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Specialty: Orthopaedics
Source: Injury
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Total 16 results found since Jan 2013.
Missed blunt cerebrovascular injuries using current screening criteria — The time for liberalized screening is now
Blunt cerebrovascular injury (BCVI) has been reported in 1-3% of traumatically injured patients [1] and upwards of 9% of patients with severe head injuries [2]. Although rare, this injury has high morbidity and mortality, mainly due to ischemic stroke, if left untreated. Mortality rates between 20-30% in trauma patients with BCVI have been reported [1] and many survivors sustain permanent neurological deficits. Postulated mechanism of injury include extension, compression, or stretching of vessels within the neck [3].
Source: Injury - February 13, 2023 Category: Orthopaedics Authors: Julia C. Schmidt, Dih-Dih Huang, Andrew M. Fleming, Valerie Brockman, Elizabeth A. Hennessy, Louis J. Magnotti, Thomas Schroeppel, Kim McFann, Landon D. Hamilton, Julie A. Dunn Source Type: research
Missed Blunt Cerebrovascular Injuries Using Current Screening Criteria - The Time for Liberalized Screening is Now
Blunt cerebrovascular injury (BCVI) has been reported in 1-3% of traumatically injured patients [1] and upwards of 9% of patients with severe head injuries. [2] Although rare, this injury has high morbidity and mortality, mainly due to ischemic stroke, if left untreated. Mortality rates between 20-30% in trauma patients with BCVI have been reported [1] and many survivors sustain permanent neurological deficits. Postulated mechanism of injury include extension, compression, or stretching of vessels within the neck.
Source: Injury - February 13, 2023 Category: Orthopaedics Authors: Julia C. Schmidt, Dih-Dih Huang, Andrew M. Fleming, Brockman Valerie, Elizabeth A. Hennessy, Louis J. Magnotti, Schroeppel Thomas, Kim McFann, Landon D. Hamilton, Julie A. Dunn Source Type: research
Natural history and nonoperative management of penetrating cerebrovascular injury
Cerebrovascular injuries from trauma confer an elevated risk of ischemic stroke, with associated morbidity and mortality. These injuries have been studied extensively in the context of blunt trauma such that screening has become standard practice (1, 2), and there are growing data on the natural history of these injuries (3-7). Penetrating cerebrovascular injuries (PCVI) are less common, and there are limited data to guide optimal care. Historically, these have been managed operatively in the setting of penetrating neck wounds, however, there are patients who sustain penetrating trauma but do not have hard signs of injury ...
Source: Injury - November 1, 2022 Category: Orthopaedics Authors: Cordelie E. Witt, Joshua J. Sumislawski, Clay Cothren Burlew Source Type: research
Does Treatment Delay for Blunt Cerebrovascular Injury Affect Stroke Rate?: An EAST Multicenter Study
Stroke is an unfortunately common occurrence in blunt cerebrovascular injury (BCVI). While rates of BCVI related strokes have decreased over time likely due to early diagnosis and use of medical therapy, BCVI still remains a significant cause of stroke occurring in trauma patients [1]. Administration of medical therapy (antiplatelet or anticoagulant agent) is a mainstay of care, with the majority of BCVI-related strokes occurring early after trauma [2].
Source: Injury - August 17, 2022 Category: Orthopaedics Authors: Rachel D Appelbaum, Emily Esposito, M Chance Spaulding, Joshua P Simpson, Julie Dunn, Linda B Zier, Sigrid Burruss, Paul P Kim, Lewis E Jacobson, Jamie M. Williams, Jeffry Nahmias, Areg Grigorian, Laura Harmon, Anna K Gergen, Matthew Chatoor, Rishi Rattan Source Type: research
Factors associated with blunt internal carotid artery injury in petrous temporal bone fractures
The incidence of blunt cerebrovascular injury (BCVI), including internal carotid artery (ICA) injury, is approximately 1% of all blunt trauma patients (1-4). Although rare, these injuries can have devastating complications, including stroke, haemorrhage and death, the chance of which may be reduced with early intervention. In light of this, there have been a number of efforts to improve the screening criteria for detection of these injuries in asymptomatic patients (2, 5). It is currently recommended that patients with a petrous temporal bone (PTB) fracture should be considered for BCVI screening with a computed-tomography...
Source: Injury - March 19, 2022 Category: Orthopaedics Authors: Christine Li, Lorne Green, Jennifer Wang, Dylan Tully, Jonathan Woliansky, Kellie Gumm, Claire Iseli, Katherine Martin, David Read Source Type: research
Effect of time intervals in critical care provided by helicopter emergency medical services on 30-day survival after trauma
Trauma remains one of the leading causes of death and disability worldwide and is the leading cause of death in children and young adults.[1,2] Prehospital patients suffering from trauma have been given special scrutiny by being in the “first hour quintet,” with the other four emergencies being cardiac arrest, acute coronary syndrome, respiratory failure, and stroke. [3] All these conditions require critical care in specialized facilities. However, current trends in European and Australasian politics dictate a centralization o f these tertiary care facilities,[4] and this centralization might prolong the transport time...
Source: Injury - January 15, 2022 Category: Orthopaedics Authors: Johannes Bj örkman, Piritta Setälä, Ilkka Pulkkinen, Lasse Raatiniemi, Jouni Nurmi Source Type: research
A Multicenter Retrospective Cohort Study of Blunt Traumatic Injury to the Common or Internal Carotid Arteries
Guidelines from the Eastern Association for the Surgery of Trauma (EAST), first published in 2010, support grade-dependent management of blunt carotid artery injury (BCI) [1]. In addition, patients presenting with neurologic deficit attributable to the carotid injury should be considered for carotid intervention [1]. More recently, studies have suggested that liberal stenting of asymptomatic patients may be associated with increased risk of stroke and cost, with only marginal benefit [2]. A review of the National Trauma Database has identified that carotid intervention may be associated with higher incidence of stroke in BCI [3].
Source: Injury - August 2, 2021 Category: Orthopaedics Authors: Jean Jacob-Brassard, Mohammed Al-Omran, Barbara Haas, Avery B. Nathens, David Gomez, Andrew D. Dueck, Thomas L. Forbes, Charles de Mestral Source Type: research
The Effect of Anticoagulation on Outcomes After Liver and Spleen Injuries: A Research Consortium of New England Centers for Trauma (ReCONECT) Study.
Over the past several decades, following the initial description of non-operative management in the pediatric population, the management of liver and splenic injuries has transformed from a predominantly operative management to a more selective approach. Non-operative management, along with the adjunctive use of angioembolization, has been successfully utilized for the management of many adults with spleen and liver injuries. [1,2,3,4] During the same time, there has also been an increasing utilization of anticoagulation (AC) agents for a variety of cardiovascular conditions including stroke prevention in atrial fibrillation.
Source: Injury - May 13, 2020 Category: Orthopaedics Authors: Bishwajit Bhattacharya, Reza Askari, Kimberly A Davis, Jon Dorfman, Ahmed I Eid, Ahmed E Elsharkawy, George Kasotakis, Sandra Mackey, Stephen Odom, Barbara U Okafor, Michael Rosenblatt, Alexander Ruditsky, George Velmahos, Adrian A Maung Source Type: research
Increased perioperative C-reactive protein and decreased postoperative albumin is associated with acute posttraumatic osteomyelitis in patients with high-energy tibial fractures
Early diagnosis of acute posttraumatic osteomyelitis (POM) is of vital importance for avoiding devastating complications. Diagnosing POM is difficult due to the lack of a highly specific and sensitive test, such as in myocardial infarct, stroke and intracranial bleeding. Serum inflammatory markers, C-reactive protein (CRP), procalcitonin (PCT), white blood cells (WBC) can support clinical findings but they are not able to differentiate between inflammatory response to infection and the host response to non-infection insult with high specificity and sensitivity.
Source: Injury - March 4, 2019 Category: Orthopaedics Authors: Matja ž Groznik, Matej Cimerman, Lara Lusa, Nina Ružić Gorenjec, Alojz Ihan Source Type: research
Influence of luminal stenosis in aneurysmal and non-aneurysmal blunt cerebrovascular injury
In high grade blunt cerebrovascular injury (BCVI), rates of stroke can be substantial with stroke frequently responsible for patient mortality [1,2]. Pharmacologic therapy with antiplatelet agents or anticoagulation and early BCVI diagnosis decrease stroke rates [3 –5]. Focus is placed on rapid screening and initiation of pharmacologic therapy to prevent strokes. Pharmacologic and endovascular BCVI treatment are chosen based on BCVI grade, which stratifies BCVI from 1-5 based on radiographic characteristics [6].
Source: Injury - November 3, 2018 Category: Orthopaedics Authors: Margaret H. Lauerman, Karen Irizarry, Clint Sliker, Brandon R. Bruns, Ronald Tesoriero, Thomas M. Scalea, Deborah M. Stein Source Type: research
Validation of a monitoring matrix for patients with brain injuries
Brain injury is a leading cause of death and disabilities worldwide whatever the etiology (traumatic, stroke, intrapenchymal hemorrhage, subarachnoid hemorrhage). Two periods are distinguished: primary and secondary brain injury. Primary brain injury is the physical damage to the parenchyma, due to shearing and compression. The secondary brain injury is the result of a complex process, following and worsening the primary brain injury in the ensuing hours and days. These secondary brain Injury (SBI) can be intracranial and extracranial (systemic brain insult).
Source: Injury - September 9, 2018 Category: Orthopaedics Authors: Micka ël Cardinale, Pierre Esnault, Erwan d’Aranda, Eric Meaudre, Guillaume Lacroix Source Type: research
Management of blunt cerebrovascular injury (BCVI) in the multisystem injury patient with contraindications to immediate anti-thrombotic therapy
Practice management guidelines for screening and treatment of patients with blunt cerebrovascular injury (BCVI) have been associated with a decreased risk of ischemic stroke. Treatment: of patients with BCVI and multisystem injuries that delays immediate antithrombotic therapy remains controversial. The purpose of this study was to determine the timing of BCVI treatment initiation, the incidence of stroke, and bleeding complications as a result of antithrombotic therapy in patients with isolated BCVI in comparison to those with BCVI complicated by multisystem injuries.
Source: Injury - July 31, 2017 Category: Orthopaedics Authors: Michelle K. McNutt, A. Cozette Kale, Ryan S. Kitagawa, Ali H. Turkmani, David W. Fields, Sarah Baraniuk, Brijesh S. Gill, Bryan A. Cotton, Laura J. Moore, Charles E. Wade, Arthur Day, John B. Holcomb Source Type: research
Internal fixation versus conservative treatment for elderly patients with a trochanteric hip fracture in conjunction with post-stroke hemiplegia
To retrospectively evaluated Gamma nail internal fixation in the treatment of elderly patients with post-stroke hemiplegia experiencing trochanteric hip fracture.
Source: Injury - July 7, 2016 Category: Orthopaedics Authors: Kainans Li, Yingjie Zheng Source Type: research
Secondary stroke in patients with polytrauma and traumatic brain injury treated in an Intensive Care Unit, Karlovac General Hospital, Croatia
Traumatic brain injury (TBI) is divided into primary and secondary brain injury. Primary brain injury occurs at the time of injury and is the direct consequence of kinetic energy acting on the brain tissue. Secondary brain injury occurs several hours or days after primary brain injury and is the result of factors including shock, systemic hypotension, hypoxia, hypothermia or hyperthermia, intracranial hypertension, cerebral oedema, intracranial bleeding or inflammation. The aim of this retrospective analysis of a prospective database was to determine the prevalence of secondary stroke and stroke-related mortality, causes o...
Source: Injury - November 24, 2015 Category: Orthopaedics Authors: M. Belavić, E. Jančić, P. Mišković, A. Brozović-Krijan, B. Bakota, J. Žunić Source Type: research
