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7 "Byung Chul Kim"
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Case Report
Experience and successful treatment of craniocerebral gunshot injury at a regional trauma center in Korea: a case report and literature review
Mahnjeong Ha, Seunghan Yu, Jung Hwan Lee, Byung Chul Kim, Hyuk Jin Choi
J Trauma Inj. 2022;35(4):277-281.   Published online November 22, 2022
DOI: https://doi.org/10.20408/jti.2022.0057
  • 1,804 View
  • 55 Download
AbstractAbstract PDF
Craniocerebral gunshot injuries is gradually increasing in the civilian population with a worse prognosis than closed head trauma. We experienced a case of craniocerebral gunshot injury which a bullet penetrating from the submandibular area into the clivus of a patient. The patient did not show any symptom. However, serial laboratory findings showed an increase in blood lead level. We removed foreign bodies without any problems using an endoscopic transnasal transclival approach. Due to the extremely low frequency, guidelines for definitive management of gunshot injuries have not been presented in Korea yet. We introduce our surgical experience of a craniocerebral gunshot injury with an unusual approach for removing intracranial foreign bodies.
Summary
Original Articles
Postoperative infection after cranioplasty in traumatic brain injury: a single center experience
Mahnjeong Ha, Jung Hwan Lee, Hyuk Jin Choi, Byung Chul Kim, Seunghan Yu
J Trauma Inj. 2022;35(4):255-260.   Published online November 16, 2022
DOI: https://doi.org/10.20408/jti.2022.0043
  • 1,368 View
  • 49 Download
AbstractAbstract PDF
Purpose
To determine the incidence and risk factors of postoperative infection after cranioplasty in patients with traumatic brain injury (TBI).
Methods
Data of 289 adult patients who underwent cranioplasty after TBI at a single regional trauma center between year 2018 and 2021 were reviewed retrospectively. Patient characteristics and various procedural variables, such as interval between craniectomy and cranioplasty, estimated blood loss, laterality and materials of the bone flap, and duration and classification of perioperative antibiotics usage were analyzed.
Results
Postoperative infection occurred in 17 patients (5.9%). Onset time of infectious symptom ranged from 9 days to 174 days (median, 24 days) after cranioplasty. The most common cultured organism was Staphylococcus aureus (47.1%), followed by Klebsiella pneumoniae (17.6%) and Enterococcus faecalis (17.6%). Patients with postoperative infection were more likely to have diabetes (odds ratio [OR], 6.96; 95% confidence interval [CI], 1.92–25.21; P=0.003), lower body mass index (OR, 0.81; 95% CI, 0.66–0.98; P=0.029), and shorter duration of perioperative antibiotics (OR, 0.83; 95% CI, 0.71–0.98; P=0.026).
Conclusions
For TBI patients with diabetes, poor nutritional status should be managed cautiously for increased risk of infection after cranioplasty. Further studies and discussions are needed to determine an appropriate antibiotics protocol in cranioplasty.
Summary
Usefulness of intraoperative transcranial sonography in patients with traumatic brain injuries: a comparison with postoperative computed tomography
Mahn Jeong Ha, Seung Han Yu, Jung Hwan Lee, Hyuk Jin Choi, Byung Chul Kim
J Trauma Inj. 2023;36(1):8-14.   Published online June 20, 2022
DOI: https://doi.org/10.20408/jti.2021.0093
  • 2,189 View
  • 62 Download
AbstractAbstract PDF
Purpose
The aim of this study was to assess the agreement between intraoperative transcranial sonography (TCS) and postoperative computed tomog¬raphy (CT) in patients with traumatic brain injuries.
Methods
We performed a retrospective cross-sectional study of 35 patients who underwent TCS during surgery, among those who presented to a regional trauma center and underwent decompressive craniectomy between January 1, 2017 and April 30, 2020.
Results
The mean difference between TCS and CT in measuring the midline shift was –1.33 mm (95% confidence inter¬val, –2.00 to –0.65; intraclass correlation coefficient [ICC], 0.96; P<0.001). An excellent correlation was found between TCS and CT in assessing contralateral subdural hematomas (ICC, 0.96; P<0.001) and focal hematoma lesions (ICC, 0.99; P<0.001). A very good correlation between TCS and CT was found for measurements of ventricle width (ICC, 0.92; P<0.001).
Conclusions
TCS during surgery is considered an effective diagnostic tool for the detection of intraoperative parenchymal changes in patients with traumatic brain injuries.
Summary
Case Report
Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report
Dong Hwan Kim, Yong Beom Shin, Mahnjeong Ha, Byung Chul Kim, In Ho Han, Kyoung Hyup Nam
J Trauma Inj. 2022;35(1):56-60.   Published online March 21, 2022
DOI: https://doi.org/10.20408/jti.2021.0083
  • 2,953 View
  • 72 Download
  • 1 Citations
AbstractAbstract PDF
The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12–L1 level will be helpful for treating patients with atypical neurological symptoms.
Summary

Citations

Citations to this article as recorded by  
  • Evaluating Acute Bilateral Foot Drop: A Case Report
    Arsh N Patel, Colby Kihara, Carter Gay, Katie Oakley, P.J. Reddy
    Cureus.2022;[Epub]     CrossRef
Original Articles
A Reappraisal of the Necessity of a Ventriculoperitoneal Shunt After Decompressive Craniectomy in Traumatic Brain Injury
Seunghan Yu, Hyuk Jin Choi, Jung Hwan Lee, Mahnjeong Ha, Byung Chul Kim
J Trauma Inj. 2020;33(4):236-241.   Published online December 31, 2020
DOI: https://doi.org/10.20408/jti.2020.0072
  • 3,349 View
  • 111 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

Cranioplasty itself is believed to have therapeutic effects on hydrocephalus. The goal of this study was to evaluate the hypothesis that not every patient with hydrocephalus after decompressive craniectomy needs cerebrospinal fluid diversion, and that cranioplasty should be performed before considering cerebrospinal fluid diversion.

Methods

Data were collected from 67 individual traumatic brain injury patients who underwent cranioplasty between January 1, 2019 and December 31, 2019. Patients’ clinical and radiographic progression was reviewed retrospectively based on their medical records.

Results

Twenty-two of the 67 patients (32.8%) had ventriculomegaly on computed tomography scans before cranioplasty. Furthermore, 38 patients showed progressive ventriculomegaly after cranioplasty. Of these 38 patients, only six (15.7%) showed worsening neurologic symptoms, which were improved by the tap test; these patients eventually underwent ventriculoperitoneal shunt placement.

Conclusions

Cerebrospinal fluid diversion is not always required for radiologically diagnosed ventriculomegaly in traumatic brain injury patients after decompressive craniectomy. A careful clinical and neurologic evaluation should be conducted before placing a shunt.

Summary

Citations

Citations to this article as recorded by  
  • Post-traumatic hydrocephalus may be associated with autologous cranioplasty failure, independent of ventriculoperitoneal shunt placement: a retrospective analysis
    Carole S. L. Spake, Dardan Beqiri, Vinay Rao, Joseph W. Crozier, Konstantina A. Svokos, Albert S. Woo
    British Journal of Neurosurgery.2022; 36(6): 699.     CrossRef
Associated Injuries in Spine Trauma Patients: A Single-Center Experience
Seunghan Yu, Hyuk Jin Choi, Jung Hwan Lee, Byung Chul Kim, Mahnjeong Ha, In Ho Han
J Trauma Inj. 2020;33(4):242-247.   Published online December 31, 2020
DOI: https://doi.org/10.20408/jti.2020.0071
  • 2,701 View
  • 76 Download
AbstractAbstract PDF
Purpose

The purpose of this study was to determine the incidence and characteristics of associated injuries in patients with spine trauma.

Methods

Data of 3,920 consecutive patients admitted to a regional trauma center during a 3-year period were analyzed retrospectively.

Results

Of the 3,920 patients who were admitted to the trauma center during the 3-year study period, 389 (9.9%) had major spinal injuries. Among these 389 patients, 303 (77.9%) had associated injuries outside the spine. The most common body region of associated injuries was the extremities or pelvis (194 cases, 49.4%), followed by the chest (154 cases, 39.6%) and face (127 cases, 32.6%). Of these 303 patients, 149 (64%) had associated injuries that required surgical treatment such as laparotomy or internal fixation. Associated injuries were more common in patients with lumbar injuries (93.3%) or multiple spinal injuries (100%) than in those with lower cervical injuries (67.4%). There was a significant correlation between the location of the spinal injury and the body region of the associated injury. However, distant associated injuries were also common.

Conclusions

Associated injuries were very common in spinal injury patients. Based on demographic groups, the trauma mechanism, and the location of spinal injury, an associated injury should be suspected until proven otherwise. Using a multidisciplinary and integrated approach to treat trauma victims is of the paramount importance.

Summary
Correlations of Weather and Time Variables with Visits of Trauma Patients at a Regional Trauma Center in Korea
Hyuk Jin Choi, Jae Hoon Jang, Il Jae Wang, Mahnjeong Ha, Seunghan Yu, Jung Hwan Lee, Byung Chul Kim
J Trauma Inj. 2020;33(4):248-255.   Published online December 31, 2020
DOI: https://doi.org/10.20408/jti.2020.0062
  • 3,007 View
  • 70 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

Trauma incidence and hospitalizations of trauma patients are generally believed to be affected by season and weather. The objective of this study was to explore possible associations of the hospitalization rate of trauma patients with weather and time variables at a single regional trauma center in South Korea.

Methods

Trauma hospitalization data were obtained from a regional trauma center in South Korea from January 1, 2017 to December 31, 2019. In total, from 6,788 patients with trauma, data of 3,667 patients were analyzed, excluding those from outside the city where the trauma center was located. Hourly weather service data were obtained from the Korea Meteorological Administration.

Results

The hospitalization rate showed positive correlations with temperature (r=0.635) and wind speed (r=0.501), but a negative correlation with humidity (r=−0.620). It showed no significant correlation (r=0.036) with precipitation. The hospitalization rate also showed significant correlations with time of day (p=0.033) and month (p=0.22).

Conclusions

Weather and time affected the number of hospitalizations at a trauma center. The findings of this study could be used to determine care delivery, staffing, and resource allocation plans at trauma centers and emergency departments.

Summary

Citations

Citations to this article as recorded by  
  • Climate change and mental health in Korea: A scoping review
    Jiyoung Shin, Juha Baek, Sumi Chae
    Journal of Climate Change Research.2023; 14(6-2): 989.     CrossRef

J Trauma Inj : Journal of Trauma and Injury