scholarly journals Retroclival and spinal subdural hematoma after traumatic brain injury - A case report and literature review

2019 ◽  
Vol 10 ◽  
pp. 86 ◽  
Author(s):  
Saúl Solorio-Pineda ◽  
Adriana Ailed Nieves-Valerdi ◽  
José Alfonso Franco-Jiménez ◽  
Guillermo Axayacalt Gutiérrez-Aceves ◽  
Luis Manuel Buenrostro-Torres ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Subdural Hematoma ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Traumatic Injury ◽  
Vascular Lesions ◽  
Vehicle Accidents ◽  
Spinal Subdural Hematoma

Background: Retroclival hematomas are rare and occur mostly in the pediatric population. They are variously attributed to trauma, apoplexy, and vascular lesions. With motor vehicle accidents (MVAs), the mechanism of traumatic injury is forced flexion and extension. There may also be associated cervical spinal and/or clivus fractures warranting fusion. Case Description: A 35-year-old male sustained a traumatic brain injury after a fall of 5 m at work. His Glasgow coma scale (GCS) on admission was 13 (M6V3O4). He had no cranial nerve deficits. The brain computed tomography (CT) showed a retroclival subdural hematoma that extended to the C2 level. Conclusions: Most retroclival hematomas are attributed to MVAs, and cranial CT and magnetic resonance studies typically demonstrate a combination of posterior fossa hemorrhage with retroclival hematomas (intra or extradural). Patients with retroclival hematomas but high GCS scores on admission usually have better prognoses following traumatic brain injuries attributed to MVA. Notable however is the frequent association with additional cervical and/or craniocervical injuries (e.g. such as odontoid fracture) that may warrant surgery/fusión.

Incidence of Neck Pain in Pediatric Mild Traumatic Brain Injury in the Emergency Department

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S10.3-S11
Author(s):  
Brieana Hope Rodriguez ◽  
Danny Thomas
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Neck Pain ◽  
Mild Traumatic Brain Injury ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Motor Vehicle Accidents ◽  
Vehicle Accidents

ObjectiveTo determine (1) the frequency of reported cervical spine pain in patients diagnosed with mild traumatic brain injury (mTBI) in the Children's Hospital of Wisconsin emergency department (ED), and (2) the predictors of number of follow up visits for concussion related symptoms between those with and without neck pain.BackgroundThere has been little research on the frequency of concomitant injury, specifically neck pain associated with TBI in the pediatric population. Given the potential influence of neck pain on recovery from mTBI, we sought to report on the frequency of reported neck pain in the sample of pediatric ED patients reporting mTBI symptoms.Design/MethodsThe sample was obtained through a retrospective analysis in the setting of Children's Hospital of Wisconsin Emergency Department with a subject selection of patients diagnosed with a concussion/mTBI between the dates of 11/1/2015–06/30/2018.ResultsWe analyzed 652 charts. The frequency of reported neck pain in the pediatric population being evaluated for mTBI in the ED was 13.8%. Of these patients, 32.2% had subsequent follow up visits related to their concussion/neck pain compared to 31.1% in patients without neck pain in the ED. In regards to the TBI cause, 47.8% were due to accidental falls, 40.3% were due to other accidents not related to motor vehicles, and 10.0% were due to motor vehicle accidents.ConclusionsIn comparison to the adult mTBI population, the pediatric mTBI population had a significantly less reported frequency of neck pain in the ED. This is not surprising as the majority of adults presenting for concussions and neck pain are post-motor vehicle accidents, whereas the majority of children are presenting after accidental falls. There did not seem to be an association between concussions with concomitant neck pain and prolonged recovery or increased morbidity as determined by follow up visits.

Mild traumatic brain injury from motor vehicle accidents: Factors associated with return to work

1999 ◽  
Vol 80 (4) ◽  
pp. 392-398 ◽  
Author(s):  
Carol F. Ruffolo ◽  
Judith F. Friedland ◽  
Deirdre R. Dawson ◽  
Angela Colantonio ◽  
Peter H. Lindsay
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Return To Work ◽  
Mild Traumatic Brain Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Factors Associated ◽  
Vehicle Accidents

scholarly journals Traumatic Brain Injury Related Hospitalization and Mortality in California

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Clint Lagbas ◽  
Shahrzad Bazargan-Hejazi ◽  
Magda Shaheen ◽  
Dulcie Kermah ◽  
Deyu Pan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Age Groups ◽  
Motor Vehicle Accidents ◽  
Elderly Male ◽  
Cross Sectional ◽  
Discharge Data ◽  
Vehicle Accidents

Objective. The aim of this study is to describe the traumatic brain injury (TBI) population and causes and identify factors associated with TBI hospitalizations and mortality in California.Methods. This is a cross-sectional study of 61,188 patients with TBI from the California Hospital Discharge Data 2001 to 2009. We used descriptive, bivariate, and multivariate analyses in SAS version 9.3.Results. TBI-related hospitalizations decreased by 14% and mortality increased by 19% from 2001 to 2009. The highest percentages of TBI hospitalizations were due to other causes (38.4%), falls (31.2%), being of age≥75years old (37.2%), being a males (58.9%), and being of Medicare patients (44%). TBIs due to falls were found in those age≤4years old (53.5%),≥75years old (44.0%), and females (37.2%). TBIs due to assaults were more frequent in Blacks (29.0%). TBIs due to motor vehicle accidents were more frequent in 15–19 and 20–24 age groups (48.7% and 48.6%, resp.) and among Hispanics (27.8%). Higher odds of mortality were found among motor vehicle accident category (adjusted odds ratio (AOR): 1.27, 95% CI: 1.14–1.41); males (AOR: 1.36, 95% CI: 1.27–1.46); and the≥75-year-old group (AOR: 6.4, 95% CI: 4.9–8.4).Conclusions. Our findings suggest a decrease in TBI-related hospitalizations but an increase in TBI-related mortality during the study period. The majority of TBI-related hospitalizations was due to other causes and falls and was more frequent in the older, male, and Medicare populations. The higher likelihood of TBI-related mortalities was found among elderly male≥75years old who had motor vehicle accidents. Our data can inform practitioners, prevention planners, educators, service sectors, and policy makers who aim to reduce the burden of TBI in the community. Implications for interventions are discussed.

Treating Severe Traumatic Brain Injury: Combining Neurofeedback and Hyperbaric Oxygen Therapy in a Single Case Study

2021 ◽  
pp. 155005942110682
Author(s):  
Rebecca D White ◽  
Robert P Turner ◽  
Noah Arnold ◽  
Annie Bernica ◽  
Brigitte N Lewis ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hyperbaric Oxygen ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Short Term Memory ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Single Case ◽  
Treatment Center

In 2014, a 26-year-old male was involved in a motor vehicle accident resulting in a severe traumatic brain injury (TBI). The patient sustained a closed-head left temporal injury with coup contrecoup impact to the frontal region. The patient underwent a left side craniotomy and was comatose for 26 days. After gaining consciousness, he was discharged to a brain injury treatment center that worked with physical, speech, and occupational issues. He was discharged after eight months with significant speech, ambulation, spasticity, and cognitive issues as well as the onset of posttraumatic epilepsy. His parents sought hyperbaric oxygen treatment (HBOT) from a doctor in Louisiana. After 165 dives, the HBOT doctor recommended an addition of neurofeedback (NFB) therapy. In March 2019 the patient started NFB therapy intermixed with HBOT. The combination of NFB and HBOT improved plasticity and functionality in the areas of injury and the correlated symptoms including short-term memory, personality, language, and executive function, as well as significantly reducing the incidence of seizures. Severe brain injuries often leave lasting deficits with little hope for major recovery and there is a need for further research into long-term, effective neurological treatments for severe brain injuries. These results suggest that HBOT combined with NFB may be a viable option in treating severe brain injuries and should be investigated.

scholarly journals Analysis of patients with spinal cord trauma associated with traumatic brain injury

2014 ◽  
Vol 13 (4) ◽  
pp. 302-305 ◽  
Author(s):  
João Simão de Melo Neto ◽  
Waldir Antônio Tognola ◽  
Antonio Ronaldo Spotti ◽  
Dionei Freitas de Morais
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Spinal Cord ◽  
Brain Injury ◽  
Injury Risk ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Vehicle Accidents ◽  
Risk Of Death ◽  
Cord Injury

Objective: Characterize victims of spinal cord injury (SCI) associated with traumatic brain injury (TBI) and risk factors. Methods: Study conducted with 52 victims of SCI associated with TBI. The variables studied were: sex; age; marital status; occupation; educational level; religion; etiology and the lesion area; neurological condition by the ASIA scale; associated injuries and potential risk factors. Results: The male (85%), aged between 21-30 years (25%), civil status stable union (56%), low level of education (69%) and the Roman Catholic religion (77%) presented the greater number of victims. Motor vehicle accidents (58%) were the main etiology. The cervical segment had higher injury risk (RR=3.48, p<0.0001). The neurological status ASIA-E (52%), the syndromic neck pain (35%) and the rate of mild TBI (65%) were the most frequent. Complications occurred in 13 patients with increased frequency of pneumonia (62%). The length of hospital stay was significantly higher (20±28 days) and 17% of patients died. Men (RR=2.14, p=0.028) and individuals exposed to motor vehicle accidents (RR=1.91, p=0.022) showed a higher risk of these lesions concurrently. Moreover, these patients had 2.48 (p<0.01) higher risk of death than victims of SCI alone. Conclusion: The SCI associated with TBI was more frequent in men, young adults, and individuals exposed to motor vehicle accidents. The cervical spine is more likely to be affected. Furthermore, the length of hospitalization is significantly higher and the subjects analyzed have higher risk of death.

scholarly journals Head Impact Injury Mitigation to Vehicle Occupants: An Investigation of Interior Padding and Head Form Modeling Options against Vehicle Crash

2021 ◽  
Author(s):  
Ermias G. Koricho ◽  
Elizabeth Dimsdale
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Impact Load ◽  
Age Groups ◽  
Vehicle Crash ◽  
Materials Modeling ◽  
Head Form ◽  
The Brain

Traumatic Brain Injuries (TBI) occur approximately 1.7 million times each year in the U.S., with motor vehicle crashes as the second leading cause of TBI-related hospitalizations, and the first leading cause of TBI-related deaths among specific age groups. Several studies have been conducted to better understand the impact on the brain in vehicle crash scenarios. However, the complexity of the head is challenging to replicate numerically the head response during vehicle crash and the resulting traumatic Brain Injury. Hence, this study aims to investigate the effect of vehicle structural padding and head form modeling representation on the head response and the resulting causation and Traumatic Brain Injury (TBI). In this study, a simplified and complex head forms with various geometries and materials including the skull, cerebrospinal fluid (CSF), neck, and muscle were considered to better understand and predict the behavior of each part and their effect on the response of the brain during an impact scenario. The effect of padding thickness was also considered to further analyze the interaction of vehicle structure and the head response. The numeral results revealed that the responses of the head skull and the brain under impact load were highly influenced by the padding thickness, head skull material modeling and assumptions, and neck compliance. Generally, the current work could be considered an alternative insight to understand the correlation between vehicle structural padding, head forms, and materials modeling techniques, and TBI resulted from a vehicle crash.

Rotational Acceleration Duration Affects Brain Strains in Lateral Impact

2007 ◽  
Author(s):  
Jianrong Li ◽  
Jiangyue Zhang ◽  
Narayan Yoganandan ◽  
Frank A. Pintar ◽  
Thomas A. Gennarelli
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Angular Acceleration ◽  
The United States ◽  
Physical Models ◽  
Lateral Impact ◽  
Diffuse Brain Injury ◽  
Diffuse Brain

Traumatic brain injury is a leading cause of disability and fatality in the United States. Approximately two million traumatic brain injury cases occur every year [1]. Motor vehicle crashes are a primary source [2]. Both clinical and laboratory studies have been conducted to understand injury mechanisms and establish injury thresholds [3, 4]. Physical models have also been used to investigate injury biomechanics [5, 6]. Angular acceleration is considered as a major cause of diffuse brain injuries (DBI) [7, 8], while the angular velocity is chosen as a suitable load descriptor for a diffuse brain injury criterion [4]. The present study is focused on the effect of angular acceleration duration on brain strains due to lateral impact.

Patterns of Nasoorbitalethmoid Fractures in the Pediatric Population

2019 ◽  
Vol 85 (7) ◽  
pp. 730-732
Author(s):  
Thuy-My T. Le ◽  
Ryan S. Berlin ◽  
Nicholas C. Oleck ◽  
Andrew A. Dobitsch ◽  
Jordan N. Halsey ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Surgical Management ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Pediatric Population ◽  
Management Strategies ◽  
Orbital Fracture ◽  
Facial Fractures ◽  
Frontal Sinus Fracture

There is an absence of literature regarding nasoorbitoethmoid (NOE) facial fractures. Although NOE fractures are uncommon, there are a significant number in the pediatric population. These fractures also often occur in conjunction with other facial fractures because the NOE region adjoins the nose, orbit, maxilla, and cranium. They can also be a harbinger for more serious concerns such as traumatic brain injury and intracranial hemorrhage. For this reason, NOE fractures can be highly complicated and a challenge to manage. We aim to define the etiologies and patterns of NOE fractures to guide hospital and surgical management strategies. From 2001 to 2014, 15 pediatric patients were identified as having sustained an NOE fracture. Four (26.7%) of the patients were female and 11 (68.8%) were male. Average age was 11.40. The most common etiologies recorded were motor vehicle accident (n = 8), pedestrian struck (n = 3), and assault (n = 2). Orbital fracture (n = 13), nasal fracture (n = 13), and frontal sinus fracture (n = 10) were the most commonly associated facial fractures sustained alongside NOE fracture. Several patients sustained traumatic brain injury (n = 11) and loss of consciousness (n = 13). The mean Glasgow Coma Score was 10.5. In addition, eight required intubation and five required a surgical airway. Thirteen of the patients were admitted to the ICU and eight required surgical management for their fractures. Titanium plates were most commonly used (n = 4) for surgical management. Alternatively, resorbable implants were used for two patients. The remaining two were treated with closed reduction.

scholarly journals Traumatic brain injury in dogs and cats: a systematic review

2018 ◽  
Vol 63 (No. 8) ◽  
pp. 345-357 ◽  
Author(s):  
LO Dos Santos ◽  
GG Caldas ◽  
CRO Santos ◽  
DB Junior
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Motor Vehicle ◽  
Brain Parenchyma ◽  
Irreversible Damage ◽  
Vehicle Accidents ◽  
Secondary Damage ◽  
Therapeutic Measures ◽  
Crush Injuries ◽  
The Brain

Traumatic brain injury occurs frequently in dogs and cats due to motor vehicle accidents, falls and crush injuries. The primary lesion occurs at the time of injury and causes direct, irreversible damage to the brain parenchyma and vasculature. Secondary lesions occur in the minutes following the trauma due to a combination of physical and biochemical changes that lead to intracranial hypertension. Therefore, knowing the pathophysiology of the cranioencephalic trauma is essential for treatment directed at minimising secondary damage. The approach to the patient affected by traumatic brain injury is based on the ABCD of trauma, guided by the neurological examination with the aid of imaging exams and adequate therapeutic measures. The treatment of patients with cranioencephalic trauma is still in many ways controversial. For that reason, this literature review aims to address the main points regarding the pathophysiology of this disease and to describe the clinical and surgical therapeutic options currently available.

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