1/16. Delayed diffuse upper motor neuron syndrome after compressive thoracic myelopathy.A 54-year-old man developed progressive spastic paraparesis beginning 2 weeks after a back injury caused by a subacute compressive thoracic myelopathy attributable to a post-traumatic arachnoid cyst. Three to 18 months after surgical decompression of the thoracic arachnoid cyst, the patient developed a diffuse predominantly upper motor neuron syndrome characterized by spastic quadriparesis, pseudobulbar paresis, and pseudobulbar affect. Retrograde corticospinal tract degeneration and upper motor neuron death after spinal cord injury is recognized. This case suggests that focal upper motor neuron injury can occasionally precipitate diffuse upper motor neuron dysfunction.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/16. Fetal gunshot wound characteristics.Firearm injury in pregnant women is reported in the literature; however, no articles to date address the forensic analysis of the wounds sustained by the fetus. This is a report of a 40 weeks gestational age fetus who died following multiple perforating gunshot wounds, while his mother survived. The fetal wounds were atypical, consisting of irregular perforations with radiating linear lacerations and adjacent abrasions. The unusual wound pattern may have been due to the presence of interposed targets, the shoring of the fetus against itself and the uterine corpus, and the intrinsic character of fetal skin.- - - - - - - - - - ranking = 0.33333333333333keywords = injury (Clic here for more details about this article) |
3/16. Post-traumatic paroxysmal exercise-induced dystonia: case report and review of the literature.A young Chinese man sustained a back injury in a motorcycle accident in 2000 and had left lower limb weakness due to a lumbosacral plexopathy, diagnosed clinically and electromyographically. With rehabilitation, he recovered full function, but developed paroxysmal dystonia of the left leg only with prolonged exertion. He responded well to oral baclofen, relapsed when he stopped taking it, and remains well on low dose maintenance therapy. dystonia occurring after trauma is well documented, but paroxysmal exercise-induced dystonia occurring after trauma has yet to be described. Paroxysmal exercise-induced dystonia responds variably to anticonvulsant therapy, but the literature does not report response to baclofen, especially in low doses.- - - - - - - - - - ranking = 0.33333333333333keywords = injury (Clic here for more details about this article) |
4/16. Manual handling and the lawfulness of no-lift policies.Recent discussions over the plight of a woman who had spent a year sleeping in her wheelchair because the local NHS trust refused to allow her to be lifted into bed highlight the dilemma facing nurses when they are required to manually handle patients (Andrews and Robinson 2003). nurses are acutely aware that the manual handling of patients can result in back injury (McGuire and Dewar 1993). Yet they are also aware that they owe a duty to patients to provide nursing care to meet their needs and that might only be achieved through manual handling. There is evidence that hospitals in particular have still not met the requirements of the Manual Handling Operations Regulations (Trevelyan 2000). The hazards of working in the community environment have generally been better addressed as part of the assessment for and delivery of individual care packages. This article considers the law's approach to balancing the opposing needs of nurses' and patients' health needs.- - - - - - - - - - ranking = 0.33333333333333keywords = injury (Clic here for more details about this article) |
5/16. glass foreign body in the spinal canal of a child: case report and review of the literature.Retained foreign bodies pose a risk to the patient from the perspective of potential morbidity. We describe a previously healthy 8-year-old boy with head and back trauma from a glass picture frame that fell off the wall. He sustained a closed head injury and a back laceration several centimeters lateral to the spine. A persistent drainage from the back laceration contained glucose and protein levels consistent with cerebral spinal fluid. A foreign body was easily visible on subsequent plain radiograph. The glass foreign body was removed by neurosurgeons after computed tomography and magnetic resonance imaging clarified the exact location of the glass fragment. physicians should have a low threshold for obtaining plain radiographs in patients with glass foreign bodies and consider that projectiles may rest some distance from the laceration site.- - - - - - - - - - ranking = 0.33333333333333keywords = injury (Clic here for more details about this article) |
6/16. Isolated renal vein thrombosis after blunt trauma.Renal vein thrombosis typically occurs in the setting of nephrotic syndrome, tumor thrombus, primary retroperitoneal processes with vein compression, oral contraceptive use, steroid therapy, transplanted kidney, or trauma. Trauma-induced renal vein thrombosis usually presents in combination with renal arterial or parenchymal injury. We report a case of isolated renal vein thrombosis secondary to blunt abdominal and flank trauma. The diagnosis was made with computed tomography, which revealed a filling defect in the affected renal vein and persistent nephrogram on delayed images. In general, conservative management is the preferred treatment approach with anticoagulation.- - - - - - - - - - ranking = 0.33333333333333keywords = injury (Clic here for more details about this article) |
7/16. Stab wound of the back causing an acute subdural haematoma and a Brown-Sequard neurological syndrome.OBJECTIVE:To report on an unusual knife stab injury of the thoracic spine, causing an acute subdural haematoma (SDH) and paraparesis.SETTING:Department of Surgical neurology, Ward 20, The Royal Infirmary of Edinburgh.CASE REPORT:The weapon was a knife, which traversed the mid-thoracic spinal region, causing an incomplete spinal cord lesion, which was demonstrated by myelography to be due to an SDH. The haematoma was removed at operation. There was a full neurological recovery.CONCLUSION:There was no bony injury. The likely cause for the development of the SDH was believed to be due to the sudden impingement on the spine by the weapon, rupturing small subdural veins.- - - - - - - - - - ranking = 0.66666666666667keywords = injury (Clic here for more details about this article) |
8/16. Distinctive patterned injuries caused by an expandable baton.Identification and documentation of patterned blunt-force injuries at autopsy is of utmost forensic importance, particularly when the object or surface producing the injury is unknown or uncertain. documentation of patterned injuries produced by known objects contributes to the catalogue of forensic knowledge regarding those objects and the injuries they cause. This report presents a case in which a 27-year-old male sustained multiple nonlethal patterned blunt-force injuries produced by an expandable baton and subsequent multiple gunshot wounds during apprehension by police.- - - - - - - - - - ranking = 0.33333333333333keywords = injury (Clic here for more details about this article) |
9/16. A reliable approach to the closure of large acquired midline defects of the back.A systematic regionalized approach for the reconstruction of acquired thoracic and lumbar midline defects of the back is described. Twenty-three patients with wounds resulting from pressure necrosis, radiation injury, and postoperative wound infection and dehiscence were successfully reconstructed. The latissimus dorsi, trapezius, gluteus maximus, and paraspinous muscles are utilized individually or in combination as advancement, rotation, island, unipedicle, turnover, or bipedicle flaps. All flaps are designed so that their vascular pedicles are out of the field of injury. After thorough debridement, large, deep wounds are closed with two layers of muscle, while smaller, more superficial wounds are reconstructed with one layer. The trapezius muscle is utilized in the high thoracic area for the deep wound layer, while the paraspinous muscle is used for this layer in the thoracic and lumbar regions. Superficial layer and small wounds in the high thoracic area are reconstructed with either latissimus dorsi or trapezius muscle. Corresponding wounds in the thoracic and lumbar areas are closed with latissimus dorsi muscle alone or in combination with gluteus maximus muscle. The rationale for systematic regionalized reconstruction of acquired midline back wounds is described.- - - - - - - - - - ranking = 0.66666666666667keywords = injury (Clic here for more details about this article) |
10/16. Trauma and multiple sclerosis. An hypothesis.An obligatory event in the pathogenesis of the multiple sclerosis plaque appears to be an increase in the permeability of the blood-brain barrier. Neuropathological observations of the brain of persons suffering from concussion after relatively minor head injury, as well as of animals subjected to experimental brain injury, have shown that alterations of the blood-brain barrier constitute a common result of such trauma. It is postulated that the alterations of the blood-brain barrier secondary to trauma of the brain or spinal cord of patients with already established multiple sclerosis may result in an exacerbation or recurrence of a previously symptomatic plaque, in the appearance of symptoms from a silent lesion, or in the formation of a new plaque in such an area of selected vulnerability. In other persons injury to the nervous system may cause the development of multiple sclerosis plaques in the previously damaged areas when the disease has its onset after the trauma. There is no evidence to support the idea that trauma ever causes multiple sclerosis.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
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