• Title/Summary/Keyword: Traumatic Injury

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A study of injury mechanism and neural plasticity of traumatic brain injury (외상성 뇌손상의 손상 기전과 신경가소성에 대한 고찰)

  • Song Ju-min;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.16 no.2
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    • pp.90-98
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    • 2004
  • Traumatic brain injury is an insult to the brain caused by an external physical force, that may product a diminished or altered state of consciousness, which results in impairment of cognitive abilities or physical function. The purposes of this study were to overview injury mechanism and neural plasticity of traumatic brain injury. Injury mecanism includes exitotoxicity, production free radical, inflammation and apoptosis. Furthermore traumatic brain injury has protective mechanisms includes production of neural growth factor, heat shock protein, anti-inflammatory cytokines.

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Analysis of Traumatic Brain Injury Using a Finite Element Model

  • Suh Chang-Min;Kim Sung-Ho;Oh Sang-Yeob
    • Journal of Mechanical Science and Technology
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    • v.19 no.7
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    • pp.1424-1431
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    • 2005
  • In this study, head injury by impact force was evaluated by numerical analysis with 3-dimensional finite element (FE) model. Brain deformation by frontal head impact was analyzed to evaluate traumatic brain injury (TBI). The variations of head acceleration and intra-cranial pressure (ICP) during the impact were analyzed. Relative displacement between the skull and the brain due to head impact was investigated from this simulation. In addition, pathological severity was evaluated according to head injury criterion (HIC) from simulation with FE model. The analytic result of brain damage was accorded with that of the cadaver test performed by Nahum et al.(1977) and many medical reports. The main emphasis of this study is that our FE model was valid to simulate the traumatic brain injury by head impact and the variation of the HIC value was evaluated according to various impact conditions using the FE model.

A Case Report of Prescribing Gamisopunghwalhyeal-tang (jiameishufenghuoxue-tang) for the Three Patients with Traumatic Knee Joint Injury (가미소풍활혈탕(加味疎風活血湯)을 투여한 외상성 슬부 손상 환자 치험 3례)

  • Kim, Chao-Young;Kim, Jeong-Won;Uhm, Bong-Kun;Han, Sang-Wook;Kim, Oh-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.1
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    • pp.63-74
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    • 2011
  • Objectives: The purpose of this study is to investigate the clinical application of Gamisopunghwalhyeal-tang to three patients traumatic knee joint injury. Methods: Patients are hospitalized at Dept. of Oriental Rehabilitation, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as traumatic knee joint injury and treated mainly with herbal medicine ; Gamisopunghwalhyeal-tang. This study was measured by VAS(Visual Analogue Scale) score and walking time and Western Ontario and McMaster Universities(WOMAC) index score. Results: After taking Gamisopunghwalhyeal-tang, the patient's pain was controlled and increased time of walking on floor after treatment. VAS & WOMAC score were decreased. Conclusions: As seen in this three cases of traumatic knee joint injury, Gamisopunghwalhyeal-tang has a positive effect to control pain with traumatic knee joint injury.

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Traumatic Subclavian Artery Rupture (외상성 쇄골하 동맥 파열)

  • 김해균
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1278-1281
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    • 1992
  • We have experienced two cases of traumatic subclavian artery rupture at the department of thoracic and cardiovascular surgery, Youngdong Severance hospital, Yonsei University college of medicine. One was combined with brachial plexus injury and the other was combined with brachial plexus injury and subclavian vein rupture. They were treated with graft interposition after segmental resection of ruptured subclavian artery and neurorrhaphy for brachial plexus injury. Post operative courses were not eventful.

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Comparison of Penetrating and Blunt Traumatic Diaphragmatic Injuries

  • Lee, Sang Su;Hyun, Sung Youl;Yang, Hyuk Jun;Lim, Yong Su;Cho, Jin Seong;Woo, Jae Hyug
    • Journal of Trauma and Injury
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    • v.32 no.4
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    • pp.210-219
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    • 2019
  • Purpose: Traumatic diaphragmatic injury (TDI) is no longer considered to be a rare condition in Korea. This study investigated differences in the prevalence of accompanying injuries and the prognosis in patients with traumatic diaphragmatic damage according to the mechanism of injury. Methods: We retrospectively reviewed the medical records of patients with TDI who were seen at a regional emergency medical center from January 2000 to December 2018. Among severe trauma patients with traumatic diaphragmatic damage, adults older than 18 years of age with a known mechanism of injury were included in this study. Surgery performed within 6 hours after the injury was sustained was defined as emergency surgery. We assessed the survival rate and likelihood of respiratory compromise according to the mechanism of injury. Results: In total, 103 patients were analyzed. The patients were categorized according to whether they had experienced a penetrating injury or a blunt injury. Thirty-five patients had sustained a penetrating injury, and traffic accidents were the most common cause of blunt injuries. The location of the injury did not show a statistically significant difference between these groups. Severity of TDI was more common in the blunt injury group than in the penetrating injury group, and was also more likely in patients with respiratory compromise. However, sex, the extent of damage, and the initial Glasgow coma scale score had no significant relationship with severity. Conclusions: Based on the findings of this study, TDI should be recognized and managed proactively in patients with blunt injury and/or respiratory compromise. Early recognition and implementation of an appropriate management strategy would improve patients' prognosis. Multi-center, prospective studies are needed in the future.

Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

  • Kim, Yun-Mi;Yoo, Byung-Won;Choi, Jae-Young;Sul, Jun-Hee;Park, Young-Hwan
    • Clinical and Experimental Pediatrics
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    • v.54 no.2
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    • pp.86-89
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    • 2011
  • Traumatic ventricular septal defect (VSD) resulting from blunt chest injury is a very rare event. The mechanisms of traumatic VSD have been of little concern to dateuntil now, but two dominant theories have been described. In one, the rupture occurs due to acute compression of the heart; in the other, it is due to myocardial infarction of the septum. The clinical symptoms and timing of presentation are variable, so appropriate diagnosis can be difficult or delayed. Closure of traumatic VSD has been based on a combination of heart failure symptoms, hemodynamics, and defect size. Here, we present a case of a 4-year-old boy who presented with a traumatic VSD following a car accident. He showed normal cardiac structure at the time of injury, but after 8 days, his repeated echocardiography revealed a VSD. He was successfully treated by surgical closure of the VSD, and has been doing well up to the present. This report suggests that the clinician should pay great close attention to the patients injured by blunt chest trauma, keeping in mind the possibility of cardiac injury.

Management of Traumatic Pancreas Injury in Multiple Trauma - Single Center Experience (다발성 외상 환자에서 췌장 손상 치료 경험)

  • Jang, Hyun-A;Shim, Hong-Jin;Cha, Sung-Whan;Lee, Jae-Gil
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.111-117
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    • 2011
  • Purposes: Pancreatic injury is rare in abdominal trauma patients (3%~12%). but it could result in significant morbidity and even mortality. Early and adequate decision making are very important in the management of patients with traumatic pancreatic injury. The purpose of this study was to assess the kinds of management and outcome through the review of our experience of pancreatic injury with multiple trauma. Methods: We reviewed 17 patients with traumatic pancreas injury via electronic medical records from Jan. 2002 and April. 2011. We collected demographic findings; the type, location and grade of pancreas injury, the treatment modality, and patient's outcomes, such as complications, length of hospital stay (LOS), and mortality. Results: Total 17 patients were reviewed, and man was 13 (88%). Traffic accident was the most common cause of injury. Pancreas neck was the most common injured site, and occured in 5 patients. Ductal injury was detected in 7 cases. Eleven patients were treated by surgical procedure, and in this group, 3 patients underwent the endoscopic retrograde pancreas drainage procedure coincidently. ERPD was tried in 8 patients, and failed in 2 patients. The major complications were post-traumatic fluid collection and abscess which accounted for 70 % of all patients. The hospital stay was 35.9 days, and it was longer in patient with ductal injury ($38.0{\pm}18.56$ vs. $34.5{\pm}33.68$ days). Only one patient was died due to septic shock associated with an uncontrolled retroperitoneal abscess. Conclusion: Early diagnosis is the most important factor to apply the adequate treatment option and to manage the traumatic pancreas injury. Aggressive treatment should be considered in patients with a post-operative abscess.

Clinical Analysis of Post-traumatic Hydrocephalus

  • Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.3
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    • pp.211-214
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    • 2005
  • Objective : Post-traumatic hydrocephalus is a complication of head injury and can present with several different clinical symptoms. However, the developing factors of post-traumatic hydrocephalus and treatment are still not well known. The authors design the study to focus on incidence, causing diseases and treatment of post-traumatic hydrocephalus. Methods : The 789patients of traumatic head injury followed by admission treatment over 7days from Jan. 1997 to Dec. 2001, were divided shunt group and shunt free group. We analyzed age, sex, causing diseases, developing time of hydrocephalus and effects of shunt operation in post-traumatic hydrocephalus. Results : The incidence of post-traumatic hydrocephalus for requiring shunt was 9.2% [64cases]. Chronic hydrocephalus which developed after 14days of injury was higher incidence [51cases]. We found following variables were significantly related to shunt-dependent hydrocephalus : low GCS score at admission, initial CT finding of traumatic subarachnoid hemorrhage and intracerebral hemorrhage [including intraventricular hemorrhage]. The effect of shunt operation was not related with the spinal pressure, but had statistically significant correlation with the response of lumbar drainage. Conclusion : We conclude that development of hydrocephalus after head trauma is related to low GCS score, intracerebral hemorrhage [including intraventricular hemorrhage] and subarachnoid hemorrhage. The effect of preoperative lumbar drainage has a significant role in predicting the result of shunt operation in patient with post-traumatic hydrocephalus.

Traumatic Aneurysm of the Callosomarginal Artery-Cortical Artery Junction from Penetrating Injury by Scissors

  • Kim, Myoung Soo;Sim, Sook Young
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.222-225
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    • 2014
  • Traumatic intracranial aneurysms (TICAs) are rare and are associated with high rates of morbidity and mortality. TICAs usually result from head injuries caused by traffic accidents, industrial accidents, or gunshots. We report a traumatic aneurysm of the callosomarginal artery-cortical artery junction arising from a penetrating injury by scissors. A 51-year-old woman was admitted to our hospital after suffering a penetrating injury caused by scissors. Computed tomography (CT) and CT-angiography demonstrated a right orbital roof fracture, subarachnoid hemorrhage, frontal lobe hemorrhage, intraventricular hemorrhage, and a traumatic aneurysm of the right callosomarginal artery-cortical artery junction. We trapped the traumatic aneurysm and repositioned a galeal flap. Postoperative CT showed a small infarction in the left frontal lobe. Follow-up angiography two months later showed no residual aneurysm. We suggest that an aggressive surgical intervention be performed whenever TICA is diagnosed.

Injury of the Thalamocortical Pathway Between the Mediodorsal Nuclei and the Prefrontal Cortex in a Patient with Traumatic Brain Injury

  • Sang Seok Yeo
    • The Journal of Korean Physical Therapy
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    • v.35 no.6
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    • pp.190-194
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    • 2023
  • Purpose: Traumatic brain injury (TBI) refers to brain damage caused by external forces or trauma. TBIs can vary in severity and result from accidents, falls, sports injuries, assaults, or other forms of physical trauma. The prefrontal cortex (PFC) is known have roles in various cognitive functions. We report on a patient with traumatic brain injury who showed prefrontal symptoms after injury of thalamocortical connections between mediodorsal nuclei (MD) of thalamus and PFC. Methods: A 54-year-old, male patient suffered a TBI as a result of a heavy object falling on his head. After onset of TBI, he showed typical symptoms of prefrontal lobe injury, including personality changes, memory impairment, and general cognition problem. The thalamocortical connections between MD and PFC (ventrolateral prefrontal cortex (VLPFC), dorsolateral prefrontal cortex (DLPFC), and obrbitofrontal cortex (OFC)) were reconstructed using diffusion tensor tractography. In terms of fractional anisotropy value, the right thalamocortical connections to the OFC were significantly lower than those of control subjects. Results: The value of mean diffusivity in the right thalamocortical connections to the DLPFC was significantly higher than that of control subjects. By contrast, both VLPFC and left OFC showed significant decrement in the tract volume of thalamocortical connections compared with that of control subjects. Conclusion: We reported on a patient who showed cognitive and neuropsychiatric impairment due to global injury of the thalamocoritcal connections between MD and PFC following TBI.