Cases reported "Facial Injuries"

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1/6. Bilateral simultaneous facial paralysis--differential diagnosis and treatment options. A case report and review of literature.

    Bilateral facial paralysis or paresis of peripheral origin is a rare condition and therefore represents a diagnostic challenge. We here present a case of a previously healthy woman who was hospitalized for symptoms of meningitis. On the second day of her hospital stay, she developed bilateral facial paresis. Later, the patient developed also tachycardia and dysrhythmias. A thorough diagnostic procedure including lumbar puncture, routine blood investigation with serological tests, MRI of the brain, Holter monitoring and transoesophageal echocardiographia, revealed meningitis with radiculitis, facial paresis and myocarditis. The clinical triad of meningitis, radiculitis and facial palsy is known as the Bannwarth syndrome (lyme disease). The patient was treated with ceftriaxone and recovered well. Despite repeatedly taken serological tests, borrelia burgdorferi immunoglobulins were not detected. Acquired bilateral facial paralysis can occur in several diseases of infectious, neurological, idiopathic, iatrogenic, toxic, neoplastic or traumatic origin. In this article, we review the differential diagnoses and treatment options of bilateral facial paresis and present a scheme that is helpful in the diagnostic evaluation of this condition.
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2/6. death caused by a constricting snake--an infant death.

    A 21-month-old male was found dead in his crib. An escaped pet python snake (Python reticulatus) was found near the child on a cribside shelf. autopsy findings included petechiae associated with asphyxial death plus puncture wounds consistent with the reptile's teeth. This report details this 1982 death of a child in Reno, nevada, and includes illustration of the reptile's bite marks plus description of snake jaw mechanics in swallowing.
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3/6. Major dog attack injuries in children.

    Children are frequently admitted to a hospital with injuries sustained as a result of being attacked by a dog. Over a 5-year period (1977 to 1981), 57 such patients have been treated at the Winnipeg Children's Hospital. Half of the dog attack victims were 5 years or younger with injuries occurring more often in boys (55%). The majority of patients (95%) sustained puncture wounds and lacerations to the face (77%) and extremities (23%). In three of the cases, the dog attack victims presented with peritonitis secondary to bowel perforation and were treated successfully. A fourth child died as a result of his injuries prior to reaching the hospital. In the past, much attention has been focused on soft tissue injuries and their cosmetic repair. It is also important to recognize that the small child is particularly vulnerable to dog maulings from which the injuries sustained may be life threatening or lethal. Prevention seems to be the only rational approach to solving this problem.
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4/6. Infection emanating from an 'innocent' facial puncture wound. case reports.

    All accidental wounds are contaminated by bacteria. The factors involved in the conversion of a wound from contaminated to infected are identical, irrespective of the site and classification of the wound, although puncture wounds are particularly suited for the growth of anaerobic organisms. A case is presented of facial infection emanating from an 'innocent' puncture wound. The management of orofacial puncture wounds is discussed and illustrated with a second case.
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5/6. Microvascular replantation of avulsed tissue after a dog bite of the face.

    Various authors have described successful microsurgical replantation of totally avulsed facial tissue. In a significant number of cases difficulties were experienced with the venous anastomoses and/or venous drainage of the tissue. Many different methods were used to overcome the problem. Despite these difficulties, good cosmetic and functional results were reported. These injuries are often caused by animal bites. Adequate wound care and the excellent local blood supply make immediate reconstruction after animal bites of the face a safe procedure. Other authors describing similar lesions and immediate repair have not reported the complication of wound infection. We report on a patient who suffered a dog bite with total avulsion of most of the left upper lip, cheek and left alar rim. Venous congestion was overcome by multiple needle punctures to drain blood from the outer surface of the flap and local of application of heparin. A good cosmetic result and the return of sensation and function of the orbicularis oris muscle were obtained.
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6/6. Q-switched ruby laser treatment of traumatic tattooing induced by pencil point puncture in children.

    Traumatic tattoos induced by pencil point puncture in children may result in persistent disfigurement if left untreated. The Q-switched ruby laser effectively removes darkly colored cutaneous chromophores with minimal disruption of unaffected skin. We present a young patient with pencil point induced traumatic tattooing of the face, suffered 1 year prior to presentation, who was successfully treated with the Q-switched ruby laser with excellent cosmetic results.
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