Imaging assessment of penetrating craniocerebral and spinal trauma

Offiah, Curtis; Twigg, S.

doi:10.1016/j.crad.2009.06.004

Cited by 43 publications

(60 citation statements)

References 49 publications

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“…3) (especially when available and always after excluding the presence of metallic foreign bodies), will have to be carried out [7,8]; Magnetic Resonance Angiography (MRA) is indispensable in explicit injuries [9]. Very small metallic fragments belonging to the foreign offending object might not be recognized on the plain film or at the CT scan [4]; these fragments are identified at MRI, because they cause the presence of small areas of susceptibility artifacts. In the emergency setting, in the presence of penetrating traumas, therapeutical options are to be chosen after considering the neurological performance of the patient, evaluating the severity of bone and ligamentous lesions and the stability of the spine, assessing the path traced by the offending object and the degree of canal involvement, and locating any retained fragments [10].…”

Section: Sharp Penetrating Injuries To the Spinementioning

confidence: 99%

“…Less resistant regions in the cranium are present, and this makes it possible for sharp objects such as scissors to damage the brain [4]. The main objective in the clinical and imaging evaluation of the patient is to locate the whole intracranial section of the sharp tool, highlighting its relationship with vital areas of the nervous system, such as the brain stem and cranial arteries and veins, either located inside and outside of the skull [4]. The diagnostic procedure for penetrating traumas of the calvarium always begins with a plain film which allows us to recognize bone lesions and/or foreign bodies.…”

Section: Introductionmentioning

confidence: 99%

“…Among the spectrum of penetrating injuries to the head, cerebral stab wounds are relatively rare, especially because the skullcap proves to be an efficient defensive wall. Less resistant regions in the cranium are present, and this makes it possible for sharp objects such as scissors to damage the brain [4]. The main objective in the clinical and imaging evaluation of the patient is to locate the whole intracranial section of the sharp tool, highlighting its relationship with vital areas of the nervous system, such as the brain stem and cranial arteries and veins, either located inside and outside of the skull [4].…”

Section: Introductionmentioning

confidence: 99%

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Sharp penetrating wounds: spectrum of imaging findings and legal aspects in the emergency setting

Reginelli

Pinto²,

Russo

et al. 2015

Radiol med

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The main cause of severe civilian trauma is not the same all over the world; while in Europe the majority of cases are due to blunt traumatic injury, in the United States, penetrating gunshot wounds are the most common. Penetrating wounds can be classified into two different entities: gunshot wounds, or more technically ballistic traumas, and sharp penetrating traumas, also identifiable with non-ballistic traumas. Sharp penetrating injuries are mainly caused by sharp pointed objects such as spears, nails, daggers, knives, and arrows. The type of injuries caused by sharp pointed objects depends on the nature and shape of the weapon, the amount of energy in the weapon or implement when it strikes the body, whether it is inflicted upon a moving or a still body, and the nature of the tissue injured. In the assessment of hemodynamically stable patients with sharp penetrating wounds, the main imaging procedure is Multidetector Computed Tomography (MDCT), especially used in complicated cases of penetrating injuries with an important impact on the final therapeutic choice. The diagnostic approach has been changed by MDCT due to its technical improvements, in particular, faster data acquiring and upgraded image reconstructions.

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Section: Sharp Penetrating Injuries To the Spinementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sharp penetrating wounds: spectrum of imaging findings and legal aspects in the emergency setting

Reginelli

Pinto²,

Russo

et al. 2015

Radiol med

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“…Conventional angiography is an invasive procedure with a potential risk of severe complications, including thrombosis of the femoral artery, arterial spasm and ischaemia in 0.16–2% of cases 54. The procedure may take up to an hour, which is questionable for unstable trauma patients and has therefore been recently superseded by CT angiography (CTA) 4,18,55. CTA demonstrates the course of the foreign object in relationship to the cerebral structures of the brain and any possible vascular injury 5.…”

Section: Role Of Angiographymentioning

confidence: 99%

Neuroimaging in adult penetrating brain injury: a guide for radiographers

Temple

Donald

Skora

et al. 2015

J of Medical Radiation Sci

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Penetrating brain injuries (PBI) are a medical emergency, often resulting in complex damage and high mortality rates. Neuroimaging is essential to evaluate the location and extent of injuries, and to manage them accordingly. Currently, a myriad of imaging modalities are included in the diagnostic workup for adult PBI, including skull radiography, computed tomography (CT), magnetic resonance imaging (MRI) and angiography, with each modality providing their own particular benefits. This literature review explores the current modalities available for investigating PBI and aims to assist in decision making for the appropriate use of diagnostic imaging when presented with an adult PBI. Based on the current literature, the authors have developed an imaging pathway for adult penetrating brain injury that functions as both a learning tool and reference guide for radiographers and other health professionals. Currently, CT is recommended as the imaging modality of choice for the initial assessment of PBI patients, while MRI is important in the sub-acute setting where it aids prognosis prediction and rehabilitation planning, Additional follow-up imaging, such as angiography, should be dependent upon clinical findings.

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“…in South Africa) spinal stab wounds (SSWs) occur quite frequently, but not so in Europe. However, according to a UK study [1], these injuries are increasing in number. Thus, they deserve closer attention.…”

Section: Introductionmentioning

confidence: 97%