• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.353-359
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• 2000

Objective : The fracture on the frontal bone in head-injured patients may be commonly encountered in the clinical situations. Biomechanical studies demonstrate that the anterior wall of the frontal sinus is intermediate in its ability to resist fracture on direct impact. If the frontal sinus is large and the anterior table is able to disperse the force of the impact over a greater area, the posterior table and intracranial contents usually can be spared. We analyzed the clinical features of the patients who presented with frontal skull fracture due to frontal blows. Patients and Methods : From January, 1992 to December, 1997, 172 patients with frontal skull fracture were selected among 1911 patients with head injury who were admitted to department of neurosurgery. Clinical records and radiological studies of all patients were reviewed and evaluated retrospectively. Results : The neurobehavioral changes was seen in 34 cases(19.8%) and showed statistical significances in case of facial bone fractures, acute subdural hematoma(SDH), and positive frontal lobe releasing sign(p<0.05). The good glasgow outcome score group(GOS, good recovery & moderate disability) at discharge was revealed in 77.3% of total patient population. The poor GOS group(severe disability & vegetative state & death) at discharge was revealed in 22.7%. The poor GOS group at discharge have statistical significances with acute epidural hematoma(EDH), traumatic intraventricular hemorrhage(t-IVH), traumatic intracranial lesion, poor initial glasgow coma scale(GCS) scores & Revised Trauma Score(RTS)(p<0.05). Conclusion : Because of their anatomical relationships and neurobehavioral patterns due to vulnerability of the frontal lobe, the frontal injury should be considered as complicated facial injuries. Therefore, these patients are more likely to have a cosmetic or neuropsychiatric problems.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.393-395
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• 2005

Cerebral infarction rarely occur following head injury. The authors present the case of a 39-year-old man with complete infarction in the middle cerebral artery[MCA] and anterior cerebral artery[ACA] territories ccurred immediately after head injury. He had compound depressed fracture in right frontal bone with no neurological deficit. After the depressed bone elevation, postoperative computed tomography scan showed the right MCA and ACA territory infarction with midline shift. Cerebral angiography obtained on the day after emergent decompressive craneictomy showed the complete occlusion of the internal carotid artery[ICA] at the level of lacerum ICA segment. There was no evidence of neck vessel dissection and basal skull fracture. Cerebral infarction can occur in an ultraearly period after head injury without neck vessel dissection or basal skull fracture. We stress the need for attention to the cerebral infarction as the cause of a rare neurological deterioration of the head trauma.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.3
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• pp.166-168
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• 2016

It can be challenging to create a safe airway in maxilla facial fracture and some skull surgeries. In this case study, the patient experienced jaw fractures that disturbed the dental occlusion and associated fracture of the base of the skull. Neither nasal nor oral intubation was possible based on the side effects of tracheotomy; therefore, submental intubation was applied successfully. The procedure and results are presented in the text.

• Journal of The Korean Dental Society of Anesthesiology
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• v.4 no.2 s.7
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• pp.96-99
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• 2004

구강저를 통한 기관내 삽관은 1986년 Altemir에 의해 처음 소개된 바 있는데 그 후 1993년 Hoenig와 Braun 및 같은 해 Stoll 등에 의해서나, 또는 1996년 Prochno 등에 의해 계속 변형된 방법으로 문헌에서 기술되어 왔다. 이 방법은 치과 영역 특히 구강악안면외과의 외상수술시 이상적인 교합을 얻기 위해 임시 상하악간 고정(intermaxillary fixation)을 할 수 있고 중안모 골절(midface fracture)의 회복을 위한 비관 삽관의 불편함을 피할 수 있는 유리한 점이 있으며, 또한, 정복 및 고정술이 필요한 비골 골절(nasal bone fracture)에서나 두개기저골 골절(skull base fracture)에서 여러 감염 등 합병증을 피하기 위해 추천될 수 있다. 또한, 목 부위에 비심미적인 반흔을 만들게 되며 여러 합병증을 초래할 수 있는 기관절개술(tracheostomy)보다 유용할 수 있다. 본 증례보고에서는 교통사고로 두개기저부 골절을 동반한 심한 중안모 골절 환자에서 적용시킨 경우를 알아보고, 아울러 이러한 악하부 삽관의 장, 단점 및 시술 과정 등에 대해 고찰해보고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.2
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• pp.189-195
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• 2010

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal & gastric aspiration and hypovolemic shock. Therefore, the rapid & correct bleeding control is very important for life-saving in the medical emergency room. In spite of the bleeding control methods of the wound suture & direct pressure, the postoperative bleeding can be occurred, because of the presence of various bleeding disorders & postoperative delayed wound infections. The proper care of bleeding disorders & wound infections are very important for the control of the delayed postoperative rebleeding. In spite of these methods, active oral bleeding can be presented by the other causes of head injury. A rare but particularly dangerous sort of bleeding that may have an especial importance to the patient with severe basal skull fracture that damage large vessels and even the cavernous sinus. The occurrence of profuse nasal or oropharyngeal bleeding may arise from damage to the anterior and posterior ethmoidal vessels, but when mixed with brain tissue it is evidence of mortal damage. In this condition, rapid entire oropharyngeal packing is essential for the control of active oral bleeding. This is a case report of rapid rational bleeding control method by much amount of wet gauze packings, in a 44-years-old male patient with active oropharyngeal bleeding by basal skull fractures.

• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.318-321
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• 2009

Tension pneumocephalus may follow a cerebrospinal fluid(CSF) leak communicating with extensive extradural air. However, it rarely occurs after diagnostic lumbar puncture, and its treatment and pathophysiology are uncertain. Tension pneumocephalus can develop even after diagnostic lumbar puncture in a special condition. This extremely rare condition and underlying pathophysiology will be presented and discussed. The authors report the case of a 44-year-old man with a basal skull fracture accompanied by pneumothorax necessitating chest tube suction drainage, who underwent an uneventful lumbar tapping that was complicated by postprocedural tension pneumocephalus resulting in an altered mental status. The patient was managed by burr hole trephination and saline infusion following chest tube disengagement. He recovered well with no neurologic deficits after the operation, and a follow-up computed tomography (CT) scan demonstrated that the pneumocephalus had completely resolved. Tension pneumocephalus is a rare but serious complication of lumbar puncture in patients with basal skull fractures accompanied by pneumothorax, which requires continuous chest tube drainage. Thus, when there is a need for lumbar tapping in these patients, it should be performed after the negative pressure is disengaged.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.534-536
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• 2014

Due to improvements in emergency resuscitation provided by rescue teams, more trauma victims who could have died due to sudden heart failure at the scene are brought to the hospital following resuscitation. Most of these patients present with major organ injuries and hypovolemic shock at the time of trauma. However, head trauma associated with sudden heart arrest is rare. Here, we report a case of ring fracture with pontomedullary laceration that led to sudden heart arrest.

• Journal of Auto-vehicle Safety Association
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• v.4 no.2
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• pp.22-26
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• 2012

Prasad and Mertz published head injury risk curves for skull fracture and for Abbreviated Injury Scale (AIS) ${\geq}4$ brain injury due to forehead impacts based on the 15 ms HIC criterion. KNCAP adopted the HIC36 criterion for the male dummy and the HIC15 criterion for the female dummy. In this paper, it was studied that which of the HIC15 and HIC36 was more effective for the male dummy head injury evaluation. The frontal US-NCAP data for the 7 vehicles from the NHTSA test database were used to evaluate the head injuries. In the case of using the HIC15 and evaluation range 250~700, the discrimination of the rating for the occupant head injury was increased.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.96-98
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• 2009

Acute epidural hematoma (AEDH) occurring as a result of traumatic head injury constitutes one of the most critical emergencies in neurosurgery. However, there are only several reports that show the rapid disappearance of AEDH without surgical intervention. We suggest redistribution of hematoma through the overlying skull fractures as the mechanism of rapid disappearance of AEDH. A 13-year-old female fell from a height of about 2 m and presented with mild headache. A computed tomography (CT) scan performed 4 hours after the injury revealed an AEDH with an overlying fracture in the right temporal region and acute small hemorrhagic contusion in the left frontal region. A repeat CT scan 16 hours after injury revealed that the AEDH had almost completely disappeared and showed an increase in the epicranial hematoma. The patient was discharged 10 days after injury with no neurological deficits. This case is characterized by the rapid disappearance of an AEDH associated with an overlying skull fracture. We believe that the rapid disappearance of the AEDH is due to the redistribution of the hematoma, rather than its resolution or absorption, and fracture plays a key role in this process.

• Journal of Korean Neurosurgical Society
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• v.46 no.5
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• pp.484-487
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• 2009

It is not uncommon for hemangiomas to occur in the calvarium, accounting for about 10% of the benign skull tumors. A 46-year-old man was presented with a palpable scalp mass on the left parietal region. Past medical history indicated that he had undergone cranioplasty 25 years prior due to a depressed skull fracture suffered from a traffic accident. Magnetic resonance imaging revealed mixed signal intensity mass on T1 -and T2- weighted images pushing a linear signal void lesion outward in the left parietal region. After total surgical removal along with cranioplasty, he was discharged without neurological deficits. Histological examination of the surgical specimen revealed a cavernous hemangioma. A skull hemangioma occurring at the site of a cranioplasty has not yet been reported. Therefore, authors report this case in combination with a pertinent literature review.