Praxis
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For many years, the FAST examination has represented the standard procedure for diagnostics in traumatology. Until just recently, the ultrasound societies in German speaking countries did not recognize this procedure, which is the reason why it has not been included in current educational programs. The acronym FAST stands for «Focused Assessment with Sonography for Trauma» and is defined as the sonographic detection of free fluid in the intraperitoneal, pleural and pericardial spaces in patients who have suffered blunt or penetrating trauma. ⋯ Nowadays, everybody is talking about FAST-plus in reference to a broad range of applications within the field of airway management, organ injury diagnostics, cerebral hypertension as well as support for invasive procedures. However, the continued rise of FAST will depend on the future role that computed tomography (CT) will be playing. Indeed, it remains unclear whether CT utilized as FACTT («Focused Assessment with Computed Tomography in Trauma») will force out FAST and advance to become the diagnostic gold standard.
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Biography Historical Article
[Physicians--Painting riddle. Paul van Ryssel, cholera, reminiscence of the 1854 epidemic in Jura (1890)].
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Case Reports Comparative Study
[Pulse synchronous bruit, swollen eye, diplopia, exophthalmos, chemosis and diplopia three weeks after a head trauma].
Traumatic carotid-cavernous sinus fistulas represent an uncommon complication of a head trauma. The consequences of a delayed diagnosis are progressive ocular complications such as visual loss, extraocular muscle palsy, progressive proptosis, conjuctival chemosis, retinal vein occlusion and secondary glaucoma. Moreover, severe epistaxis, intracerebral and subarachnoidal hemorrhage may occur. ⋯ Apart from inflammatory, mechanical, autoimmune, vascular and tumorous disorders, a traumatic cause was highly probable considering the patient's history of craniocerebral injury. A rapid elimination of such a fistula is necessary in order to prevent long-term damage. However it is important to consider the possible complications due to the intervention, in our case the risk of a hyperperfusion syndrome with a consecutive cerebral hemorrhage.