Penetrating head injury with bilateral eye avulsion due to <scp>H</scp>imalayan bear bite

Roka, Yam Bahadur; Roka, Narayani; Shrestha, Manzil; Puri, Puspa R; Adhikari, Hari

doi:10.1111/1742-6723.12007

Cited by 6 publications

(5 citation statements)

References 5 publications

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“…5 A case is also reported with penetrating head injury with bilateral eye avulsion. 6 In our study avulsion injury were found to be 8 (16%) and similar study is found where avulsion injury in 18.94% and tissue loss in 9.11% cases.…”

Section: Discussionsupporting

confidence: 84%

Study of Bear Bite Injury and Management in Tribal Belt of Chhattisgarh, India

Siddharth¹,

Kujur²,

Shivhare³

et al. 2020

jebmh

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BACKGROUND Bear injuries are unusual, but a trend is often observed in areas of bear habitats. Northern part of Chhattisgarh, a tribal belt is surrounded by bear habitat dense tropical moist deciduous forest. Industrialization and human invasion in their habitats resulting in frequent attacks by bear and victims present to the health care center with grievous injuries and psychological trauma. METHODS Present study included 50 victims of bear attacks admitted in the Department of Surgery, Government Medical College, Ambikapur, Surguja, Chhattisgarh, from 2016 to 2018. Data included are age, sex, precision time of attack, seasons, body parts involved, types of injuries and activity of victims during attack including the course of management. RESULTS In our study of 50 cases, most of the victims were attacked early in the morning and most of the attacks were in winter and monsoon. Common age group encountered was young adults to middle age ranging from 21-40 years. Out of 50 cases studied, 31 (62%) were males and 19 (38%) were females with a male: female ratio of 1.63:1. Attacked victims were usually engaged in cattle grazing activity (40%) and common tendency of attack observed was on face in 46%, followed by scalp in 24% and upper limb in 14%. Commonest injuries made in chronological order were laceration 76% followed by punctured wound in 48%, and avulsion injuries in 16%. Common major complications observed were wound infections 26%, followed by wound dehiscence 10%, with a fatality rate of 4%. CONCLUSIONS Human and bear interactions are accidental and unusual, but frequency is found to be increasing due to encroachment of forest by humans. Victims are usually villagers of near forest. Face and scalp are most commonly attacked body parts but no part is spared and the attack is sometimes fatal. Laceration injury was most common, and mostly on the face and scalp. Management of bear injury required multispecialty approach due to the variety of injuries with involvement of eye, ear, fractures, head injury including reconstruction surgery, to minimise complications.

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Section: Discussionsupporting

confidence: 84%

Study of Bear Bite Injury and Management in Tribal Belt of Chhattisgarh, India

Siddharth¹,

Kujur²,

Shivhare³

et al. 2020

jebmh

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“… 11 The injury to the eyeballs makes the victim blind to retaliate. 12 The brutal force applied by the bear led to multiple shattering of facial bones involving the maxilla, zygoma, mandible, nasal bones, orbit, frontal, and parietal calvarias along with extensive soft tissue injury. 5 It is common to observe tissue loss to a certain extent.…”

Section: Discussionmentioning

confidence: 99%

Management Challenges and Outcomes of Traumatic Brain Injury due to Bear Maul in Tribal Areas of Chhattisgarh, India—Man versus Wild

Borde

Kumar

Sahana

et al. 2021

JNRP

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Objectives Neurosurgeons working in the vicinity of tribal areas face traumatic brain injury (TBI) cases due to bear maul which is on the rise in Chhattisgarh. Most of the literature is focused on the management of maxillofacial injuries. This study intends to describe the challenges in management and outcomes of TBI due to bear maul. Materials and Methods A retrospective review was conducted from May 2018 to April 2020. The patients without TBI were excluded. The variables studied were age, gender, timing and mode of conflict, Glasgow coma scale (GCS) at arrival, injury spectrum, hospital stay, the modified Rankin score (MRS), mini mental status examination (MMSE), and surgical site infections (SSI). Results Twenty-eight patients were eligible for analysis. The mean age of presentation was 40.67 ± 13.99 years. There were 23 males (82.15%). Most common time of attack was during dawn (n = 11, 39.28%) followed by dusk (n = 9, 32.14%) and day (n = 8, 28.57%) time. Provoked conflicts were seen in 64.28%. The mean preoperative GCS was 11.07 ± 3.54 and hospital stay was 18.71 ± 9.51 days. Skull fractures were found in 24/28 (85.71%). The mean MRS was 1.67 ± 1.38 at a mean follow-up of 14.53 ± 6.59 months. Favorable outcome (MRS ≤ 2) was seen in 64.28% of patients. The mean MMSE score was 22.28 ± 5.36. Eight patients developed SSI (28.57%). Conclusion Outcomes of TBI due to bear maul depend on preoperative GCS. There are higher incidences of skull fractures and SSI. Humans need to avoid infiltration in wildlife territory to reduce the number of conflicts.

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“…Trauma is the leading cause for eyeball luxation with cases reported in children and adult secondary to surfboard injury, human bite, trauma by blunt or penetrating injury, animal bite, vehicle crush injury and self-enucleation in psychiatric cases (Hindman et al, 2007;Paya et al, 2012, Roka et al, 2012,2013Kosaki et al,2018). The overall visual prognosis is poor in such cases and various methods to salvage the eyeball have been proposed including simple reposition by patient relaxation and fi nger Roka N and Roka Y.B.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Luxation of the Eye Ball with Optic Nerve Transection Following Road Traffic Accident: Report of Two Cases and Brief Review of Literature

Roka

2018

Nep J Oph

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Background: Traumatic luxation of the eye ball is rare with only 106 cases reported in PubMed till date. The anatomic location of the eyeball within the socket and the resilience of the globe to pressure force, attachment to extraocular muscles and optic nerve prevents luxation during trauma. Case: Road traffic accidents (RTA) is the most common cause for these injuries and the outcome can vary from complete recovery on repositioning to visual loss due to globe perforation or optic nerve injury. We report two unique cases of traumatic right globe luxation and complete optic nerve transection due to RTA and give a brief review of literature. Conclusion: RTA leading to eye ball luxation though rare can be a challenging situation when encountered. Given the limited time for the salvage of the eye early intervention is not always possible especially in developing countries where there is delay in reaching the hospital. Despite all these confounding factors attempt must be made to salvage the eye either for functional, cosmetic or psychological reasons.

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Penetrating head injury with bilateral eye avulsion due to Himalayan bear bite

Cited by 6 publications

References 5 publications

Study of Bear Bite Injury and Management in Tribal Belt of Chhattisgarh, India

Study of Bear Bite Injury and Management in Tribal Belt of Chhattisgarh, India

Management Challenges and Outcomes of Traumatic Brain Injury due to Bear Maul in Tribal Areas of Chhattisgarh, India—Man versus Wild

Traumatic Luxation of the Eye Ball with Optic Nerve Transection Following Road Traffic Accident: Report of Two Cases and Brief Review of Literature

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