phenylephrine-hydrochloride and Craniocerebral-Trauma

Penetrating cranionasal injuries are relatively rare, usually occur in young children, and can be caused by a variety of unusual objects. The mortality and disability rates are high without appropriate treatment. We report a penetrating cranionasal injury caused by a bicycle spoke. Some fundamental principles in the diagnosis and treatment of penetration injuries are emphasized from this case and the surrounding literature reviewed.

Topics: Anti-Bacterial Agents; Bed Rest; Bicycling; Ceftriaxone; Child, Preschool; Craniocerebral Trauma; Female; GABA Agents; Humans; Nose; Tomography, X-Ray Computed; Valproic Acid; Wounds, Penetrating

Although many conditions and medications have been associated with chemosensory disturbances, data from major chemosensory clinical research centers support three major disorders as being causative: nasal and paranasal sinus disease (21%), post-upper respiratory tract viral infection (19%), and head trauma (14%). Despite extensive evaluation, 22% of patients do not demonstrate identifiable causation.

Topics: Craniocerebral Trauma; Humans; Nose; Nose Diseases; Olfaction Disorders; Paranasal Sinus Diseases; Prognosis; Respiratory Tract Infections; Smell; Taste; Taste Disorders; Virus Diseases

Morphological variations of falx cerebri and tentorium cerebelli are extremely rare. The authors report an extremely rare type of combined variation of falx cerebri and dural venous sinuses in the tentorium cerebelli. During the removal of the brain from cranial cavity, it was noted that the anterior part of the falx cerebri had fenestrations and it looked like a mesh. There was no associated variations of medial surface of cerebrum. Further, there were unusual sinuses within the tentorium cerebelli. Two of them were present in the right half of the tentorium cerebelli and one in the left half of the tentorium cerebelli. There variations could be of importance to radiologists and neurosurgeons. The fenestrations of falx cerebri might lead to misinterpretations in cases of head injuries and the additional sinuses in the tentorium cerebelli might cause unexpected bleeding during surgeries of posterior cranial fossa.

Topics: Aged; Craniocerebral Trauma; Dura Mater; Humans; Male; Nose; Skull

Otorhinologic trauma is an important condition at the ear, nose and throat (ENT) outpatient clinic in children. Attention deficit hyperactivity disorder (ADHD) has been identified as a potential risk factor that may contribute to the incidence of traumatic injuries. The aim of the study was to investigate whether there is an association between otorhinologic trauma and ADHD symptoms in children.. A prospective study was conducted between September 2017 and March 2018. Fifty-six pediatric patients admitted to the Ear Nose and Throat (ENT) outpatient clinic of a research and training hospital aged between 4 and 18 years were included. The control group consisted of 56 age- and gender-similar children without otorhinologic trauma. Conner's parent Rating Scale (CPRS) was used to evaluate the ADHD symptoms.. The children with otorhinologic trauma had significantly higher mean scores in all subscales, including inattentiveness, hyperactivity, oppositional defiant disorder (ODD) (p < 0.05). Furthermore, analysis of the study group showed that the hyperactivity score in the subgroup with a history of repetitive injuries were significantly higher than those of the subgroup without a history of repetitive injuries (p < 0.05).. These findings suggest that patients admitted to the ENT outpatient clinic for otorhinologic trauma had a higher number of ADHD and ODD symptoms than those who did not have otorhinologic trauma. Psychiatric evaluation for ADHD and ODD should be considered for patients admitted to clinics with similar injuries, especially those who have a history of repetitive injuries.

Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Child, Preschool; Craniocerebral Trauma; Ear; Female; Humans; Incidence; Male; Nose; Prospective Studies; Risk Factors

Several approaches exist for the treatment of animal attacks targeting the head and neck region. The treatment options and timing vary depending on the animal species, the nature of the defect, and the experience of the surgeon. In this study, early surgical treatment options used in head-neck injuries caused by domesticated or wild animal attacks are presented.We consider 12 patients who were admitted to our clinic between June 2006 and May 2010 with head-neck injuries caused by animal attacks. Tissue defect had developed in 10 patients due to half-wild dog bite and in 2 patients due to wolf bite. The ages of the patients ranged from 3 to 45 years (mean, 21.3 years). Among the patients included in the study, 4 had facial injury, 3 had ear, 3 had scalp, 1 had eye, and 2 had nose injuries. In all patients, early surgical reconstruction was performed after irrigation, antisepsis, and debridement. Concurrent rabies and tetanus prophylactic antibiotherapy program was started.Infection or surgical complications were not observed in any of the patients. Rabies symptoms were determined in one of the quarantined dogs under surveillance. There were no positive findings in the patient bitten by the dog. The surgical treatment results from all patients were at satisfactory levels.As a result, it is observed that, in the treatment of head and neck injuries resulting from animal bites, early acute approach has replaced the traditional long-term treatment. We believe that debridement and early surgical reconstruction used in combination with medical support and prophylactic treatment are the best treatment method.

Topics: Adolescent; Adult; Animals; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Bites and Stings; Child; Child, Preschool; Craniocerebral Trauma; Debridement; Dogs; Ear, External; Eye Injuries, Penetrating; Facial Injuries; Female; Follow-Up Studies; Humans; Lacerations; Male; Middle Aged; Neck Injuries; Nose; Plastic Surgery Procedures; Povidone-Iodine; Rabies Vaccines; Scalp; Surgical Flaps; Tetanus Toxoid; Wolves

beta-Trace protein (Btp) has been proposed as a valuable marker of cerebrospinal fluid (CSF) leakage overcoming the drawbacks of beta-2-transferrin (B-2Tr) determination. However, there is still controversy about the appropriate cut-offs to be used (range 0.35-6 mg/L). The aim of the study was to evaluate cut-offs of Btp determination for detection CSF leakage. Further, we assessed whether the Btp secretion to serum ratio (Btp-sec/ser-ratio) would add diagnostic value.. Prospective study in patients with suspected CSF leakage. Quantitative determination of Btp in secretion and serum (Dade-Behring) and qualitative measurement of B-2-Tr in secretion and serum. Results were assessed in view of clinical data. Cut-offs and diagnostic characteristics were determined by ROC analysis.. A total of 176 samples were assessed originating from 105 patients. In 43 samples CSF leakage could be confirmed. Sensitivity of B-2-Tr was 84%, specificity amounted to 100%. The area under the curve (AUC) for Btp-measurement in secretion was 0.98. At a cut-off of 0.68 mg/L, sensitivity was 100% and specificity 91%. At a cut-off of 1.11 mg/L, the specificity was 100% with a sensitivity of 93%. The Btp-sec/ser-ratio has an AUC of 0.99. Combining a 0.68 mg/L cut-off in secretion with a Btp-sec/ser-ratio cut-off of 4.9 reveals a sensitivity of 99% and a specificity of 100%.. Btp is a rapid and accurate marker for the presence of CSF leakage. Combining measurement of Btp in secretion together with determination of the Btp-sec/ser-ratio enhances the diagnostic characteristics of the Btp assay. Determination of Btp in both serum and secretion is thus recommended.

Topics: Adult; Aged; Biomarkers; Cerebrospinal Fluid; Craniocerebral Trauma; Ear; Female; Humans; Intramolecular Oxidoreductases; Lipocalins; Male; Middle Aged; Nephelometry and Turbidimetry; Neurosurgical Procedures; Nose; Prospective Studies; Radiography; ROC Curve; Skull Fractures; Transferrin

The time-dependent appearance of hematomas of the eyelids was investigated in 484 cases of head injury. In individuals with apparent signs of direct violence to the orbit or the nose, black eyes could be observed even without relevant post-infliction intervals. Similarly, in victims with fractures at the anterior base of the skull hematomas of the eyelids were found even though death had occurred rapidly within less than 30 min after trauma. Black eyes that can be explained exclusively by a seepage of blood from frontal scalp wounds appeared approximately 4 h after wound infliction at the earliest, indicating a minimum post-infliction interval. Since hemorrhages of the eyelids can also be induced postmortem by direct violence to the orbit, particularly in cases with hypostasis of the face, the presence of black eyes seems not to be an unambiguous sign of vital trauma.

Topics: Autopsy; Cause of Death; Craniocerebral Trauma; Drowning; Eyelids; Female; Forensic Medicine; Hematoma; Humans; Middle Aged; Nose; Orbit; Scalp; Skull Fractures; Suicide; Time Factors

The accident intracranial insertion of a nasogastric tube is a well known complication. We report the case of 19-year-old girl with a severe craniofacial trauma who had a nasogastric tube inserted at the site of the traffic accident. The aspiration gave issue of haemorrhagic fluid. At admission the X-ray of the skull showed the intracerebral penetration of the tube. It was removed but the patient died two days later. The various means of prevention and treatment of this complication are discussed.

Topics: Adult; Craniocerebral Trauma; Fatal Outcome; Female; Humans; Iatrogenic Disease; Intubation, Gastrointestinal; Nose; Pneumocephalus; Radiography; Skull Fractures

The present retrospective study was aimed to scrutinize constant traumatic sequelae in otorhinolaryngology on 586 traumatic reports, which have been documented by the Bohemian State Insurance starting from 1965 to 1985. Constant sequelae appeared to be subsequent both to individual damages of otorhinolaryngologic organs and multiple traumas, from them 59.4% affected the ear region. Most frequently were presented the partial hearing loss, deafness, and labyrinth lesions especially in multiple traumas. As to the nasal area, the amount of 22.7 per cent consisted of external nasal shape deformities with the disordered passage, and olfactory disorders in multiple traumas. The remaining 17.9% sequelae was concerned with the anatomical and functional lesions of other otorhinolaryngologic organs. To determine features and the extent of constant sequelae, most current diagnostical approaches and consiliary examinations were used. However, the objective assessment of olfactory disorders and tinnitus aurium is stated to be still diagnostically intricated. Both the simulation and aggravation were found out in 2.5% of insurers. Other relations were also studied, e.g.: insurer vice versa physician. In addition to other causes, the most frequent ones represented an underestimation of traumatic consequences all along with their erroneous treatment, low levelled outpatient care of ORL specialists as to the multiple trauma management outside ORL service. In many instances, the injured subjects were not appropriately recommended to provide them with simple and effective surgical treatment of yet manifested constant sequelae. The proper expertize activity was complicated with the defective trauma documentation, terminology variants and erroneous regulations dealing with the recompensation of injuries.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Craniocerebral Trauma; Ear; Female; Hearing Disorders; Humans; Male; Middle Aged; Nose; Retrospective Studies

Topics: Craniocerebral Trauma; Eye Injuries; Humans; Multiple Trauma; Nose; Paranasal Sinuses

Topics: Acute Disease; Craniocerebral Trauma; Humans; Intubation, Intratracheal; Nose; Sinusitis

From the beginning of the 16th century the use of the padded cap to prevent injuries of the middle-face and skull in infants during their period of learning to walk is documented in art and medicine. Especially the painters of the Dutch and Flemish schools left beautiful paintings and drawings showing children with head-pads. Till the end of the 18th century the use of the head-pad was widely spread over Europe. In the 19th century the educational concepts of Rousseau and Kant probably induced a rejection and an abolition of this useful protective cap, which has been rediscovered during the past 20 years.

Topics: Craniocerebral Trauma; Head Protective Devices; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; Humans; Infant; Infant Care; Medicine in the Arts; Nose; Protective Devices

Although diving is one of the safer sports, because of the inherent complexity of many maneuvers, injuries can occur. Most of the injuries that a diver sustains are minor, but major and even fatal injuries have occurred. Training under a well qualified and experienced coach is important. Support from parents in terms of encouragement and finance is needed to ensure that the diver receives the best and safest training available. With appropriate facilities and preparation, many of the serious injuries can be prevented.

Topics: Athletic Injuries; Craniocerebral Trauma; Diving; Ear; Equipment Design; Extremities; Eye Injuries; Humans; Nose; Panic; Physical Education and Training; Physical Fitness; Spinal Cord Injuries; Tooth Injuries

Lebanon has witnessed over the past 10 years fierce outbreaks of violence resulting in heavy casualties. Head and neck injuries secondary to bullets, shrapnel, and/or glass were quite frequent: 1,357 injuries in 1,021 patients were taken care of by members of the Department of Otolaryngology between 1975 and 1984. They were distributed as follows: (Formula: see text). Fractures of the mandible were treated by closed reduction in 54% of cases and by open reduction in 46%; 74% healed well and 26% required secondary surgery. Primary repair of oral cavity injuries resulted in healing in 68% of cases; 32% had dehiscences or fistulae. In around one-third of the orbital injuries, the orbital contents herniated into the maxillary sinus, so orbital floor repairs had to be done with good results in 82% of cases. The nasal fractures were treated by closed reduction in 75% of cases and open reduction when the wound was open in the rest. The overall infection rate was 12%. The most common offending organisms were, in order of frequency, S. aureus, P. aeruginosa, and E. coli.

Topics: Bacteria; Craniocerebral Trauma; Fractures, Bone; Humans; Lebanon; Mandibular Fractures; Mandibular Injuries; Maxillary Fractures; Maxillofacial Injuries; Military Medicine; Mouth; Neck Injuries; Nose; Orbit; Orbital Fractures; Outcome and Process Assessment, Health Care; Wounds and Injuries

We have described a case of intracranial placement of a nasogastric tube in a patient with severe head trauma. This complication occurs as a result of either passage through a traumatic defect in the cribriform plate associated with a severe head injury or direct penetration through an intact cribriform plate by an improperly passed rigid nasogastric tube. In combative semicomatose or comatose patients, oral placement may be preferable to nasogastric placement of a gastric tube.

Topics: Accidents, Traffic; Aged; Brain; Craniocerebral Trauma; Ethmoid Bone; Humans; Intubation, Gastrointestinal; Male; Nose

Topics: Craniocerebral Trauma; Facial Nerve Injuries; Humans; Nose; Reflex

Topics: Child, Preschool; Cranial Nerve Diseases; Craniocerebral Trauma; Female; Foreign Bodies; Humans; Nose; Tetanus

Cranial gunshot wounds can result in a number of possible and seemingly impossible combinations of neurological deficits. It is unusual for an individual to both survive and remain neurologically intact. This is the report of such an incident.

Topics: Adult; Aluminum; Cataract; Craniocerebral Trauma; Eye Foreign Bodies; Eye Injuries; Humans; Male; Nose; Skull Fractures; Wounds, Gunshot

Topics: Adult; Craniocerebral Trauma; Emergencies; Epistaxis; Eye Injuries; Facial Injuries; Female; Foreign Bodies; Humans; Larynx; Male; Nasopharynx; Neck Injuries; Nose; Nose Deformities, Acquired; Paranasal Sinuses; Skull Fractures; Tongue; Trachea

A case is presented in which a patient who had suffered severe facial fractures erroneously had a nasogastric tube placed in the intracranial cavity. It is believed that no such complication of nasogastric intubation has been reported previously.

Topics: Adult; Craniocerebral Trauma; Ethmoid Bone; Female; Humans; Intubation, Gastrointestinal; Nose; Skull Fractures

Topics: Accidents, Traffic; Adult; Child; Craniocerebral Trauma; Facial Injuries; Fractures, Bone; Humans; Male; Nose

The extent to which emotional factors play a direct or indirect role in the causation of traffic accidents has been presented along with the early and late emotional response of individuals to facial injuries as a result of traffic accidents. Illustrated case histories are presented.

Topics: Accidents, Traffic; Adult; Age Factors; Automobile Driving; Craniocerebral Trauma; Depression; Emotions; Facial Injuries; Female; Fractures, Bone; Humans; Judgment; Male; Mental Disorders; Middle Aged; Neurotic Disorders; Nose; Personality Disorders; Phobic Disorders; Schizophrenia; Stress Disorders, Post-Traumatic; Suicide

Topics: Cervical Vertebrae; Craniocerebral Trauma; Education, Medical; Education, Nursing; Fractures, Bone; Head; Humans; Mandibular Fractures; Maxillary Fractures; Models, Structural; Neck; Neck Injuries; Neurologic Manifestations; Nose; Pupil; Teaching; Zygomatic Fractures

Topics: Accidents, Traffic; Craniocerebral Trauma; Facial Injuries; Glass; Humans; Mandibular Fractures; Maxillary Fractures; Maxillofacial Injuries; Nose; Seat Belts; Suture Techniques; Zygomatic Fractures

Topics: Craniocerebral Trauma; Ethmoid Bone; Facial Injuries; Fracture Fixation; Frontal Bone; Humans; Maxillofacial Injuries; Methods; Nose; Orbit; Paranasal Sinuses; Skull Fractures

Topics: Amputation, Traumatic; Craniocerebral Trauma; Ear, External; Facial Injuries; Female; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Lip; Male; Maxillofacial Injuries; Necrosis; Nose; Replantation; Time Factors

Topics: Angiography; Carotid Arteries; Cervical Vertebrae; Craniocerebral Trauma; Debridement; Facial Injuries; Humans; Mandibular Fractures; Maxillary Fractures; Nose; Orbit; Palate; Spinal Injuries; Wounds, Gunshot; Zygomatic Fractures

Topics: Animals; Biological Evolution; Brain Neoplasms; Cats; Central Nervous System Diseases; Cerebral Arteries; Cerebral Cortex; Craniocerebral Trauma; Diagnosis, Differential; Electroencephalography; Encephalocele; Endocrine System Diseases; Female; Genital Diseases, Female; Genital Diseases, Male; Haplorhini; Humans; Hypothalamus; Limbic System; Lymphatic Metastasis; Male; Manometry; Neoplasm Metastasis; Neural Conduction; Neuroectodermal Tumors, Primitive, Peripheral; Neurons; Nose; Nose Neoplasms; Olfaction Disorders; Olfactory Mucosa; Olfactory Nerve; Rabbits; Sensory Receptor Cells; Smell

Topics: Brain Injuries; Cerebral Hemorrhage; Craniocerebral Trauma; Fracture Fixation; Hearing Disorders; Humans; Intracranial Pressure; Nose; Skull Fractures

Topics: Cartilage; Craniocerebral Trauma; Female; Frontal Bone; Humans; Male; Nose; Orbit; Transplantation, Autologous

Topics: Adult; Anticoagulants; Arteries; Blood Coagulation Disorders; Craniocerebral Trauma; Epistaxis; Hematologic Diseases; Hemostasis; Humans; Hypertension; Liver Diseases; Methods; Nose; Nose Diseases; Tampons, Surgical

Topics: Brain Injuries; Craniocerebral Trauma; Fractures, Bone; Humans; Maxillofacial Injuries; Nose; Rhinoplasty; Skull

Topics: Bronchi; Craniocerebral Trauma; Ear; Esophagus; Facial Injuries; First Aid; Foreign Bodies; Humans; Nose; Tracheotomy

Topics: Cerebrospinal Fluid Rhinorrhea; Congenital Abnormalities; Craniocerebral Trauma; Diagnosis; Ethmoid Bone; Humans; Meningeal Neoplasms; Meningioma; Meningitis; Nose; Pneumocephalus; Radiography; Skull Fractures; Wounds, Gunshot

Topics: Adolescent; Cerebrospinal Fluid Rhinorrhea; Craniocerebral Trauma; Humans; Meningitis; Nose

Topics: Burns; Cheek; Cicatrix; Craniocerebral Trauma; Eyelids; Facial Injuries; Hand Injuries; Humans; Neck; Nose; Plastics; Surgery, Plastic; Tendon Injuries; Thoracic Injuries

Topics: Craniocerebral Trauma; Humans; Nose

Topics: Arteries; Carotid Arteries; Craniocerebral Trauma; Epistaxis; Humans; Ligation; Nose; Ophthalmic Artery

Topics: Cerebrospinal Fluid Rhinorrhea; Craniocerebral Trauma; Humans; Nasopharyngitis; Nose

Topics: Brain; Brain Injuries; Craniocerebral Trauma; Humans; Nose; Skull; Spinal Cord Injuries; Wounds, Penetrating