• Title/Summary/Keyword: Traumatic intracranial hemorrhage

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Evaluation of Traumatic Intracranial Hemorrhage Using Computed Tomography and Magnetic Resonance Imaging in Four Dogs (개에서 컴퓨터단층촬영술과 자기공명영상을 이용한 창상성 두개관내 출혈의 평가)

  • Choi Ho-Jung;Lee Ki-Ja;Kang Sang-Kyu;Lee Hee-Chun;Chang Dong-Woo;Lee Ki-Chang;Jeong Seong-Mok;Cho Sung-Whan;Lee Young-Won
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.96-101
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    • 2006
  • Four dogs with neurologic dysfunction resulted from intracranial hemorrhage by head trauma were referred to Veterinary Medical Teaching Hospital, Chungnam National University. There were no remarkable findings in survey radiography in four cases. CT and MRI scans were diagnostic in these cases. Three dogs underwent CT scanning. On CT images, the lesion was hyperdense and was not enhanced after intravenous contrast administration in dog 1 and dog 2. On CT of dog 4, there was no significant finding. All of four dogs were verified by dorsal, sagittal, and transverse T1-weighted (T1W) and T2-weighted (T2W) images. Appearance of the lesions in dog 1 and dog 2 was isointense (dog 2) or isointense with hyperintense rim (dog 1) on T1W images and hyperintense on T2W images. In dog 3 and dog 4, there were hypointense and hyperintense lesions on T1Wand T2W images respectively. The lesions in four dogs were located in the left intracerebral region, intracerebral and cerebellovestibular region, subdural space, and right cerebral hemisphere, respectively.

Computed Tomographic Evaluation of Three Canine Patients with Head Trauma (개에서 컴퓨터단층촬영을 이용한 두부 외상의 평가 3례)

  • Kim, Tae-Hun;Kim, Ju-Hyung;Cho, Hang-Myo;Cheon, Haeng-Bok;Kang, Ji-Houn;Na, Ki-Jeong;Mo, In-Pil;Lee, Young-Won;Choi, Ho-Jung;Kim, Gon-Hyung;Chang, Dong-Woo
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.667-672
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    • 2007
  • This report describes the use of conventional computed tomography(CT) for the diagnosis of head trauma in three canine patients. According to physical and neurologic examinations, survey radiography and computed tomography, these patients were diagnosed as traumatic brain injury. Especially, CT is the imaging modality of first choice for head trauma patients. It provides rapid acquisition of images, superior bone detail, and better visualization of acute hemorrhage than magnetic resonance imaging. It is also less expensive and more readily available. Pre-contrast computed tomography was used to image the head. Then, post-contrast CT was performed using the same technique. The Modified Glasgow Coma Scale(MGCS) score was used to predict their probability of survival rate after head trauma in these dogs. Computed tomogram showed fluid filled tympanic bulla, fracture of the left temporal bone and cerebral parenchymal hemorrhage with post contrast ring enhancement. However, in one case, computed tomographic examination didn't delineate cerebellar parenchymal hemorrhage, which was found at postmortem examination. Treatments for patients placed in intensive care were focused to maintain cerebral perfusion pressure and to normalize intracranial pressure. In these cases, diagnostic computed tomography was a useful procedure. It revealed accurate location of the hemorrhage lesion.

Anterior Cranial Base Reconstruction in Complex Craniomaxillofacial Trauma: An Algorithmic Approach and Single-Surgeon's Experience

  • Shakir, Sameer;Card, Elizabeth B.;Kimia, Rotem;Greives, Matthew R.;Nguyen, Phuong D.
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.174-183
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    • 2022
  • Management of traumatic skull base fractures and associated complications pose a unique reconstructive challenge. The goals of skull base reconstruction include structural support for the brain and orbit, separation of the central nervous system from the aerodigestive tract, volume to decrease dead space, and restoration of the three-dimensional appearance of the face and cranium with bone and soft tissues. An open bicoronal approach is the most commonly used technique for craniofacial disassembly of the bifrontal region, with evacuation of intracranial hemorrhage and dural repair performed prior to reconstruction. Depending on the defect size and underlying patient and operative factors, reconstruction may involve bony reconstruction using autografts, allografts, or prosthetics in addition to soft tissue reconstruction using vascularized local or distant tissues. The vast majority of traumatic anterior cranial fossa (ACF) injuries resulting in smaller defects of the cranial base itself can be successfully reconstructed using local pedicled pericranial or galeal flaps. Compared with historical nonvascularized ACF reconstructive options, vascularized reconstruction using pericranial and/or galeal flaps has decreased the rate of cerebrospinal fluid (CSF) leak from 25 to 6.5%. We review the existing literature on this uncommon entity and present our case series of n = 6 patients undergoing traumatic reconstruction of the ACF at an urban Level 1 trauma center from 2016 to 2018. There were no postoperative CSF leaks, mucoceles, episodes of meningitis, or deaths during the study follow-up period. In conclusion, use of pericranial, galeal, and free flaps, as indicated, can provide reliable and durable reconstruction of a wide variety of injuries.

Neural Tract Injuries by Penetration of Foreign Body: a Diffusion Tensor Tractography Study

  • Kwon, Hyeok-Gyu;Hong, Ji-Heon;Kwon, Yong-Hyun;Lee, Mi-Young;Kim, Seong-Ho;Jang, Sung-Ho
    • The Journal of Korean Physical Therapy
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    • v.25 no.3
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    • pp.132-135
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    • 2013
  • We presented with a patient who showed injury of the cingulum and fornix by penetration of a foreign body into the brain on diffusion tensor tractography (DTT). A 63-year-old man suffered a brain injury by a part of a power saw blade that was suddenly detached from a power saw during work. A part of the power saw blade penetrated his right frontal skull and advanced to the right posterior horn of the lateral ventricle. This penetration caused traumatic intracerebral hemorrhage in the right frontal lobe and intraventricular hemorrhage in the lateral ventricle. He underwent craniotomy and removal of intracranial foreign bodies (bony pieces and saw blade). The patient's Memory Assessment Scale scores were 74 (4%ile) for global memory, 78 (7%ile) for verbal memory, and 80 (9%ile) for visual memory. DTTs showed disruptions in the anterior portion of the fornical body, right fornical crus, the anterior portion of the right cingulum, and the middle portion of the left cingulum, compared to the control. It seems that the sustained memory impairment of this patient might be related to injury of the cingulum and fornix.

Primary Choriocarcinoma of the Lung - Case report - (폐에 발생한 원발성 융모막 상피종 - 1예 보고 -)

  • 최명석
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.1003-1008
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    • 1990
  • Primary choriocarcinoma of the lung is extremely rare and have been reported ten and several cases only in the literature. It is very difficult to confirm the "Pure primary pulmonary choriocarcinoma" clinically, so most cases that have been reported in the literature confirmed by autopsy and the prognosis is relatively poor compared with metastases. We experience one case of the primary pulmonary choriocarcinoma. She was 53 year old multiparous woman[4 \ulcorner0 \ulcorner2 \ulcorner0] who complain right chest pain for 4 years. On plain film and computerized tomogram of the thorax at admission, 2.5cmx3.5cmx5 cm sized, well demarcated ovoid mass was founded on the right middle lobe just below the parietal pleura and growing rapidly on plain film to 5cm x 6.5cm x 7cm after 15 days. We confirm the choriocarcinoma in the lung by percutaneous needle aspiration biopsy and strongly suspect primary after various examination for rule out metastases from the ovary or uterus. We perform middle lobe lobectomy because that can not confirm the primary or the metastases because there are not complete histological examination by bilateral ovariectomy and hysterectomy, and under the belief that extragestational or extragonadal primary choriocarcinoma is more resistant to the chemotherapy, and could be reduce the duration of hospitalization and the amount of chemotherapy used to achieve remission On 14th postoperative day, serum p-HCG level was returned to normal limit, and perform chemotherapy two times on 3rd and 5th week for prevention surgical traumatic hematogenous metastases or undetected microfocus, but the patient expire on 68th postoperative day due to intracerebral hemorrhage in the intracranial choriocarcinoma which strongly suspected surgical traumatic hematogenous metastases.etastases.

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Clinical Evaluation of Traumatic Diaphragmatic Ruptures (외상성 횡격막 파열에 대한 임상적 고찰)

  • 조재민;김은기;이종국;박승일
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1257-1262
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    • 1996
  • From January 1989 to February 1996, 50 patients with a traumatic diaphragmatic rupture were treated at the Yonsei University Wonju College of Medicine. There were 40 male and 10 female patients. The ages ranged from 2 to 80 years, with peak incidence in third decades. Thirty-nine cases had blunt trauma (traffic accident 29, falls down 7, others 3), and 11 cases had penetrating injuries (stab injury 9, gun shot 1, broken glass 1). The most common symptoms were dyspnea (76%), chest pain (58%), and abdominal pain (52%). In blunt trauma, the rupture was located in the left in 30 cases, right in 9 cases and in penetrating trauma, the rupture was located in the left in 8 cases and in the right in 3 cases. Eighteen cases underwent thoracotomy alone, 29 cases underwent laparotomy only and 3 cases had combined thoracotomy and laparotomy. The postoperative mortality occurred in 6% (3 cases), and the cause of death were septic shock (1), intracranial hemorrhage (1), and respiratory failure (1).

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Three Case Reports of Patients with Secondary Dementia Treated with Korean Traditional Medicine, Especially Boshiniknoe-tang-gami (속발성 치매 환자에 대한 보신익뇌탕가미방의 효과 3례)

  • Bae, Go-eun;Cho, Jae-hyun;Choi, Jin-yong;Seo, Hee-jeong;Shim, So-hyun;Kwon, Jung-nam;Hong, Jin-woo;Kim, So-yeon;Choi, Jun-young;Han, Chang-woo;Yun, Young-ju;Park, Seong-ha;Lee, In
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.628-640
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    • 2017
  • Purpose: To describe the effectiveness of traditional Korean medicine (TKM) on the patients with secondary dementia (case 1: Rt. MCA infarction; case 2: traumatic subacute subdural hemorrhage and traumatic intracranial hemorrhage; case 3: delayed encephalopathy after carbon monoxide poisoning). Methods: We used a complete TKM treatment. The acupoints used were as follows: acupoints frequently used in hemiparesis (GV20, GV24, ST4, LI11, LI14, ST36, GB34, SP9, and LR3), and we used herbal medicine (補腎益腦湯加味, Boshiniknoe-tang-gami). The efficacy was evaluated using the Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Modified Barthel Index (MBI). Results: After treatment, the total MMSE-DS score was increased from 14 to 24 (case 1), 14 to 19 (case 2), and 0 to 17 (case 3). The total K-MBI was increased from 30 to 44 (case 1), 82 to 86 (case 2), and 30 to 86 (case 3) Conclusions: We suggest that TKM could positively influence cognition and improve activity of daily living (ADL). This study has limitations, so further studies are needed.

Identification of intracerebral hematoma using ultrasonography in a dog

  • Jung, Dong-In;Park, Chul;Kang, Byeong-Teck;Yoo, Jong-Hyun;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Lee, So-Young;GU, Su-Hyun;Heo, Ra-Young;Jeon, Hyo-Won;Kim, Jung-Hyun;Eom, Ki-Dong;Park, Jong-Im;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.47 no.1
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    • pp.127-129
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    • 2007
  • A 3-month-old male Maltese dog was presented with generalized trembling, ataxia, and seizure.The patient had traumatic injury on history takings. Physical examination revealed dome shaped craniumwith open fontanelle, nasal hemorrhage, and blepharoedema with hemorhage on the left side. On serumbiochemical profiles, creatine phosphokinase was severely elevated. There was no remarkable findingon radiography. Ultrasound images of brain were obtained via a persistence bregmatic fontanelle, andbilateraly dilated lateral ventricles with a hyperechoic mass on the left temporal lobe were detected.Based on clinical signs, history, physical examination, laboratory findings, and ultrasonographic findings,we suspected this intracranial mass to intracerebral hematoma induced by head trauma. Methylprednisoloneh after initial diagnosis. We performed necropsy and confirmed intracerebral hematoma. This case reportdescribes the identification of intracerebral hematoma using ultrasonography.

The New Recreational Transportation on the Street: Personal Mobility, Is It Safe?

  • Kim, Young Woo;Park, Won Bin;Cho, Jin Seong;Hyun, Sung Youl;Lee, Geun
    • Journal of Trauma and Injury
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    • v.31 no.3
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    • pp.125-134
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    • 2018
  • Purpose: The interest in the personal mobility started to grow and as the interest increases, there are growing concerns about the safety of it. The purpose of the study is to look at the types and dynamics of patients injured by the personal mobilities. Methods: This was a retrospective 2-year observational study, from January 2016 to December 2017, on the patients who visited the emergency center and the trauma center, with an injury related to driving the personal mobility. Cases of the personal mobility-related accident were collected based on electronic medical records and hospital emergency department-based injury in-depth surveillance data. Results: A total of 65 patients visited the emergency center and the trauma center, during this study period. Six patients of 50 adults admitted the alcohol consumption (12%) and two adult patients wore the helmet as the protection gear (3.1%). The number of the patients in 2017 rises three times more than the number of patients in 2016 (51 vs. 14). Injuries to the head and neck region (67.7%) was the most common, followed by the upper extremity (46.2%). Eleven patients (16.9%) were admitted to the hospital, of whom three were admitted to the intensive care unit due to intracranial hemorrhage. Nine patients underwent surgery. Conclusions: The use of the personal mobility will continue to grow and the accidents, caused by the vehicle, will increase along with it. The study showed the damage is worse than expected. Personal mobility currently has a limited safety laws and the riders are not yet fully aware of its danger. The improvement of the regulation of the personal mobility, safety education is needed.

Clinical Characteristics in Patients for Mental Disability Assessment Following Traumatic Brain Injury -Comparison between Patients with and without Abnormal Brain Imaging- (두부외상 후 장애평가 환자들의 임상적 특징 -뇌영상검사 이상유무에 따른 비교-)

  • Ha, Kang-Su;Kim, Sang-Hoon;Kim, Hack-Ryul;Park, Sang-Hag;Pyo, Kyung-Sik;Cho, Yong-Rae
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.28-36
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    • 2001
  • Objectives : This study was undertaken to identify the clinical and psychological characteristics in patients of mental disability assessment following traumatic brain injury who had the finding with or without abnormal brain imaging study. Methods : A consecutive series of 59 patients were assessed in hospital from January 1994 to December 1998. Patients were divided into 2 groups based on normal or abnormal brain imaging and the two groups were compared in demographic characteristics, psychiatric symptoms, type of head injury, clinical psychological findings. There were 27 patients with abnormal findings and 32 with normal findings in brain imaging study. Results : Abnormal finding group in brain imaging study had significantly higher incidence of psychosis, decreased memory, decreased appetite, increased nihilistic idea, and intracranial hemorrhage. Also, abnormal finding group showed significantly lower level of performance on the block design subtest of K-WAIS and had significantly lower scores on F, hypochodriasis, depression, hysteria, psychopathic deviate, psychasthenia and schizophrenia subscale of the MMPI. Conclusion : The findings suggest that the patients undergone brain surgery due to intracranial hemorrage at that time of brain injury may have higher frequency of abnormal findings in brain imaging study, complain more cognitive and affective symptoms, and have lower the abstract concept formation and perceptual organization abilities.

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