1/68. spinal cord injury in a fetus.In her eighth month of pregnancy a woman was stabbed in the abdomen with a barbecue fork. Upon delivery one week later, the child was noted to have two scars in the thoracic region on the back. The legs were flaccid. Surgical exploration at the age of seven months revealed marked, dense scarring of spinal cord and arachnoid membrane. No similar case was found in the literature.- - - - - - - - - - ranking = 1keywords = spinal, cord (Clic here for more details about this article) |
2/68. Pericardial drainage prior to operation contributes to surgical repair of traumatic cardiac injury.We report on two cases of successful surgical repair of cardiac injury: one involving a left ventricular stab injury and the other a blunt rupture of the right atrium. Each patient underwent emergency surgical repair, the former via left anterolateral thoracotomy and the latter via median sternotomy, following pericardial drainage tube insertion from the subxiphoid area. The operative approach was chosen according to the color of drained blood, i.e., arterial bleeding indicated left anterolateral thoracotomy, while venous bleeding indicated median sternotomy. We conclude that pericardial drainage via the subxiphoid approach prior to induction of anesthesia is an easy and useful technique to perform, not only to release cardiac tamponade but to determine the operative approach in patients suffering from cardiac tamponade following cardiac injury.- - - - - - - - - - ranking = 0.11885040013658keywords = cord (Clic here for more details about this article) |
3/68. Delayed presentation of spinal stab wound: case report and review of the literature.Stab wounds to the spinal cord are relatively uncommon in north america, but even rarer is the presentation of such an injury in a delayed fashion. We report a case of a 31-year-old male who presented with neurologic deficit 4 weeks after a stab wound injury to the spine. Because of worsening neurologic deficit, the retained knife fragment was operatively removed, and the patient had an uneventful recovery. The management of such an injury is discussed, with a review of the literature.- - - - - - - - - - ranking = 2.147590396722keywords = spinal, cord (Clic here for more details about this article) |
4/68. Suicides by sharp force: typical and atypical features.A total of 65 consecutive cases of suicide by sharp force were investigated by evaluating the autopsy and prosecution department records. Suicides constituted 17% of all fatalities from sharp force autopsied between 1967 and 1996. Young males and persons with a psychiatric history predominated among the persons who chose this "hard" method of suicide. The most common implements used were knives (62%) and razor blades (15%). Cutting injuries in isolation were present in 26, stab injuries in isolation in 24 and a combination of both in 15 fatalities. The number of injuries per case varied from 1 to 37 but 1/3 showed one injury. More than 85% of the cutting injuries were located at the wrist, elbow crease or neck whereas 79% of the stab injuries involved the ventral aspect of the trunk. Perforation of clothing was present in 16 (52%) out of 31 stab injuries to the trunk. Injuries to more than one body region were observed in 34 (52%) cases. Tentative marks were present in 50 (77%) fatalities and the number varied from 1 to 60 per case. Superficial incisions of the fingers were found in 15% with razor blades constituting the weapon in half of these cases. Deviations from these typical patterns occurred not infrequently. The utter determination of the victim to carry it through or the use of unusual weapons resulted in a few bizarre cases which are outlined briefly.- - - - - - - - - - ranking = 0.11885040013658keywords = cord (Clic here for more details about this article) |
5/68. An unusual stab wound of the cervical spinal cord: a case report.STUDY DESIGN: A rare case of a laterally directed stab wound injury of the cervical spinal cord is reported. OBJECTIVE: To describe the unusual mechanism of injury of this case and its clinical features. The surgical indications for penetrating injuries of the spinal cord are discussed. SUMMARY OF BACKGROUND DATA: Spinal stab wound injuries are rare, and the literature on the subject is scant. There has been only one large clinical review from south africa, published in 1977. The clinical features and the injury mechanism of a laterally directed stab wound to the cervical spine have not been previously described. methods: An 18-year-old man was stabbed in the right side of the neck at C1-C2. The blade penetrated the spine laterally and went through the ligaments without affecting the bony structures. On admission the patient had tetraplegia and was in respiratory failure. Radiologic investigation showed the retained blade passing through the cord but showed no bony or vascular injuries. RESULTS: Before extraction, the knife was followed to its tip with careful dissection. Because no cerebrospinal fluid leak was noted in the area, the dura was not exposed. After surgery, magnetic resonance images showed a complete transection of the spinal cord at C1-C2. The patient was neurologically unchanged in follow-up examinations. CONCLUSION: Laterally directed horizontal stab wounds of the spine are particularly dangerous because the blade can pass between two vertebrae to transect the cord. The neurologic injury that results is irreversible. The more common stab wounds, inflicted from behind, usually produce incomplete cord damage.- - - - - - - - - - ranking = 4.4344879959025keywords = spinal, cord (Clic here for more details about this article) |
6/68. Injury caused by deeply penetrating knife blade lodged in infratemporal fossa.Knife-inflicted, deeply penetrating head and neck trauma is an uncommon life-threatening injury and a challenging problem. An examination of the neurovascular and systemic physical status is a first requirement and the decision as to which approach to adopt for the removal of the blade is of critical importance. Here we report a rare case of a pre-auricular stab wound with the knife blade deeply lodged in the extracranial infratemporal fossa. Radiological investigations showed that the knife blade had entered from the temporomandibular joint and become lodged through the anterior margin of foremen magnum below the petrosal bone. Minimal left vocal cord paresis, left palatal weakness and a slight deviation of the tongue towards the left side were observed. The other neurological and systemic physical evaluations were normal. Simple withdrawal of the blade in the operating room did not cause serious neurovascular injury. Here we discuss and compare the expanded exposure of anatomical structures for blade removal and simple withdrawal in similar injuries.- - - - - - - - - - ranking = 0.11885040013658keywords = cord (Clic here for more details about this article) |
7/68. Stab injury of the spinal cord surgically treated.The authors report a case of thoracic spinal cord stab injury with neurologic impairment that was treated surgically after injury. A literature review and case analysis indicate that surgical extraction of foreign bodies retained within the spinal canal is indicated to avoid infection, delayed myelopathy, and neurologic loss. The amount of motor and functional recovery for incomplete injuries after spinal cord stab wound can be strikingly good despite pathologic changes to severely damaged areas, and removal of retained intraspinal metallic fragment can improve this neurologic outcome. Open removal of the knife seems preferable to avoid bleeding and infection.- - - - - - - - - - ranking = 3.9590863953562keywords = spinal, cord (Clic here for more details about this article) |
8/68. pneumocephalus secondary to a neck stab wound without neurologic injury in a 13-year-old girl.pneumocephalus is usually caused by injury that damages the brain meninges and thus allows air to enter the intracranial cavity. Our intention was to establish the importance of considering a stab wound in the neck as a possible cause of traumatic pneumocephalus. The paper presents the case of a 13-year-old girl who was accidentally stabbed in the neck with a kitchen knife by her brother. She had no neurological deficit but had developed headaches. An examination showed cerebrospinal fluid leaking from the neck wound and a CT scan revealed the pneumocephalus. Following surgical treatment, the patient's clinical symptoms regressed. To our knowledge, this case is the first report of the manifestation of pneumocephalus as the result of a neck stab wound in a child; overall, there are only three reported cases of pneumocephalus caused by a neck stab wound.- - - - - - - - - - ranking = 0.40574799931708keywords = spinal (Clic here for more details about this article) |
9/68. Traumatic Brown-Sequard-plus syndrome.BACKGROUND: In the 1840s Brown-Sequard described the motor and sensory effects of sectioning half of the spinal cord. Penetrating injuries can cause Brown-Sequard or, more frequently, Brown-Sequard-plus syndromes. OBJECTIVE: To report the case of a 25-year-old man who developed left-sided brown-sequard syndrome at the C8 level and left-sided horner syndrome plus urinary retention and bilateral extensor responses following a stab wound in the right side of the neck. RESULTS: magnetic resonance imaging demonstrated a low cervical lesion and somatosensory evoked potentials confirmed the clinical finding of left-side dorsal column disturbance. At follow-up, the patient's mobility and bladder function had returned to normal. CONCLUSION: This patient recovered well after a penetrating neck injury that disturbed function in more than half the lower cervical spinal cord (Brown-Sequard-plus syndrome).- - - - - - - - - - ranking = 1.0491967989073keywords = spinal, cord (Clic here for more details about this article) |
10/68. Penetrating cardiac injury.Penetrating cardiac injury is still a diagnostic problem at this time. The authors want to show the breadth of problems on the case histories of two patients. It is important to classify the patients according to their risk group, and then to proceed. In each suspicion of cardiac injury we started with thoracotomy. It is an important "life endangering thoracotomy in emergency room". The hypotension with abdominal symptoms was started with laparotomy. Transdiaphragmatic pericardiotomy is a helpful adjunct in the decision as to whether proceed to median sternotomy. (Tab. 2, Fig. 3, Ref. 7.)- - - - - - - - - - ranking = 0.11885040013658keywords = cord (Clic here for more details about this article) |
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