Pub Date : 2023-08-19DOI: 10.5005/jp-journals-10030-1418
Doris Sarmiento, Amber N Himmler, Antonella Gallegos, Mateo Pacurucu, Rafael Valdivieso, Catherine Cabrera
{"title":"Choledocholithiasis: Easy and Early Diagnosis","authors":"Doris Sarmiento, Amber N Himmler, Antonella Gallegos, Mateo Pacurucu, Rafael Valdivieso, Catherine Cabrera","doi":"10.5005/jp-journals-10030-1418","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1418","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"302 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135936951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The scope of this special issue covers recent trends in neurotrauma research in different regions of the world, including studies in cranial and spinal trauma from epidemiological studies to clinical studies. Cross sectional and transversal studies, systematic reviews and meta-analysis are also welcome in order to present the different approaches that experts in the field are actually using for generating science at global level, filling gaps in knowledge independent of the level of available resources. This topic is urgently needed due to the actual background were neurotrauma care guidelines and protocols are required in order to decrease heterogeneity of care and the related mortality and disability associated with this disease independent of the level of resources available for care.
{"title":"Panamerican Journal of Trauma, Critical Care & Emergency Surgery","authors":"","doi":"10.5005/pajt-12-1-vii","DOIUrl":"https://doi.org/10.5005/pajt-12-1-vii","url":null,"abstract":"The scope of this special issue covers recent trends in neurotrauma research in different regions of the world, including studies in cranial and spinal trauma from epidemiological studies to clinical studies. Cross sectional and transversal studies, systematic reviews and meta-analysis are also welcome in order to present the different approaches that experts in the field are actually using for generating science at global level, filling gaps in knowledge independent of the level of available resources. This topic is urgently needed due to the actual background were neurotrauma care guidelines and protocols are required in order to decrease heterogeneity of care and the related mortality and disability associated with this disease independent of the level of resources available for care.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135847772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.5005/jp-journals-10030-1361
Ashley Williams, Myron L. Rolle
bstrAct Medical products transportation has become an important research topic requiring multidisciplinary collaboration among experts in surgery, public health, and health economics. Drones can be a promising tool to increase access to stabilizing neurotrauma care following a pediatric traumatic brain injury in the Caribbean. This commentary describes how the use of drones and neurotrauma education can increase health outcomes of neurosurgical emergencies on remote islands of low-and middle-income nations in the developing world.
{"title":"A Done Delivery Network for Acute Traumatic Brain Injury Management in the Caribbean: A Commentary","authors":"Ashley Williams, Myron L. Rolle","doi":"10.5005/jp-journals-10030-1361","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1361","url":null,"abstract":"bstrAct Medical products transportation has become an important research topic requiring multidisciplinary collaboration among experts in surgery, public health, and health economics. Drones can be a promising tool to increase access to stabilizing neurotrauma care following a pediatric traumatic brain injury in the Caribbean. This commentary describes how the use of drones and neurotrauma education can increase health outcomes of neurosurgical emergencies on remote islands of low-and middle-income nations in the developing world.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85961958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advances and Updates in Acute Biliary Disease for Surgeons","authors":"S. Rizoli, M. D. de Moya","doi":"10.5005/pajt-10-3-i","DOIUrl":"https://doi.org/10.5005/pajt-10-3-i","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85435701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.5005/jp-journals-10030-1351
J. Duchesne, S. Ninokawa, K. Nordham
Background: Here, we investigate the incidence of traumatic injuries during the COVID-19 pandemic over a year-long period which includes the first documented COVID-19 case in the US as well as rollout of vaccines. The study period includes the months of strictest lockdowns which early reports have focused on, as well as reopening. Methods: This retrospective analysis was performed with all records of trauma patients from our level 1 trauma center’s trauma registry. Mean weekly and total yearly patient counts from 2017–2019 and 2020 were compared using independent samples t-test or Mann-Whitney U test. Shapiro-Wilk and Levene’s tests were used to assess normality and variances, respectively. Results: There were more trauma patients in 2020 than the 2017–2019 average. In 2020, there were significantly higher weekly counts of penetrating injuries vs the 2017–2019 average [mean (SD)] [22.5 (7.2) vs 17.5 (3.1), p < 0.000], specifically gunshot wounds (GSWs) [15.8 (6.0) vs 11.3 (2.7), p < 0.0000] and more assaults [23.3 (6.7) vs 19.4 (3.2), p < 0.0003]. In 2020, fewer falls [11.9 (4.3) vs 13.4 (2.6), p < 0.03], pedestrian/bicycle accidents [5.5 (3.1) vs 7.5 (2.1), p < 0.0002], and accidents in general [45.9 (17.1) vs 50.9 (5.6), p < 0.05] presented to our hospital compared to previous years. Overall, weekly totals were higher than average in 2020, but were lower than average during the strictest shutdowns from March 18 to May 15. Conclusion: During the first 3 months and strictest lockdown of the pandemic, the number of traumatic injuries was significantly lower than average. Once restaurants reopened at 50% capacity, bars reopened, and gatherings of <50 people were allowed, weekly counts of trauma patients were above average in most (26/32, 81%) weeks through the end of the year. Increased GSWs and assaults this year may suggest increased interpersonal conflict. Increased violent and traumatic injury necessitating medical care is concerning for emergency departments and hospitals already overloaded with patient volume and facing staffing shortages due to the COVID-19 pandemic.
{"title":"Patterns of Traumatic Injury Volume during First Year of COVID-19 Pandemic","authors":"J. Duchesne, S. Ninokawa, K. Nordham","doi":"10.5005/jp-journals-10030-1351","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1351","url":null,"abstract":"Background: Here, we investigate the incidence of traumatic injuries during the COVID-19 pandemic over a year-long period which includes the first documented COVID-19 case in the US as well as rollout of vaccines. The study period includes the months of strictest lockdowns which early reports have focused on, as well as reopening. Methods: This retrospective analysis was performed with all records of trauma patients from our level 1 trauma center’s trauma registry. Mean weekly and total yearly patient counts from 2017–2019 and 2020 were compared using independent samples t-test or Mann-Whitney U test. Shapiro-Wilk and Levene’s tests were used to assess normality and variances, respectively. Results: There were more trauma patients in 2020 than the 2017–2019 average. In 2020, there were significantly higher weekly counts of penetrating injuries vs the 2017–2019 average [mean (SD)] [22.5 (7.2) vs 17.5 (3.1), p < 0.000], specifically gunshot wounds (GSWs) [15.8 (6.0) vs 11.3 (2.7), p < 0.0000] and more assaults [23.3 (6.7) vs 19.4 (3.2), p < 0.0003]. In 2020, fewer falls [11.9 (4.3) vs 13.4 (2.6), p < 0.03], pedestrian/bicycle accidents [5.5 (3.1) vs 7.5 (2.1), p < 0.0002], and accidents in general [45.9 (17.1) vs 50.9 (5.6), p < 0.05] presented to our hospital compared to previous years. Overall, weekly totals were higher than average in 2020, but were lower than average during the strictest shutdowns from March 18 to May 15. Conclusion: During the first 3 months and strictest lockdown of the pandemic, the number of traumatic injuries was significantly lower than average. Once restaurants reopened at 50% capacity, bars reopened, and gatherings of <50 people were allowed, weekly counts of trauma patients were above average in most (26/32, 81%) weeks through the end of the year. Increased GSWs and assaults this year may suggest increased interpersonal conflict. Increased violent and traumatic injury necessitating medical care is concerning for emergency departments and hospitals already overloaded with patient volume and facing staffing shortages due to the COVID-19 pandemic.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76405006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.5005/jp-journals-10030-1356
Tariq Janjua, L. Moscote-Salazar
Blood flow to the brain is mainly through anterior circulation via bilateral internal carotid arteries and through posterior circulation via bilateral vertebral arteries. The anterior circulation is for the respective side with the communication with the anterior communicating artery. The posterior flow is with the single basilar artery formed from vertebral arteries. There are collaterals present but the main vasculature determines most of the flow. This dynamic is normally balanced except in pathological conditions where flow is compensated from other vessels through the circle of Willis. It is rare to see a competing flow on each side and further, it is more complex when one region has a restricted flow and while another region has hyperdynamic
{"title":"Double Oxymoron Crisis: Posterior Circulation Intracranial Bleeding with Anterior Circulation Ischemic Stroke—A Management Dilemma","authors":"Tariq Janjua, L. Moscote-Salazar","doi":"10.5005/jp-journals-10030-1356","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1356","url":null,"abstract":"Blood flow to the brain is mainly through anterior circulation via bilateral internal carotid arteries and through posterior circulation via bilateral vertebral arteries. The anterior circulation is for the respective side with the communication with the anterior communicating artery. The posterior flow is with the single basilar artery formed from vertebral arteries. There are collaterals present but the main vasculature determines most of the flow. This dynamic is normally balanced except in pathological conditions where flow is compensated from other vessels through the circle of Willis. It is rare to see a competing flow on each side and further, it is more complex when one region has a restricted flow and while another region has hyperdynamic","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86589480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.5005/jp-journals-10030-1352
R. Ivatury
{"title":"Our Surgical Heritage: Walter Edward Dandy: A Founding Father of Neurosurgery","authors":"R. Ivatury","doi":"10.5005/jp-journals-10030-1352","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1352","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88576530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.5005/jp-journals-10030-1359
Lauren Ford, J. Ouma
Nutrition The World Health Organization (WHO) defines nutrition as the intake of food in relation to the body’s dietary needs: however, if the body’s nutritional needs are not met, either overnourishment or undernourishment/malnutrition develops.6 Malnutrition is defined as a body mass index (BMI) of <18.5 kg/m2, or unintentional weight loss (mandatory) with an associated reduction in BMI or a low-fat free mass index (FFMI). Weight loss can be defined as either >10% of habitual weight loss over an indefinite period or >5% over 3 months.7 An all-encompassing In t r o d u c t I o n
{"title":"A Descriptive Study of Malnutrition in Traumatic Brain Injury Patients","authors":"Lauren Ford, J. Ouma","doi":"10.5005/jp-journals-10030-1359","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1359","url":null,"abstract":"Nutrition The World Health Organization (WHO) defines nutrition as the intake of food in relation to the body’s dietary needs: however, if the body’s nutritional needs are not met, either overnourishment or undernourishment/malnutrition develops.6 Malnutrition is defined as a body mass index (BMI) of <18.5 kg/m2, or unintentional weight loss (mandatory) with an associated reduction in BMI or a low-fat free mass index (FFMI). Weight loss can be defined as either >10% of habitual weight loss over an indefinite period or >5% over 3 months.7 An all-encompassing In t r o d u c t I o n","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87753212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.5005/jp-journals-10030-1358
C. R. Guetter, Rebeca T Iurkiewiecz, M. S. Evangelista, G. M. Nogueira, L. K. Rafael, S. Pimentel, Fábio Henrique de Carvalho
On March 11, 2020, the World Health Organization (WHO) characterized COVID-19 as a pandemic.1 Most patients infected with SARS-CoV-2, the etiologic agent of COVID-19, may initially be oligosymptomatic, even those individuals presenting the pulmonary form of the disease. As a result, many trauma patients can arrive at the emergency department without signs or symptoms compatible with COVID-19 and, even so, be active agents for disease transmission.2,3 Pandemics generate socioeconomic crises and may overload the healthcare system, similarly to what might be seen in periods of war. This leads to the need for adjustments in the previously established forms of care, aiming at the rational use of material, physical, and human resources so as to reserve them for a future 1Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States 2,3,6,7Department of Surgery, Hospital Do Trabalhador, Curitiba, Brazil 4,5School of Medicine, Universidade Federal Do Paraná, Curitiba, Brazil Corresponding Author: Camila R Guetter, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States, e-mail: camilaguetter@gmail.com How to cite this article: Guetter CR, Iurkiewiecz RT, Evangelista MS, et al. Chest Computed Tomography for Screening Suspected Cases of SARS-CoV-2 Infection in Trauma Patients. Panam J Trauma Crit Care Emerg Surg 2021;10(3):101–106. Source of support: Nil Conflict of interest: None Chest Computed Tomography for Screening Suspected Cases of SARS-CoV-2 Infection in Trauma Patients Camila R Guetter1 , Rebeca T Iurkiewiecz2 , Matheus S Evangelista3 , Gabriel M Nogueira4 , Leonardo K Rafael5, Silvania K Pimentel6 , Fabio Henrique De Carvalho7
2020年3月11日，世界卫生组织(世卫组织)将COVID-19定性为大流行大多数感染SARS-CoV-2 (COVID-19的病原体)的患者最初可能没有症状，即使是那些表现为肺部形式的患者。因此，许多创伤患者在到达急诊科时，可能没有与COVID-19相符的体征或症状，即便如此，他们仍是疾病传播的活跃媒介。流行病产生社会经济危机，并可能使卫生保健系统超负荷，类似于战争时期可能出现的情况。这导致需要对以前建立的护理形式进行调整，目的是合理使用物质、体力和人力资源，以便为未来保留这些资源1美国马里兰州巴尔的摩约翰霍普金斯布隆伯格公共卫生学院2、3、6、7巴西库里蒂巴特拉巴尔哈多医院外科4、5巴西库里蒂巴帕拉纳联邦大学医学院Camila R Guetter，约翰霍普金斯大学彭博公共卫生学院，巴尔的摩，马里兰州，美国，e-mail: camilaguetter@gmail.com本文引用方式:Guetter CR, Iurkiewiecz RT, Evangelista MS，等。胸部计算机断层扫描筛查创伤患者SARS-CoV-2感染疑似病例中华创伤与急救外科杂志[J]; 2011;10(3): 101-106。Camila R Guetter1, Rebeca T Iurkiewiecz2, Matheus S evangelist3, Gabriel M Nogueira4, Leonardo K Rafael5, silia K Pimentel6, Fabio Henrique De Carvalho7
{"title":"Chest Computed Tomography for Screening Suspected Cases of SARS-CoV-2 Infection in Trauma Patients","authors":"C. R. Guetter, Rebeca T Iurkiewiecz, M. S. Evangelista, G. M. Nogueira, L. K. Rafael, S. Pimentel, Fábio Henrique de Carvalho","doi":"10.5005/jp-journals-10030-1358","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1358","url":null,"abstract":"On March 11, 2020, the World Health Organization (WHO) characterized COVID-19 as a pandemic.1 Most patients infected with SARS-CoV-2, the etiologic agent of COVID-19, may initially be oligosymptomatic, even those individuals presenting the pulmonary form of the disease. As a result, many trauma patients can arrive at the emergency department without signs or symptoms compatible with COVID-19 and, even so, be active agents for disease transmission.2,3 Pandemics generate socioeconomic crises and may overload the healthcare system, similarly to what might be seen in periods of war. This leads to the need for adjustments in the previously established forms of care, aiming at the rational use of material, physical, and human resources so as to reserve them for a future 1Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States 2,3,6,7Department of Surgery, Hospital Do Trabalhador, Curitiba, Brazil 4,5School of Medicine, Universidade Federal Do Paraná, Curitiba, Brazil Corresponding Author: Camila R Guetter, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States, e-mail: camilaguetter@gmail.com How to cite this article: Guetter CR, Iurkiewiecz RT, Evangelista MS, et al. Chest Computed Tomography for Screening Suspected Cases of SARS-CoV-2 Infection in Trauma Patients. Panam J Trauma Crit Care Emerg Surg 2021;10(3):101–106. Source of support: Nil Conflict of interest: None Chest Computed Tomography for Screening Suspected Cases of SARS-CoV-2 Infection in Trauma Patients Camila R Guetter1 , Rebeca T Iurkiewiecz2 , Matheus S Evangelista3 , Gabriel M Nogueira4 , Leonardo K Rafael5, Silvania K Pimentel6 , Fabio Henrique De Carvalho7","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84954699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.5005/jp-journals-10030-1357
Tariq Janjua, L. Moscote-Salazar, Fotis G. Souslian, S. A. Meyer
right-handed patient presented to an outside hospital with wakeup stroke. His deficit was complete right-sided weakness and marked aphasia. He was out of recombinant tissue plasminogen activator (rTPA) window and his CT scan showed early left middle cerebral artery (LMCA) stroke (Fig. 1A). There was a dense clot present in the first segment of LMCA. He was sent to comprehensive stroke center for an embolectomy attempt. On arrival a perfusion magnetic resonance imaging (MRI) brain was done which confirmed no viable penumbra and major LMCA area stroke. He was intubated prior to this MRI due to decline in neurological status. He was admitted to neurocritical care unit for close neuro checks. His repeat CT scan in 12 hours showed worsen cerebral edema and shift from left to right. At that stage an emergent left side decompressive hemicraniectomy was performed. Follow-up CT brain in 6 hours showed progressive cerebral edema. His postoperative CT skull showed extremely limited bone over left frontal area (Fig. 1B). A decision was made to place PPP. Raumedic ® bolt was selected. Left limited forehead area was evaluated for the access site. Sagittal images showed minimal area behind the resection and cephalad to frontal sinus (Fig. 1C). The bolt was placed with an opening pressure of 26 mm Hg. His repeat CT scan showed appropriate placement of the probe without any complications. to this article: Janjua T, Souslian Meyer SA, et al. Cerebral Parenchymal Probe Placement with Extreme Limitation of Cranial Bone. Panam J Trauma Crit Emerg 2021;10(3):147–149. Neurocritical care monitoring is prudent for the close neurological evaluation and adjustment of the treatment. Neuromonitoring allows the identification and evaluation of various physiological variables that can be modified after the primary injury. In severe TBI management, the use of intracranial probe is part of the advanced management of the neurocritical patient. Decompressive craniectomy, focal brain surgery, fracture skull, and previous prothesis makes it extremely tricky to achieve cerebral parenchymal probe placement (PPP).
{"title":"Cerebral Parenchymal Probe Placement with Extreme Limitation of Cranial Bone","authors":"Tariq Janjua, L. Moscote-Salazar, Fotis G. Souslian, S. A. Meyer","doi":"10.5005/jp-journals-10030-1357","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1357","url":null,"abstract":"right-handed patient presented to an outside hospital with wakeup stroke. His deficit was complete right-sided weakness and marked aphasia. He was out of recombinant tissue plasminogen activator (rTPA) window and his CT scan showed early left middle cerebral artery (LMCA) stroke (Fig. 1A). There was a dense clot present in the first segment of LMCA. He was sent to comprehensive stroke center for an embolectomy attempt. On arrival a perfusion magnetic resonance imaging (MRI) brain was done which confirmed no viable penumbra and major LMCA area stroke. He was intubated prior to this MRI due to decline in neurological status. He was admitted to neurocritical care unit for close neuro checks. His repeat CT scan in 12 hours showed worsen cerebral edema and shift from left to right. At that stage an emergent left side decompressive hemicraniectomy was performed. Follow-up CT brain in 6 hours showed progressive cerebral edema. His postoperative CT skull showed extremely limited bone over left frontal area (Fig. 1B). A decision was made to place PPP. Raumedic ® bolt was selected. Left limited forehead area was evaluated for the access site. Sagittal images showed minimal area behind the resection and cephalad to frontal sinus (Fig. 1C). The bolt was placed with an opening pressure of 26 mm Hg. His repeat CT scan showed appropriate placement of the probe without any complications. to this article: Janjua T, Souslian Meyer SA, et al. Cerebral Parenchymal Probe Placement with Extreme Limitation of Cranial Bone. Panam J Trauma Crit Emerg 2021;10(3):147–149. Neurocritical care monitoring is prudent for the close neurological evaluation and adjustment of the treatment. Neuromonitoring allows the identification and evaluation of various physiological variables that can be modified after the primary injury. In severe TBI management, the use of intracranial probe is part of the advanced management of the neurocritical patient. Decompressive craniectomy, focal brain surgery, fracture skull, and previous prothesis makes it extremely tricky to achieve cerebral parenchymal probe placement (PPP).","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87519986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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