1/18. rupture of several parasagittal bridging veins without subdural bleeding.This case reports on a fatal craniocerebral trauma involving numerous ruptured cerebral bridging veins that did not bleed subdurally, despite approximately 15 hours of survival. A 15-year-old girl was severely injured as the passenger of a car that crashed sideways into a tree. She-suffered a cerebral trauma of the "diffuse injury" type and was unconscious after the accident. Her computed tomographic scan at admission showed massive brain edema, axial herniation, and marked hypodensity of the bilateral carotid flow area. Despite intensive care measures, the clinical course was characterized by central decompensation with therapy-resistant cardiocirculatory insufficiency. The autopsy revealed ruptures of numerous parasagittal bridging veins. The injured vessels were not thrombosed, and yet there was absolutely no subdural bleeding. This unusual combination of findings is assumed to be caused by an isolated collapse of cerebral circulation occurring shortly after the accident and primarily attributed to a rapid increase of intracranial pressure.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/18. Amputated lower limbs as a bank of organs for other organ salvage.Aggressive modern technologies have made it possible to attempt limb salvage in even the most extreme cases. However, it is imperative to remember that prolonged salvage attempts may lead to devastating complications. The decision-making is more problematic in patients with bilateral severely injured mangled lower limbs. In such a case, protocols like the MESS are no longer valid because of the implications of bilateral amputation. In these rare cases, we use a multi-team approach and modern micro-surgical reconstructive techniques in attempting to salvage at least one of the lower limbs. We present here our experience in six patients with bilateral mangled lower limbs where an amputated limb was the source of "spare parts" for the salvage of the contralateral limb. In each of the cases, after evaluation and planning, the harvesting of the required tissues (including skin, muscle, bone, nerve and blood vessels) from the amputated leg was performed and simultaneously, a reconstruction of the contralateral severely injured limb was done. These cases emphasize the importance of modern trauma care, not only the ability to treat multiply traumatized patients, but also the capability to execute sophisticated techniques during the acute phase of treatment with maximal cooperation between teams from different disciplines.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/18. survival of an aortic trauma patient with ehlers-danlos syndrome type IV: a case report.ehlers-danlos syndrome type IV is the most lethal variant of that illness and is associated with fatal large vessel arterial hemorrhages. The literature reports only two survivors of elective aortic surgery and two survivors of spontaneous aortic hemorrhage. This article presents a 14-year-old boy who had aortic and vena cava blunt trauma and survived.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/18. Alternative technique to cannulate the descending aorta for abdominal organ procurement in a hemodynamically unstable patient.During organ procurement, maintaining adequate organ perfusion is crucial. Hemodynamic instability may compromise organ viability and demand quick intervention, sometimes rapid, early cannulation of vessels, so that organs may be salvaged. In this case report of an unstable donor with large retroperitoneal hematoma, a surgical approach is presented that has previously not been described. The technique facilitated hemodynamic stability while allowing rapid cannulation of the retrocardiac descending aorta.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/18. Recovery of an impalement and transfixion chest injury by a reinforced steel bar.A 36-year-old man was admitted to our hospital because of impalement injury due to a downwards fall upon some reinforced steel rods. An emergency operation was performed using percutaneous cardiopulmonary support (PCPS). The steel rods were taken out in the operating room. The heart, great vessels, vertebrae, and spinal cord were not involved in the impalement wounds. We performed a bronchoplasty of the torn and separated right main bronchus, and repaired the impaled left lung without any pulmonary resection. He recuperated without sequelae.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/18. Management of innominate artery injury in the setting of bovine arch anomaly.Blunt injury to the aortic arch vessels is rare and can be life-threatening. Historically urgent repair of these injuries is emphasized. We describe the initial nonoperative management of a blunt injury to the brachiocephalic trunk in the setting of bovine arch anomaly, followed by delayed surgical management.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/18. Traumatic subarachnoid hemorrhage and extracranial vertebral artery injury: a case report and review of the literature.The case is presented of a 19-year-old man who was assaulted and died shortly afterward from a large traumatic basal subarachnoid hemorrhage (TBSAH) that arose from rupture of the left vertebral artery, proximal to the point at which the artery penetrated the dura. The literature regarding TBSAH and vertebral artery rupture is reviewed, and a number of points are highlighted: patients with TBSAH may remain conscious for a period of hours after injury, subcutaneous or muscular bruising may be contralateral to the ruptured vessel, fractures of the transverse processes of the cervical vertebrae and significant pathology of the vertebral artery are not typically associated with TBSAH, and rupture of the vertebral artery may be intracranial, junctional, or extracranial.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/18. basilar artery thrombosis in a trauma patient. Case report and review of the literature.Thrombotic disease of the vertebrobasilar circulation is associated with a poor prognosis. It may occur in trauma patients, especially those with neck injuries and even several months after the initial insult. We report on the case of a young polytrauma patient, victim of a traffic accident, with associated cervical and thoracic spinal injuries resulting in paraplegia. consciousness was not impaired initially, but during transfer to our hospital he became suddenly unconscious. An occluded basilar artery was found on angiography, but unfortunately we were unable to reopen the vessel with thrombolytic therapy. This case again proves that lesions of the vertebro-basilar system must always be suspected in neck injuries. Even after minor whiplash injuries, fatal basilar thrombosis may occur. A review of all reported cases of traumatic basilar artery thrombosis is given and the use of thrombolytic therapy is discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/18. Sonographic intraperitoneal fluid in patients with pelvic fracture: two cases of traumatic intraperitoneal bladder rupture.Two patients who presented to the Emergency Department (ED) in shock with severe pelvic fractures were evaluated for intra-abdominal injury with a focused assessment with sonography in trauma (FAST) examination. Free intraperitoneal fluid was identified in the hepato-renal recess of both patients. At laparotomy both patients were found to have extensive uroperitoneum resulting from intraperitoneal bladder rupture and no other intra-abdominal injuries. The source of shock in both cases was ultimately determined to be arterial hemorrhage from pelvic vessels. The utility of FAST examinations in the setting of major pelvic injury is relatively unstudied. Coincident injuries make the evaluation for source of hemorrhage in this subset of patients challenging. This is a report of sonographic intraperitoneal fluid in the setting of major pelvic injury and hemodynamic instability found to be uroperitoneum and not hemoperitoneum.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/18. Rectosigmoid ischemia following blunt abdominal trauma in a patient treated with radiation therapy: case report.Ionizing radiation, frequently used to treat cancer, is known to injure skin and blood vessels and to deleteriously affect wound healing. We present the case of a patient whose previous radiation treatment predisposed him to colonic ischemia following blunt abdominal trauma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
| | Next -> |