Cases reported "Neck Injuries"

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1/5. Puncture wounds caused by glass mistaken for with stab wounds with a knife.

    Three cases are presented where fatal puncture wounds caused by broken glass were very similar to stab wounds inflicted by a knife with a single-edged blade. Thus, all three cases caused a murder investigation to be initiated. It could only be determined that these wounds had been caused by glass after a detailed forensic autopsy. In two of the three cases, the only evidence for this was the identification of glass fragments in the wounds. The importance of X-ray examinations is underlined because modern glass in common use is radiopaque. glass fragments lodged in the wounds can reduce the loss of blood and thus, prolong the capacity to act despite severe injuries.
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2/5. neck haematoma and airway obstruction in a patient with goitre: complication of internal jugular vein cannulation.

    Attempted jugular vein cannulation in a patient with a discrete goitre resulted in a rapid growing haematoma and airway obstruction. This life-threatening complication is rare, and is usually related to two conditions: pre-existing coagulopathy and/or arterial puncture by a large bore cannula or vessel dilator. None of these was present in this patient. Investigations revealed a retrosternal goitre causing tracheal compression and major changes in the calibre and the anatomical relationships of neck vessels. Possible origin and mechanism for the sudden haematoma are discussed, as well as the airway management. This case clearly illustrates how internal jugular vein cannulation using the traditional blind technique, guided by external landmarks, can be extremely hazardous in patients with distorted anatomy of the neck.
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3/5. Sequential endovascular coil embolization for a traumatic cervical vertebral AV fistula.

    An arteriovenous (AV) fistula involving the cervical vertebral artery is rare. Iatrogenic injury from percutaneous puncture and penetrating wounds are the most common causes. Symptoms include tinnitus and the presence of a pulsatile mass with a thrill. Conservative treatment with coil embolization and preservation of the vertebral artery is an alternative to surgical intervention. We report a patient who developed an AV fistula involving the vertebral artery and internal jugular vein following surgical repair of a stab wound to the neck. The sequential endovascular coil embolism was performed with subsequent successful occlusion of fistula. No neurological deficit developed during or after intervention. This approach appears to be a safe method in the treatment of vertebral AV fistula.
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4/5. An autopsy case of suicide by hanging with multiple stab wounds of the neck and chest.

    We report, from the aspect of 'acting' capability, an autopsy case of suicide by hanging in which multiple deep stab wounds were observed in the neck and chest. A 49-year-old man was found dead in a state typical of hanging. His car was found about 100m away with a blood-stained climber's knife on the seat. Multiple incised and stab wounds were in the neck, with a lesion of the right inner jugular vein. Three penetrating stab wounds of the chest punctured the lungs, with pooling of about 500ml of blood in the left thorax and about 100ml in the right. Two other shallow stab wounds were in the chest. All the above wounds were explainable as self-inflicted. From the autopsy findings and the circumstantial evidence, it was concluded that he walked approximately 100m after stabbing his neck and chest and finally committed suicide by hanging.
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5/5. Cougar attacks on children: injury patterns and treatment.

    PURPOSE: Cougar attacks on humans appear to be on the rise. A review of all attacks on children was performed to determine the method of attack and injury patterns so that a treatment regimen as well as possible preventative measures could be determined. methods: A review of all attacks, including attacks on children, was performed, including three recent attacks treated at our institution. Situation, adult supervision, patient age, injuries recorded, survival, and mode of attack, if known, were reviewed. RESULTS: There were 50 documented attacks on children with a 25% fatality rate. Most children were not alone at the time of the attack (92%), and in many instances adult supervision was present or nearby. Severe head and neck lacerations along with puncture wounds were the most common injury. Examples of typical cervical injuries include a nonfatal vertebral artery injury, phrenic nerve injury, a fatal internal carotid artery injury, and a fatal cervical spine injury. The cougar was rabid in two cases. Pasteurella resulted in late infections in two patients. CONCLUSIONS: Based on the pattern of injuries, the authors recommend aggressive evaluation for occult cervical injuries as well as surgical debridement. Antibiotics should cover oropharyngeal flora including pasteurella multocida. rabies prophylaxis is indicated. adult supervision in wilderness areas is not necessarily protective.
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keywords = puncture
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