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Blunt Neck Trauma

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141. Mystery solved: Chiropractic manipulation of the neck did cause Katie May’s death from stroke

who posed for Playboy and gained a massive following on Snapchat, suffered a “catastrophic” stroke in early February and . Now, reports that a visit to the chiropractor left her with an injury that precipitated the stroke. TMZ obtained May’s death certificate, which says that she suffered a blunt force injury during a “neck manipulation by [a] chiropractor.” That injury tore an artery in her neck and cut off blood flow to her brain, which led to the stroke that killed her. Several of you e-mailed (...) be catastrophic. Another aspect I discussed was whether Katie May’s stroke could have been due to the trauma she suffered at her photo shoot a day or two before her first chiropractic manipulation. Now that we know, assuming that TMZ is accurately relaying the results of the coroner’s report, that May had a tear in her left vertebral artery, it’s almost certain that the chiropractor accidentally killed her through neck manipulation. That is what the coroner concluded, that this injury to her vertebral artery

2016 Respectful Insolence

142. Did chiropractic manipulation of her neck cause Katie May’s stroke?

life support on Thursday and died a few hours later that evening. Given that timeline, which is as accurate as I can currently deduce based on the news reports, the next question is: What killed Katie May? Obviously, it was a stroke. But what caused the stroke that killed her? Was it chiropractic? Was it her original trauma to the neck suffered when she fell? Was it a combination? Contrary to a lot of the speculation out there, this is not nearly as straightforward a question as it sounds at first (...) the question myself. This case, however, is different because it poses the question of whether what killed Katie May was a stroke due to her original trauma or a complication of chiropractic adjustments. Also, it must be pointed out that her stroke would be considered atypical for a chiropractic-induced stroke, for reasons that I will discuss shortly. What is the relationship between chiropractic neck adjustments and stroke? Given how extensively the issue has been discussed elsewhere, I don't feel

2016 Respectful Insolence

143. Is Cervical spine protection always necessary following penetrating neck injury Full Text available with Trip Pro

in the civilian environment, it is not surprising that most evidence is from military settings. Contemporary trauma teaching does not make a distinction between blunt and penetrating trauma in terms of the need for spinal immobilisation. In contrast with blunt injuries, the value of cervical spine protection by means of a neck collar is questionable and may be harmful after penetrating neck trauma. The incidence of airway injury needing advanced airway protection and that of major vascular injury is much (...) in a civilian setting Connell et al, 2003, UK 34,903 trauma patients, of which 1929 (5.5%) sustained penetrating trauma. 12 out of 27 patients had penetrating trauma and concurrent spinal injury. (15 excluded who also had major blunt mechanism or had trivial injury to the spine). One GSW, others were sharp weapons Retrospective analysis of data from the Scottish Trauma Audit Group (STAG) Incidence of mechanically unstable spinal column injuries and spinal cord injuries: All 12 patients with spinal cord

2010 BestBETS

144. Clinical and economic effects of selective radiological evaluation of high-energy trauma patients: a prospective experience of a level 1 busy trauma centre. (Abstract)

systems.This prospective cross-sectional study was performed over a 3-month period. During the determined time frame, all haemodynamically stable, high-energy blunt trauma patients were included. Based on the predefined criteria, selective radiographic images of the neck, chest and pelvis were obtained. Patients were followed during their hospital stay and for a 2-week period after discharge.1002 cases were included in the final survey. 247/1002 (24.6%) cervical radiographic images, 500/1002 (49.9%) CXRs (...) Clinical and economic effects of selective radiological evaluation of high-energy trauma patients: a prospective experience of a level 1 busy trauma centre. Cervical spine, thoracic and pelvic fractures are the main causes of devastation in patients who have suffered blunt trauma. Radiographic imaging plays an important role in diagnosing such injuries. Nevertheless, the present dominant approach, the routine use of X-ray studies, seems to have no cost-benefit justification for healthcare

2014 Emergency Medicine Journal

145. Blunt Cerebrovascular Injury

, Mullins RJ, Velmahos GC. Blunt carotid artery injury: the futility of aggressive screening and diagnosis. Arch Surg . 2004;139:609–612; discussion 612–613. Cothren CC, Moore EE, Biffl WL, et al. Cervical spine fracture patterns predictive of blunt vertebral artery injury. J Trauma . 2003;55:811–813. DiPerna CA, Rowe VL, Terramani TT, et al. Clinical importance of the “seat belt sign” in blunt trauma to the neck. Am Surg . 2002;68:441–445. Rozycki GS, Tremblay L, Feliciano DV, et al. A prospective (...) tomographic angiography as a screening modality for blunt cervical arterial injuries: a cautionary note. Letter. J Trauma . 1999;47:438–439. Biffl WL, Egglin T, Benedetto B, Gibbs F, Cioffi WG. Sixteen-slice computed tomographic angiography is a reliable noninvasive screening test for clinically significant blunt cerebrovascular injuries. J Trauma . 2006;60:745–751; discussion 751–752. Schneidereit NP, Simons R, Nicolaou S, et al. Utility of screening for blunt vascular neck injuries with computed

2010 Eastern Association for the Surgery of Trauma

146. An Uncommon, Life-Threatening, Traumatic Hematoma in the Neck Area Full Text available with Trip Pro

An Uncommon, Life-Threatening, Traumatic Hematoma in the Neck Area It is well known that blunt neck trauma, when compared to a penetrating injury in the same anatomical area, is very rare. We report a case of an 81-year-old Caucasian woman with a blunt life-threatening neck trauma due to a bully goat. Although rare, direct evaluation should always be done in these cases because any misinterpretation may result in unfavorable outcomes. We have to highlight that close medical attention and prompt

2014 Case Reports in Emergency Medicine

147. Civilian Airway Trauma: A Single-Institution Experience. (Abstract)

Civilian Airway Trauma: A Single-Institution Experience. Injuries to the airway in the neck and thorax are uncommon, but may be potentially life threatening. The objective of this study is to determine the clinical characteristics and outcomes for patients with airway injury.From 1974 to 2014, a prospectively entered trauma database at a Level 1 trauma center was accessed to identify patients with injuries to the larynx, cervical trachea, or thoracic airway. Hospital charts were reviewed (...) to obtain data on demographics, presentation, injury management, in-hospital and long-term morbidity and in-hospital mortality. Multivariate logistic regression was used to estimate predictors of mortality and long-term vocal cord morbidity. Data are expressed as N (%).One hundred and twenty patients were included (median injury severity score: 19 [interquartile range: 10-27]). There were 65 (54 %) blunt and 55 (46 %) penetrating injuries, with 90 (75 %) suffering multiple injuries. Sixteen (13

2016 World Journal of Surgery

148. Blunt Cerebrovascular Injuries In Association With Craniocervical Distraction Injuries: A Retrospective Review of Consecutive Cases. (Abstract)

assessed were BCVI subdivided into blunt carotid artery injuries and/or blunt vertebral artery injuries and classified according to the Biffl criteria. Secondary measures included associated strokes and evidence of emboli on transcranial Doppler.All consecutive patients diagnosed with unstable CCD injuries that were surgically treated at a single Level I trauma center during the period of 1996 to 2009 were identified. Those who were adequately screened with a catheter angiogram and/or computed (...) Blunt Cerebrovascular Injuries In Association With Craniocervical Distraction Injuries: A Retrospective Review of Consecutive Cases. Blunt cerebrovascular injuries (BCVIs) have the potential to cause brain, cerebellar, and/or spinal cord ischemia. Certain subtypes of spine fractures, such as vertebral subluxation, fractures through the foramen transversarium, and C1-C3 fractures have been linked to a higher incidence of BCVI. On the other hand, BCVI in association with craniocervical

2014 The Spine Journal

149. Head and Neck Cancer: Reconstruction

Head and Neck Cancer: Reconstruction Head and Neck Cancer - Reconstruction: Overview, General Concepts of Reconstruction, Reconstruction of Lip Defects Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTI4OTc5OS1vdmVydmlldw== processing > Head and Neck Cancer - Reconstruction Updated: Jan 28, 2016 Author: Samuel J Lin, MD; Chief Editor: Jorge I de la Torre, MD, FACS Share Email Print Feedback Close Sections Sections Head and Neck Cancer - Reconstruction Overview Overview History Head and neck tumors can lead to devastating cosmetic and functional deficits with resultant psychological, physical, and nutritional detriment. Despite recent advances in medicine, the overall survival for patients with head and neck

2014 eMedicine Surgery

150. Pathology: Sarcomas of the Head and Neck

years, and males are more commonly affected than females, with a 3:1 ratio. While most patients are asymptomatic at the time of diagnosis, some have pain or bleeding at the tumor site. Conditions associated with angiosarcoma include long-standing lymphedema and prior irradiation. Exposure to vinyl chloride is associated with angiosarcomas of the liver, but this association has not been reported with head and neck angiosarcomas. Trauma, either in the form of direct tissue injury or an adjacent (...) Pathology: Sarcomas of the Head and Neck Pathology - Sarcomas of the Head and Neck: Overview, Sarcoma Classification, Staging of Soft Tissue Sarcomas Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine Surgery

151. Modified Radical Neck Dissection

blade using a feather-light touch. Previous extensive blunt dissection along the posterior aspect of the IJV prevents elevation of the neck dissection over the IJV. If the IJV requires sacrifice due to metastatic nodal involvement or tumor thrombosis, the vein is ligated and divided superiorly and inferiorly following identification and preservation of the vagus nerve (see the image below). Modified radical neck dissection (MRND). The omohyoid muscle has been divided. The jugular vein has been (...) are excluded). Radiotherapy can affect IJV patency. During surgery, trauma to the IJV should be minimized by atraumatic manipulation and avoiding IJV desiccation. Postoperatively, compression of the IJV should be minimized by avoiding tight dressings and tracheostomy tube ties. If simultaneous IJV ligation is performed, IJV reconstruction with a greater saphenous vein graft should be considered. Previous References Crile G. Excision of cancer of the head and neck. JAMA . 1906. 47:1780-1786. Martin H, Del

2014 eMedicine Surgery

152. Liposuction of the Face and Neck

in significant deficits and is usually well compensated. However, damage to the marginal mandibular nerve during liposuction across the sharp angle of the mandible may cause unilateral paralysis of muscles to the lower lip and potentially result in a permanently asymmetric smile. The arterial blood supply to the superficial face and upper neck arrives via the facial and temporal branches of the external carotid artery. A draining vein often accompanies the arterial supply. If blunt dissection during (...) for facial rejuvenation and body contouring. Dermatol Surg . 2000 Dec. 26(12):1140-4. . Schaeffer BT. Endoscopic liposhaving for neck recontouring. Arch Facial Plast Surg . 2000 Oct-Dec. 2(4):264-8. . Sclafani AP, Kwak E. Alternative management of the aging jawline and neck. Facial Plast Surg . 2005 Feb. 21(1):47-54. . Media Gallery A 6-mm straight suction cannula commonly used in cervicofacial liposuction. Note the atraumatic blunt tip design. A small 1-cm puncture incision is made in the midline

2014 eMedicine Surgery

153. Screening via CT angiogram after traumatic cervical spine fractures: narrowing imaging to improve cost effectiveness. Experience of a Level I trauma center Full Text available with Trip Pro

Screening via CT angiogram after traumatic cervical spine fractures: narrowing imaging to improve cost effectiveness. Experience of a Level I trauma center Screening for vertebral artery injury (VAI) following cervical spine fractures is routinely performed across trauma centers in North America. From 2002 to 2007, the total number of neck CT angiography (CTA) studies performed in the Medicare population after trauma increased from 9796 to 115,021. In the era of cost-effective medical care (...) , the authors aimed to evaluate the utility of CTA screening in detecting VAI and reduce chances of posterior circulation strokes after traumatic cervical spine fractures.A retrospective review of all patients presenting with cervical spine fractures to Northeast Ohio's Level I trauma institution from 2002 to 2012 was performed.There was a total of 1717 cervical spine fractures in patients presenting to Northeast Ohio's Level I trauma institution between 2002 and 2012. CTA screening was performed in 732

2015 Journal of neurosurgery. Spine

154. Cricotracheal Separation after Gunshot to the Neck: Report of a Survivor with Recovery of Bilateral Vocal Fold Function. (Abstract)

Cricotracheal Separation after Gunshot to the Neck: Report of a Survivor with Recovery of Bilateral Vocal Fold Function. Traumatic tracheal injury via blunt or penetrating mechanism comes with a grave prognosis. Cricotracheal separation is a rare entity among these injuries and even more infrequent by means of penetrating trauma. Resultant airway discontinuity subsequent to these insults causes immense global hypoxia and tends to be uniformly fatal.Our aim was to discuss emergent and surgical (...) and stabilization of the airway is critical to survival in the context of trauma involving the neck and airway structures.Copyright © 2014 Elsevier Inc. All rights reserved.

2013 Journal of Emergency Medicine

155. Blunt Dissection

Blunt Dissection Blunt Dissection Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Blunt Dissection Blunt Dissection Aka: Blunt (...) Dissection II. Indication III. Advantages over other surgical techniques (e.g. ED&C) Does not disturb normal tissue IV. Efficacy Cure rate in s approaches 90% V. Equipment Blunt Dissector or Schamberg acne expressor VI. Technique Administer anesthesia Outline edge of lesion Insert blunt tipped scissors between wart and skin Move tip circumferentially around wart Creates plane of dissection (separate wart from skin) Insert blunt dissector into cleavage plane Use short strokes to separate wart from skin

2015 FP Notebook

156. Timing and mechanism of ischemic stroke due to extracranial blunt traumatic cerebrovascular injury. Full Text available with Trip Pro

period. All patients who suffered blunt trauma and had risk factors for TCVI underwent screening CT angiography (CTA) of the head and neck on admission. All patients with either an ischemic stroke or CTA suggesting TCVI underwent confirmatory digital subtraction angiography (DSA). Patients with DSA-confirmed TCVI were treated with 325 mg aspirin daily; all patients were observed during their hospitalization for the occurrence of new ischemic stroke. In addition, a subset of patients with TCVI (...) Timing and mechanism of ischemic stroke due to extracranial blunt traumatic cerebrovascular injury. Extracranial cerebrovascular injury is believed to be an important cause of neurological injury in patients who have suffered blunt trauma. The authors sought to determine the timing and mechanisms of ischemic stroke in patients who suffered traumatic cerebrovascular injury (TCVI).This is a prospective study of all patients with TCVI who were admitted to a Level I trauma center during a 28-month

2012 Journal of Neurosurgery

157. Triage of the Trauma Patient

may be considered as stand alone triage criteria. All other mechanisms may not be useful in and of themselves as triage criteria. The Revised Trauma Score (rTS), Prehospital Index (PHI), Trauma Score (TS), CRAMS (Circulation, Respiration, Abdomen, Motor GCS, and Speech GCS), Baxt Trauma Triage Rule (TTR), and Triage Index are not to be used as standalone criteria to triage patients. There should be increased weight given to advanced age (≥65) during triage. GCS Motor Score is valid for blunt (...) for highest level trauma team response. GCS Motor Score is valid for blunt trauma triage. Level 3 Recommendations There are no Level 3 recommendations. Pediatric Triage Level 1 Standards There are no Level 1 standards. Level 2 Guidelines There are no Level 2 guidelines. Level 3 Recommendations A two-tiered triage system in the ED by physicians can effectively reduce unnecessary resource utilization. Mechanism of injury alone may not be useful in triaging pediatric patients. A combination of physiologic

2010 Eastern Association for the Surgery of Trauma

158. Penetrating Abdominal Trauma, Selective Non-Operative Management of

, which included patients with GSWs and SWs, along with blunt trauma victims, investigated this new practice. One hundred eighty patients admitted with abdominal trauma from 1956 to 1958 were studied; 63% of these were penetrating injuries. Of the penetrating injuries, 92% of patients were victims of SWs. The decision to operate was based on the following: peritoneal irritation as manifested by tenderness, reduced or absent bowel sounds, spasm of the abdominal wall or rebound tenderness were (...) a 43.9% negative exploration rate after penetrating abdominal trauma, with a complication rate of 8.7%, chiefly pulmonary complications and wound infections (21). A prospective series of 372 operations performed on 368 patients with penetrating injuries to the abdomen, chest, neck and extremities was reported by Demetriades and colleagues [22] . There were 46 negative or non-therapeutic operations. Eleven percent of patients with nontherapeutic operations developed major complications due

2010 Eastern Association for the Surgery of Trauma

159. Cervical spine clearance protocols in level I, II and III trauma centers in California. (Abstract)

Cervical spine clearance protocols in level I, II and III trauma centers in California. Cervical spine clearance protocols were developed to standardize the clearance of the cervical spine after blunt trauma and prevent secondary neurologic injuries. The degree of incorporation of evidence-based guidelines into protocols at trauma centers in California is unknown.To evaluate the cervical spine clearance protocols in all trauma centers of California.An observational cross-sectional (...) study.Included from Level I, II, III trauma centers in California.The self-reported outcomes of each trauma center's cervical spine clearance protocols were assessed.Level I (n=15), II (n=30), and III (n=11) trauma centers in California were contacted. Each available protocol was reviewed for four scenarios: clearing the asymptomatic patient, the initial imaging modality used in patients not amenable to clinical clearance, and the management strategies for patients with persistent neck pain with a negative

2014 The Spine Journal

160. Lower Urinary Tract Injuries Following Blunt Trauma: A Review of Contemporary Management Full Text available with Trip Pro

detailing the mechanisms, classification, diagnosis, management, and complications of blunt trauma to the bladder and urethra. The prognosis for bladder rupture is excellent when treated. Significant intraperitoneal rupture or involvement of the bladder neck mandates surgical repair, whereas smaller extraperitoneal lacerations may be managed with catheterization alone. With the push for management of trauma patients in larger centers, urologists in these hospitals are seeing increasing numbers of lower (...) Lower Urinary Tract Injuries Following Blunt Trauma: A Review of Contemporary Management Lower urinary tract trauma, although relatively uncommon in blunt trauma, can lead to significant morbidity when diagnosed late or left untreated; urologists may only encounter a handful of these injuries in their career. This article reviews the literature and reports on the management of these injuries, highlighting the issues facing clinicians in this subspecialty. Also presented is a structured review

2011 Reviews in urology

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