trauma has been strikingly increasing with the high-speed development of economical construction, traffic transport and sharp increase of vehicles in number. Therefore, trauma is called the twin brother of the modem civilization. Accidents occur not only due to ignorance but also due to carelessness, thoughtlessness and over confidence. Human, vehicular and environmental factors play role before, during and after a road traffic accidents (RTA). Road traffic injuries are partially predictable and hence preventable.Methods: this was prospective observational study in which all cases of road traffic accident victims admitted to the hospital (AVBRH) between July 2014 to September 2016, were analyzed statistically with respect to their demographic profile, injury characteristics and outcome.Results:This study showed that motorcyclists were predominantly affected (77.3%) in RTA. Males (80.67%) in the working age group 21-40 years (64.66%) were most commonly affected leading to huge economic losses to their families. Majority RTA took place between 4pm to 12am (57.33 %), on Sundays and Saturday (41.66%) and during summer season (52.67%). Extremity injury (67%) was the most common injury followed by craniocerebral injuries (58.33%). Maximum mortality was seen in LMV/HMV occupants (25%).Conclusions:Road traffic accidents are preventable. Strict traffic laws and penalties have to be imposed to curb this ever growing menace.

An unusual lethal gunshot wound to the head.

Atypical gunshot wounds present a challenge for the forensic expert, and sometimes differentiating these from a blunt trauma can be difficult. A careful crime scene investigation can be helpful in finding additional evidence and clarifying the nature of the injuries. We describe a case of an unusual craniocerebral injury that was initially interpreted as a blow from a wooden object. The appearance of the wound lacked the classical characteristics of entrance and exit bullet wounds, but the investigation showed it was due to the ricocheting of a destabilized bullet. Potentially lethal, craniocerebral gunshot injuries are a common occurrence in developing countries even in non-conflict areas, with very bad outcomes even when treated aggressively in specialized neurosurgical facilities. The authors briefly discuss similar cases and opinions in the relevant literature, emphasizing the importance of a rational approach during the reconstruction of the crime scene.

Pourazowe obrażenia czaszkowo-mózgowe u pacjentów w stanie nietrzeźwości, przyjmowanych doraźnie do szpitalnego oddziału ratunkowego

Pourazowe obrażenia czaszkowo-mózgowe u pacjentów w stanie nietrzeźwości, przyjmowanych doraźnie do szpitalnego oddziału ratunkowego

ANALYSIS OF X-RAY FINDINGS IN CASE OF CRANIOCEREBRAL INJURY

The aim of the study was to determine the clinical features and diagnosis of severe craniocerebral injuries. The case histories of patients admitted to the Department of Neurosurgery at I.I.Mechnikov Regional Hospital in Dnepropetrovsk with severe craniocerebral injuries mostly after traffic accidents have been analyzed. A number of normal anatomic structures able to simulate the fracture of the skull base should be considered in order to avoid overdiagnosis. They can be: sulci of the middle meningeal artery branches; sulci of the parietal-sphenoid sinus; channels of the diploic veins; cleft of the parietalsphenoid synchondrosis behind the back of the pituitary fossa; occipital-mastoid suture. With the introduction into practice of computer and magnetic resonance imaging to diagnose damage of structures in the presence of hematomas in the posterior fossa became much easier. Since patients are not always in a conscious condition the given instrumental methods of diagnosis as quick as possible enable to diagnose and make differential diagnosis of injuries that are accompanied by the presence of intracranial hematomas in the posterior fossa.

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

ObjectiveTo analyze the epidemiological features of patients with head injuries in the 2008 Wenchuan earthquake. MethodsMedical records of patients with head injuries who were admitted to 14 hospitals in Deyang, Mianyang and Chengdu cities after the earthquake were retrospectively analyzed. The patients’ age, gender, cause of injury, diagnosis, and outcome were analyzed retrospectively. ResultsA 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 patients underwent surgical treatment. Good recovery was achieved in 1 056 patients, moderate disability in 106, severe disability in 71, coma in 29 and death in 19. ConclusionsIn Earthquakhis 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.

The study of abdominal trauma: non operative and operative intervention and their outcome

Background: The aim was to study the cases of abdominal trauma in context of surgical intervention and criteria for non-operative and operative management, post-operative morbidity, mortality and final outcome. Methods: The study of 50 cases of abdominal trauma, including blunt as well as penetrating trauma was conducted prospectively during the period of 23 months (January 2010 to November 2011). Patients of all age and sex who were admitted in our department after abdominal trauma were potential candidate for enrolment in this study and study was done in context to fulfill our aim. Results: In our study, 4 (8%) patients had undergone conservative management while 46 (92%) patients were managed by operative intervention. Amongst the surgical procedures drainage of haemoperitoneum and haemostasis (n = 20, 43.47%) is commonly done procedure for abdominal trauma involving solid organs especially liver. However some splenic injury may warrant removal of spleen (n = 10, 21.79%). In small bowel perforation primary repair (n = 8, 17.39%) is the choice of procedure however resection anastomosis (n = 4, 08.69%) is necessary if multiple perforations are present in small segment. Post-operative recovery in this study was generally good with rate of complication as 8% (n = 4) and most of the complications were wound related (n = 04, 08%). we have observed mortality rate of 8% (n = 04) and persistent shock and haemorrhage (n = 3, 75%) is the most common cause of death in our study. The reason was extensive polytrauma involving massive injuries of spleen, liver, pancreas and kidney associated with thoracic injuries, orthopaedic injuries and cranio-cerebral injuries. The average hospital stay in our study was 9.26 days. Out of 50 abdominal trauma patients 46 (92%) has survived and shown good prognosis on follow ups. These data suggests that good outcome can be achieved if proper evaluation done and timely definitive treatment is given to the trauma victims. Conclusions: From our study we can conclude that for “optimum outcome” of abdominal trauma through timely definitive treatment is of prime importance. Establishment of dedicated and efficient trauma care system is mandatory to achieve these goals in abdominal trauma management.

Patterns of Cranio-cerebral Injuries in Fatal Head Trauma

The objective of this study was to find out pattern of cranio-cerebral injuries in medico-legal cases of fatal head trauma with regards to age, sex, survival period, causes and complications leading to death of the victim. Materials were collected from 48 medico-legal cases of fatal head injury which were brought for autopsy at the mortuary of PCMS & RC, Bhopal from 01 Jan 2011 to 31Dec 2011. It was found that most commonly involved age group was 21–40 with male outnumbering the female in a ratio of 4.9 to 1. Vehicular accident was the leading cause for fatalities in 91.66% cases. 18.75% died on the spot while 45.83% of the remaining survived for 0–12 hrs. Fractures of the skull had occurred in around 81.25% of the cases. Among whole of skull cap temporal bone was most prone to fracture (22.91%) while linear/fissured fracture was the commonest type (35.41%). SDH was noted in 31.25% of cases. 18.75% deaths had occurred on the spot while 45.83% of the remaining had survived for 0–12 hrs. Traumatic cranio-cerebral injury was the primary cause of death in slightly more than the half of the victims (52.08%) indicating that timely intervention could have saved the lives of unfortunate hapless victims.

Study of skull fractures in fatal cranio cerebral injuries in light with the manner of death

Study of skull fractures in fatal cranio cerebral injuries in light with the manner of death

Pattern of Cranio Cerebral Injuries in Fatal Cases of Road Traffic Accidents

Pattern of Cranio Cerebral Injuries in Fatal Cases of Road Traffic Accidents

Intracranial wooden foreign body with uncertain route of entry.

Penetrating craniocerebral injuries are not uncommon in children, however, it can be obscured if history or examination is missed.

Profile of Fatal Craniocerebral Injuries

Profile of Fatal Craniocerebral Injuries

Delayed presentation of a penetrating craniocerebral nail injury with the weapon lodged in the ventricle

Introduction: Penetrating craniocerebral injuries presenting with the weapon lodged in the ventricle are uncommon. they are associated with an increased risk of ventriculitis, which can have lethal consequences. case report: We report an unusual case of a 57-year-old female treated for delayed presentation of a penetrating craniocerebral nail injury following an assault. the admission Glasgow coma scale (Gcs) was 14/15. the nail was lodged within the ventricle, requiring emergency removal, which was performed successfully. However, she developed ventriculitis and Escherichia coli was cultured from the cerebrospinal fluid. the Gcs dropped to 8/15 necessitating an urgent ct brain scan, which showed hydrocephalus, requiring insertion of an external ventricular drain. targeted antibiotic therapy was administered. However, she deteriorated further and demised on the fourth day of admission as a result of intracranial sepsis. conclusion: Penetrating craniocerebral nail injury presenting with the weapon lodged in the ventricle requires urgent surgical intervention and targeted antibiotic therapy to ensure a favorable outcome.