• Journal of Trauma and Injury
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• v.19 no.1
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• pp.8-13
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• 2006

Purpose: Traumatic head injury is very common in the emergency room. Early diagnosis and treatment can significantly reduce mortality and morbidity. When diagnosis is delayed, however, it could be critical to the patients. In reality, it is difficult to take a brain CT for all patients with head trauma, so this study examined the relationship between type and size of scalp injury and intracranial injury. Methods: This prospective study was conducted from May 2005 to July 2005. The participants were 193 patients who had had a brain CT. Head trauma included obvious external injury or was based on reports of witnesses to the accident. Children under three years of age were also included if there was a witness to the accident. The size of the injury was measured based on the maximum diameter. Results: Out of the total of 193 patients, patients with scalp bleeding totaled 126 (65.2%), and patients without scalp bleeding totaled 67 (34.8%). Among patients with scalp bleeding, patients with intracranial injuries numbered nine, and among patients without scalp bleeding, patients with intracranial injuries numbered 17 (P=0.001). Among patients who showed evidence of scalp swelling with no scalp bleeding, the relationship between the size of the scalp swelling and intracranial injury was statistically significant when the size of the scalp swelling was between 2 cm and 5 cm. Conclusion: Among patients who visit an emergency medical center due to traumatic head injury, patients with no scalp bleeding, but with scalp swelling between 2 cm and 5 cm, should undergone more accurate and careful examination, as well as as a brain CT.

• Transactions of the Korean Society of Automotive Engineers
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• v.13 no.5
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• pp.29-34
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• 2005

141,841 car-to-car collision had occurred in 2003, and among the accidents 51,796 were rear-end impact. According to insurance company for loss or damage, more than $60\%$ of rear-end impact victims suffer neck injury. This means at least 31,000 neck injury victims have happened in 2003. More than $97\%$ of the neck injury victims have low severity injury than A.I.S 2. Head restraint, which is designed to limit rearward head movement and equipped on seat, can considerably protect neck from rear-end impact. In this paper we evaluated head restraint geometry and drivers' sitting position according to RCAR standard and carried out low speed volunteer crash test. The crash speed is 4km/h and N.I.C value is used to determine injury probability. Through these research results we can introduce the method to prevent neck injury at rear-end impact.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.179-183
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• 2005

Whiplash injury commonly seen in automobile accident. This type of acceleration-deceleration injury may rarely lead to unfavorable outcomes as in the case of retropharyngeal hematoma. Because this lesion has the possibility of compressing the potential airway acutely or gradually, not only the rapid assessment and treatment but also closed observation are needed. We report a case of a 20-year-old man, who sustained a whiplash injury from contact with the headrest of his seat after his car was involved in a rollover. He had no symptom except posterior neck pain initially, but complained odynophagia and acute dyspnea after 10 hours of admission. The diagnostic work-up comprising lateral radiograph, CT imaging disclosed the rare constellation of a retropharyngeal hematoma with cervical spine fractures. Medical treatment and close observation were sufficient for the patient because he had no progressive dyspnea or major dysphagia.

• Journal of Auto-vehicle Safety Association
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• v.10 no.2
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• pp.13-19
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• 2018

The purpose of this study was to evaluate the effect of air bag deployment in passenger car head-on collisions on injuries to the driver. The drivers in head-on collisions who were brought to the emergency rooms of two hospitals from January 2011 and October 2014 were evaluated, as were the vehicles involved. The driver injury level were assessed by utilizing Collision Deformation Classification (CDC) codes, and the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS), respectively. In this study, it was shown that the chest ISS and AIS were significantly high when an air bag only is deployed. A statistically significant difference was found in the crush extent when the driver who fastened the seatbelt was found to be affected more than the ISS 9. Even when an air bag is deployed in a head-on car collision, injury severity can vary according to accident circumstances and crash severity. Accordingly, first aid can be rapidly given, and the injured person can be quickly referred to a hospital, only if the assessment of persons involved in a vehicle accident is accurately carried out.

• Journal of Auto-vehicle Safety Association
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• v.4 no.2
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• pp.5-10
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• 2012

Whiplash is the most frequent injury among occupants in low speed rear-end car collision. The aim of this paper is to analyze thecorrelation between influence parameters of head restraints and whiplash injury criteria.In this paper, DFSS (Design for Six Sigma) method is used for optimum design of head restrains. Four control factors of head restraints have selected by function matrix method. The effects of the control factors have been experimentally evaluated by using a sled pulse from 16km/h relative velocity which is suggested by KNCAP (Korean New Car Assessment Program). In order to reduce the noise factors of dynamic tests, whiplash tests were repeated twice. By using DFSS, the correlation between control factors and injury criteria has been comprehended.

• Journal of Trauma and Injury
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• v.33 no.4
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• pp.227-235
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• 2020

Purpose: Alcohol intoxication is commonly associated with traumatic brain injury (TBI), but the influence of alcohol on the Glasgow Coma Scale (GCS) score remains unclear. This study investigates the effects of blood alcohol concentration (BAC) on the GCS score in head trauma patients with alcohol intoxication. Methods: In total, 369 head trauma patients with alcohol intoxication in a 1-year period were retrospectively analyzed. The patients underwent head computed tomography and had a BAC ≥80 mg/dL. Patients were divided into TBI and non-TBI groups. Brain injury severity was further classified using the head Abbreviated Injury Score (AIS). The effects according to 5 BAC groups were examined. Results: The TBI group consisted of 64 patients (16.2%). The mean BAC was significantly higher in the non-TBI group (293.4±87.3 mg/dL) than in the TBI group (242.8±89.9 mg/dL). The mean GCS score was significantly lower in the TBI group (10.3±4.6) than in the non-TBI group (13.0±2.5). A higher BAC showed a significant association with a lower mean GCS score in the TBI group, but not in the non-TBI group. Above ≥150 mg/dL, higher BACs showed significant odds ratios for a lower GCS score. Conclusions: The influence of alcohol in patients with head trauma depended on the presence of a brain injury. An association between a higher BAC and a lower GCS score was only observed in patients with TBI. Therefore, if a severe brain injury is suspected based on a GCS evaluation in patients with alcohol intoxication, prompt diagnosis and intensive care should be performed without delay.

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.271-276
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• 2006

Objective : Despite the recent progress that has been made in intracerebral monitoring, it is still difficult to quantify the exact extent of primary brain damage after severe head injury. In this work, we investigate the role of S-100B protein as a serum marker of brain damage after severe head injury. Methods : 21 patients with severe head injury [GCS score <9] were selected for this prospective study. A venous blood sample was taken as soon as possible after head injury and the serum concentration of S-100B protein was measured daily for five consecutive days. The serum level of S-100B protein was compared with the patients' outcome. The outcome was measured twice, at hospital discharge and after 6 months of follow-up using the Glasgow Outcome Scale[GOS]. Results : Those patients who died within two weeks [after head injury] had a significantly higher serum S-100B value than those who survived [median, 9.64ug/L versus 2.91ug/L]. Seven [78%] of the nine patients who died had a maximum S-100B value of 2ug/L or higher, while three [25%] of the twelve surviving patients showed a maximum S-100B protein value of more than 2ug/L [P<005]. Conclusion : These results indicate that S-100B protein appears to be the most reliable index for estimating the extent of brain damage.

• Journal of Trauma and Injury
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• v.35 no.3
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• pp.159-167
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• 2022

Purpose: The aim of this study was to investigate the epidemiology of trauma inpatients with venous thromboembolism (VTE) symptoms diagnosed using computed tomographic angiography (CTA) in Korea. Methods: In total, 7,634 patients admitted to the emergency department of Gachon University Gil Medical Center, a tertiary hospital, and hospitalized between July 1, 2018 and December 31, 2020 were registered for this study. Of these patients, 278 patients who underwent CTA were enrolled in our study. Results: VTE was found in 120 of the 7,634 patients (1.57%), and the positive diagnosis rate of the 278 patients who underwent CTA was 43.2% (120 of 278). The incidence of VTE was statistically significantly higher among those with severe head and neck injuries (Abbreviated Injury Scale, 3-5) than among those with nonsevere head and neck injuries (Abbreviated Injury Scale, 0-2; P=0.038). In a subgroup analysis, the severe and nonsevere head and neck injury groups showed statistically significant differences in known independent risk factors for VTE. In logistic regression analysis, the adjusted odds ratio of severe head and neck injury (Abbreviated Injury Scale, 3-5) for VTE was 1.891 (95% confidence interval, 1.043-3.430). Conclusions: Trauma patients with severe head and neck injuries are more susceptible to VTE than those with nonsevere head and neck injuries. Thus, physicians must consider CTA as a priority for the diagnosis of VTE in trauma patients with severe head and neck injuries who show VTE-associated symptoms.

• Structural Engineering and Mechanics
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• v.48 no.5
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• pp.661-679
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• 2013

In this work, the safety performance of a commercial motorcycle helmet already placed on the market is assessed. The assessed motorcycle helmet is currently homologated by several relevant motorcycle standards. Impacts including translational and rotational motions are accurately simulated through a finite element numerical framework. The developed model was validated against experimental results: firstly, a validation concerning the constitutive model for the expanded polystyrene, the material responsible for energy absorption during impact; secondly, a validation regarding the acceleration measured at the headform's centre of gravity during the linear impacts defined in the ECE R22.05 standard. Both were successfully validated. After model validation, an oblique impact was simulated and the results were compared against head injury thresholds in order to predict the resultant head injuries. From this comparison, it was concluded that brain injuries such as concussion and diffuse axonal injury may occur even with a helmet certified by the majority of the motorcycle helmet standards. Unfortunately, these standards currently do not contemplate rotational components of acceleration. Conclusion points out to a strong recommendation on the necessity of including rotational motion in forthcoming motorcycle helmet standards and improving the current test procedures and head injury criteria used by the standards, to improve the safety between the motorcyclists.

• Korean Journal of Head & Neck Oncology
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• v.36 no.1
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• pp.9-14
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• 2020

Visual identification of recurrent laryngeal nerve (RLN) is considered as a gold standard of RLN preservation during thyroid surgery. Intraoperative neuromonitoring (IONM) is classified into the intermittent type and continuous type and helps surgeons identify the functional integrity of RLN and predict the postoperative vocal cord function. RLN injury during thyroid surgery is associated with tumor factors and surgeon factors. Tumor factors mean such as direct tumor invasion, adhesion of RLN to the tumor, and compression by a large thyroid tumor. Surgeon factors include nerve transection, stretching, thermal injury, and ligation injury. A recent meta-analysis reported that the IONM could reduce the RLN injury. Considering various nerve injury mechanism, we suggest that using both I-ONM and C-IONM together is more effective method in preventing nerve damage than using I-IONM alone.