ro13-9904 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

We report a case of Escherichia coli infection of a cephalohematoma in an infant delivered by vacuum extraction. After excluding potential complications, the patient was treated with intravenous ceftriaxone while hospitalized followed by oral cephalexin after discharge. Infection is a rare but serious complication of cephalohematomas in the newborn period. Escherichia coli is the most common pathogen responsible for infected cephalohematomas. Clinicians should be aware that infected cephalohematomas may be complicated by sepsis, meningitis, or osteomyelitis.

Topics: Anti-Bacterial Agents; Birth Injuries; Ceftriaxone; Craniocerebral Trauma; Escherichia coli Infections; Hematoma; Humans; Infant; Male; Vacuum Extraction, Obstetrical

Maxillofacial traumatic injuries concomitant with craniocerebral trauma are still considered as an actual problem in emergency medicine. For this category of patients one of the dangerous and severe complications is development of inflammatory process in the injured areas. Fracture lines of upper and middle facial zones pass through the accessory sinuses of the nose, maxillary/upper dental arch area and are considered to be open and infected fractures. Combination of these fractures with craniocerebral injuries and especially, with open traumas creates predisposition for development of inflammatory processes in CNS that can result in heavy outcome. 29 patients (among them 5-females and 24 -males) with severe and open craniofacial fractures were observed by the authors. For prevention of inflammatory complications in complex treatment of the patients, intra-arterial infusions of therapeutic agents (wide spectrum of antibiotics, Heparin) were used for stimulation of reparative regeneration in fractured fragments of facial bones. After the main surgical interventions (neurosurgery, surgery of facial bones) sanitation of infected centers (accessory sinuses of the nose, oral cavity) and catheterization of external carotid arteries through the temporal arteries were performed. According to the severity of the trauma and its preferential localization, catheterization of carotid arteries was conducted unilaterally (12 cases) or bilaterally (17 cases). Insertion depth through femoral artery was 6-8 cm. Catheter was stayed in the artery for 7-8 days. Intra-arterial infusions were carried out in the morning and evening. Therapeutic agents for arterial infusion included: antibiotic (Rocephin and its analogues), Heparin. To determine the effectiveness of vascular therapy dopplerography of external carotid artery, its branches and supratrochlear artery was performed. Dopplerography of supratrochlear artery, which is the branch of internal carotid artery, was conducted to detect the impact of therapeutic agents, administered in external carotid artery, on the internal carotid artery. During the treatment of complicated concomitant craniofacial injuries in a sequential order, development of inflammatory processes was not observed even in the patients with basic inflammatory processes in accessory sinuses of the nose. After infusion of therapeutic agents to external carotid artery, dopplerographically, sharp increase in blood flow in main artery and its branches, indicate

Topics: Anti-Bacterial Agents; Anticoagulants; Carotid Artery, External; Ceftriaxone; Craniocerebral Trauma; Face; Female; Heparin; Humans; Inflammation; Infusions, Intra-Arterial; Male; Maxillofacial Injuries; Postoperative Complications; Ultrasonography, Doppler

Topics: Adolescent; Bacteroidaceae Infections; Ceftriaxone; Cerebrospinal Fluid Otorrhea; Craniocerebral Trauma; Drug Therapy, Combination; Follow-Up Studies; Humans; Male; Meningitis, Bacterial; Metronidazole; Prevotella intermedia; Risk Assessment; Severity of Illness Index; Skull Fractures; Treatment Outcome

Topics: Bacteria; Barbiturates; Ceftriaxone; Craniocerebral Trauma; Critical Care; Female; Humans; Male; Minocycline; Respiratory Tract Infections; Tetracyclines