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head trauma in Infants: Experience of a High Flow Tertiary Hospital in a Developing Country

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Open Journal of Modern Neurosurgery 2016年第2期6卷 76-81页

作者： Mohamed M. Salama Ahmed El-Fiki Department of Neurosurgery Faculty of Medicine Cairo University Giza Egypt

Background and Objective: head trauma in infants is a common health problem that has not been the focus of many research articles. The aim of study was to describe the epidemiology, etiology, management and clinical outcome of head trauma in infants (head trauma admitted to the neurotrauma unit in Cairo University hospitals during the period between September 2013 and December 2014. The data of these patients including age, sex, mode of trauma, neurological status on admission, CT findings, operative details in surgical cases, clinical outcome, and length of hospital stay were analyzed. Results: The study included 57 boys and 38 girls, with mean age of 13.2 months (range: 3 days - 23 months). The most common mode of trauma was falls (82.1%). Most of the patients had mild head injury (84.2%). Twenty two patients were operated upon, including 9 patients for evacuation of hematomas, 11 patients for elevation of depressed fractures, 1 patient for decompressive craniotomy and 1 patient for growing skull fracture. Good recovery followed in 83 patients. There were 4 deaths. Mean length of stay was 4 days (range: 1 - 31 days). Conclusion: Most of head injuries in infants are mild. The commonest etiology is falls, which is a preventable cause in many circumstances. The majority of these patients do not require surgical intervention. Good recovery is the rule in most of these infants with low mortality rates.

关键词： head trauma Infants traumatic Brain Injury

The usefulness of diffusion tensor imaging in detection of diffuse axonal injury in a patient with head trauma

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Neural Regeneration Research 2012年第6期7卷 475-478页

作者： Hyeok Gyu Kwon Sung Ho Jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University

Diffuse axonal injury is the predominant mechanism of injuries in patients with traumatic brain injury. Neither conventional brain computed tomography nor magnetic resonance imaging has shown sufficient sensitivity in the diagnosis of diffuse axonal injury. In the current study, we attempted to demonstrate the usefulness of diffusion tensor imaging in the detection of lesion sites of diffuse axonal injury in a patient with head trauma who had been misdiagnosed as having a stroke. A 44-year-old man fell from a height of about 2 m. Brain magnetic resonance imaging （32 months after onset） showed leukomalactic lesions in the isthmus of the corpus callosum and the left temporal lobe. He presented with mild quadriparesis, intentional tremor of both hands, and trunkal ataxia. From diffusion tensor imaging results of 33 months after traumatic brain injury onset, we found diffuse axonal injury in the right corticospinal tract （centrum semiovale, pons）, both fomices （columns and crus）, and both inferior cerebellar peduncles （cerebellar portions）. We think that diffusion tensor imaging could be a useful tool in the detection of lesion sites of diffuse axonal injury in patients with head trauma.

关键词： traumatic brain injury diffuse axonal injury diffusion tensor imaging head trauma

Delayed neurological deterioration following head trauma

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Neural Regeneration Research 2010年第23期5卷 1829-1831页

作者： Sung Ho Jang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam University

We report a patient who presented with neurological deterioration 26 days after a motor vehicle accident. A 25-year-old man crashed a car onto farmland from a height of approximately 3 meters. Neurological deterioration including ataxia and visual disturbance became apparent 26 days after the accident. Brain magnetic resonance imaging did not reveal any abnormality, but brain single photon emission computed tomography showed mild hypoperfusion in the left frontotemporal lobe. An ophthalmic examination revealed no specific abnormality, but visual-evoked potentials revealed prolonged latencies in both eyes. We propose that this neurological deterioration might have resulted from traumatic axonal injury. As such, future studies should examine preventive strategies against delayed deterioration in patients with head trauma.

关键词： brain injury ataxia axonal injury head trauma

Anticipation of Dural Tear in Patients with Blunt head trauma

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Open Journal of Modern Neurosurgery 2022年第3期12卷 132-140页

作者： Mohamed M. Elsherbini Ali H. Elmokadem Hatem Badr Amr F. Khalil Neurosurgery Department Mansoura University Mansoura Egypt Radiology Department Mansoura University Mansoura Egypt

Background: Dural tears are considered among the neurosurgical challenges to be dealt with during management of head trauma patients;it’s important to anticipate such pathology pre-operatively;the purpose of this study is to discuss and analyze various predictors of dural tear as a sequala of blunt head trauma. Methods: Patients with blunt head trauma who underwent surgery during the year 2020 were analyzed;operative data were reviewed;only patients with reported dural repair as a step during surgery were included. Patients with penetrating head injury were excluded. Preoperative radiology, epidemiological and clinical details were analyzed to conclude specific criteria for dural tear. Results: Twenty-three patients were involved in the study;male predominance was evident. The most common primary injury was depressed fracture (73.9%), while the most common mode of trauma was domestic injury (43.5%), especially in pediatric group (76.9%). Two cases of growing skull fracture were involved, and both were in pediatric group. CT findings were conclusive for immediate dural tear findings, however, suggestive for patients with growing skull fractures. Mean depth of depression for depressed fracture group was 15.07 mm. Conclusion: Dural tears are not a serious complication of head trauma, however, their sequalae are life-threatening. Anticipation of dural tear is feasible radiologically pre-operatively for immediate dural repair and craniotomy fashioning;for cases of growing skull fractures, it’s difficult to anticipate the course from time of impact till time of presentation.

关键词： Dural Tear Growing Skull Fracture head trauma Depressed Fracture

Unusual head trauma: About Three Observations at the Chu Pr Bocar Sidy Sall (BSS) of Kati

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Open Journal of Medical Imaging 2023年第3期13卷 57-62页

作者： Coulibaly Salia Ilias Guindo Traore Ousmane Diarra Issa Traore Youssouf Sanogo Souleymane Diarra Ouncoumba Diarra Hawa Sidibe Siaka Medical Imaging Department Pr BSS University Hospital of Kati Mali Medical Imaging Department Kati University Hospital Kati Mali Department of traumatology Neurosurgery Unit Pr BSS University Hospital of Kati Mali

Introduction: Penetrating head injuries are often due to human-to-human violence, mainly by firearms, those by stab are rare. CT is the exam of choice in the assessment of emergency lesions. We report three observations, all victims of knife assault during the brawl in order to clarify the contribution of DTM in the care. Observations: 1) Mr. I S, 21-year-old, student, was admitted with the hillside implanted in the skull. There were traces of blood on his face and clothes. There was no neurological deficit on examination. The CT scan performed showed the knife penetrating the vault of the skull at the left parietal level, up to 5 cm in the cerebral parenchyma with a minimal subdural and intracerebral hematoma;2) Mr. S C, 43-year-old, farmer, admitted with a large left fronto-temporo-parietal wound, bleeding and right hemiplegia. The CT scan performed showed a frontal linear fracture (with fronto-ethmoid hemosinus) and left temporoparietal with a parietal intraparenchymal hematoma and homolateral frontoparietal subdural hematoma;3) Mr. S B: 40 years old, driver, admitted with a parietal wound. The CT scan performed objectified a left parietal cortical hematoma in relation to a metallic foreign body (3000 HU) corresponding to the distal end of the knife penetrating the vault of the skull. They all underwent emergency surgery and received antibiotics and preventive serotherapy. The postoperative follow-up was simple, the follow-ups are without neurological sequelae. Conclusion: head trauma by knife is rare, it results from inter-human violence. The lesion diagnosis is computed tomography. The prognosis depends on the severity.

关键词： head trauma Stabbing CT CHU Kati

A case of malignant fibrous histiocytoma of the head after trauma and radiation therapy

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The Chinese-German Journal of Clinical Oncology 2009年第5期8卷 300-302页

作者： S. Mourgela A. Sakellaropoulos K. Kirgiannis A. Spanos Neurosurgical Department "Agios Savvas" Anticancer InstituteAthens Greece Pulmonary and Critical Care Medicine Athens Greece

Malignant fibrous histiocytoma(MFH) firstly described as"malignant fibrous xanthoma"by O' Brien and Stout in 1964, is the most common soft tissue sarcoma of late adult *** histogenesis and numerous subtypes make MFH a rather controversial *** only rare arises from structures of the head and *** it does, it most often originates in facial structures, particularly the *** report details a case of a patient with malignant fibrous histiocytoma presenting clinically as a right-sided large indurated frontoparietal mass, three months after head trauma and eight years after radiation therapy for brain lymphoma located in the right frontal and parietal *** excision was a surgical challenge because of the extensiveness of the lesion.

关键词： malignant fibrous histiocytoma brain lymphoma head trauma

Road Traffic Accident Fatalities and its Association with Key SocioDemographic Determinants in Nashik,Maharashtra:A Recurring Challenge

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Journal of Forensic Science and Medicine 2022年第2期8卷 52-56页

作者： Tej Bahadur Chhetri Syed Meraj Ahmed Departments of Forensic Medicine Community Medicine Dr.Vasantrao Pawar Medical CollegeHospital and Research CentreNashikMaharashtraIndia

Background:Road traffic accidents are not a new phenomenon,rather ifs a disturbing occurrence which shows no sign of abating very ***,it remains one of those public health issues which even the most educated and civilized populations tend to ignore,primarily for the thrill of *** study aims to identify the outcome associated with vehicular accidents and its association with socio-demographic ***:This is a retrospective,record-based study of victims of road traffic accidents admitted in a tertiary care hospital in Nashik,*** data would include records from the 2018 to *** variables will include the socio-demographic factors,site of injuries and its severity.A descriptive analysis would be done by SPSS software to find out the prevalence of vehicular accidents,association of site of injury with age and severity of the *** approval would be taken before the initiation of the ***:A total of486 victims ofRTAs were included from the medical records of the casualty of a tertiary care hospital,out of which 330 were from the year 2018 and 156 from 2019.A look at the sociodemographic profiles of the RTA victims showed that females comprised only 19.3%(2018)and 18.6%(2019)of the total victims in road traffic accidents,while majority,80.6%(2018)and 81.4%(2019)were males during the same ***,we can also observe that both in 2018(38.5%)and 2019(50.6%)most of the road traffic accidents among the victims were of moderate ***:The need of the hour is to bring about a change from within through self-reflection of lawmakers,strict implementation of traffic rules and guidelines with hefty fines,lockup,and criminal punishment to habitual wrongdoers.

关键词： Age facial trauma gender head trauma multiple injuries road traffic accident

Motor recovery via aberrant pyramidal tract in a patient with traumatic brain injury A diffusion tensor tractography study

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Neural Regeneration Research 2013年第1期8卷 90-94页

作者： Sang Seok Yeo Sung Ho Jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University

The aberrant pyramidal tract is the collateral pathway of the pyramidal tract through the medial lemniscus in the brainstem. A 21-year-old man presented with right hemiparesis due to a traumatic intracerebral hemorrhage in the left corona radiata. His motor function recovered almost to the normal state at 10 months after onset. Through diffusion tensor tractography, the pyramidal tract in the affected （left） hemisphere showed discontinuation at the pontine level at 13 months after onset. An aberrant pyramidal tract was observed, which originated from the primary motor cortex and the supplementary motor area and descended through the corona radiata, then through the posterior limb of the internal capsule and the medial lemniscus pathway from the midbrain to the pons, finally entered into the pyramidal tract area at the pontomedullary junction, it suggests that the motor functions of the right extremities in this patient had recovered by this aberrant pyramidal tract.

关键词： neural regeneration neuroimaging diffusion tensor imaging diffusion tensor tractography transcranial magnetic stimulation pyramidal tract aberrant pyramidal tract motor paralysis motorrecovery traumatic brain injury head trauma intracerebral hemorrhage grant-supported paper photographs-containing paper neuroregeneration

The occurrence of diffuse axonal injury in the brain:associated with the accumulation and clearance of myelin debris

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Neural Regeneration Research 2014年第21期9卷 1902-1906页

作者： Liang Wen Jun Xu Tianxiang Zhan Hao Wang Xin Huang Wenchao Liu Xiaofeng Yang Renya Zhan Department of Neurosurgery First Affiliated HospitalCollege of MedicineZhejiang University

The accumulation of myelin debris may be a major contributor to the inlfammatory response after diffuse axonal injury. In this study, we examined the accumulation and clearance of myelin debris in a rat model of diffuse axonal injury. Oil Red O staining was performed on sections from the cerebral cortex, hippocampus and brain stem to identify the myelin debris. Seven days after diffuse axonal injury, many Oil Red O-stained particles were observed in the cerebral cortex, hippocampus and brain stem. In the cerebral cortex and hippocampus, the amount of myelin debris peaked at 14 days after injury, and decreased signiifcantly at 28 days. In the brain stem, the amount of myelin debris peaked at 7 days after injury, and decreased signiifcantly at 14 and 28 days. In the cortex and hippocampus, some myelin debris could still be observed at 28 days after diffuse axonal injury. Our ifndings suggest that myelin debris may persist in the rat central ner-vous system after diffuse axonal injury, which would hinder recovery.

关键词： nerve regeneration neurodegeneration diffuse axonal injury myelin debris neuroin-flammation traumatic brain injury head trauma central nervous system inflammation axon prognosis NSFC grants neural regeneration