Transorbital orbitocranial penetrating injuries (TOPIs) are relatively rare, can be caused by high-speed projectile foreign bodies to low-energy trauma (which is rarer), and account for 24% of penetrating head injuries in adults and approximately 45% in children. We report an uncommon nonfatal case of TOPI where a 16-year-old male child sustained injury due to accidental penetration of metal bar into the forehead. A bicoronal flap was raised to remove the metal bar. The patient recovered well, had normal vision, and doing well at follow-up.
Anterior surgical approaches provide direct access to symptomatic areas of the cervical spine, allow management of the vast spectrum of cervical spine pathologies and there are many articles in the literature that discussed these techniques in detail. Cosmesis is an important issue for patients who undergone surgeryon neck structures as an improperly placed incision attracting significant morbidity and few publications discuss this issue in details. The purpose of the present article is to describe our experience with transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure.
Blast injuries are caused by rapid chemical transformation of a solid or liquid into a gas resulting in a high-pressure wave exceeding the speed of sound. We discuss a case 28 year gentleman who sustained severe traumatic brain injury and elevated skull fracture secondary to a blast of refrigeration gas cylinder.
Aim: The aim of present article is to share our experiences and lessons learned from a pilot study which was conducted to collect data to serve as a model in establishing a multi-center registry on traumatic brain injury patients.
Methods: The present study was conducted from December 2013 to June 2014 in the Department of Neurosurgery and Department of Accident and Emergency Medicine. All patients with the diagnosis of traumatic brain injury (as per the criteria laid by International Classification of Disease injury codes ICD 10) were enrolled in the study. Variables were identified as per the international norms and the data points were selected which included demographic details, pre-hospital characteristics, clinical details in emergency room, injury details, course during hospital stay, treatment and disposition. The data were categorized into master data, data related to pre-hospital events including pre-hospital care, data related to emergency room care offered in the emergency department, data related to hospital stay and patient course, outcome and follow up.
Results: A total of 231 patients were admitted with the diagnosis of traumatic brain injury. There were 79.1% male and 20.5% female patients. Mean age was 37.19 years (SD±17.02 years, range 4-87 years). Mean hospital stay was 3.66 days (SD±4.46 days, range-1-21 days). Data were collected daily for all the admitted patients on previous day fulfilling the inclusion criteria. The Proforma was easy to comprehend and it was easy to fill.
Conclusion: We found that a well-designed Proforma based under supervision data collection in a relatively low volume trauma center. We found that a well-designed Proforma based under supervision data collection in a relatively low volume trauma center and at regular intervals can be costeffective which can be managed by personnel with basic training.
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