Correlation of Head Trauma and Traumatic Aneurysms

Abstract

<jats:p> Subarachnoid hemorrhage following severe trauma to the head is relatively common. In most cases the bleed originates from superficial veins and occasionally from arteries. Following the replacement of cerebral angiography with CT in the diagnostic evaluation of head traumas fewer traumatic aneurysms have been observed. This may indicate that some traumatic aneurysms are missed if angiographic procedures are not performed in patients with severe head injury. </jats:p><jats:p> Trauma patients admitted to our institution are submitted to CT including a bone algorithm. In case of subarachnoid hemorrhage, especially in the basal cisterns, CT- angiography is performed. Digital subtraction angiography is performed as well in cases with uncertain interpretations. </jats:p><jats:p> During one year 81 patients were admitted with subarachnoid hemorrhage following head trauma. Thirteen (16%) of them underwent CT-angiography and in five (6.2%) with SAH in the basal cistern traumatic aneurysms were found. Four of these cases had a skull base fracture including fractures through the clivus. Four cases were embolized and one very small extradural aneurysm is still not treated. One small pericallosal aneurysm was operated. </jats:p><jats:p> A traumatic aneurysm should always be suspected n patients with skull base fractures and subarachnoid hemorrhage in the basal cisterns. </jats:p>

Peritoneal dialysis in children undergoing congenital cardiac surgery under three years of age

“…This may be due to lower time interval between surgery and PD in the recovery and survivor groups, whereas most other groups started PD later. [2,4] In the current study, the renal function normalized after PD in all surviving patients, and this rate was in consistent with the previous studies.…”

“…[1,4,13,14] Several studies have attempted to identify the risk factors of ARF requiring RRT in pediatric patients undergoing congenital cardiac surgery. [2,7,14] In consistent with previous studies, [15][16][17] patients who showed recovery of renal function following PD with associated lower CPB and CC times, RACHS-1 category and inotrope scores, BUN and SCr values before PD and a lower time interval between surgery and PD had lower mortality. Additionally, in the present study, higher MAP and CVP scores before PD, late beginning of PD, lower perioperative urine output, and lower diuresis after PD were significant risk factors for increased mortality.…”

“…[1][2][3] Despite progress in cardiac surgery and intensive care techniques, the mortality rate still remains high (ranging from 20 to 79%) in this group of patients. [2,4] Peritoneal dialysis (PD) is the most widely available form of renal replacement therapy used in neonates, infants, and children. [5,6] The possible advantages and potential limitations of PD should be considered in the management of patients with ARF.…”

MDCT findings in sports and recreational accidents

“…The routine protocol for cerebral trauma MDCT will be supplemented in the near future with routine CT angiography to exclude cerebrovascular injuries, such as traumatic aneurysm, which we believe to be a so far under-diagnosed injury (15).…”

Traumatic intracranial aneurysm in blunt trauma

“…Results: A total of 10 257 patients with blunt TBI were identified, out of which 459 patients were included in the analysis. Mean age was 47.3 ± 22.5, the majority were male (65.1%) and median ISS was 16 [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Thirty-six patients (7.8%) had intracranial aneurysm, of which three patients (0.65%) had TICAs.…”