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1.
Tokai J Exp Clin Med ; 40(2): 76-80, 2015 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-26150188

RESUMO

A tissue expansion technique in conjunction with a custom-made artificial bone implant was effective for a large cranial reconstruction in a pediatric patient. The patient was an eight-year-old boy with cranial bone fracture, acute subdural hematoma in the left lobe, and acute epidural hematoma in the right lobe due to an accident. Wound dehiscence and artificial dura infection were observed as postoperative complications. Because of insufficiency of the skin flap caused by scar contracture, a scalp skin expansion using a tissue expander was necessary before reconstruction with the artificial bone implant. This combined procedure provided safe coverage of the implant and resulted in good wound healing. There are relatively few reports involving the use of tissue expanders for cranioplasty; furthermore, our search of the literature did not reveal any reports involving children. We believe that this procedure is safe and effective for early rehabilitation in pediatric patients.


Assuntos
Durapatita , Procedimentos de Cirurgia Plástica/métodos , Próteses e Implantes , Implantação de Prótese/métodos , Fraturas Cranianas/cirurgia , Crânio/cirurgia , Dispositivos para Expansão de Tecidos , Expansão de Tecido/métodos , Criança , Humanos , Masculino , Desenho de Prótese , Crânio/lesões , Fraturas Cranianas/etiologia , Fraturas Cranianas/reabilitação , Resultado do Tratamento
2.
Injury ; 45(9): 1355-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24933443

RESUMO

BACKGROUND: Assaults with a machete cause compound skull fractures which present as a neurosurgical emergency. We aimed to profile cranial injuries caused by a machete over a 10 year period in a single neurosurgical unit. MATERIALS AND METHODS: Retrospective data analysis of cranial injuries following assault with a machete, admitted to the neurosurgery ward, from January 2003 to December 2012 was performed. Medical records were analyzed for demographics, clinical presentation, CT scan findings, surgical treatment and Glasgow Outcome Scale (GOS) at discharge. Management involved wound debridement with antibiotic cover. RESULTS: Of 185 patients treated 172 (93%) were male. Mean age was 31±11.4 years. Mean GCS on admission was 13±2. Presenting features were focal neurological deficit (48%), brain matter oozing from wounds (20%), and post traumatic seizures (12%). Depressed skull fractures were found in 162 (88%) patients. Findings on CT brain scan were intra-cranial haematoma (88%), pneumocephalus (39%) and features of raised intra-cranial pressure (37%). Thirty-one patients (17%) presented with septic head wounds. One hundred and fifty seven patients (85%) were treated surgically. The median hospital stay was 8 days (range 1-145). The median GOS at discharge was 5 (range 1-5). Twelve patients died within the same admission (6.5%). CONCLUSION: Machetes cause complex cranial injuries with associated neurological deficit and should be treated as neurosurgical emergency. Timeous intervention and good surgical principles are advocated to prevent secondary infection and further neurological deterioration.


Assuntos
Traumatismos Craniocerebrais/terapia , Epilepsia Pós-Traumática/tratamento farmacológico , Fraturas Cominutivas/terapia , Fraturas Cranianas/terapia , Violência , Armas , Ferimentos Penetrantes/terapia , Adolescente , Adulto , Distribuição por Idade , Anticonvulsivantes/administração & dosagem , Vazamento de Líquido Cefalorraquidiano/mortalidade , Rinorreia de Líquido Cefalorraquidiano/mortalidade , Criança , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/mortalidade , Traumatismos Craniocerebrais/reabilitação , Serviço Hospitalar de Emergência/estatística & dados numéricos , Epilepsia Pós-Traumática/reabilitação , Feminino , Fraturas Cominutivas/mortalidade , Fraturas Cominutivas/reabilitação , Escala de Coma de Glasgow , Escala de Resultado de Glasgow , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Fenitoína/administração & dosagem , Estudos Retrospectivos , Choque Hemorrágico/mortalidade , Fraturas Cranianas/mortalidade , Fraturas Cranianas/reabilitação , África do Sul/epidemiologia , Tomografia Computadorizada por Raios X , Infecção dos Ferimentos/mortalidade , Infecção dos Ferimentos/prevenção & controle , Ferimentos Penetrantes/mortalidade , Ferimentos Penetrantes/reabilitação
3.
Injury ; 45(1): 203-5, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24095269

RESUMO

INTRODUCTION: Periorbital ecchymosis (PE) is caused by blood tracking along tissue plains into periorbital tissues, causing discoloration in the upper and lower eyelids. This clinical feature is most commonly associated with basal skull fractures. Our objective is to present the first patient series describing the clinical features associated with traumatically induced PE. METHODS: The authors retrospectively reviewed 36 consecutive cases of patients presenting to the emergency department with PE over a three-year period at St. Michael's Hospital in Toronto. Data were obtained using a standardised data acquisition template. RESULTS: All patients presented to the emergency department with PE. The mean age in our series was 39 years (range 19-88 years), 31 patients were male. PE was associated with a variety of injuries including: 15 basal skull fractures, 9 soft tissue injuries without fractures, 8 convexity fractures, and 3 facial fractures. The other classic signs of basal skull fracture (Battle's sign, hemotympanum, cerebrospinal fluid otorrhea, cerebrospinal fluid rhinorrhea) were observed in 3, 7, 1, and 3 patients with PE, respectively. The most common clinical feature associated with PE was cranial nerve injury, observed in 10 patients. Surgical intervention was required in 8 patients. Five patients were discharged to a rehabilitation centre. No meningitis, cerebral abscess, encephalitis or deaths were observed. CONCLUSION: Periorbital ecchymosis is a useful clinic sign that should alert the clinician to assess for skull fractures, intracranial haemorrhage, and cranial nerve injury. However, this series shows that PE can be associated with a variety of clinical features, is rarely accompanied by other classic signs of basal skull fracture, and most patients with PE do not have injuries severe enough to require surgical intervention or post-discharge rehabilitation.


Assuntos
Traumatismos Craniocerebrais/diagnóstico , Equimose/diagnóstico , Doenças Orbitárias/diagnóstico , Base do Crânio/lesões , Fraturas Cranianas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Canadá , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/reabilitação , Equimose/etiologia , Equimose/reabilitação , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Orbitárias/etiologia , Doenças Orbitárias/reabilitação , Estudos Retrospectivos , Fraturas Cranianas/complicações , Fraturas Cranianas/reabilitação
4.
In. �lvarez Rivero, Alfredo V. Pr�tesis bucomaxilofacial. Procedimientos de labortatorio. La Habana, Ecimed, 3.ed; 2013. , ilus.
Monografia em Espanhol | CUMED | ID: cum-57601
5.
Brain Inj ; 20(11): 1131-7, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17123929

RESUMO

BACKGROUND: Mild traumatic brain injury (MTBI) defined as Glasgow Coma Scale (GCS) 14 or 15 has shown contradictory short- and long-term outcomes. The objective of this study was to correlate intra-cranial injuries (ICI) on CT scan to neurocognitive tests at admission and to complaints after 1 year. METHODS: Two hundred and five patients with MTBI underwent a CT scan and were examined with neurocognitive tests. After 1 year complaints were assessed by phone interviews. RESULTS: The neurocognitive tests in 51% of the patients showed significant deficits; there was no difference for patients with GCS 14-15, nor was there a difference between patients with ICI to patients without. After 1 year patients with ICI had significantly more complaints than patients without ICI, the most frequent complaint was headache and memory deficits. CONCLUSIONS: No correlation was found between GCS or ICI and the neurocognitive tests upon admission. After 1 year, patients with ICI have significantly more complaints than patients without ICI. No cost savings resulted by doing immediate CT scan on all.


Assuntos
Lesões Encefálicas/reabilitação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Lesões Encefálicas/diagnóstico por imagem , Lesões Encefálicas/economia , Lesões Encefálicas/psicologia , Emprego , Feminino , Seguimentos , Escala de Coma de Glasgow , Custos de Cuidados de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Prognóstico , Estudos Prospectivos , Fraturas Cranianas/diagnóstico por imagem , Fraturas Cranianas/reabilitação , Tomografia Computadorizada por Raios X/economia , Resultado do Tratamento
6.
Emerg Radiol ; 13(2): 79-82, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16941109

RESUMO

Occipital condylar fractures (OCFs) seem to be rare. The exact incidence is unknown, but a few studies reported a 3-4% incidence of OCFs in patients with severe head injury and altered Glasgow Coma Scale score. The low incidence of OCFs and missed diagnoses in these patients may result in late neurological deficits. We report the history of a patient with bilateral OCFs, a combined fracture of the anterior arcus of the atlas and associated retropharyngeal and epidural cervical haematomas, who presented without life-threatening symptoms or neurological deficits.


Assuntos
Hematoma Epidural Espinal/etiologia , Côndilo Mandibular/lesões , Osso Occipital/diagnóstico por imagem , Osso Occipital/lesões , Fraturas Cranianas/diagnóstico por imagem , Fraturas Cranianas/etiologia , Acidentes de Trânsito , Adulto , Atlas Cervical/diagnóstico por imagem , Atlas Cervical/lesões , Hematoma Epidural Espinal/diagnóstico por imagem , Hematoma Epidural Espinal/patologia , Hematoma Epidural Espinal/reabilitação , Humanos , Imageamento por Ressonância Magnética , Masculino , Côndilo Mandibular/diagnóstico por imagem , Motocicletas , Restrição Física , Fraturas Cranianas/patologia , Fraturas Cranianas/reabilitação , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/patologia , Fraturas da Coluna Vertebral/reabilitação , Tomografia Computadorizada por Raios X
7.
Minerva Stomatol ; 55(3): 151-7, 2006 Mar.
Artigo em Inglês, Italiano | MEDLINE | ID: mdl-16575386

RESUMO

The authors report their experience with temporomandibular joint (TMJ) traumas involving breakage of the roof of the glenoid cavity, an infrequent event that occurs in those cases in which, as a result of the condylar neck not fracturing, the traumatic energy is transmitted to the middle skull base. As the literature contains no valid series for establishing standardized protocols for the treatment of these fractures, we propose our own orthopedic-functional approach. The patient observed by us had suffered a cranio-facial trauma and presented the classical symptoms and signs of TMJ traumas and complete bilateral Bell paralysis. He was subjected to a CAT scan and then to 2-stage treatment consisting of functional rest with liquid diet followed by physiotherapy. An almost total recovery in TMJ function was observed after 1 month. At 1-year follow-up the facial paralysis had resolved completely. On the basis of our experience, breakages of the glenoid cavity can be compared, in terms of treatment procedure, to intracapsular fractures of the TMJ with surgery confined to cases of ankylosis sequelae. To avoid the onset of ankylosis careful control of clinical, functional and radiological follow-up is required.


Assuntos
Base do Crânio/lesões , Fraturas Cranianas/terapia , Osso Temporal/lesões , Articulação Temporomandibular/lesões , Adulto , Amnésia Retrógrada/etiologia , Paralisia de Bell/etiologia , Edema Encefálico/etiologia , Disartria/etiologia , Traumatismos Cranianos Fechados/complicações , Traumatismos Cranianos Fechados/reabilitação , Humanos , Masculino , Má Oclusão/etiologia , Modalidades de Fisioterapia , Recuperação de Função Fisiológica , Fraturas Cranianas/complicações , Fraturas Cranianas/diagnóstico por imagem , Fraturas Cranianas/reabilitação , Tomografia Computadorizada por Raios X
8.
Pediatr Neurosurg ; 42(3): 197-9, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16636626

RESUMO

Spinal subdural hematoma (SSDH) is a rare entity and post-traumatic cervical SSDH is very rare. Review of the literature revealed 8 reported cases of traumatic SSDH and only 2 were cervical. The exact mechanism and pathogenesis of SSDHs are unclear. There are still controversies about the source of bleeding and mechanisms of formation of a hematoma. Here we report a case of a unique traumatic craniocervical junction focal subdural hematoma in an 8-year-old boy and discuss the possible mechanisms of SSDHs in trauma cases.


Assuntos
Vértebras Cervicais/lesões , Hematoma Subdural Espinal/diagnóstico , Luxações Articulares/diagnóstico , Traumatismos da Coluna Vertebral/diagnóstico , Vértebras Cervicais/patologia , Criança , Osso Frontal/lesões , Osso Frontal/patologia , Hematoma Subdural Espinal/reabilitação , Humanos , Luxações Articulares/reabilitação , Imageamento por Ressonância Magnética , Masculino , Aparelhos Ortopédicos , Fraturas Cranianas/diagnóstico , Fraturas Cranianas/reabilitação , Traumatismos da Coluna Vertebral/reabilitação , Tomografia Computadorizada por Raios X
9.
Brain Inj ; 19(12): 1041-8, 2005 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16263647

RESUMO

PRIMARY OBJECTIVE: To assess subjective well-being and quality-of-life in nationally representative samples of patients at long intervals following traumatic brain injuries. METHODS AND PROCEDURES: Patients with either cranial fractures or cerebral lesions were identified in a national computer-based register of hospital admissions and random samples were selected among those who had suffered the injury at 5, 10 or 15 years prior to the follow-up. Postal questionnaires were sent to them covering quality of life, e.g. return to employment, family relations and current subjective well-being in terms of symptomatology, e.g. somatic complaints, cognitive dysfunction. A response rate of 76% was obtained, comprising 114 patients with cranial fracture and 126 with cerebral lesions. MAIN OUTCOMES AND RESULTS: The group with cerebral lesions had markedly poorer quality of life and subjective well-being than the group with cranial fractures and this did not vary across time. In both groups, the most common symptoms concerned cognition. Among the cerebral lesion group, quality of life outcome was fairly well predicted by severity of injury, but subjective well-being was less well predicted. CONCLUSIONS: The negative consequences of traumatic cerebral lesions are marked and do not vary at long periods following injury.


Assuntos
Lesões Encefálicas/psicologia , Lesões Encefálicas/reabilitação , Nível de Saúde , Qualidade de Vida , Atividades Cotidianas , Adulto , Transtornos Cognitivos/etiologia , Feminino , Seguimentos , Indicadores Básicos de Saúde , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Psicometria , Sistema de Registros , Fraturas Cranianas/psicologia , Fraturas Cranianas/reabilitação
10.
Brain Inj ; 18(6): 533-45, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15204335

RESUMO

PRIMARY OBJECTIVE: On a national basis to conduct a 5, 10 and 15 year follow-up study of representative samples of survivors after traumatic brain injury (TBI) and to identify factors of importance for long-term survival and life satisfaction after TBI occurring in 1982, 1987 or 1992. RESEARCH DESIGN: Epidemiological, register-based questionnaire survey. MAIN OUTCOMES, RESULT AND CONCLUSIONS: Out of 389 survivors randomly chosen from a national complete hospital register, 173 had suffered a cranial fracture, 186 a cerebral lesion (brain contusion or traumatic haemorrhage) and 30 patients a chronic subdural haematoma. Out of 337 survivors found eligible for a questionnaire, 76% responded. Among the data registered according to the above mentioned areas, the main findings were that 23-31% of the cerebral lesion responders were unable to maintain earlier work/education at pre-injury level, against up to 14% of cranial fracture patients. Significantly more cerebral lesion patients than cranial fracture patients found emotional control more difficult, as well as increased difficulties with memory and concentration, maintenance of leisure time interests and general life satisfaction. In the long run, an important factor influencing survival among cerebral lesion patients seemed to be whether relations with family and friends could be maintained at the pre-injury level.


Assuntos
Lesões Encefálicas/reabilitação , Qualidade de Vida , Adolescente , Adulto , Idoso , Lesões Encefálicas/psicologia , Escolaridade , Emprego , Métodos Epidemiológicos , Feminino , Hematoma Subdural/psicologia , Hematoma Subdural/reabilitação , Humanos , Relações Interpessoais , Masculino , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Prognóstico , Fraturas Cranianas/psicologia , Fraturas Cranianas/reabilitação , Classe Social
11.
Mund Kiefer Gesichtschir ; 5(5): 320-2, 2001 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-11693023

RESUMO

BACKGROUND: The treatment of sport accidents in professional athletes requires special treatment modalities, especially concerning quick rehabilitation. CASE REPORT: As early as 5 days after treatment of a nasal bone fracture under local anesthesia on an outpatient basis, an individual nasal shield out of silicone and acrylate could be manufactured from a facial impression for a professional soccer player. This shield enabled unlimited participation in the ensuing premier league matches 7 and 14 days after the accident. The same treatment was performed for another team member after closed reposition of a zygomatic arch fracture. Treatment modalities and manufacturing of the facial protection masks in these two cases are presented as examples.


Assuntos
Traumatismos em Atletas/reabilitação , Osso Nasal/lesões , Fraturas Cranianas/reabilitação , Futebol/lesões , Contenções , Fraturas Zigomáticas/reabilitação , Adulto , Consolidação da Fratura/fisiologia , Humanos , Masculino
14.
Sportverletz Sportschaden ; 14(1): 35-40, 2000 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-10859793

RESUMO

Uncomplicated midfacial fractures represent a frequent and typical injury of soccer-players in oral and maxillofacial surgery. The treatment of these fractures in professional players requires special treatment modalities, especially concerning quick rehabilitation. The examples of a nasal bone fracture, a malar bone fracture and a zygomatic arch fracture in 3 professional soccer players demonstrate the therapeutic principles of these most common uncomplicated midfacial fractures. In this context the fabrication of individual facial masks is presented, which allow an improved postoperative protection and therefore an earlier participation of the player in training and matches.


Assuntos
Traumatismos em Atletas/cirurgia , Traumatismos Faciais/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Fraturas Cranianas/cirurgia , Futebol/lesões , Adulto , Traumatismos Faciais/etiologia , Traumatismos Faciais/reabilitação , Dispositivos de Proteção da Cabeça , Humanos , Masculino , Prevenção Secundária , Fraturas Cranianas/etiologia , Fraturas Cranianas/reabilitação , Resultado do Tratamento
15.
Neurochirurgie ; 46(6): 563-567, 2000 Dec.
Artigo em Francês | MEDLINE | ID: mdl-11148409

RESUMO

A 47-year-old woman presented with a rare case of epidural hematoma of the clivus. The patient had bilateral occipital condyle fractures (a comminuted fracture on the right side, an avulsion fracture on left side and a lower clivus fracture). On admission the patient was tetraparetic with left abducens palsy. Preoperative imaging showed no atlanto-axial or occipito-atlantal dislocation. The patient was operated with a posterior approach. An occipital craniectomy with C1 laminectomy was achieved without atlanto-occipital fusion. Two years after the trauma, the patient had mild left hemiparesis but was able to walk normally. Head motion was normal, but just mildly decreased by pain in flexion and extension. Imaging control did not show any occipito-atlantal instability. We describe the imaging features allowing precise diagnosis and discuss the management of a rare entity: bilateral occipital condyle fractures and epidural hematoma of the clivus.


Assuntos
Fossa Craniana Posterior/lesões , Descompressão Cirúrgica , Fraturas Cominutivas/complicações , Hematoma Epidural Craniano/etiologia , Osso Occipital/lesões , Fraturas Cranianas/complicações , Acidentes de Trânsito , Fossa Craniana Posterior/cirurgia , Doenças dos Nervos Cranianos/etiologia , Transtornos de Deglutição/etiologia , Fixadores Externos , Feminino , Fraturas Cominutivas/reabilitação , Fraturas Cominutivas/cirurgia , Movimentos da Cabeça , Hematoma Epidural Craniano/cirurgia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Osso Occipital/cirurgia , Paresia/etiologia , Quadriplegia/etiologia , Fraturas Cranianas/reabilitação , Fraturas Cranianas/cirurgia , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgia
16.
Rev Stomatol Chir Maxillofac ; 99 Suppl 1: 122-5, 1998 Jul.
Artigo em Francês | MEDLINE | ID: mdl-9697245

RESUMO

A patient presented complex fractures of the face and skull with leg trauma after a traffic accident. Maxillofacial repair used sophisticated procedures: bone grafts, muscle flaps and multiple osteotomies. After reconstructing the mid face and the mandibular repair, bone implants were used to stabilize the maxillary prosthesis. The psychological and functions problems raised in this case are discussed considering the occupational and social outcome.


Assuntos
Implantação Dentária Endóssea , Ossos Faciais/lesões , Fraturas Maxilomandibulares/cirurgia , Procedimentos de Cirurgia Plástica , Fraturas Cranianas/cirurgia , Transplante Ósseo , Criança , Prótese Dentária Fixada por Implante , Planejamento de Dentadura , Ossos Faciais/cirurgia , Humanos , Fraturas Maxilomandibulares/reabilitação , Masculino , Músculo Esquelético/transplante , Osteotomia , Fraturas Cranianas/reabilitação , Retalhos Cirúrgicos
17.
J Trauma Nurs ; 4(2): 33-43, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9325818

RESUMO

TOPIC: Maxillofacial trauma case management. PURPOSE: To present a collaborative team approach to the patient with maxillofacial injuries. SOURCES: Published information and clinical experience. CONCLUSIONS: Outcome management is facilitated by a plan of care addressing acute, intermediate and rehabilitation phases of care.


Assuntos
Administração de Caso , Ossos Faciais/lesões , Traumatismos Maxilofaciais/cirurgia , Enfermagem Perioperatória , Fraturas Cranianas/cirurgia , Adulto , Cuidados Críticos , Humanos , Masculino , Traumatismos Maxilofaciais/reabilitação , Avaliação em Enfermagem , Planejamento de Assistência ao Paciente , Equipe de Assistência ao Paciente , Fraturas Cranianas/classificação , Fraturas Cranianas/reabilitação
18.
Unfallchirurg ; 100(2): 100-4, 1997 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-9157557

RESUMO

Three cases involving fractures of the occipital condyle were recently treated by the authors. Since plain radiographs of the upper cervical spine often fail to reveal this lesion, it can be difficult to diagnose. It seems to be more common than previously suspected and described. We found one axial compression fracture and two avulsion fractures with different degrees of atlanto-occipital instability. Mandibular fracture occurred in all cases. There was no severe craniocervical trauma. The atlanto-occipital junction should always be included in the CT evaluation of facial or craniocervical trauma. Thin-section CT of the craniocervical region can best visualize this fracture and should be used when it is suspected. All cases were treated by orthotic immobilisation.


Assuntos
Articulação Atlantoccipital/lesões , Vértebras Cervicais/lesões , Luxações Articulares/diagnóstico por imagem , Osso Occipital/lesões , Fraturas Cranianas/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Articulação Atlantoccipital/diagnóstico por imagem , Feminino , Consolidação da Fratura/fisiologia , Humanos , Luxações Articulares/reabilitação , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/reabilitação , Masculino , Traumatismo Múltiplo/diagnóstico por imagem , Traumatismo Múltiplo/reabilitação , Exame Neurológico , Osso Occipital/diagnóstico por imagem , Fraturas Cranianas/reabilitação , Fraturas da Coluna Vertebral/reabilitação
19.
Brain Inj ; 10(7): 487-97, 1996 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-8806009

RESUMO

To determine what consequences cognitive, behavioural or somatic impairments had on disabilities and recovery after a head injury (HI), a population-based sample of 231 adult patients was studied 5 years after an HI. Eighty lower-limb-injured (LLI) patients were considered as controls. Sixty-four LLI and 176 HI patients were reviewed (114 minor, 35 moderate, and 27 severe HI). Prevalence values of headaches (44-54%), dizziness (26-37%), and anxiety (47-63%) were not significantly different in the three HI severity groups, but were significantly lower in patients with an isolated limb injury (12-15%). Memory problems and depressive mood increased with injury severity. Mental impairments were frequent in severe HI patients (18-40% of patients). In minor and moderate HI patients, most disabilities were related to associated injuries. According to the Glasgow Outcome Scale (GOS), recovery was not considered as good because of somatic, behavioural or cognitive complaints in 2.5%, 5.7% and 59.2% of surviving patients in each of the above HI groups. Somatic or behavioural complaints may have considerable consequences in some minor HI patients, and the long-term management of certain patients needs improvement because these impairments are misunderstood.


Assuntos
Dano Encefálico Crônico/reabilitação , Lesões Encefálicas/reabilitação , Avaliação da Deficiência , Traumatismos Cranianos Fechados/reabilitação , Fraturas Cranianas/reabilitação , Adolescente , Adulto , Dano Encefálico Crônico/diagnóstico , Dano Encefálico Crônico/psicologia , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/psicologia , Seguimentos , Escala de Coma de Glasgow , Traumatismos Cranianos Fechados/diagnóstico , Traumatismos Cranianos Fechados/psicologia , Humanos , Traumatismos da Perna/diagnóstico , Traumatismos da Perna/psicologia , Traumatismos da Perna/reabilitação , Pessoa de Meia-Idade , Transtornos Neurocognitivos/diagnóstico , Transtornos Neurocognitivos/psicologia , Transtornos Neurocognitivos/reabilitação , Exame Neurológico , Testes Neuropsicológicos , Fraturas Cranianas/diagnóstico , Fraturas Cranianas/psicologia , Resultado do Tratamento
20.
J Oral Maxillofac Surg ; 54(6): 715-9; discussion 719-20, 1996 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8648476

RESUMO

PURPOSE: This study investigated the number and type of maxillofacial fractures caused by various athletic activities. PATIENTS AND METHODS: The ninety-eight patients were treated between 1977 and 1993, and the type of sport involved, patient age and sex, cause of accident, site of injury, and mode of treatment were evaluated. RESULTS: Sports-related maxillofacial fractures accounted for 10.4% of all patients with facial bone fractures. The number of different sports was 19, with the incidence of the fractures being most common in rugby and skiing, followed by baseball and soccer. The ratio of males to females was 5.5:1, and most of the patients were between 10 and 29 years of age. Total restriction from sports activity was between 8 and 12 weeks after initial treatment. CONCLUSION: The treatment for sports-related maxillofacial fractures is not different from that for fractures from other causes. However, it is important to establish some standard for deciding the time when it is possible to participate in sports after a fracture.


Assuntos
Traumatismos em Atletas/epidemiologia , Ossos Faciais/lesões , Fraturas Maxilomandibulares/epidemiologia , Fraturas Cranianas/epidemiologia , Adolescente , Adulto , Traumatismos em Atletas/reabilitação , Traumatismos em Atletas/terapia , Beisebol/lesões , Criança , Feminino , Seguimentos , Futebol Americano/lesões , Fixação de Fratura/estatística & dados numéricos , Humanos , Incidência , Fraturas Maxilomandibulares/reabilitação , Fraturas Maxilomandibulares/terapia , Masculino , Fraturas Mandibulares/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Esqui/lesões , Fraturas Cranianas/reabilitação , Fraturas Cranianas/terapia , Futebol/lesões , Fatores de Tempo , Tóquio/epidemiologia
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