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Head injury in the child
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Helen Whitwell, Christopher Milroy
Skull fractures are frequent in inflicted head injury. They indicate impact injury – whether or not there has been additional shaking may be impossible to say. In one series of cases (Geddes et al. 2001a), 36 per cent had one or more skull fractures. This compares with Atwal et al. (1998), where the incidence was 42 per cent. Skull fractures may occur during natural and assisted birth (Figure 15.5) (Heise et al. 1996; King and Boothroyd 1998; Dupuis et al. 2005).
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
Head injury most commonly arises from accidental falls or involvement in high impact injuries such as road traffic accidents and assault. Operative management is more importantly associated with the level and degree of intracranial pathology rather than the fractures incurred.
Cranial Neuropathies I, V, and VII–XII
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Ciliopathy disorders resulting in congenital anosmia: Bardet–Biedl syndrome (retinitis pigmentosa, obesity, polydactyly, hypogonadism, renal dysfunction, and cognitive deficits), Meckel–Gruber syndrome (occipital encephalocele, polydactyly, and cystic renal disease), and Joubert's syndrome (hypoplasia of the cerebellar vermis, hypotonia, oculomotor apraxia, dysregulation of breathing pattern, developmental delay, retinal dystrophy, and renal anomalies).4Disruption of the delicate filaments of the receptor cells as they pass through the cribriform plate: Head injury, particularly if severe enough to cause skull fracture but may occur without a fracture. The damage may be unilateral or bilateral. This accounts for 20% of cases of anosmia/hyposmia.Complications of cranial surgery.Complications of nasal and sinus surgery.Subarachnoid hemorrhage.Chronic meningitis.
Neurosurgical trauma from E-Scooter usage: a review of early case series in London and a review of the literature
Published in British Journal of Neurosurgery, 2022
Sami Rashed, Anna Vassiliou, James Barber
These case series and the wider literature demonstrate the breadth and severity of neurosurgical trauma related to E-scooter usage documented thus far. In terms of cranial trauma, we see head injuries are frequently cited in the literature and often recorded as the most frequently injured body region with mild head injury/concussion accounting for the greatest proportion of these.10,34,35 However, it is also apparent that a significant amount of head injuries reflect more severe pathologies with ICH representing around 15% of head injuries, of which tSAH was the most common. Skull fractures were also seen in around 15% of the head injury population with skull base and frontal bone fractures the most commonly cited. Spinal trauma appears to occur less frequently than head injuries however a wide range of spinal pathologies from E-scooter usage is seen including acute vertebral compression fractures, central cord syndromes, spinal contusions, and ligamentous injuries. Concordantly the level of intervention required for these injuries is varied between simple wound closures, brace fitting, and neurological observations to immediate neurosurgery, protracted stays in the ITU, and 6 mortalities. Two mortalities were assigned to TBI and one to an occipital bone fracture in the literature.
Neurobiology of traumatic brain injury
Published in Brain Injury, 2021
Kajal Bagri, Puneet Kumar, Rahul Deshmukh
Head injury, other than above-discussed mechanisms, causes skull fracture, rapid bleeding, intracranial hemorrhage, and BBB damage as primary events (8). Days or months later, secondary complications arise due to edema, hypoxia, brain ischemia and intracranial pressure (Figure 6). Injury to the hypothalamus and pituitary gland leads to growth hormone deficiency (GHD), which further contributes to decreased muscle mass, increased fat mass, altered metabolic profile, decreased exercise capacity, reduced bone mineral density etc (51).TBI destroy the basal region of the right temporal lobe and the right orbitofrontal cortex, which develop the manic-like symptoms (52,53). Focal brain destruction of CNS leads to aggressive and violent behavior, which could be experienced even by minute stimuli. The patients could found upset, and hypersomnia condition could be observed after TBI.
Symptoms upon postural change and orthostatic hypotension in adolescents with concussion
Published in Brain Injury, 2021
M Nadir Haider, Kush S Patel, Barry S Willer, Victoria Videira, Charles G Wilber, Andrew R Mayer, Christina L Master, Brandon L Mariotti, Christopher Wertz, Eileen P Storey, Kristy B Arbogast, Grace Park, Scott J Oglesbee, Itai Bezherano, Kenneth Aguirre, Jesse G Fodero, Blair D Johnson, Rebekah Mannix, Jeffrey C Miecznikowski, John J Leddy
Concussion, a subset of mild traumatic brain injury (mTBI), is a physiological (1) metabolic (2), and microstructural (3) insult to the brain resulting in, among other findings, altered cardiovascular autonomic nervous system (ANS) function (4–7). Damage to the primary ANS control center, located in the brainstem, has been confirmed in a recent diffusion tensor imaging study following concussion (8). Physiological research has shown that subjects with concussion demonstrate reduced baroreflex sensitivity moving from supine to standing (9) and reduced heart rate variability (HRV, a measure of sympathovagal balance) at rest and during exercise (10), which is consistent with functional uncoupling of the cardiovascular ANS after concussion. Symptoms reported after head injury are not specific to concussion (11), which makes it challenging to diagnose concussion using symptoms alone (12). Physical examination maneuvers that stress the cardiovascular ANS may therefore improve a clinician’s ability to more objectively diagnose concussion beyond that of resting symptom reports, and help identify symptom generators amenable to treatment (13).