Depressed skull fractures: a pattern of abusive head injury in three older children

2003 ◽  
Vol 27 (11) ◽  
pp. 1323-1329 ◽  
Author(s):  
Anselm C.W Lee ◽  
Yvonne Ou ◽  
Dawson Fong
Author(s):  
Chimba Mkandawire ◽  
Eric S. Winkel ◽  
Nicholas A. White ◽  
Edward Schatz

Operators of personal watercraft (PWC) can perform maneuvers that may result in riders separating from the moving watercraft; the tested hypothesis was whether substantial brain injury concurrent with substantial facial and skull fractures can occur from contact with the PWC during a fall. The present study reports the potential for AIS2+ facial/skull fractures and AIS2+ traumatic brain injury (TBI) during a generic fall from the PWC in the absence of wave-jumping or other aggressive maneuvers. While it is well known that PWC can be used for wave-jumping which can result in more severe impacts, such impacts are beyond the scope of the present study because of the wide variability in occupant and PWC kinematics and possible impact velocities and orientations. Passenger separation and fall kinematics from both seated and standing positions were analyzed to estimate head impact velocities and possible impact locations on the PWC. A special purpose headform, known as the Facial and Ocular CountermeasUre Safety (FOCUS) device was used to evaluate the potential for facial fractures, skull fractures and TBI. Impacts between the FOCUS headform and the PWC were performed at velocities of 8, 10, and 12 miles per hour at 5 locations near the stern of a PWC. This study reports impact forces for various facial areas, linear and angular head accelerations, and Head Injury Criteria (HIC). The risk for facial fracture and TBI are reported herein. The results of this study indicate that concurrent AIS2 facial fractures, AIS2+ skull fractures, and AIS2+ TBI do not occur during a simple fall from a PWC.


Neurosurgery ◽  
1979 ◽  
Vol 5 (5) ◽  
pp. 559-565 ◽  
Author(s):  
Paul Steinbok ◽  
Gordon Thompson

Abstract Serial estimations of serum cortisol were performed in 49 patients with craniocerebral trauma. Abnormalities of serum cortisol, including alterations in diurnal rhythm and elevations of serum cortisol level, occurred in 21 patients. The frequency and severity of the abnormalities correlated with the severity of the head injury, and there was a trend suggesting that middle fossa basal skull fractures predisposed to cortisol abnormalities. A further 6 patients were studied to assess the effects of exogenous dexamethasone, and in all patients there was suppression of elevated serum cortisol levels by the dexamethasone. The findings suggest that hypercortisolemia after head injury is related to an alteration rather than an abolition of the normal feedback mechanism.


2018 ◽  
Vol 5 (1) ◽  
pp. 126
Author(s):  
Raunaq S. Chhabra ◽  
Vinayak V. Raje ◽  
Pandurang S. Barve ◽  
Sunil R. Yadav

Background: To study the association of CSF leak in Fronotbasal skull Fractures classified with the Burstein’s Classification.Methods: A prospective study was conducted from November 2014 to May 2016 in patients admitted with head injuries to KIMSDU, Karad, Maharashtra. All data was retrieved using a standardized data collection form.Results: Out of the total 55 patients of frontobasal fracture, 39 (70.9%) were found to have CSF leak. Out of 39 patients with CSF leak 34 (61.8%) had Type I head injury, 3 (5.5%) had Type II head injury, and 2 (3.6%) had Type III head injury. Statistical analysis showed significant association between CSF leak and Burstein’s classes of head injury patients (p< 0.05).Conclusions: It was found that patients who had Burstein Type I injuries had a higher chance of CSF leak and most post traumatic leaks could be managed conservatively.


PEDIATRICS ◽  
1988 ◽  
Vol 81 (1) ◽  
pp. 93-97
Author(s):  
Frederick P. Rivara ◽  
Michael D. Kamitsuka ◽  
Linda Quan

The circumstances and characteristics of emergency room-treated injuries in children younger than 1 year of age were studied and unintentional injuries were compared with those caused by abuse. Unintentional injuries were seen 15 times more frequently in an emergency room than injuries caused by abuse. The majority of unintentional injuries were minor, although skull fractures and fractures of the clavicle did occur. In contrast, injuries caused by abuse were commonly multiple and severe and were more likely to result in long-term disability. Results of this study indicate that unintentional injuries are rarely serious and that closed head injury, rib or lower extremity fractures, and abdominal injuries are usually indicative of abuse.


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