Repercusión social en la persona con traumatismo craneoencefálico / Social repercussion in the person with traumatic brain injury

Resumen

Introducción: el enfoque social de una lesión cerebral por traumatismo craneoencefálico, de primera instancia, tiene que ver con la adquisición de una discapacidad que tendrá un impacto importante sobre la función social de quién lo padece.

Desarrollo: incluye los aspectos de percepción y manejo del trauma craneoencefálico, el cual se manifiesta por deterioro físico o funcional con daño neuropsicológico, la presencia de lesiones primarias y lesiones secundarias denominadas insultos extra neurológicos interfieren en la atención, la memoria, las funciones frontales, la emoción y la conducta. La valoración neuropsicológica posterior al traumatismo craneoencefálico se enfoca al deterioro intelectual, la movilidad voluntaria y el nivel de conciencia.

Conclusiones: el entorno social de las personas con traumatismo craneoencefálico, de acuerdo con la magnitud de la lesión, pueden presentar reacciones antisociales, por lo tanto la intervención de un profesional neuroeducador es la mejor alternativa para mejorar las respuestas conductuales, cognitivas y de aprendizaje.

Abstract

Introduction: The social approach to a brain injury due to traumatic brain injury, first instance has to do with the acquisition of a disability, which will have a significant impact on the social function of who has it.

Development: Includes aspects of perception and management of cranioencephalic trauma, which is manifested by physical or functional impairment with neuropsychological damage, presence of primary lesions and secondary lesions called extra neurological insults interfere with attention, memory, frontal functions, emotion and behavior. The neuropsychological assessment after traumatic brain injury focuses on intellectual deterioration, voluntary mobility and level of consciousnes.

Conclusions: The social environment of people with traumatic brain injury, according to the magnitude of the injury, may present antisocial reactions; therefore the intervention of a neuroeducator is the best alternative to improve the behavioral, cognitive and learning responses.

Managing Subacute Subperiosteal Hematoma with High Intraocular Pressure: A Case Report

Subperiosteal haematoma of the orbit is an uncommon complication of maxillofacial trauma, hence easily missed. It usually presents subacutely with proptosis and diplopia. In our case, the subperiosteal haematoma is complicated with high intraocular pressure, necessisating measures to reduce the intraocular pressure. Unresponsive to only medical treatment, surgical evacuation was carried out in this patient. Removal of the clot finally relieved the intraocular pressure and simultaneously improved the proptosis and the cumbersome diplopia.

Síntomas del trastorno por estrés postraumático en la comuna chilena de Cobquecura, 2010 / Post-trauma stress syndrome observed in Chilean commune of Cobquecura 2010

Objetivo: estimar síntomas del trastorno por estrés postraumático en habitantes de la Comuna de Cobquecura, Chile después del terremoto de 2010. Métodos: se utilizó un diseño no experimental de tipo descriptivo. Para recoger los datos se aplicó la Escala de Davidson, que mide percepción de síntomas relacionados con estrés postraumático. Resultados: el 58,5 por ciento de los entrevistados presentaba estrés postraumático con dificultades para elaborar la situación vivida, ya sea por la reexperimentación, la evitación de hablar acerca del suceso o la sobrevigilancia referida a los estímulos. A lo anterior debe agregarse que el 41,5 por ciento del resto de la población no alcanzaron el umbral mínimo para clasificarlo como trastorno por estrés postraumático según la validación y confiabilidad que entrega la Escala de Davidson. Sin embargo esto no implica que no tuvieran un grado de estrés postrauma. Conclusiones: se podría haber esperado un porcentaje más alto de la población con estrés postraumático dado que se encontraban en la zona del epicentro, sin embargo, Cobquecura resistió el terremoto de buena manera, sin víctimas fatales y no fue afectado por tsunami, por ende la población regresó rápidamente a su funcionamiento normal después del evento. Esto se refleja en el hecho de que los participantes notificaron pocos daños materiales causados por el terremoto(AU)

Objective: to determine post-trauma stress disorder symptoms in inhabitants of Cobquecura community after 2010 earthquake. Methods: non-experimental descriptive-type design was used to collect data as well as Davidson Trauma Scale was applied to measure symptoms related with post traumatic stress. Results: in the study population, 58.5 percent of the interviewed people presented with post traumatic stress, having difficulties in describing the situation that they had lived, whether for the re-experimentation, avoiding any talk about the event, or due to excessive surveillance of stimuli. It must be added that the remaining 41.5 percent of the inhabitants did not reach the minimum threshold to be classified as post traumatic stress disorder individuals, according to the validation and the reliability of Davidson Trauma Scale. However, this does not imply that they did not suffer post-trauma stress. Conclusions: a higher percentage of population with post trauma stress could have been expected, since this community was located in the epicentre area. Cobquecura withstood the earthquake; there were neither fatal victims nor tsunami, so people returned rapidly to their normal life after the event. This is mainly revealed in the fact that the participants reported few material damages caused by the earthquake(AU)

Exploration of acupoints selection law for post-traumatic stress disorder treated with acupuncture and moxibustion / 中国针灸

To analyze the modern clinical literature on post-traumatic stress disorder(PTSD) treated with acupuncture and moxibustion so as to summarize the acupoints selection law. The related articles from 2005 to 2014 were collected and then the frequencies were statistically analyzed. Finally 16 papers were gathered,while the main acupoints among the 23 acupoints refer to Baihui(GV 20),Sishencong(EX-HN 1),Shenting(GV 24),Fengchi(GB 20),Shenmen(HT 7),Neiguan(PC 6),Taichong(LR 3) and Sanyinjiao(SP 6). It is concluded that the law means taking smoothing liver and governor vessel to regulate the spirit as priority,and assisted by nourishing kidney and supportingto peace the spirit,as well as strengthening spleen and helpingto smooth meridians.

Hemobilia pós-trauma / Hemobilia post trauma

Our objective is to report a case of a patient, with a thoraco-abdominal gunshot wound with right hemothorax and liver lesion in the right lobe. The liver and the diafragm were sutured and the chest was drained. On the 9th post operative day the patient had hematemesis, jaundice and pain in the right upper quadrant of the abdomen. The abdominal ultrasound image with Doppler, revealed arteriobiliary fistulae. The diagnosis of hemobilia was made and the patient underwent embolization of the fistulae by liver arteriography.

Post-Traumatic Cerebral Fat Embolism

Post-traumatic fat embolism was first reported by Zenker in 1862, Von Bergmann reported the first clinical diagnosis of the fat embolism syndrome in 1873. Fat embolism has been associated with traumatic or non-traumatic disorders. Fat embolization after long bone trauma is probably common as a subclinical event. The diagnosis of fat embolism syndrome is based on the patient's history, is supported by clinical signs of pulmonary, cerebral, and cutaneous dysfunction, and is confirmed by the demonstration of arterial hypoxemia in the abscence of other disorders. Two different mechanisms cause fat to embolize: direct entry of deposit fat into the blood stream and agglutination of endogenous or exogenous plasma fat. MRI can detect a cerebral fat embolism with a higher sensitivity than cerebral CT. We report a case of post-traumatic cerebral fat embolism without pulmonary involvement, and we present a review of the literature. A 16-year girl had a traffic accident and pelvic bone fracture. Forty eight hours later severe trauma become stuporous without a focal neurological deficit. The patient received supportive therapy, and her condition improved throughout her hospital course. She was discharged with good condition after a 30-day hospital stay.