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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.
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.
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.
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.
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The purpose of this study was to determine the incidence and characteristics of associated injuries in patients with spine trauma.
Data of 3,920 consecutive patients admitted to a regional trauma center during a 3-year period were analyzed retrospectively.
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.
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.
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.
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.
The hospitalization rate showed positive correlations with temperature (
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.
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