The Journal of cranio-maxillofacial trauma
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Ocular injuries occur commonly in patients with facial trauma. Patients with significant eye injuries may present with grossly normal eyes and good visual acuity; however, subsequent ocular disorders may become apparent. The estimates of incidence vary considerably. Trauma is the second leading cause of blindness, and a review is, therefore, warranted. ⋯ The diagnosis of ocular injuries resulting from trauma is difficult. The recently introduced scoring system was found to improve the procedure. Based on this system, the authors have devised an algorithm to assist the clinician, with emphasis on visual acuity and the importance of visual examination.
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J Craniomaxillofac Trauma · Jan 1996
ReviewAvoiding secondary brain injury after severe head trauma: monitoring and management.
Research has demonstrated that much of the mortality and morbidity in severely head-injured patients is due to secondary injury. The development of techniques to monitor cerebral blood flow, arteriovenous difference of oxygen or saturation of jugular venous blood flow with oxygen, and cerebral metabolic rate of oxygen has led to recognition, treatment, and prevention of secondary insults. ⋯ Special emphasis is given to the factors governing both cerebral blood flow and cerebral blood volume, and how these factors can be monitored and manipulated to strike an optimal balance between the two. This information can aid in determining when it is safe to operate on patients with non-life-threatening conditions.
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J Craniomaxillofac Trauma · Jan 1996
Review Case ReportsTrauma to the temporal bone: diagnosis and management of complications.
The temporal bone contains important sensory and neural structures that may be damaged in patients who experience craniofacial trauma. The most serious complications of temporal bone trauma include facial nerve paralysis, cerebrospinal fluid leak, and hearing loss. ⋯ A high index of suspicion and a thorough knowledge of how to diagnose injury to the temporal bone are paramount in treating patients who present to the emergency room with craniofacial trauma. This article provides an overview of temporal bone trauma, outlines a methodical approach to the patient with temporal bone trauma, details four cases, and describes the treatment of complications.
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J Craniomaxillofac Trauma · Jan 1995
ReviewCarotid-cavernous sinus fistulae in craniofacial trauma: classification and treatment.
Carotid-cavernous sinus fistulae (CCF) represent pathological communications between the intracavernous internal carotid artery and the cavernous venous sinus. Although trauma is the most common cause of high flow carotid cavernous fistulae, they are relatively uncommon in patients sustaining craniofacial trauma. Nevertheless, CCF require early diagnosis and rapid and effective treatment in order to prevent severe and significant morbidity. ⋯ Cerebral angiography is currently the definitive diagnostic study. Obliteration of the fistula by endovascular techniques is the current mainstay treatment, and direct surgery is reserved for cases that have failed endovascular therapy. This article reviews clinical features, pertinent anatomy, and therapeutic approaches to carotid-cavernous sinus fistulae.