Injury patterns in patients who “talk and die”

Kim, Jun; Kemp, S.; Kullas, K.; Hitos, Kerry; Dexter, Mark

doi:10.1016/j.jocn.2013.02.021

Cited by 12 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Traumatic intracranial hemorrhage or diffuse cerebral edema can cause progressive symptomatic deterioration following brain injury, even in the absence of a first impact. [146][147][148][149][150] Mutations in the CACNA1A gene, which encodes a voltage-gated calcium channel subunit, have been implicated as a cause of delayed cerebral edema following minor head trauma. 151 McCrory and Berkovic classified 17 published SIS patients as "definite," "probable," "possible," and "not SIS."…”

Section: Posttraumatic Seizures and Epilepsymentioning

confidence: 99%

The Diagnosis and Management of Concussion in Children and Adolescents

Rose

Weber

Collen

et al. 2015

Pediatric Neurology

View full text Add to dashboard Cite

Section: Posttraumatic Seizures and Epilepsymentioning

confidence: 99%

The Diagnosis and Management of Concussion in Children and Adolescents

Rose

Weber

Collen

et al. 2015

Pediatric Neurology

View full text Add to dashboard Cite

“…Around 1% of minor head injured patients have life-threatening traumatic brain injuries (TBI) (injury to the brain/functional impairment due to external force), but this may not be initially clinically apparent 1. Early identification of severe TBI can facilitate life-saving neurosurgery 4. The clinical challenge is to differentiate patients with life-threatening TBI who present with a high conscious level from patients who can be discharged safely.…”

Section: Introductionmentioning

confidence: 99%

Impact of the SIGN head injury guidelines and NHS 4-hour emergency target on hospital admissions for head injury in Scotland: an interrupted times series

et al. 2018

View full text Add to dashboard Cite

ObjectivesHead injury is a common reason for emergency department (ED) attendance. Around 1% of patients have life-threatening injuries, while 80% of patients are discharged. National guidelines (Scottish Intercollegiate Guidelines Network (SIGN)) were introduced in Scotland with the aim of achieving early identification of those with acute intracranial lesions yet safely reducing hospital admissions.This study aims to assess the impact of these guidelines and any effect the national 4-hour ED performance target had on hospital admissions for head injury.SettingAll Scottish hospitals between April 1998 and March 2016.ParticipantsPatients admitted to hospital for head injury or traumatic brain injury (TBI) diagnosed by CT imaging identified using administrative Scottish Information Services Division data. There are 275 hospitals in Scotland. In 2015/2016, there were 571 221 emergency hospital admissions in Scotland.InterventionsThe SIGN head injury guidelines introduced in 2000 and 2009. The 4-hour ED target introduced in 2004.OutcomesThe monthly rate of hospital admissions for head injury and traumatic brain injury.Study designAn interrupted time series analysis.ResultsThe first guideline was associated with a reduction in monthly admissions of 0.14 (95% CI 0.09 to 4.83) per 100 000 population. The 4-hour target was associated with a monthly increase in admissions of 0.13 (95% CI 0.06 to 0.20) per 100 000 population. The second guideline reduced monthly admissions by 0.09 (95% CI−0.13 to −0.05) per 100 000 population. These effects varied between age groups.The guidelines were associated with increased admissions for patients with injuries identified by CT imaging—guideline 1: 0.06 (95% CI 0.004 to 0.12); guideline 2: 0.05 (95% CI 0.04 to 0.06) per 100 000 population.ConclusionIncreased CT imaging of head injured patients recommended by SIGN guidelines reduced hospital admissions. The 4-hour ED target and the increased identification of TBI by CT imaging acted to undermine this effect.

show abstract

“…En el síndrome de «caminar y morir» o «hablar o morir», Kim et al describen un periodo de lucidez, hasta un tiempo de 48 horas de haber ocurrido la lesión 4 , siendo el mecanismo de lesión cerebral traumática las caídas el más frecuente 2 . Por otro lado, Veevers et al reportaron tres casos en los que los individuos luego de la lesión se desplazaron entre 3-73 metros, hablaron 20-50 segundos, respondiendo a preguntas simples, y luego colapsaron 6 .…”

Section: Discussionunclassified

“…El síndrome de «caminar y morir» o «hablar y morir» se describe en aquellos pacientes que después de presentar una lesión cerebral traumática caminan, hablan y luego se deterioran a una condición grave (ECG < 8 puntos) dentro de las 48 horas posteriores a la lesión 4 .…”

Section: Introductionunclassified

Caminar, hablar y morir. Caso inusual de lesión cerebral traumática

Ayala-García¹

2023

REIE

View full text Add to dashboard Cite

La lesión cerebral traumática es motivo frecuente de morbimortalidad. La severidad se establece en relación con los hallazgos clínicos. Existen pacientes con lesiones potencialmente graves que no manifiestan evidencia clínica importante en las primeras horas, permanecen lúcidos, hablan y caminan. Se muestra la presentación clínica inusual de una lesión cerebral traumática, que se describe en los textos tradicionales de semiología y clínica médica, sin embargo no mencionada en las publicaciones científicas de ámbito local. Se presenta el caso de una paciente joven, que sufrió una caída, permaneció lúcida con mínima sintomatología, cursó con deterioro progresivo del nivel de consciencia, encontrándose lesiones cerebrales importantes, que no fueron sospechadas; requirió manejo quirúrgico inmediato. Se describen casos que posterior a un evento traumático, tienen un periodo de lucidez, caminan, hablan y luego se deterioran bruscamente. En estos pacientes en la valoración inicial no se diagnostica la presencia de lesiones secundarias graves, si no se tiene la alta sospecha clínica, basada en el mecanismo de lesión.

show abstract

Injury patterns in patients who “talk and die”

Cited by 12 publications

References 27 publications

The Diagnosis and Management of Concussion in Children and Adolescents

The Diagnosis and Management of Concussion in Children and Adolescents

Impact of the SIGN head injury guidelines and NHS 4-hour emergency target on hospital admissions for head injury in Scotland: an interrupted times series

Caminar, hablar y morir. Caso inusual de lesión cerebral traumática

Contact Info

Product

Resources

About