Snow sports related head and spinal injuries: an eight-year survey from the neurotrauma centre for the Snowy Mountains, Australia.

Neurotrauma from snow-sports related injuries is infrequently documented in the literature. In Australia no collective data has ever been published. The aim of this study is to document the injury pattern of snow sports related neurotrauma admissions to The Canberra Hospital, the regional trauma centre for the Snowy Mountains. A computerised hospital record search conducted between January 1994 and July 2002 revealed 25 head and 66 spinal injury admissions. The incidence of severe injuries requiring referral to tertiary trauma hospital was estimated to be 7.4 per 100,000 skier-days and for head and spinal injury 1.8 per 1,000,000 skier-days and 5.6 per 1,000,000 skier-days, respectively. Collision with a stationary object was disproportionately associated with head injury ( [Formula: see text] ) and falling forward with spinal injury ( [Formula: see text] ). Snowboarders tended to sustain cervical fractures more often than skiers ( [Formula: see text] ). The importance of helmet usage in buffering the impact of head-on collision and the proposition of having both feet fastened to a snowboard in leading to cervical injury were highlighted.

Cerebellar haemorrhage following supratentorial craniotomy.

Distant cerebellar haemorrhage is a rare complication occurring in approximately 0.3-0.6% of all supratentorial craniotomy. A Medline and Pubmed search revealed only 98 cases in the English literature. We report three cases from our institution. An overall review of these 101 cases demonstrated that this complication commonly presented early in the postoperative course as decreased level of consciousness following aneurysm repair surgery or lobectomy for epilepsy. Asymptomatic presentation due to small haemorrhage was not uncommon. A transtentorial pressure gradient set up by excessive CSF loss is generally held responsible for disrupting the cerebellar venous blood flow and consequently leading to venous haemorrhage. Perioperative hypertension may also play a role. The outcome of patients who survived the complications was generally good, though not infrequently fatality resulted from the mass effect of extensive cerebellar haemorrhage demanded vigilance in its management.

Traumatic middle cerebral artery occlusion: case report and review of pathogenesis.

Traumatic occlusion of the middle cerebral artery (MCA) is a rare cause of cerebral infarct. We describe a case of MCA occlusion following blunt head trauma. The literature reports some 65 cases of MCA occlusion following non-penetrating blunt trauma to the head. Arterial dissection, cerebral vasospasm and thrombosis have been some of the theories discussed in the pathogenesis of this condition. We review the pathogenesis based on anatomy of the M1 segment.

Lumbar discectomy and the diabetic patient: incidence and outcome.

Medical records of 363 patients who had a diagnosis of lumbar disc disease and were managed by a posterior approach lumbar discectomy over a 7 year period were reviewed: 33 patients had a preoperative diagnosis of diabetes, an incidence in this patient population of 9.1%. The results for these 33 patients who had a diagnosis of diabetes mellitus were compared with those of 33 age and sex matched nondiabetic (control) patients who had a similar operative approach. Twenty-five of the diabetic and 28 of t he control patients were available for long term follow up. The results were positive (good to excellent) for 24 of the 28 (86%) control patients and 15 of the 25 (60%) diabetic patients. Seven of the 25 (28%) diabetic patients had reoperation for recurrent disc herniation at the same level following the initial procedure compared with one of the 28 (3.5%) control patients.

Cerebellopontine angle Hodgkin's disease.

Intracranial Hodgkin's disease is a rare site of involvement, and even more rare is its presentation as a cerebellopontine angle mass. The imaging findings are non-specific but the rapid response to therapy may provide a clue to diagnosis.