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Original Article
Surgical Outcomes in Patients with Simultaneous Traumatic Brain and Torso Injuries in a Single Regional Trauma Center over a 5-Year Period
Jung-Ho Yun
J Trauma Inj. 2021;34(4):270-278.   Published online December 31, 2021
DOI: https://doi.org/10.20408/jti.2021.0099
  • 2,446 View
  • 76 Download
AbstractAbstract PDF
Purpose

The purpose of the study is to analyze the results of surgical treatment of patients with brain and torso injury for 5 years in a single regional trauma center.

Methods

We analyzed multiple trauma patients who underwent brain surgery and torso surgery for chest or abdominal injury simultaneously or sequentially among all 14,175 trauma patients who visited Dankook University Hospital Regional Trauma Center from January 2015 to December 2019.

Results

A total of 25 patients underwent brain surgery and chest or abdominal surgery, with an average age of 55.4 years, 17 men and eight women. As a result of surgical treatment, there were 14 patients who underwent the surgery on the same day (resuscitative surgery), of which five patients underwent surgery simultaneously, four patients underwent brain surgery first, and one patient underwent chest surgery first, four patients underwent abdominal surgery first. Among the 25 treated patients, the 10 patients died, which the cause of death was five severe brain injuries and four hemorrhagic shocks.

Conclusions

In multiple damaged patients require both torso surgery and head surgery, poor prognosis was associated with low initial Glasgow Coma Scale and high Injury Severity Score. On the other hand, patients had good prognosis when blood pressure was maintained and operation for traumatic brain injury was performed first. At the same time, patients who had operation on head and torso simultaneously had extremely low survival rates. This may be associated with secondary brain injury due to low perfusion pressure or continuous hypotension and the traumatic coagulopathy caused by massive bleeding.

Summary
Case Reports
Experiences of Emergency Surgical Treatment for a COVID-19 Patient with Severe Traumatic Brain Injury at a Regional Trauma Center: A Case Report
Jung-Ho Yun
J Trauma Inj. 2021;34(3):212-217.   Published online September 30, 2021
DOI: https://doi.org/10.20408/jti.2021.0073
  • 3,204 View
  • 72 Download
AbstractAbstract PDF

Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient’s consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient’s transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

Summary
Effects of Resuscitative Endovascular Balloon Occlusion of the Aorta in Neurotrauma: Three Cases
Dong Hun Kim, Ye Rim Chang, Jung-Ho Yun
J Trauma Inj. 2020;33(3):175-180.   Published online September 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0047
  • 3,835 View
  • 78 Download
  • 5 Citations
AbstractAbstract PDF

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely performed as an adjunct to resuscitation or bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It is a crucial adjunct for the maintenance of cerebral and coronary perfusion during resuscitation. However, in polytrauma patients with concomitant neurotrauma, such as traumatic brain injury (TBI) or spinal cord injury, the physiological effects of REBOA are unclear. In this report on REBOA performed in a clinical setting for polytrauma patients with spinal cord injury or TBI, the physiological effects of REBOA in neurotrauma are reviewed.

Summary

Citations

Citations to this article as recorded by  
  • Resuscitative Endovascular Balloon Occlusion of Aorta Versus Aortic Cross-Clamping by Thoracotomy for Noncompressible Torso Hemorrhage: A Meta-Analysis
    Saad Khalid, Mahima Khatri, Mishal Shan Siddiqui, Jawad Ahmed
    Journal of Surgical Research.2022; 270: 252.     CrossRef
  • REBOA as a bridge to brain CT in a patient with concomitant brain herniation and haemorrhagic shock - A case report
    Luca Bissoni, Emiliano Gamberini, Lorenzo Viola, Carlo Bergamini, Emanuele Russo, Giuliano Bolondi, Vanni Agnoletti
    Trauma Case Reports.2022; 38: 100623.     CrossRef
  • Transsplenic Ultrasound-Guided Balloon Positioning During a Zone 1 Resuscitative Endovascular Balloon Occlusion of the Aorta: A Case Report
    Yoonjung Heo, Sung Wook Chang, Dong Hun Kim
    Journal of Acute Care Surgery.2022; 12(1): 34.     CrossRef
  • Current Approaches to Resuscitative Endovascular Balloon Occlusion of the Aorta Use in Trauma and Obstetrics
    Linden O. Lee, Paul Potnuru, Christopher T. Stephens, Evan G. Pivalizza
    Advances in Anesthesia.2021; 39: 17.     CrossRef
  • Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm
    Michael W Parra, Carlos Alberto Ordoñez, David Mejia, Yaset Caicedo, Javier Mauricio Lobato, Oscar Javier Castro, Juan Alfonso Uribe, Fernando Velasquez
    Colombia Medica.2021; 52(2): e4164800.     CrossRef

J Trauma Inj : Journal of Trauma and Injury