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A motorcycle accident
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Signs that indicate a base of skull fracture include: fluid from the ears/nose: this can be colourless with or without blood (CSF otorrhoea/rhinorrhoea with or without blood)racoon eyes: black eyes with no associated damage around the eyescleral/retinal haemorrhageloss of hearing in one or both earsBattle’s sign: bruising over the mastoid behind one/both earspenetrating injury signs, or visible trauma to the skull.
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).
mTBI in the Military and Contact Sports
Published in Mark A. Mentzer, Mild Traumatic Brain Injury, 2020
Since most hits are off center, the premise is that most head accelerations will be rotational, and that “rotational forces strain nerve cells and axons more than linear forces do” as stated by Robert Cantu of Boston University School of Medicine (Foster, 2012). While helmets do a nice job of preventing skull fractures, it is desired that the helmets would also alleviate injury from rotational forces.
Ability of S100B to predict post-concussion syndrome in paediatric patients who present to the emergency department with mild traumatic brain injury
Published in British Journal of Neurosurgery, 2023
Fatos M. Kelmendi, Arsim A. Morina, Agon Y. Mekaj, Shefki Dragusha, Feti Ahmeti, Ridvan Alimehmeti, Qamile Morina, Murat Berisha, Blerim Krasniqi, Berat Kerolli
To the best of our knowledge, this study is the first to compare the number of intracranial lesions, S100B value and the presence of PCS. Using the same set of PCS criteria, Bohnen et al. reported that symptoms in 25% of patients persisted for up to six months.28 This large variation is due to different definitions of mTBI and the use of different outcome variables. The presence of headache, vomiting, LOC, amnesia and nausea in the emergency room after mTBI is closely associated with the presence and severity of PCS. Although the presence of headache within 24 h after the trauma has previously been described as a prognostic factor for outcome after mTBI,29 the relationship with LOC and amnesia has not, to the best of our knowledge, been reported; in our study, 68.2% of patients had amnesia, and 95.5% had LOC. In the literature, a twofold increased risk of skull fracture has been reported in association with post-traumatic vomiting.30 In our study, we did not find any strong correlation between skull fracture and vomiting because only 27% of patients with PCS had a skull fracture and 81% of patients with PCS displayed vomiting in the emergency room. However, in our study, there was a strong association between skull base fracture and dizziness after three months, which can be explained by labyrinth contusion.
Cerebrospinal fluid leak management in anterior basal skull fractures secondary to head trauma
Published in Neurological Research, 2022
Jian-Cheng Liao, Buqing Liang, Xiang-Yu Wang, Jason H. Huang
Indications for operative intervention of CSF leaks after skull base fracture depend on accompanied pathologies, whether it is delayed, persistent/recurrent, or complicated by recurrent meningitis. During the acute phase (from presentation to up to 5 days), surgery is generally performed for complex fractures and/or hematoma evacuation [18]. The onset of CSF leaks can be delayed up to 30 days and rarely recur late after skull fracture. However, recurrent CSF leaks have been reported as late as 48 years after injury [24]. Delayed diagnosis carries a higher risk of meningitis, with up to 16% of patients with occult CSF leaks presenting with meningitis [25,26]. Patients with skull base fractures should therefore be followed accordingly to prevent a missed diagnosis of an occult CSF leak.
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.