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Head Injury (head + injury)

Distribution by Scientific Domains

Medical Sciences	79%
Humanities and Social Sciences	9%
Psychology	7%
2 Other Domains	5%

Distribution within Medical Sciences

Neurology	17%
Anesthesia & Pain Management	10%
Surgery & Surgical Specialties	5%
Nursing General	2%
21 Other Subdomains	52%

Kinds of Head Injury

severe head injury

Selected Abstracts

Does Glucocorticoid Administration Prevent Late Seizures after Head Injury?

EPILEPSIA, Issue 6 2004
Nathaniel F. Watson
Summary: Purpose: Preventing posttraumatic epilepsy has been a difficult challenge. In this study we evaluated the association between glucocorticoid administration after traumatic brain injury (TBI) and posttraumatic seizures. Methods: We examined a seizure-prevention trial database of 404 patients with severe TBI for exposure to glucocorticoids in the early (<1 week) posttraumatic period. After controlling for seizure risk, we compared the odds of developing first and second late posttraumatic seizures between those that received glucocorticoids and those that did not. Results: Patients dosed with glucocorticoids within 1 day of their TBI were more likely to develop first late seizures than were those without [p = 0.04; hazard ratio = 1.74; 95% confidence interval (CI), 1.01,2.98]; whereas those receiving glucocorticoids ,2 days after their injury had no similar association (p = 0.66; hazard ratio = 0.77; 95% CI, 0.23,2.56; p = 0.10 among the three groups). Receiving glucocorticoids within 1 day, or ,2 days after TBI was not associated with second late seizure development. Conclusions: Glucocorticoid treatment after TBI is not associated with decreased late posttraumatic seizures, and early treatment is associated with increased seizure activity. [source]

An Unusual Case of Child Head Injury by Coat Hanger,

JOURNAL OF FORENSIC SCIENCES, Issue 5 2008
Biagio Solarino M.D.
Abstract:, Traumatic brain injury is the leading cause of morbidity and mortality among children suspected of child abuse. Penetrating cranio-facial injuries are generally rare in the pediatric age group and are caused by both accidental and inflicted mechanisms. We report an unusual case of a 2-year-old female who was admitted to a pediatric emergency room with an industrial stainless steel coat hanger impaled in her skull. Pertinent clinical forensic medicine examination, coupled with home inspection and interviews by the local law enforcement, revealed a horrible episode of domestic violence. [source]

Practitioner Review: Psychological Sequelae of Head Injury in Children and Adolescents

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 2 2001
Judith A. Middleton
Many children suffer an injury to the head at some time, but relatively few of these cause major problems. However, in a few cases the sequelae can be far reaching. This review considers how to evaluate the significance of a head injury. Factors to consider are (1) injury variables: cause, severity and type of injury ; (2) child variables: premorbid functioning, age, and developmental level of the child both at injury and at assessment; and (3) the cognitive, behavioural, and emotional problems that may arise. Parental beliefs and knowledge about the injury as well as the overall effect of an injury on the family as a whole are also considered. [source]

Head Injury: A Multidisciplinary Approach

ACADEMIC EMERGENCY MEDICINE, Issue 9 2010
Michael D. Burg MD
No abstract is available for this article. [source]

Head injuries related to sports and recreation activities in school-age children and adolescents: Data from a referral centre in Victoria, Australia

EMERGENCY MEDICINE AUSTRALASIA, Issue 1 2010
Louise M Crowe
Abstract Objectives:, Head injuries (HI) in children are common and even mild HI can lead to ongoing cognitive and behavioural changes. We set out to determine the causes of sport-related HI in school-age children presenting to a large urban ED as a basis for future interventions. Method:, Identification and medical record review of all sport-related HI in children aged 6,16 years at a tertiary children's hospital ED in Victoria, Australia, over a 1 year period. Information was collected on demographics, injury variables and radiology findings. HI were classified as mild, moderate and severe based on GCS and radiography reports. Results:, Over 12 months there were 406 HI in school-age children. Seventy per cent were male. A large number of HI (129; 33%) were related to sports. Of these, most were classified as mild and 13% were classified as moderate or severe. Among a range of sports, Australian Rules football was associated with more than 30% of all HI attributable to a sport and recreation cause. Equestrian activities were the main cause of moderate HI. Conclusion:, The present study identified sports as a major cause of HI in the Victorian paediatric emergency setting with Australian Rules football the most commonly involved sport. Further prevention initiatives should consider targeting Australian Rules football and equestrian activities. [source]

Hospital admissions of Indigenous and non-Indigenous Australians due to interpersonal violence, July 1999 to June 2004

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009
Jesia G. Berry
Abstract Objective: To compare the incidence of injury-related hospitalisations and the injury profiles for interpersonal violence, in the Indigenous and non-Indigenous populations of Australia. Method: Descriptive analysis of the National Hospital Morbidity Database (NHMD), using data for the Northern Territory, Western Australia, South Australia and Queensland for the period 1 July 1999 to 30 June 2004. Results: Indigenous people were twice as likely as non-Indigenous people to be hospitalised for injury (age-standardised rate ratio [SRR] 2.26, 95% CI 2.24,2.29), and had a 17-fold greater hospitalisation rate for interpersonal violence (SRR, 16.9, 95% CI 16.6,17.3). Indigenous males and females were most commonly injured by a family member or intimate partner and females constituted 54% of Indigenous cases. Most non-Indigenous cases were males (82%), most commonly injured by stranger(s). Head injuries by bodily force were the most frequent injuries. Age-standardised hospitalisation rates of interpersonal violence increased with remoteness of usual residence for Indigenous people and, less so, for others. Conclusion: The largest differential between Indigenous and non-Indigenous injury-related hospitalisations was for interpersonal violence, particularly for women. About half the excess morbidity from interpersonal violence among Indigenous people is due to factors associated with remote living. Implications: Culturally appropriate interventions that tackle a wide range of social and economic issues are needed to mitigate Indigenous interpersonal violence. [source]

Fall-related brain injuries and the risk of dementia in elderly people: a population-based study

EUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2005
H. Luukinen
Severe head injury in early adulthood may increase the risk of dementia in older age, but it is not known whether head injury in later life also increases the risk of dementia. A representative sample (82%) of persons aged 70 years or older with a Mini-Mental State Examination (MMSE) test score of ,26 (n = 325) were followed-up for 9 years to record all their fall-related head injuries resulting in traumatic brain injury (TBI). At the end of the follow-up period, 152 persons (81% of the surviving population) were examined for clinical dementia, according to DSM-IV criteria. Eight persons sustained a TBI and 34 developed dementia. Brain injury was associated with younger age at detection of dementia even when adjusted for sex and educational status (low educational status significantly associated with dementia); age-specific hazard ratio (95% confidence interval) 2.80 (1.35,5.81). In a population scoring ,28 points in the baseline MMSE an apolipoprotein E (ApoE) ,4 phenotype was also associated with younger age at the time of detecting dementia; 3.56 (1.35,9.34), and the effect of brain injury and ApoE ,4 phenotype was synergistic; 7.68 (2.32,25.3). We conclude that fall-related TBI predicts earlier onset of dementia and the effect is especially high amongst subjects who carry the ApoE ,4 allele. [source]

Comorbidity of Alcohol Abuse and Dependence with Medical Conditions in 2 American Indian Reservation Communities

ALCOHOLISM, Issue 4 2006
Jay H. Shore
Background: The objective was to examine the association of self-reported Diagnostic and Statistical Manual,IV edition alcohol abuse and dependence with medical conditions among American Indians (AIs). Methods: We analyzed data previously collected in a large epidemiological study of members of 2 culturally distinct AI tribes from the Southwest (SW; n=1,446) and the Northern Plains (NP; n=1,638) living on or near their reservations. Associations of combined self-reported alcohol abuse and alcohol dependence with 19 medical conditions were examined through multinomial logistic regression. Results: Medical conditions that had significant relationships with alcohol abuse/dependence were sprains and strains [odds ratio (OR) 2.04, p<0.001], hearing and vision problems (OR 2.05, p<0.001), kidney and bladder problems (OR 1.55, p<0.01), head injuries (OR 2.20, p<0.001), pneumonia/tuberculosis (OR 1.49, p<0.01), dental problems (OR 1.89, p<0.001), and liver problems/pancreatitis (OR 2.18, p<0.001). The total count of medical conditions was also significantly related to alcohol abuse/dependence, with a higher count being associated with the outcome (OR 1.17, p<0.001). Conclusions: In this community-based study of rural AIs, diverse medical conditions were associated with alcohol abuse and dependence. Further research should examine, and confirm, the nature, extent, and tribal variation of the medical consequences of alcohol abuse and dependence in these unique populations. [source]

Axonal injury in head injuries with very short survival

NEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 3 2008
R. E. McLendon
No abstract is available for this article. [source]

Axonal injury in head injuries with very short survival times , Authors' Reply

NEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 3 2008
C. Morrison
No abstract is available for this article. [source]

Traumatic axonal injury: practical issues for diagnosis in medicolegal cases

NEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 2 2000
J. F. Geddes
In the 25 years or so after the first clinicopathological descriptions of diffuse axonal injury (DAI), the criterion for diagnosing recent traumatic white matter damage was the identification of swollen axons (,bulbs') on routine or silver stains, in the appropriate clinical setting. In the last decade, however, experimental work has given us greater understanding of the cellular events initiated by trauma to axons, and this in turn has led to the adoption of immunocytochemical methods to detect markers of axonal damage in both routine and experimental work. These methods have shown that traumatic axonal injury (TAI) is much more common than previously realized, and that what was originally described as DAI occupies only the most severe end of a spectrum of diffuse trauma-induced brain injury. They have also revealed a whole field of previously unrecognized white matter pathology, in which axons are diffusely damaged by processes other than head injury; this in turn has led to some terminological confusion in the literature. Neuropathologists are often asked to assess head injuries in a forensic setting: the diagnostic challenge is to sort out whether the axonal damage detected in a brain is indeed traumatic, and if so, to decide what , if anything , can be inferred from it. The lack of correlation between well-documented histories and neuropathological findings means that in the interpretation of assault cases at least, a diagnosis of ,TAI' or ,DAI' is likely to be of limited use for medicolegal purposes [source]

Relationship of age, injury severity, injury type, comorbid conditions, level of care, and survival among older motor vehicle trauma patients,

RESEARCH IN NURSING & HEALTH, Issue 3 2005
Linda J. Scheetz
Abstract The purpose of this secondary data analysis was to compare age, injury severity, injury types, selected comorbidities, level of care (at trauma center [TC] and non,trauma center [NTC] hospitals), and survival among older motor vehicle trauma patients (N,=,1,478). Patients admitted to both levels of care had similar comorbid conditions. TC patients had a higher injury severity, whereas NTC patients had a greater proportion of soft tissue injuries. Results of logistic regression analyses subsequent to group comparisons revealed that higher injury severity was associated with TC admission. The likelihood of TC admission of severely injured patients decreased in the presence of spinal, internal, and head injuries. Internal injuries, liver, renal, and cardiovascular diseases were associated with non-survival while hypertension was associated with survival. Special attention is needed when triaging older trauma patients because their injuries may be covert, thus putting them at risk for admission to a level of care that may be inappropriate given the extent of their injuries. © 2005 Wiley Periodicals, Inc. Res Nurs Health 28: 198,209, 2005 [source]

Neuroimaging for Pediatric Head Trauma: Do Patient and Hospital Characteristics Influence Who Gets Imaged?

ACADEMIC EMERGENCY MEDICINE, Issue 7 2010
Rebekah Mannix MD
ACADEMIC EMERGENCY MEDICINE 2010; 17:694,700 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, The objective was to identify patient, provider, and hospital characteristics associated with the use of neuroimaging in the evaluation of head trauma in children. Methods:, This was a cross-sectional study of children (,19 years of age) with head injuries from the National Hospital Ambulatory Medical Care Survey (NHAMCS) collected by the National Center for Health Statistics. NHAMCS collects data on approximately 25,000 visits annually to 600 randomly selected hospital emergency and outpatient departments. This study examined visits to U.S. emergency departments (EDs) between 2002 and 2006. Multivariable logistic regression was used to analyze characteristics associated with neuroimaging in children with head injuries. Results:, There were 50,835 pediatric visits in the 5-year sample, of which 1,256 (2.5%, 95% confidence interval [CI] = 2.2% to 2.7%) were for head injury. Among these, 39% (95% CI = 34% to 43%) underwent evaluation with neuroimaging. In multivariable analyses, factors associated with neuroimaging included white race (odds ratio [OR] = 1.5, 95% CI = 1.02 to 2.1), older age (OR = 1.3, 95% CI = 1.1 to 1.5), presentation to a general hospital (vs. a pediatric hospital, OR = 2.4, 95% CI = 1.1 to 5.3), more emergent triage status (OR = 1.4, 95% CI = 1.1 to 1.8), admission or transfer (OR = 2.7, 95% CI = 1.4 to 5.3), and treatment by an attending physician (OR = 2.0, 95% CI = 1.1 to 3.7). The effect of race was mitigated at the pediatric hospitals compared to at the general hospitals (p < 0.001). Conclusions:, In this study, patient race, age, and hospital-specific characteristics were associated with the frequency of neuroimaging in the evaluation of children with closed head injuries. Based on these results, focusing quality improvement initiatives on physicians at general hospitals may be an effective approach to decreasing rates of neuroimaging after pediatric head trauma. [source]

Factors Associated with Helmet Use among Motorcycle Users in Karachi, Pakistan

ACADEMIC EMERGENCY MEDICINE, Issue 4 2008
Imran Khan MBBS
Abstract Objectives:, Wearing a helmet is the single most effective measure for preventing head injuries in motorcycle users. The authors undertook this study to estimate compliance and determine reasons for noncompliance with helmet use among motorcyclists in their community. Methods:, This was a cross-sectional survey of motorcyclists in three large randomly selected public-access parking spaces across Karachi, Pakistan's largest city. Questions covered personal demographics, frequency of helmet use, reasons for use or nonuse, and knowledge of local helmet laws. Analysis was based on frequencies and group comparisons using chi-square test or independent sample t-test. Results:, Of the 300 (100% male) subjects, 169 (56%) reported using helmets regularly. Users listed injury prevention (78%) as the major reason for compliance, while nonusers listed physical discomfort (44%) and limited vision (25%) as the leading reasons for noncompliance. In univariate analysis, helmet users were significantly better educated than nonusers and were more likely to believe that helmets are protective (p = 0.002) and that passengers should also wear helmets (p < 0.001). The significance of these variables persisted in multivariate analysis. Several other variables (such as mean age, marital status, and knowledge of helmet laws) did not differ between users and nonusers. Conclusions:, Helmets are underused by motorcyclists in the authors' community. This study underscores the need for improved helmet design, public understanding, intense public education, and rigorous law enforcement in raising compliance with helmet use and minimizing the risk of preventable trauma. [source]

Evaluation of documentation in potential abusive head injury of infants in a Paediatric Emergency Department

ACTA PAEDIATRICA, Issue 5 2009
Björn Tingberg
Abstract Aim: The aim is to evaluate medical record documentation regarding potential abusive head injury (AHI) in infants presenting to a Paediatric Emergency Department (ED) with certain primary complaints known to be associated with AHI. Methods: A database search was performed to find all medical records over a period of one year relating to those children who had one AHI-related primary complaint and who had had a CT head-scan performed in conjunction with admission. Each medical record was reviewed, in order to assess whether potential abuse had been investigated and documented. Each CT-scan image was re-evaluated for missed indications of potential injuries attributable to AHI. Results: Forty-seven such medical records were found. Of these, 87% showed the diagnosis to be head injuries. The largest group of children was in the age group 0,3 months (38%). Of the children admitted to the Paediatric ED due to a head injury, 54% had a history deemed to raise suspicions of abuse but only five of them had had a documented investigation of child abuse. The re-evaluation of the CT-scans showed no missed cases. Conclusion: In this study we found that among children with known risk factors for AHI, only a few had documentation regarding potential child abuse. The use of a standardized protocol could be helpful in the important work to help staff discover potential AHI. [source]

Bicycle helmet campaigns and head injuries among children.

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2004
Does poverty matter?
Objectives To assess the impact of a community-based bicycle helmet programme aimed at children aged 5,12 years (about 140 000) from poor and well-off municipalities. Methods A quasi-experimental design, including a control group, was used. Changes in the risk of bicycle-related head injuries leading to hospitalization were measured, using rates ratios. Results Reductions in bicycle-related head injuries were registered in both categories of municipalities. Compared with the pre-programme period, the protective effect of the programme during the post-programme period was as significant among children from poor municipalities (RR 0.45; 95% CI 0.26,0.78) as among those from richer municipalities (RR 0.55; 95% CI 0.41,0.75). Conclusion Population-based educational programmes may have a favourable impact on injury risks in poor areas despite lower adoption of protective behaviours. [source]

Neuro-ophthalmological sequelae of horse-related accidents

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2001
P Richard I Fleming FRACO
ABSTRACT Purpose: The aim of this study was to highlight the neuro-ophthalmological dangers associated with horse riding, and working around horses, and the importance of wearing adequate headgear to protect the rider from neuro- ophthalmic injuries. It raises the questions of whether the current laws regarding helmet use are satisfactory, and whether helmets currently used are of an adequate standard. Methods: The records over a 20-year period of one neuro-ophthalmologist in Adelaide were reviewed producing 22 patients with neuro-ophthalmological sequelae of head injuries as a result of horse-related accidents. Results: There were 22 patients (16 female, six male), one of whom was involved in three separate accidents. Of these, seven were professional riders and 15 amateur. In 20 of the 24 accidents, patients were either thrown or fell from the horse. Helmets were worn in 15 of the accidents. All the patients had closed head injuries of varying severity. The most common neuro-ophthalmological complication found was a fourth-nerve palsy in 11 patients. Five patients had a significant loss of vision and two of these were severe enough to warrant a blind pension. Conclusions: Horse riding and working around horses constitute an occupation or recreation with inherent dangers. Previous studies have shown that wearing of protective headgear reduces the risk and severity of head injuries, and helmet use should be vigorously promoted. The current laws and practices regarding helmet use are not uniform and seem to be inadequate. The current standard for equestrian safety helmets (AS/NZS 3838:1998) embodies improvements on earlier helmet standards and certainly increases the rider's chances of surviving a severe impact. Nevertheless, serious brain injuries have occurred in wearers of approved helmets, and further research is desirable to ensure the optimum degree of protection compatible with rider acceptance. [source]

Prevalence and correlates of traumatic brain injury among delinquent youths

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2008
Brian E. Perron
Background,Delinquent youth frequently exhibit high-risk behaviours that can result in serious injury. However, little is known about traumatic brain injuries (TBIs) and their correlates in this population. Aims,To examine the period prevalence and correlates of TBIs in delinquent youths. Method,Interviews were conducted with 720 (97.3%) residents of 27 Missouri Division of Youth Services rehabilitation facilities between March 1 and May 31, 2003. Participants [mean age (Mage) = 15.5, standard deviation (SD) = 1.2, 87% male] completed measures assessing TBI, substance use, psychiatric symptoms, and antisocial traits/behaviours. TBI was defined as ever having sustained a head injury causing unconsciousness for more than 20 minutes. Results,Nearly one-in-five youths (18.3%) reported a lifetime TBI. Youths with TBIs were significantly more likely than youths without to be male, have received a psychiatric diagnosis, report an earlier onset of criminal behaviour/substance use and more lifetime substance use problems and past-year criminal acts, evidence psychiatric symptoms, report lifetime suicidality, be impulsive, fearless, and external in locus of control and criminally victimized in the year preceding incarceration. Male gender and frequency of own criminal victimization were important predictors of TBI in multivariate analyses. Regression analyses adjusted for demographic factors, indicated that youths with TBIs were at significantly elevated risk for current depressive/anxious symptoms, antisocial behaviour, and substance abuse problems. Conclusions,TBI is common among delinquent youth and associated with wide ranging psychiatric dysfunction; however, the causal role of TBIs in the pathogenesis of co-morbid conditions remains unclear. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Chronic post-traumatic headache after head injuryin children and adolescents

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2008
Charlotte Kirk MBChB MRCPCH BSc
This was a prospective, observational study of children aged 3 to 15 years admitted to hospital with head injury (HI). Demographic data and information on the nature of the HI, and history of premorbid headache were collected. A structured telephone questionnaire was used to interview parents and children 2 months after injury and at 4-monthly intervals for up to 3 years, if headache was reported. One hundred and ninety children were admitted with HI. Data were available on 117 children (81 males, 36 females; mean age 8y 5mo [SD 3y 1mo]). HI was minor in 93 patients and significant in the rest. Minor HI was defined as a closed injury, no loss of consciousness, and a Glasgow Coma Score (GCS) of 13 to 15. Significant HI was associated with loss of consciousness for >30 minutes, GCS of <13, and post-traumatic amnesia for >48 hours. Eight children (five males, three females; mean age 10y 7mo [SD 2y]) reported chronic post-traumatic headache (CPTH). Five children had episodic tension-type headache and three had migraine with or without aura. Headache resolved over 3 to 27 months in all except one child who was lost to follow-up. Premorbid headache in three children transformed in frequency and type following HI. These patients were excluded from the study. CPTH is common after minor and significant HI. It has the clinical features of tension-type headache and migraine and has a good prognosis. [source]

Inflicted head injury in infancy and the wisdom of King Solomon

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2005
Colin Kennedy
No abstract is available for this article. [source]

A comparison of risk factors for habitual violence in pre-trial subjects

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2002
S. Z. Kaliski
Objective: Pre-trial referrals to the Valkenberg Hospital forensic unit over a 6-month period were studied. Habitually violent offenders were compared with those with no history of violence. Methods:, Risk factors known to be associated with violent behaviour were elicited, i.e. demographics, behaviour during index offence (such as impulsivity, identity of victim, use of weapon, accomplices, intoxication, psychotic symptoms), psychiatric and family histories, history of suicide attempts, past child abuse, head injury, criminal record, psychiatric diagnosis and presence of medical disorders. EEG's, Barratt's Impulsivity, Zuckerman's Sensation Seeking and Mini-Mental Scales were administered. Behaviour in the ward during the 30 days was also appraised. Logistic regression models were used to determine relative risks. Results:, There were 155 subjects; 89.7% were male, 71.6% were single and 58.7% were unemployed. For 44.5% the index offence was violent, and 9.7% had committed sexual offences; 61.9% had histories of habitual violence. A psychotic disorder was diagnosed in 32.3% and a personality disorder in 48.4%. Habitually violent subjects were distin- guished by a history of issuing threats (OR=3.68; CI=3.19,4.16; P= 0.000), delusions of persecution (OR=3.43; CI=2.67,4.17; P=0.001), history of conduct disorder (OR=1.95; CI=1.70,2.19; P=0.006), alcohol/substance abuse (OR=2.08; CI=1.53,2.61; P=0.008) and violent index offence (OR=1.66; CI=1.54,2.61; P=0.035). Conclusion: This seems to confirm the relationship between threats, feeling threatened, psychosis, a history of antisocial behaviour and alcohol abuse. [source]

White-eyed blowout fracture: Another look

EMERGENCY MEDICINE AUSTRALASIA, Issue 3 2009
Patrick Mehanna
Abstract Orbital floor fractures have the potential to cause significant morbidity both in the short and long terms and commonly present to the ED for initial assessment. Although treatment of the majority of these injuries involves clinic review and possible later surgery, there is a specific subset that present to emergency clinically suggestive of a head injury. This subset, ,white-eyed blowout', usually occurring under 18 years of age, with a history of trauma and little sign of soft tissue injury, describes a trap door orbital floor fracture with herniation and acute entrapment of orbital muscle and is regarded as a maxillofacial emergency. The injury presents with marked nausea, vomiting, headache and irritability suggestive of a head injury that commonly distracts from the true aetiology. It requires prompt diagnosis and treatment to avoid permanent morbidity. We present three cases and discuss their management. [source]

Fall-related brain injuries and the risk of dementia in elderly people: a population-based study

Early predictors of morbidity and mortality in trauma patients treated in the intensive care unit

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2010
O. BRATTSTRÖM
Background: We investigated the incidence and severity of post-injury morbidity and mortality in intensive care unit (ICU)-treated trauma patients. We also identified risk factors in the early phase after injury that predicted the later development of complications. Methods: A prospective observational cohort study design was used. One hundred and sixty-four adult patients admitted to the ICU for more than 24 h were included during a 21-month period. The incidence and severity of morbidity such as multiple organ failure (MOF), acute lung injury (ALI), severe sepsis and 30-day post-injury mortality were calculated and risk factors were analyzed with uni- and multivariable logistic regression analysis. Results: The median age was 40 years, the injury severity score was 24, the new injury severity score was 29, the acute physiology and chronic health evaluation II score was 15, sequential organ failure assessment maximum was 7 and ICU length of stay was 3.1 days. The incidences of post-injury MOF were 40.2%, ALI 25.6%, severe sepsis 31.1% and 30-day mortality 10.4%. The independent risk factors differed to some extent between the outcome parameters. Age, severity of injury, significant head injury and massive transfusion were independent risk factors for several outcome parameters. Positive blood alcohol was only a predictor of MOF, whereas prolonged rescue time only predicted death. Unexpectedly, injury severity was not an independent risk factor for mortality. Conclusions: Although the incidence of morbidity was considerable, mortality was relatively low. Early post-injury risk factors that predicted later development of complications differed between morbidity and mortality. [source]

Amantadine for traumatic brain injury: does it improve cognition and reduce agitation?

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2005
H. Leone PharmD
Summary Objective:, To review the available literature pertaining to amantadine as therapy for improving cognition and reducing agitation following a non-penetrating traumatic brain injury (TBI). Data sources:, Clinical literature was accessed through MEDLINE (from 1966 to February 2004) and bibliographic searches. Key search terms included ,amantadine', ,traumatic brain injury', ,cognition', and ,agitation'. Data synthesis:, Amantadine is primarily used for treatment and prophylaxis of influenza A. Its ability to improve mentation and motor function in patients with head injury remains questionable. An evaluation of five clinical trials, two case reports, and one case series is conducted focusing on the use of amantadine following TBI. Patients in clinical trials were assessed using a variety of neuropsychological tools aimed at, among other things, assessing cognition and agitation. Although individual patient results varied, the majority of patients studied showed improved neuropsychological test scores. Similar observations are noted in the case reports and case series. Improvement in cognition and reduced agitation seems to occur with post-injury amantadine therapy. Conclusions:, Amantadine is a reasonable option for improving cognition and reducing agitation following a TBI but confirmatory evidence of the efficacy the drug is necessary. [source]

Traumatic pseudoaneurysm of superficial temporal artery: A case report

JOURNAL OF CLINICAL ULTRASOUND, Issue 5 2009
Suzi Su-Hsin Chen PhD
Abstract We report a case of a 36-year-old male who presented with a pulsatile mass at the left temporal region after a head injury. Duplex sonographic examination confirmed the diagnosis of traumatic pseudoaneurysm of the superficial temporal artery. Imaging showed the pseudoaneurysm was partially thrombosed. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009 [source]

Reduced right hemisphere activation in severely abused violent offenders during a working memory task: An fMRI study

AGGRESSIVE BEHAVIOR, Issue 2 2001
Adrian Raine
Abstract This study uses functional magnetic resonance imaging (fMRI) to address two important gaps in our knowledge of brain functioning and violence: (1) What are the brain correlates of adults in the community who have suffered severe physical abuse early in life and who go on to perpetrate serious violence in adulthood? (2) What characterizes those who experience severe physical abuse but who refrain from serious violence? Four groups of participants recruited from the community (controls, severe physical child abuse only, serious violence only, and severely abused, seriously violent offenders) underwent fMRI while performing a visual/verbal working memory task. Violent offenders who had suffered severe child abuse show reduced right hemisphere functioning, particularly in the right temporal cortex. Abused individuals who refrain from serious violence showed relatively lower left, but higher right, activation of the superior temporal gyrus. Abused individuals, irrespective of violence status, showed reduced cortical activation during the working memory task, especially in the left hemisphere. Brain deficits were independent of IQ, history of head injury, task performance, cognitive strategy, and mental activity during the control task. Findings constitute the first fMRI study of brain dysfunction in violent offenders, and indicate that initial right hemisphere dysfunction, when combined with the effects of severe early physical abuse, predisposes to serious violence but that relatively good right hemisphere functioning protects against violence in physically abused children. Aggr. Behav. 27:111,129, 2001. © 2001 Wiley-Liss, Inc. [source]

Prognosis following head injury: a survey of doctors from developing and developed countries

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2007
Pablo Perel MSc MD
[source]

An Unusual Zip Gun Suicide,Medicolegal and Ballistic Examination

JOURNAL OF FORENSIC SCIENCES, Issue 1 2010
Petr Hejna M.D., Ph.D.
Abstract:, Home-made guns are imitations of typical firearms and usually have handgun characteristics. This article presents an unusual case of a suicide carried out by means of a fatal gunshot wound to the head using a home-made zip gun. A 49-year-old male, with a history of paranoid psychosis was found dead in the dwelling place of a family house. The investigation at the crime scene did not lead to suspicion of a gunshot wound because of the unusual nature of the firearm used. A medical examiner diagnosed an opened head injury as the primary cause of the victim's death. The autopsy findings provided immediate grounds for further inspection of the crime scene. Subsequently, a simple zip gun, which had been overlooked during the scene investigation, was discovered. An undeformed projectile recovered from the victim's head was consistent with the use of the home-made firearm. Following the completion of the investigations and autopsy, the death was classified as a suicide. [source]

Resumption of oral intake following percutaneous endoscopic gastrostomy

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 6 2009
Sudarshan Paramsothy
Abstract Background and Aims:, Percutaneous endoscopic gastrostomy (PEG) provides enteral nutrition to patients who cannot swallow. Few studies have prospectively evaluated its long-term outcomes or eventual resumption of oral intake. Methods:, Consecutive PEG patients were prospectively recruited from a tertiary hospital over 12 months and followed until all had met the primary endpoints of death or resumption of oral diet with PEG extubation. Data was collected by standardised periodic phone interview. Results:, Forty patients (24 males, median age 74 years) were followed for up to 8.4 years (median 5.3 months, interquartile range [IQR] 13.6 months). The end-of-study mortality rate was 70% (median 6.8 months, IQR 19.9 months) and the only predictor of mortality was head injury as the indication for PEG (Cox regression HR 5.90, 95% CI: 1.2,28.4). At two years following PEG, 30% of patients had resumed oral intake (median 2.9 months, IQR 7.2 months) and 19% remained on PEG-feeding. Predictors of resumption of oral intake were the ability to tolerate some oral intake at 3 months (HR: 248.5, 95% CI: 8.7,7065.3) and 6 months (HR: 6.3, 95% CI: 1.03,38.9) but not at 12 months. Cumulative survival was highest for ear nose and throat (ENT) tumour and worst for acute head injury (log rank P = 0.048). Conclusions:, Half of all PEG patients remained alive at 2 years using PEG or have resumed full oral intake. A supervised trial of oral intake at 3 or 6 months may help predict eventual resumption of per oral diet. [source]