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Should pediatric patients with isolated skull fractures be admitted, transferred, or discharged from the emergency department, and what are the economic consequences? Original series, systematic review of the literature, and a proposed admission protocol.

OBJECTIVE: Pediatric head trauma is a common reason for emergency department (ED) referrals. Skull fractures are the most common imaging fin … on CT were included. Patients with additional traumatic intracranial findings on imaging (bleeding, pneumocephalus, edema, etc.) were excluded, as were patients with depressed, open, or displaced fractures. A systematic literature review of the Medline and PubMed databases was performed. RESULTS: Two hundred fifty-eight children met the criteria between 2019 an …

Recurrent Meningitis After a Post-Traumatic Intradiploic Arachnoid Cyst: A Case Report.

Intradiploic arachnoid cysts are infrequent but benign lesions of the central nervous system. Etiologically, they can be non-traumatic or po … ars ago. As we understood from the patient's medical records, a couple of millimetric non-specified pneumocephalus areas, located next to the sella turcica, were detected on the cranial non-contrast-enhanced CT scan after the minor blunt trauma to the frontal bone. However, there was no sign of any obvious skull base fracture. The patient was hospitalized for fi …

Pediatric nonoperative skull fractures: delayed complications and factors associated with clinic and imaging utilization.

OBJECTIVE: Skull fractures represent a common source of morbidity in the pediatric trauma population. This study characterizes the type of f … cranial hemorrhage, a follow-up recommendation and actual follow-up compliance were associated with pneumocephalus and other polytraumatic injuries, and outpatient imaging was associated with a bilateral fracture. No complications were found in patients with linear fractures above the skull base in those without an intracranial hemorrhage. CONCLUSIONS: Pediatri …

Delayed diagnosis of posterior reversible encephalopathy syndrome (PRES) in a parturient with preeclampsia after inadvertent dural puncture.

Posterior reversible encephalopathy syndrome is a rare complication generally associated with headache and acute changes in blood pressure. We present a case of posterior reversible encephalopathy syndrome where diagnosis was delayed because the patient also had preeclampsia and an inadvertent dural puncture, both associated with headache. The clinical challenge and the need for prompt diagnosis and treatment are emphasized.

Repair of intractable cerebrospinal fluid rhinorrhea with mucosal flaps and recombinant human basic fibroblast growth factor: technical case report.

OBJECTIVE AND IMPORTANCE: Repair of a cerebrospinal fluid leak is not always easy, especially when a large fistula, with concomitant infection and injured mucosa, has developed from repeated transsphenoidal operations. We repaired such a sellar floor defect with mucosal flaps via the endonasal endoscopic approach and finally obliterated the fistula by promoting granulation-like tissue formation with recombinant human basic fibroblast growth factor (bFGF). CLINICAL PRESENTATION: A 27-year-old woman with intractable cerebrospinal fluid rhinorrhea was referred to our department after repeated op

Clinical Decision Rules for Paediatric Minor Head Injury: Are CT Scans a Necessary Evil?

INTRODUCTION: High performing clinical decision rules (CDRs) have been derived to predict which head-injured child requires a computed tomography (CT) of the brain. We set out to evaluate the performance of these rules in the Singapore population. MATERIALS AND METHODS: This is a prospective observational cohort study of children aged less than 16 who presented to the emergency department (ED) from April 2014 to June 2014 with a history of head injury. Predictor variables used in the Canadian Assessment of Tomography for Childhood Head Injury (CATCH), Children's Head Injury Algorithm for the

Use of an External Ventricular Drain for Treatment of a Thoracolumbar Cerebrospinal Fluid Leak: A Case Report and Review of Literature.

Post-operative cerebrospinal fluid (CSF) leak is a known complication in spine surgery. This mostly iatrogenic issue is typically treated using a variety of modalities (i.e., bed rest, epidural patch), CSF diversion methods, or primary repair. The use of an external ventricular drain to treat this post-operative complication has been infrequently reported. We describe a case of a CSF leak after thoraco-lumbar surgery treated using an external ventricular drain and a review of the literature regarding this treatment modality. A 70-year-old man presented to our clinic with a recent diagnosis of

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… A head CT scan (Figure 4 ) was performed which showed multifocal subarachnoid hemorrhage (SAH), layering of acute blood in bilateral ventricles, and small amounts of pneumocephalus. … Figure 4 Post-operative CT of the brain without contrast shows scattered subarachnoid blood with some layering on the lateral ventricles along with small amounts of pneumocephalus. …

EEG changes and seizure outcomes following anterior corpus callosotomy in adults with Lennox-Gastaut syndrome: A single-center experience.

INTRODUCTION: Lennox-Gastaut syndrome (LGS) is a drug-resistant epileptic encephalopathy that typically begins in infancy or childhood but o … nfections (10.5 %), frontal lobe edema (7.9 %), status epilepticus (7.9 %), hemorrhage (2.6 %), and pneumocephalus (5.3 %). CONCLUSION: Anterior corpus callosotomy, either open or radiosurgical, effectively reduced atonic, tonic, and generalized tonic-clonic seizures in adults with drug-resistant LGS. EEG changes post-CC suggest a network reorganization, guidin …

Do children with blunt head trauma and normal cranial computed tomography scan results require hospitalization for neurologic observation?

STUDY OBJECTIVE: Children evaluated in the emergency department (ED) with minor blunt head trauma, defined by initial Glasgow Coma Scale (GC … ation. An abnormal imaging study result was defined by any intracranial hemorrhage, cerebral edema, pneumocephalus, or any skull fracture. Patients with normal CT scan results who were hospitalized were followed to determine neurologic outcomes; those discharged to home from the ED received telephone/mail follow-up to assess for subsequent neuroimaging, neurolog …

[Imaging of cranial gunshot traumas].

Cranial traumas from gunshot wounds are characterised by the impact of a high velocity projectile. There are therefore serious, life threatening traumas. CT Scan is essential in the emergency setting for initial evaluation of traumatic bone and parenchymatous injuries to determine the indication for neurosurgery and appropriate medical management. In case of survival, CT Scan and MRI can be used to monitor progress and any possible complications, in particular vascular or infectious complications which are specific to this type of injury.

Alleviation of intracranial air using carbon dioxide gas during intraventricular tumor resection.

OBJECTIVES/PURPOSES: Postoperative vomiting occurs more frequently in patients after intraventricular surgery than after other intracranial surgeries. This has been attributed to intracranial air. Carbon dioxide gas (CO2) has properties beneficial to the treatment of some medical disorders, displaying a higher specific gravity and more rapid absorption into surrounding tissues than air. We therefore, attempted to replace air with CO2 during intra- and paraventricular tumor resections. The aim of the present study was to elucidate whether intracranial air after intraventricular surgery could be

Leakage detection on CT myelography for targeted epidural blood patch in spontaneous cerebrospinal fluid leaks: calcified or ossified spinal lesions ventral to the thecal sac.

OBJECT: The purpose of this study was to describe significant CT myelography findings for determination of the leak site and outcome of targ … ient, bur hole drainage before EBP on the day of admission to hospital resulted in subdural tension pneumocephalus. The patient's headache immediately disappeared after EBP, and the hematoma did not recur. The other 2 patients underwent EBP followed by bur hole drainage, which resulted in improvements and disappearance of the hematomas. Over the follow-up period …

The Endoscopic Versus Open Approach for Anterior Skull Base Tumors: A Systematic Review of Comparative Outcomes and a Framework for Surgical Selection.

BACKGROUND: Anterior skull base tumors (ASBTs) pose significant surgical challenges due to their proximity to critical neurovascular structu … o vasospasm, subarachnoid hemorrhage, vascular damage, or electrolyte imbalances, while the risk of pneumocephalus is minimized through careful lumbar drain management and sinus precautions. Open surgical approaches commonly result in CSF leaks, meningitis, vascular injury, and visual disturbances. CONCLUSION: This systematic review synthesizes evidence from 60 …

Surgical outcomes after reoperation for recurrent skull base meningiomas.

OBJECTIVE: Skull base meningiomas are surgically challenging tumors due to the intricate skull base anatomy and the proximity of cranial ner … pseudomeningocele (11), wound infection (9), postoperative hematoma (4), venous infarction (1), and pneumocephalus (1). Postoperative neurological deficits included new or worsened cranial nerve deficits (10) and hemiparesis (3). There were no perioperative deaths in this series. On multivariate analysis, posterior fossa location was significantly associated wit …

Искусственный интеллект в педиатрической нейрорадиологии: текущий ландшафт, проблемы и будущие направления.

В настоящем обзоре содержится информация о нынешнем ландшафте искусственного интеллекта (АИ) в области педиатрической и эмбриональной нейрорадиологии, критическая оценка текущей практики, барьеров на пути к клиническому усыновлению и будущего потенциала. Мы искали рецензированные исследования за последнее десятилетие, сфокусировавшись на сегментации изображений, обнаружении повреждений, классификации, прогнозировании и поддержке клинического решения при педиатрической съемке мозга. Особое внимание было уделено уникальным педиатрическим факторам, таким, как развитие мозга и нехватка данных. Мет

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… During: perception aid (prompting all abnormalities/results/heatmaps) qER Qure.ai CT Intracranial hemorrhage, infarct, cranial fracture, pneumocephalus, hydrocephalus, midline shift, cerebral atrophy Brain pathology detection, mobile notifications, worklist prioritisation, report generation, traumatic … results/heatmaps), interactive decision support (shows abnormalities/results only on demand) Annalise Enterprise CTB | annalise.ai | CT | 130 findings present in the emergent, urgent, and non-urgent care settings including: Intracranial haemorrhage, haematomas (acute subdural/extradural), fractures, pneumocephalus …

Validation of a New Clinico-Radiological Grading for Compound Head Injury: Implications on the Prognosis and the Need for Surgical Intervention.

BACKGROUND: Lack of risk stratification among patients with varying severities of compound head injury has resulted in too-inconsistent and … 2 (53%) had no dural violation or midline shift (Grade 1), 56 (16%) had cerebrospinal fluid leak or pneumocephalus (Grade 2), 34 (10%) had exposed brain (Grade 3), 47 (14%) had midline shift (Grade 4), and 25 (7%) had both exposed brain and midline shift (Grade 5). Each successive grade of compound injury had significant incremental impact on all the outcome mea …

Frontal sinus fractures: principles of treatment and long-term results after sinus obliteration with the use of lyophilized cartilage.

The most commonly used techniques for frontal sinus obliteration involve the implantation of an autogenous tissue graft: either fat, muscle or bone. Lyophilized allogenic cartilage due to its unique properties, such as the tendency to ossification and resistance to volume reduction, can be used as the material of choice for sinus obliteration. A clinical and radiological study of 66 patients operated on for frontal sinus fractures, between January 1 1988 through December 31 1995 was undertaken. Variables recorded included the aetiological factors, the clinical and radiological fracture feature

An Evaluation of Firearm Injuries in the Emergency Department.

Introduction Firearm injuries are a significant cause of mortality and morbidity. Our study aims to evaluate the injury patterns, results of … s significantly higher in the patients who suffered injuries to the head or neck. The patients with pneumocephalus had a very low chance of survival. Compared to wound care and dressing, patients who received surgical treatment were more likely to die as these patients had more critical injuries. Conclusion Although most injuries were to the extremities, there w …