Head and neck injuries after leopard attack: Presentation and management

Agarwal, Padmanidhi; Dhiman, Ajay; Rashid, Nouman; Kataria, Raman

doi:10.1016/j.cjtee.2021.01.003

Cited by 5 publications

(22 citation statements)

References 11 publications

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“…These attacks, therefore, generate public-health needs surrounding trauma care infrastructure, which has not followed the human population into these remote regions. 6 There was little difference in the resulting anatomical injury pattern regardless of captivity status or population characteristics. These are non-domesticated animals, and despite being held in captivity they appeared to instinctually attack as though in the wild, 17,35 aiming for the neck.…”

Section: Discussionmentioning

confidence: 90%

“…49 This is an important haemodynamic consideration for those delayed in seeking healthcare, which is likely in the rural locations these attacks occur. 55 The reasons for these time delays to attend a treatment facility in wild cases were not well documented, although the event was often remote from definitive facilities 6,21 (up to 30 miles 9 ) and in areas with poor access to transport. 9,22 Delays to definitive care also existed in high-income countries with transfers from local hospitals to specialist centres, 20,22 highlighting the need to recognise the complexity of these injuries at the scene.…”

Section: Discussionmentioning

confidence: 99%

“…All species dragged their victims once clasped in their jaws with distances reaching 60 m 44 and associated wound contamination was recorded in 38 patients. 5,6,23,32 Transfixion of the neck by canines was identified in six cases, 5,19,42,43,47,48 and was a causal agent of spinal injury 5,19,43,47,48 and vascular injury 42,48 due to ligamentous rupture and vessel shearing.…”

Section: Key Characteristics Of Study Population and Exposuresmentioning

confidence: 99%

“…49 Teeth caused direct fracture to the skull 29 and cervical spine, 48 and deep longitudinal scalp wounds were a common source of bleeding in 16 cases. 6,9,16,17,21,22,27,[29][30][31]33,44,50,51 Penetrating thoracoabdominal trauma was principally perpetrated by claws (n = 8). 18,19,31,35,36,43,45,48 Claw wounds were lesser in diameter, 18 linear rather than oval and typified by superficial grazes leading to the puncture site.…”

Section: Pooled Injury Pattern Of All Cats: Wound Morphology and Frac...mentioning

confidence: 99%

“…30,53 Compound cervical spine fracture or dislocation was common (Table 1, Group D) and included multilevel injury in seven patients 16,19,36,42,43,45,48 (Figure 4). Mandibular fracture 6,9,17,25,29,34,36 accounted for 70% of maxillofacial fractures, and the temporal and occipital bones were the most fractured of the calvarium. 21,22,29,30,36 Unique injury patterns per species Differences between species were found in the global fracture pattern, and bite locations of the neck.…”

Section: Pooled Injury Pattern Of All Cats: Wound Morphology and Frac...mentioning

confidence: 99%

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Traumatic injury patterns in humans from large feline predators: A systematic review and descriptive analysis

Kirtland

Tremoleda

Trivedy

2022

Trauma

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Background Traumatic attacks from large feline predators cause a small yet significant burden of disease in rural populations, are increasing in frequency, cause complex injuries and worsen human–wildlife conflicts. Data on the traumatic injury pattern found in victims of these animals is sparse, and this study aimed to collate and synthesise patterns of injury to inform the care and management of these patients. Methods A multi-ethnographic literature search (PubMed, Embase, Web of Science, Google Scholar, and other sources) was performed on 12/1/21 to capture all available data describing anatomical injury and the mechanism of injury sustained by humans from attacks by lions, leopards and tigers. Quality and bias assessment was performed using the Joanna Briggs Critical Evaluation tools. Results Of 5110 studies identified, 42 were included in this review totalling 84 individual patient cases. A total of 85% of fatal injuries were due to exsanguination combined with neuroaxis injury of the neck. All wounds were susceptible to tissue loss, infection and long-term neuro-vascular complications. Leopards injured anterior-midline structures of the neck more often than did lions and tigers, while the latter caused high-energy fractures. Time lag to treatment for survivors of wild attacks extended to multiple days, and occult injury was common. Conclusion In addition to the primary finding of complex neck injury, this study generated specific patterns of injury seen from the included species and highlighted occult injury and healthcare disparity as challenges in providing patient care.

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Section: Discussionmentioning

confidence: 90%