• Title/Summary/Keyword: blunt trauma

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Clinical Predictors of Permanent Neuropathy in Patients with Peripheral Painful Traumatic Trigeminal Neuropathy

  • Ryu, Ji-Won;Ahn, Jong-Mo;Yoon, Chang-Lyuk
    • Journal of Oral Medicine and Pain
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    • v.41 no.3
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    • pp.118-125
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    • 2016
  • Purpose: The aims of this study were to evaluate the clinical characteristics of patients with altered sensation and/or pain, and to determine outcome predictors affecting persistent neuropathy. Methods: Patients who complained an altered sensation or pain following trigeminal nerve trauma were involved in this study. To determine outcome predictors affecting persistent neuropathy, the patients were divided into two groups; transient vs. persistent, and the clinical phenotypes are compared between groups. Data were analyzed with t-tests, chi-square, and multiple regression analyses with 95% confidence interval and p<0.05 significance level. Results: A total of 111 patients were included: 23 with transient and 88 persistent groups. The panoramic result and pin-prick test score were statistically different between the groups. Radiating symptoms after blunt and pinprick stimuli were also significantly different between groups. The results revealed that the presence of a neurologic lesion in the panoramic view result, reduced sensation in the pinprick test, and radiation in the pinprick test could affect the persistent group. Conclusions: The presence of a neurologic lesion in panoramic view result and reduced sensation and radiating symptoms in the pin prick test would be defining features of one of the main clinical features of persistent neuropathy. These features could serve as outcome predictors diagnosing the permanent nerve injury in trigeminal nerve.

Scapulothoracic Dissociation (A Case Report) (견갑 흉곽 해리 증후군(1례 보고))

  • Han Chang-Whan;Sung Jin-Hyung;Kim Weon-Yoo;Yoo Jae-Duk;Cha, Weon-Jin;Kim Jin-Young
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.123-127
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    • 1998
  • Scapulothoracic dissociation is a rare entity that consists of the disruption of the scapulothoracic articulation. The mechanism of injury is probably traction caused by a blunt force to the shoulder girdle. This lesion is characterized by massive soft-tissue swelling of the shoulder; lateral displacement of the scapula, an injury to bone, and a severe neurovascular injury. An l8-year-old man sustained a scapulothoracic dissociation as a result of severe shoulder girdle trauma. We report the diagnostic method, clinical and surgical management.

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Esophageal Rupture Due to Diving in Shallow Waters

  • Han, Sung Ho;Chon, Soon-Ho;Lee, Jong Hyun;Lee, Min Koo;Kwon, Oh Sang;Kim, Kyoung Hwan;Kim, Jung Suk;Lee, Ho hyoung;Chon, June Raphael
    • Journal of Trauma and Injury
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    • v.31 no.1
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    • pp.16-18
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    • 2018
  • Delayed esophageal rupture due to blunt injury is not new. However, rupture due to suspected barotrauma is very rare. We describe a case of esophageal rupture in a male 24-year-old patient after diving in shallow waters. The patient was quadriplegic and could not experience the typical chest pain related to rupture and resulting mediastinitis. The rupture was discovered 4 days after emergency decompressive laminectomy and fusion for his cervical spine. The rupture was evidently caused by barotrauma and was discovered four days after admission. He underwent primary closure and pericardial flap as a life-saving procedure.

Traumatic diaphragmatic injuries: Report of 11 cases (외상성 횡격막 손상 치험 11례)

  • Lee, Young;Chang, Il Sung;Kim, In Koo;Bae, Jin Sun;Son, Ki Sub
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.323-327
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    • 1976
  • Eleven cases of traumatic diaphragmatic injuries were treated at the department of Surgery from Jan. 1972 to Nov. 1976 were reviewed in this study. 1. Sex ratio of the observed patients was 10 : 1 showing definitely high incidence male patients. 2. The age distribution in this series ranged from 4 to 49 years of age, and average age was 26 years age. 3. Seven cases were received blunt injury on lower chest and upper abdomen, three cases were stabbed by knife and gunshot injury case was on case 4. Six cases were diagnosed and treated early post-traumatic stage within 24 hours, three cases were repaired within I0 days, and the last case was repaired after 5 years post-trauma. 5. The operative mortality was 10% (1/10), the cause of death was liver failure, after right lobectomy of the liver for traumatic liver rupture.

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Quantitative analysis of hemothorax by computed tomography (흉부 전산화 단층촬영을 이용한 혈흉의 정량분석)

  • 강청희
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.228-232
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    • 1995
  • Computed tomography[CT is an effective technique for the evaluation of the thorax following blunt trauma. To evaluate multiply injured 30 patients who were diagnosed as hemothorax in emergency room, computed tomography of thorax was done. The thickness of slice was one centimeter and the entire pleural cavity from the apex to the costophrenic angle was included in the evaluation. Integration and addition of the hemothorax area for each CT slice was made and amount of blood in the pleural cavity was estimated. The slice which showed largest area of hemothorax was selected and the height and width of the hemothorax area were measured. The number of slices which showed radiographic evidence of hemothorax was counted. Regression analysis was done and measured amount of hemothorax, the height and width of the hemothorax area for each slice and number of slices were put as variables. And following equation was derived. V=108.3A-0.8B-7.4C+84.7 [R2=0.74 [ V: amount of hemothorax, A: height, B: width, C: number of slices Total amount of blood from thoracic drainage was compared to the measured amount by computed tomography and the relation between the two values was statistically significant.[p=0.001 In conclusion, quantitative estimation of size of hemothorax was possible by the above equation and the process was very helpful for determination policy of treatment of individual patient.

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Demonstration of Traumatic Subarachnoid Hemorrhage from the Anterior Choroidal Artery

  • Sim, Ki-Bum;Park, Sukh Que;Choi, H. Alex;Kim, Daniel H.
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.531-533
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    • 2014
  • We present a case of angiographically confirmed transection of the cisternal segment of the anterior choroidal artery (AChA) associated with a severe head trauma in a 15-year old boy. The initial brain computed tomography scan revealed a diffuse subarachnoid hemorrhage (SAH) and pneumocephalus with multiple skull fractures. Subsequent cerebral angiography clearly demonstrated a complete transection of the AChA at its origin with a massive extravasation of contrast medium as a jet trajectory creating a plume. We speculate that severe blunt traumatic force stretched and tore the left AChA between the internal carotid artery and the optic tract. In a simulation of the patient's brain using a fresh-frozen male cadaver, the AChA is shown to be vulnerable to stretching injury as the ipsilateral optic tract is retracted. We conclude that the arterial injury like an AChA rupture should be considered in the differential diagnosis of severe traumatic SAH.

Quantitative Analysis of Lung Contusion (폐좌상의 정량분석)

  • 오중환
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.833-837
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    • 1994
  • Lung contusion due to blunt chest trauma is the most common lung injury and correlated with the clinical course and prognosis. Its diagnosis by CT[Computerized Tomogram] gives a more clear and understandable three dimensional view, by which we are able to measure the volume of the contused and entire lung. Other variables are arterial blood gas, number of rib fracture, presence of hemopneumothorax, sternal fracture and clavicle fracture, number of associated non-thoracic injuries, ventilator time and presence of pulmonary complication. Percentage[%] of lung contusion are expressed as mean $\pm$ standard deviation and data analysis was performed by means of multivariate repeated measures analysis of variance to detect significant differences in variables between positive thoracic injury group and negative group. The paired t-test was used. Differences of percentage of lung contusion between groups were assessed by one-way analysis of variance. Simple linear regression was used to perform correlation analysis in the number of rib fracture and ventilator time. A p value less than 0.05 was considered statistically significant. Pneumothorax and the number of associated other injuries affect the amount of lung contusion and pulmonary complication group has more contused lung volume. Arterial blood gas study shows no correlation with the amount of lung contusion statistically. The number of rib fracture correlated with the amount of lung contusion, which also correlated with ventilator time[r=0.56, p<0.05]. In conclusion, quantitative anlysis of lung contusion by CT predicts the clinical course and treatment such as ventilator care.

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Subperiosteal Orbital Extension of Subgaleal Hematoma - A Case Report - (두피하 혈종으로부터 확장된 안구내 골막하 혈종 - 증 례 보 고 -)

  • Jeong, Byung Ha;Moon, Jae Gon;Kim, Chang Hyun;Lee, Ho Kook;Hwang, Do Yun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1255-1257
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    • 2000
  • The authors present a case of subperisoteal orbital hematoma which is extended from subgaleal hematoma. A 15-year-old-male was admitted with a complaint of multiple visual symptoms of left eye following blunt head trauma. He has suffered from Wilson's disease. Several coagulative laboratory findings were abnormal(fibrinogen and coaguation factor V, X). Computed tomography, sonography and magnetic resonance imaging established the subperiosteal orbital extension of subgaleal hematoma into the orbital cavity. Needle aspiration of orbital subperiosteal hematoma was failed but symptoms and signs of the patient were much improved spontaneously following decrease of subgaleal hematoma. The literature is reviewed and management is discussed.

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Traumatic Aortic Injury: Single-center Comparison of Open versus Endovascular Repair

  • Cho, Jun Woo;Kwon, Oh Choon;Lee, Sub;Jang, Jae Seok
    • Journal of Chest Surgery
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    • v.45 no.6
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    • pp.390-395
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    • 2012
  • Background: Conventional open repair is a suboptimal therapy for blunt traumatic aortic injury (BTAI) due to the high postoperative mortality and morbidity rates. Recent advances in the thoracic endovascular repair technique may improve outcomes so that it becomes an attractive therapeutic option. Materials and Methods: From August 2003 to March 2012, 21 patients (mean age, 45.81 years) with BTAI were admitted to our institution. Of these, 18 cases (open repair in 11 patients and endovascular repair in 7 patients) were retrospectively reviewed and the early perioperative results of the two groups were compared. Results: Although not statistically significant, there was a trend toward the reduction of mortality in the endovascular repair group (18.2% vs. 0%). There were no cases of paraplegia or endoleak. Statistically significant reductions in heparin dosage, blood loss, and transfusion amounts during the operations and in procedure duration were observed. Conclusion: Compared with open repair, endovascular repair can be performed with favorable mortality and morbidity rates. However, relatively younger patients who have acute aortic arch angulation and a small aortic diameter may be a therapeutic challenge. Improvements in graft design, delivery sheaths, and graft durability are the cornerstone of successful endovascular repair.

Traumatic Hemorrhage in Suprapatellar Bursa Complicated by Suprapatellar Plica with Complete Septum -A Case Report- (완전 격막형 슬개상 추벽에 의해 합병된 슬개상 점액낭 내 외상성 출혈 -1예 보고-)

  • Koh, Hae-Seok;In, Yong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.63-65
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    • 2008
  • We treated a 37-year-old male with traumatic hematoma in the suprapatellar bursa that had developed in the form of persistent swelling on suprapatellar area of left knee after blunt trauma. Though there were no obvious abnormal findings on plain roentgenographs, an isolated suprapatellar cystic lesion with fluid-fluid level on T2-weighted sagittal image of MRI was noted. We found the suprapatellar plica with complete septum and no synovitis in the knee joint proper by arthroscopy. We incised the plica and found leakage of blood-stained fluid from the suprapatellar bursa. There were no findings of pigmented villonodular synovitis or other tumorous lesions. At 6 months after surgery, the patient felt symptom-free and there was no recurrence.

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