Articles: trauma.
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Eur J Trauma Emerg S · Apr 2009
Acute Traumatic Brain Injury: A Review of Recent Advances in Imaging and Management.
Acute traumatic brain injury (TBI) is a major cause of death and disability in young persons worldwide, producing a substantial economic burden on health services. New technology in computed tomography and magnetic resonance imaging is allowing the acquisition of more accurate and detailed information on cerebral pathology post-TBI. This has greatly improved prognostic ability in TBI and enables earlier identification of pathology, making it potentially amenable to therapeutic intervention. ⋯ Some traditional therapies for the treatment of acute TBI have been proven to be harmful and should be avoided. A number of management strategies have proved potentially beneficial post-TBI, but there is insufficient evidence to make definitive recommendations at present. Future therapies that are currently under investigation include decompressive craniectomy, progesterone therapy, and possibly therapeutic hypothermia.
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It is important to be alert to the possibility of pneumocephalus in patients with head injury. Pneumocephalus is a potentially lethal complication in patients with craniofacial fractures following severe head trauma. ⋯ A time sequence of cerebral CT scans shows how the pneumocephalus developed and finally resolved without surgical intervention. The etiology, diagnosis, treatment and possible complications of this injury are discussed briefly.
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Iatrogenic nerve lesions affecting the long thoracic nerve are very rare after a median sternotomy. Here we report on a patient who developed clinical signs of a so-called "winged scapula" after an uneventful aortic valve replacement for infective endocarditis.
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Traumatic allogenic bone implantation is becoming increasingly common in the setting of road trauma and suicide bombings. We present a unique case where a large bony fragment from one individual became embedded in the arm of another person following a "head-on" collision involving two motorbikes. Several management issues are outlined.