Avulsion of the occipital bone-an airbag-specific injury

Hansen, Tine Plato; Nielsen, Anne Lerberg; Thomsen, Troels Kragsig; Knudsen, Peter Juel Thiis

doi:10.1016/s0140-6736(99)00845-4

Cited by 16 publications

(8 citation statements)

References 1 publication

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“…Similar occipital condyle injuries were described in two cases of unrestrained drivers in Denmark 3 . Common to all three cases was the identification of submental bruising implying a blunt force to the base of the chin.…”

Section: Discussionsupporting

confidence: 71%

Quadriplegia As A Result Of Airbag-Related Trauma

2010

IJS

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Airbags are known to significantly reduce mortality and morbidity of road-related trauma. Yet since the 1990s, with increasing use of these safety devices, there has been an increase in the number of minor facial soft tissue and bony injuries related to them. More worrying is the increase in the number of cases of cervical fracture and death reported. This report describes one such case that has resulted in quadriplegia and a review of the literature looks at other similar cases highlighting a common and disturbing trend.

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Section: Discussionsupporting

confidence: 71%

Quadriplegia As A Result Of Airbag-Related Trauma

2010

IJS

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“…Type II fractures result from cranial base fractures which continue onto the occipital condyles. Type III fractures are avulsion fractures associated with trauma affecting the alar ligaments [1, 7, 17]. Stretching forces along either of these ligaments cause the ipsilateral condyle to fracture, at the site of ligament attachment, but the contralateral ligament can also be damaged.…”

Section: Discussionmentioning

confidence: 99%

Isolated condylar fractures diagnosed by post mortem computed tomography

Borowska-Solonynko

Prokopowicz

Samojłowicz

et al. 2019

Forensic Sci Med Pathol

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Due to their anatomical location, occipital condylar fractures (OCFs) are usually not observed during traditional autopsies and are therefore considered a rare injury. The aim of this study was to determine the true frequency of OCFs using post-mortem computed tomography (PMCT) in traumatic casualties. We retrospectively analyzed 438 PMCT studies of victims of traffic accidents, falls from height, violence, and low-energy head injuries (324 males and 114 females). OCFs were present in 22.6% of cases ( n = 99), mostly in victims of railway accidents (48.5%, n = 17), falls from height (26.6%, n = 29), cyclists (24%, n = 6), and pedestrians hit by cars (22.5%, n = 29). Isolated OCFs were found in 5.5% of cases ( n = 24), most often in cyclists (12%, n = 3) and pedestrians (9.3%, n = 12) hit by cars. There were no OCFs in the cases of fatalities caused by violence or accidental low-energy head injury. PMCT scans revealed that OCFs are common in high-energy injury fatalities and can be useful for determining the mechanism of trauma more precisely.

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“…Basilar skull fractures as seen in our patient may not be uncommon in this context as illustrated by a recent report from Denmark of two similar cases. 32 However, in both of these cases the drivers were unbelted. Our patient was wearing a seat belt, and the exact contribution of individual factors (such as initial seating position and pre-crash braking) that were responsible for placing her too close to the expanding airbag are not certain.…”

Section: Key Messagesmentioning

confidence: 96%

A useful form of glue ear

Benger

Davies²

2000

Emergency Medicine Journal

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A case of domestic violence is reported. The patient presented with the triad of injuries associated with the shaking of infants: retinal haemorrhages, subdural haematoma, and patterned bruising; this has been described as the shaken adult syndrome. This case report reflects the diYculties in diagnosing domestic violence in the accident and emergency setting. (J Accid Emerg Med 2000;17:138-139) Keywords: domestic violence; women; assault Domestic violence is an under-reported and major public health problem that often first presents to the accident and emergency (A&E) department. It accounts for half of all violent crimes against women, and two deaths per week have been linked to domestic violence in Britain.1 Indeed, the Department of Health has issued statements to ensure health professionals are aware of domestic violence in this context when patients present with consistent traumatic injuries. 2The following case report reflects the diYculties in diagnosing domestic violence in the A&E setting, and stresses the timely referral of such patients to the relevant authorities. Case reportA 34 year old woman was brought to the A&E department by ambulance at 0400 hours with head injuries. When handed over from the ambulance crew an assault was queried, although the patient later stated she had fallen down stairs after moderate alcohol ingestion.Her initial blood pressure was 119/72 mm Hg, pulse 88 beats/min, her pupils were equal and reactive directly and consensually, and her Glasgow coma score was 13/15 (she was confused and was opening her eyes to command). Examination of the head showed bilateral periorbital ecchymoses, nasal bridge swelling and epistaxis, a right frontal abrasion, and an occipital scalp haematoma. Ecchymoses were also noted on her back and buttocks, being linear in fashion on both upper arms, and her underpants were torn. Initial skull and facial x ray films were normal, and she was admitted under the care of A&E for neurological observations.Over the next 24 hours, her Glasgow coma score improved to 15/15, but she had vomited five times and complained that her vision remained blurred. Visual acuity was only hand movements in the right eye and finger counting in the left. Ophthalmological review confirmed both retinal and preretinal haemorrhages in the right eye and a retinal haemorrhage on the left. Both maculae were aVected by the haemorrhage (fig 1). Haematological investigations, including a full blood count and a clotting screen, were within normal parameters, and computed tomography of the head revealed a small left temporal subdural haemorrhage with adjacent oedema.It was only after 48 hours and repeated advice that she should seek help and report the injuries to the police, that she admitted that domestic violence had occurred.Ongoing police and consultant medical review showed photographic evidence of patterned bruising to the upper arms, and also several circular burns to the face and arm, similar to the type caused by the deliberate Five weeks after the initial injury s...

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Avulsion of the occipital bone-an airbag-specific injury

Cited by 16 publications

References 1 publication

Quadriplegia As A Result Of Airbag-Related Trauma

Quadriplegia As A Result Of Airbag-Related Trauma

Isolated condylar fractures diagnosed by post mortem computed tomography

A useful form of glue ear

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