Missed injury in patients with severe traumatic brain injury complicated by multiple trauma

Yi, Feng; Zhong-hua, Shi; Wang, Yuhai; Ji-rong, Dong; Cai, Xianhua

doi:10.5137/1019-5149.jtn.6669-12.1

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…Optic nerve injury is an easily ignored case, especially in brain hernia patients. A 2013 study on 432 polytraumatized patients reported that 3 patients suffered from TON, which diagnosis have been missed in 2 of them leading to patient disability in one case [22]. Indirect injury to the optic nerve following head trauma occurs as a result of shearing of the nerve fibers, interruption of blood supply, or secondary edema and hemorrhage following shearing or transection of the optic nerve vessels.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic optic neuropathy: our surgical and medical protocol

Emanuelli

Bignami

Digilio

et al. 2014

Eur Arch Otorhinolaryngol

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Post-traumatic optic neuropathy (TON) is a rare, but very much feared event. It is a traumatic injury of the optic nerve at any level along its course (often inside the optic canal), with partial or total loss of visual acuity, temporarily or permanently. Until now, an univocal treatment strategy does not exist. The clinical records of 26 patients, treated from 2002 to 2013, were reviewed. The most frequent cause of injury was road traffic accident (63%), followed by iatrogenic damage, work injuries, sport or home accidents. All patients underwent pre-operative ophthalmological evaluation, neuro-imaging (angio-CT or angio-MRI scans) and systemic corticosteroid therapy. All patients required a surgical treatment, due to poor response to medical therapy; it consisted of an endonasal endoscopic decompression of the intracanalicular segment of the optic nerve, performed by removing the bony wall of the optical canal and releasing the perineural sheath. Improvement of visual acuity was reached in 65% of cases. No minor or major complication occurred intra- or post-operative, with a maximum follow-up time of 41 months. An improvement in visual acuity was achieved, although very limited in some cases, when surgery was performed as close as possible to the traumatic event. In the literature, there is no evidence-based data evaluating both of the two main treatment options (medical therapy versus surgical decompression), to state which is the gold standard in the treatment for TON. We discuss the pro and cons of our protocol: medical endovenous steroid treatment, within 8 h of injury, and endoscopic surgical decompression within 12-24 since the beginning of medical therapy, represent the best solution in terms of risk-benefit ratio for the patients.

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Section: Discussionmentioning

confidence: 99%

Post-traumatic optic neuropathy: our surgical and medical protocol

Emanuelli

Bignami

Digilio

et al. 2014

Eur Arch Otorhinolaryngol

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“…Many previous studies have demonstrated that a higher ISS has a significant relationship with missed injuries in trauma patients [16][17][18][19][20]. The ISS is an established medical score used to assess trauma severity and is correlated with mortality, morbidity, and hospitalization duration after trauma.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Missed Skeletal Injuries Detected Using Whole-Body Bone Scan Applied to Trauma Patients: A Case–Control Study

Chung

Gong

et al. 2023

Diagnostics

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(1) Background: Skeletal injuries may be missed in patients presenting multiple traumas during initial assessment. A whole-body bone scan (WBBS) may aid the detection of missed skeletal injuries, but the current level of research in this regard is insufficient. Thus, this study aimed to investigate whether a WBBS is useful for the detection of missed skeletal injuries in patients with multiple traumas. (2) Methods: This retrospective, single-region, trauma center study was conducted at a tertiary referral center from January 2015 to May 2019. The rate of missed skeletal injuries detected via WBBSs was evaluated, and factors that could influence the outcome were analyzed and divided into missed and not-missed groups. (3) Results: A total of 1658 patients with multiple traumas who underwent WBBSs were reviewed. In the missed group, the percentage of cases with an Injury Severity Score (ISS) ≥ 16 was higher than the not-missed group (74.66% vs. 45.50%). The rate of admission route through surgery and embolization was high in the missed group. Moreover, the proportion of patients that experienced shock in the missed group was higher than that in the not-missed group (19.86% vs. 3.51%). In univariate analysis, ISS ≥ 16, admission route through surgery and embolization, orthopedic surgery involvement, and shock were related to missed skeletal injuries. ISS ≥ 16 was determined to be statistically significant in multivariate analysis. Additionally, a nomogram was constructed based on multivariable analysis. (4) Conclusions: Missed skeletal injuries were significantly associated with several statistical factors, and a WBBS can be used as a screening method to detect missed skeletal injuries in patients with multiple blunt traumas.

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“…The storage and processing of such a substantial number of keys bring many overheads, especially in terms of memory. To overcome such issues, compression techniques can be integrated with the PPCT to reduce the storage consumption in the platform [21,22]. Apart from employing compression techniques, parallel architectures can be employed rather than serial architectures to match the keys of infected individuals to find the potentially exposed contacts [23].…”

Section: Lack Of Compression Techniques To Seamlessly Reduce Computin...mentioning

confidence: 99%

Technical Analysis of Contact Tracing Platform Developed by Google–Apple for Constraining the Spread of COVID-19

Majeed

2022

IJGI

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Amid the ongoing COVID-19 pandemic, technical solutions (e.g., smartphone apps, web-based platforms, digital surveillance platforms, etc.) have played a vital role in constraining the spread of COVID-19. The major aspects in which technical solutions have helped the general public (or health officials) are contact tracing, spread prediction, trend forecasting, infection risk estimation, hotspot identification, alerting people to stay away from contaminated places, hospitalization length estimation, clinical severity analysis, and quarantine monitoring, to name a few. Apart from other services, contact tracing has been extensively performed with the help of Bluetooth and GPS-powered smartphone applications when vaccines were unavailable. In this article, we technically analyze the contact tracing platform developed by Google–Apple for constraining the spread of COVID-19. We suggest unexplored technical functionalities that can further strengthen the platform from privacy preservation, service scenarios, and robustness point of view. Lastly, some AI-based and privacy-assured services that can be integrated with the platform to control the pandemic adequately are suggested. The technical analysis demonstrates that while the Google–Apple platform is well-engineered, it is not free of vulnerabilities, weaknesses, and misconfigurations that may lead to its poor adoption in real-life scenarios. This work can serve as a guideline for further enhancing the practicality of contact tracing platform to effectively handle future infectious diseases.

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Missed injury in patients with severe traumatic brain injury complicated by multiple trauma

Cited by 3 publications

References 9 publications

Post-traumatic optic neuropathy: our surgical and medical protocol

Post-traumatic optic neuropathy: our surgical and medical protocol

Analysis of Missed Skeletal Injuries Detected Using Whole-Body Bone Scan Applied to Trauma Patients: A Case–Control Study

Technical Analysis of Contact Tracing Platform Developed by Google–Apple for Constraining the Spread of COVID-19

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