Brain injury : [BI]
-
Brain injury : [BI] · Jan 2012
Review Case ReportsPenetrating brain injury caused by nail guns: two case reports and a review of the literature.
To the best of the authors' knowledge, there are few case reports of penetrating brain injuries (PBI) caused by nail guns and these have usually involved incomplete penetration of the skull. Complete penetration of a nail into the intracranial cavity is extremely rare. ⋯ Here, two such cases are presented. In the first, the nail entered through the right temporal bone, lodged in the right temporal lobe and was removed via craniotomy with intra-operative ultrasound guidance. In the second, the nail destroyed the left parietal bone, damaged the left internal capsule and lodged in the left temporal lobe near the left petrous apex and the brain stem. According to the latest literature retrieval, this is the first reported case of nail-gun injury to the internal capsule. The position of the nail precluded removal without further neurologic damage. Treatment strategies designed to optimize outcome, with or without surgery, and possible complications are discussed in this report.
-
Brain injury : [BI] · Jan 2012
Review Comparative StudyA clinical comparison of penetrating and blunt traumatic brain injuries.
Traumatic brain injury (TBI) is a leading cause of injury death and long-term disability in the USA. It commonly results from blunt (closed) or penetrating trauma. The majority of civilian TBI is caused by falls or motor vehicle collisions, whereas military TBI mainly results from explosions. Although penetrating injuries are less common than closed injuries in the civilian population, they are far more lethal. Unfortunately, the pathophysiologic differences between penetrating and closed TBI remain poorly understood due to the lack of studies on the subject. Many studies on the prognostic factors of mortality and functional outcome after TBI exclude penetrating brain injuries from their series because they are believed to have a different pathophysiology. ⋯ In view of the incomplete understanding of the impact of mechanism of injury on TBI outcomes, as demonstrated in the current review, new research studies are required to improve evidence-based TBI guidelines tailored especially for penetrating injuries.
-
Brain injury : [BI] · Jan 2012
ReviewVisual impairments in the first year after traumatic brain injury.
This article reviews literature regarding individuals with traumatic brain injury who have vision related impairments up to one year, post-injury. Such impairments may impact rehabilitation of activities of daily living and mobility since vision is integral in much of what one does on a daily basis. ⋯ This review should alert the reader to common visual complaints and defects seen after traumatic brain injury. It is important to screen persons who have suffered traumatic brain injury for sensorimotor vision deficits early on in recovery so that these issues may be addressed and recovery of function and independence in the community are not delayed.
-
Brain injury : [BI] · Jan 2012
Review Case ReportsSyndrome of the trephined following bifrontal decompressive craniectomy: implications for rehabilitation.
The syndrome of the trephined is a rare complication observed following a unilateral decompressive craniectomy for traumatic brain injury. What has not been previously reported is the occurrence of this complication following a bifrontal procedure. The objective of this study was to present two clinical cases that serve to highlight this condition. ⋯ If the use of bifrontal decompressive craniectomies continues to increase it is important that those involved in the rehabilitation process are familiar with this rare condition. Early recognition is important so that patients can receive timely intervention and it also avoids valuable health resources being allocated to patients who cannot receive maximal benefit.
-
Brain injury : [BI] · Jan 2012
Review Case ReportsIs high PEEP ventilation strategy safe for acute respiratory distress syndrome after severe traumatic brain injury?
To investigate the safety and efficacy of high positive end-expiratory pressure (PEEP) ventilation strategy for acute respiratory distress syndrome (ARDS) after traumatic brain injury. ⋯ With close monitoring of cerebral and systemic haemodynamics, PEEP can be safely applied and titrated to an optimal level in the management of ARDS following traumatic brain injury.