Trauma
Thomas H. Williamson in Vitreoretinal Disorders in Primary Care, 2017
Ocular trauma remains a leading cause of visual loss internationally, most often affecting men. Patients are usually aged less than 30 years; trauma may be associated with alcohol and illicit drug usage. The patterns of ocular trauma are constantly changing depending on social, demographic and geographical variations. In blunt trauma, the most common break is an inferotemporal dialysis with superonasal quadrant as the next most common. The patient may not be symptomatic for some time because of the slow onset of detachment and late detachment of the macula. Blunt trauma may rupture the eye wall, most commonly, the sclera at the limbus or posterior to the extraocular muscle insertions often with immediate loss of the crystalline lens and prolapse of the choroid and retina. There are two models for the prediction of visual outcome in open globe injury, the ocular trauma score (OTS) and the classification and regression tree; both have been found to be predictive of outcome.
Ophthalmic trauma
Mary E. Shaw, Agnes Lee in Ophthalmic Nursing, 2018
The ophthalmic nurse requires special skills of observation and history taking, together with the ability to care for a patient who has received trauma to the eye or its surrounding area. Penetrating injury and ocular burns are considered ophthalmic emergencies. Blunt trauma can result in serious ocular damage. Therefore, the nurse must take an accurate history, examine the eye carefully and decide in what order of priority each patient presenting with ocular trauma needs to be placed. An intraocular foreign body results when something enters the eye under force, such as fragments generated when using a hammer and chisel or a lathe. The foreign body may lodge itself in any of the structures of the eye, and examination may not reveal its presence, highlighting the importance of history taking. Subconjunctival haemorrhage can result from a penetrating or blunt trauma which causes the conjunctival blood vessels to bleed.
Severe head injuries
Brian Sindelar, Julian E. Bailes in Sports-Related Concussion, 2017
This chapter briefly discusses the continuum of head injuries involving those of a severe and even catastrophic nature. In general, traumatic brain injury (TBI) can be divided into diffuse and focal injuries. The chapter introduces the various focal lesions and other post-traumatic sequela, such as seizures and arterial dissections, which can potentially occur following a concussion and further contribute to significant morbidity and mortality of the athlete. It discusses the entity of Second Impact Syndrome and describes its presentation, pathophysiology, and management. Skull fractures occur due to direct blunt trauma to the skull. The incidence of this type of injury in athletics has seen a dramatic reduction due to the implementation and improvement in protective equipment, specifically helmets. Patients may be asymptomatic on presentation with Traumatic subarachnoid hemorrhage or complain of headache, nausea, vomiting, or have a spectrum of neurological deficits depending on the extent of injury or location.
COMMON OCULAR INJURIES Assessing the Severity
Published in Postgraduate Medicine, 1975
While the widespread use of impact-resistant eyeglass lenses has helped to prevent penetrating ocular lacerations, blunt trauma to the eye and orbit is still frequent. This article deals with several common injuries to the eye and surrounding areas due to blunt trauma.
Isolated Common Femoral Artery Injury Caused by Blunt Trauma
Published in Acta Chirurgica Belgica, 2008
J.-P. Avaro, N. Biance, P.-H. Savoie, T. Peycru, P.-M. Bonnet, P. Balandraud
The authors report an isolated common femoral artery injury caused by blunt trauma with dissection and secondary ischaemia. A 21-year-old man was admitted to hospital after being stabbed during acute alcoholic intoxication. He presented with a stab wound on the left leg and blunt trauma in the right groin. The surgical exploration of the left-sided wound did not disclose any vascular injury. After a 12-hour period of observation, the patient was discharged. Six hours later, he came back with severe ischaemia on the right leg caused by a femoral artery dissection. The patient underwent surgical revascularization, and fully recovered. Isolated artery blunt trauma is a rare event. In this observation, the absence of early symptoms resulted in delayed diagnosis.
Cervical spine radiography after blunt trauma
Published in Postgraduate Medicine, 1993
Preview Use of cervical spine radiography in patients who have sustained blunt trauma should not be a knee-jerk response; rather, the need for imaging should be based on information obtained from careful history taking and examination of the patient. Dr Roberge discusses who should and should not have cervical spine radiography after blunt trauma and examines other factors in decision making, such as cost, radiation exposure, and fear of litigation.