SciCombinator

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Concept: Bruise

168

The term, hip pointer, is applied in the setting of a blunt trauma injury to the iliac crest. It typically occurs in contact and collision sports and can cause significant pain and loss of practice or game time. A direct blow results in subperiosteal edema with hematoma formation within surrounding muscle or soft tissue and bone contusion of the iliac crest. Conservative management with compression, ice, antiinflammatories, and rehabilitation exercises are successful in treating hip pointers. Injection therapy with the use of local anesthetic can be helpful in minimizing pain and increasing function to allow more rapid return to play.

Concepts: Monotonic function, Function, Injuries, Pelvis, C, Hematoma, Iliac crest, Bruise

27

This study evaluated the sensitivity of susceptibility-weighted angiography (SWAN) compared with gradient echo (GRE) sequence in the depiction of haemorrhagic and calcium lesions by virtue of correlation analysis between the number, area and contrast index. The study included 21 patients (15 women, 6 men; age range 18 to 80 years) in whom intracranial haemorrhage or calcifications were previously diagnosed with CT and/or MR. GRE and SWAN sequences were performed as part of a conventional Brain MR study using a 3T scanner. Pathologic findings were: cavernoma (n=8), chronic intraparenchymal haemorrhage (n=5), petechial bleeding (n=3), parenchymal calcifications (n=2), sequelae of haemorrhagic contusion focus (n=1), post-surgical glioma (n=1) and venous angioma (n=1). In eight patients, more lesions were found in the SWAN sequence than in GRE. In the measurement of the largest area, in all cases the measured area was larger in the SWAN sequence than in GRE. The SWAN sequence was reported to have shown higher contrast between the lesion and the healthy white matter than in GRE. The SWAN sequence is more sensitive than GRE in the identification of cerebral haemorrhage and calcifications. The SWAN sequence also obtained significantly larger images than with GRE, and a higher contrast difference between the lesion and the healthy parenchyma.

Concepts: Blood, Bleeding, Subarachnoid hemorrhage, Cerebral hemorrhage, Intracranial hemorrhage, Bruise

27

BACKGROUND: Transradial coronary angiography (CA) and percutaneous coronary intervention (PCI) are gaining worldwide popularity due to the low incidence of major vascular complications and early mobilization of patients post procedures. Although post transradial access site complications are generally considered as minor in nature, they are not being routinely recorded in clinical settings. OBJECTIVES: To evaluate the incidence of access site complications and level of puncture site pain experienced by patients undergoing transradial coronary procedures and to examine factors associated with access site complications occurrence and puncture site pain severity. METHODS: A cross-sectional correlational study of 85 Chinese speaking adult patients scheduled for elective transradial CA and or PCI. Ecchymosis, bleeding, hematoma and radial artery occlusion (RAO) were assessed through observation, palpation and plethysmographic signal of pulse oximetry after coronary procedures. Puncture site pain was assessed with a 100mm Visual Analogue Scale. Factors that were related to access site complications and puncture site pain were obtained from medical records. RESULTS: Ecchymosis was the most commonly reported transradial access site complication in this study. Paired t-test showed that the level of puncture site pain at 24h was significantly (p<0.001) lower than that at 3h after the procedure. Stepwise multivariable regression showed that female gender and shorter sheath time were found to be significantly associated with bleeding during gradual deflation of compression device. Only longer sheath time was significantly associated with RAO. Female gender and larger volume of compression air were associated with the presence of ecchymosis and puncture site pain at 3h after procedure, respectively. CONCLUSIONS: The study findings suggest that common access site complications post transradial coronary procedures among Chinese population are relatively minor in nature. Individual puncture site pain assessment during the period of hemostasis is important. Nurses should pay more attention to factors such as female gender, sheath time and volume of compression that are more likely to be associated with transradial access site complications and puncture site pain.

Concepts: Myocardial infarction, Atherosclerosis, Cardiology, Atheroma, Pulse, Student's t-test, Radial artery, Bruise

23

The case is presented of a 32 year-old male with no medical history of interest who suffered a traffic accident with mild traumatic brain injury. He had a left supraciliary incised and contused wound that extended to the left upper eyelid, with no loss of vision. After palpebral anaesthetic injection, there was a sudden visual acuity decrease in the left eye and hyposphagma located between I-III at 4mm from the limbus, with increased intraocular pressure. A whitish lesion with a central haemorrhagic focus was observed in the ocular fundus, corresponding to the area where the hyposphagma was located.

Concepts: Brain, Traumatic brain injury, Retina, Eye, Visual perception, Ophthalmology, Eyelid, Bruise

22

A crossbow is a bow that shoots an arrow when a gun-like trigger is pulled. Deaths caused by accidental crossbow shootings are extremely rare. Here we describe an autopsy case of a penetrating wound to the left cerebral hemisphere caused by an accidental shooting with a crossbow. A man in his early 60s who lived with his wife and had used crossbows for 20 years as his hobby was found one early morning in the shed of his house, collapsed and bleeding from the head and neck. He was taken to a hospital and died after approximately 3 days of conservative treatment. At autopsy, a penetrating wound between the upper part of the left anterior neck and the left frontoparietal region was evident. Traumatic intracerebral hematoma was observed in the left frontal lobe, and severe traumatic subarachnoid hemorrhage was present throughout the brain. Cerebral contusion and hematoma without any organization were noted around the penetration. The cause of death was determined to be cerebral contusion and intracerebral hematoma due to the penetrating wound by the crossbow arrow. He was probably trying to load an arrow into the crossbow by placing it on the floor, pointing upward, and made a mistake in its operation that resulted in the shooting of the arrow. This case is unique because it was a rare accidental death caused by a crossbow arrow, and a detailed histopathological examination was performed.

Concepts: Death, Cerebral cortex, Bleeding, Subarachnoid hemorrhage, Frontal lobe, Bruise, Bow, Crossbow

16

Intracerebral hemorrhage (ICH) is an acute neurological disorder with high mortality and no effective treatment. In addition to the initial bleeding event, rebleeding and hematoma expansion are associated with poor outcome in these patients. We studied the effectiveness of the new antifibrinolytic agent CM352, a short-half-life matrix metalloproteinase inhibitor, for achieving early hemostasis and improving functional recovery in a rat model of collagenase-induced ICH.

Concepts: Neurology, Hemostasis, Bleeding, Cerebral hemorrhage, Neurological disorder, Bruise, 2004 albums, Matrix metalloproteinase inhibitor

6

The extent that inherited bleeding disorders affect; number, size and location of bruises in young children <6 years.

Concepts: Longitudinal study, Hematology, Bleeding, Bruise

4

The motions causing noncontact anterior cruciate ligament (ACL) injury remain unclear. Tibiofemoral bone bruises are believed to be the result of joint impact near the time of ACL rupture. The locations and frequencies of these bone bruises have been reported, but there are limited data quantifying knee position and orientation near the time of injury based on these contusions.

Concepts: Knee, Anterior cruciate ligament, Joint, Ligament, Anterior cruciate ligament injury, Cruciate ligament, Sprain, Bruise

2

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used as a non-invasive clamp of the aorta after diverse post-traumatic injuries. Balloon inflation in zone 3 (from the lower renal artery to the aortic bifurcation) can be performed to stop on-going bleeding after severe pelvic trauma with life-threatening hemorrhage. The aim of our study was to describe our 20-year experience with REBOA in terms of efficacy and safety in patients with a suspicion of severe pelvic trauma and extreme hemorrhagic shock.

Concepts: Blood, Medical emergencies, Abdominal aorta, Syphilis, Hypovolemia, Physical trauma, Bruise

2

Motor vehicle accidents (MVA) are often difficult to distinguish from non-accidental injury (NAI). This retrospective case-control study compared animals with known MVA trauma against those with known NAI. Medical records of 426 dogs and cats treated after MVA and 50 after NAI were evaluated. Injuries significantly associated with MVA were pelvic fractures, pneumothorax, pulmonary contusion, abrasions, and degloving wounds. Injuries associated with NAI were fractures of the skull, teeth, vertebrae, and ribs, scleral hemorrhage, damage to claws, and evidence of older fractures. Odds ratios are reported for these injuries. MVA rib fractures were found to occur in clusters on one side of the body, with cranial ribs more likely to fracture, while NAI rib fractures were found to occur bilaterally with no cranial-caudal pattern. Establishing evidence-based patterns of injury may help clinicians differentiate causes of trauma and may aid in the documentation and prosecution of animal abuse.

Concepts: Medical emergencies, Pulmonary contusion, Injuries, Injury, Wound, Tetrapod, Physical trauma, Bruise