Cases reported "Craniocerebral Trauma"

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11/15. mutism after closed head injury.

    Prospective study of patients admitted to a hospital for closed head injury showed that nine patients (nearly 3%) became mute for varying periods despite recovery of consciousness and communication through a nonspeech channel. Computed tomography (CT) showed subcortical lesions situated primarily in the putamen and internal capsule of four patients, whereas four of the five patients without subcortical lesions had left-hemisphere cortical injury. The patients without subcortical injury visualized by CT exhibited a longer duration of impaired consciousness consistent with severe diffuse brain injury and they showed more long-term linguistic deficits. We related our findings to recent studies of atypical aphasia after occlusive vascular lesions of the basal ganglia.
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12/15. Dural arteriovenous malformation of the major venous sinuses: an acquired lesion.

    arteriovenous malformations of the dura are thought to be congenital. However, arteriographic investigations of four patients who, after a head injury, developed dural arteriovenous fistulae with features of congenital malformations suggest that these abnormal communications may also be acquired. thrombosis or thrombophlebitis in the dural sinus or vein may be the primary event in their formation. The pathogenesis is probably "growth" of the dural arteries normally present in the walls of the sinuses during the organization of an intraluminal thrombus. This may result in a direct communication between artery and vein or sinus, establishing an abnormal shunt. Ultimate fibrosis of the sinus wall and intraluminal thrombus may be the factors responsible for the spontaneous disappearance of such malformations.
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13/15. Early discovery of a traumatic carotid-cavernous sinus fistula by jugular venous oxygen saturation monitoring. Case report.

    This report describes the early diagnosis, due to an acute increase of jugular venous oxygen saturation occurring 20 hours after trauma, of a traumatic carotid-cavernous sinus fistula after severe head injury. hyperemia in severe head injury should be treated only after an intracerebral arteriovenous communication has been excluded.
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14/15. Tension pneumocephalus and tension orbital emphysema following blunt trauma.

    We present the first reported case of vision loss due to tension orbital emphysema associated with tension pneumocephalus resulting from blunt trauma. In the setting of trauma, intraorbital air indicates paranasal sinus-orbital communication. Tension orbital emphysema may cause vision loss through optic nerve compression, ischemia, or contusion; or central retinal artery occlusion. Vision impairment after craniofacial injury should prompt urgent computed tomography. Tension orbital emphysema with associated vision impairment requires treatment including direct decompression and, in some cases, high-dose steroids to preserve vision. Increases in sinus pressure from coughing, nose-blowing, or vomiting should be avoided until definitive treatment can be instituted.
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15/15. Paramesencephalic arachnoid cysts.

    The term "paramesencephalic" is proposed to describe the location of a general class of arachnoid cysts observed in four patients. These cysts, which appear to arise within the subarachnoid space, are characterized by a lack of communication with the ventricular system. Usually, the arachnoid tissue is normal, and the cyst fluid resembles cerebrospinal fluid both macroscopically and microscopically. hydrocephalus is variably accompanied by localizing signs. Problems may be encountered in the diagnosis of suprasellar (case 4), parapineal (case 3), incisural (case 1), and interpeduncular (cases 2 and 4) arachnoid cysts. Early surgical exploration is strongly recommended.
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