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At least 19 recordsLinked to original sources
PubMed1998

Pathogenesis of the mass effect of cerebral contusions: rapid increase in osmolality within the contusion necrosis.

The non-hemorrhagic mass effect of cerebral contusions is commonly attributed to vasogenic edema and/or cytotoxic edema (cellular swelling). We propose that a marked increase in osmolality within the contusion necrosis proper, in which the cellular elements uniformly undergo shrinkage, disintegration and homogenation, represents an important and unique mechanism underlying the contusion edema. The present study demonstrates in a rat model of cerebral contusion, that 1) the osmolality of the contused brain tissue increases rapidly, 2) the increase in osmolality is not caused by changes in inorganic ion contents, suggesting a metabolic production of osmoles or release of idiogenic osmoles, and 3) the contused brain tissue strongly attracts water, provided that blood supply is maintained. We suggest that the primary driving force of water accumulation into contused brain tissue is the elevated colloid osmotic potential of contusion necrosis.

Animals↗
PubMed2001

[Quantification of cerebral contusions using the contusion index].

The submitted results provide evidence that calculation of the contusion index (CI) for objective expression of the extent and depth of cerebral contusion is very suitable for various comparative studies. The authors assessed, using the CI the influence of direction, site of violent action, and age on the extent and depth of cerebral contusion in different types of head injuries. Consistent with the literature, the greatest contusion developed in areas of the frontal and temporal lobes. In case of violence from the back and from the side, in subjects above 50 years of age the CI of contusion par contrecoup was markedly greater than at the site of violence. The highest CI of the whole brain was in case of violence from the side. During falls from major heights or walking during alcohol intoxication the contusion was worse than in casualties during traffic accidents where pedestrians predominated. Fractures of the skull in junior subjects occurred only after an intensity which at the same time led also to the development of more extensive and deeper contusion as compared with older subjects where CI in fractures of the skull and intracranial haemorrhage were markedly smaller.

Adolescent↗
PubMed2002

Ocular contusion caused by elastic cords: a retrospective analysis using the Erlangen Ocular Contusion Registry.

PURPOSE: Elastic cords are common tools to secure luggage to the roof of motor vehicles or the carrier of bicycles. In comparison with other variants of ocular contusion, patients with elastic cord injuries appear to suffer more severe ocular damage. METHODS: The charts of 398 consecutive patients of the Erlangen Ocular Contusion Registry who had been hospitalized for ocular contusion over a 10-year period were retrospectively reviewed. The acute clinical findings of 23 patients with elastic cord injury were compared with 375 patients with other contusions. Open globe injuries were excluded. RESULTS: A total of 5.8% of the patients were injured by elastic cords; their mean age was 36.6 +/- 17.0 years (range 8-66; median 34 years). The following morphological changes were documented in elastic cord injuries versus other ocular contusions: hyphema 100% versus 75%; angle recession 92% versus 72%; iridodialysis 17% versus 9%; traumatic cataract 14% versus 10%; lens dislocation 38% versus 13%; choroidal rupture 19% versus 6%; peripheral Berlin's oedema 57% versus 35%; and central Berlin's oedema 29% versus 12%. The difference of the incidence was significant for lens dislocation (P < 0.01), choroidal rupture (P = 0.024), and central (P = 0.029) and peripheral Berlin's oedema (P = 0.043). The final visual outcome was lower in patients with elastic cords injuries (P = 0.008). CONCLUSION: Elastic cord injuries induce more severe ocular damage than most other contusions. The elastic cords producing industry is called on to develop safer luggage fixation systems and warn against the potential harmful consequences of injury to the eye.

Adolescent↗
PubMed2001

ARDS after pulmonary contusion: accurate measurement of contusion volume identifies high-risk patients.

BACKGROUND: The pathophysiology of pulmonary contusion (PC) is poorly understood, and only minimal advances have been made in management of this entity over the past 20 years. Improvement in understanding of PC has been hindered by the fact that there has been no accurate way to quantitate the amount of pulmonary injury. With this project, we examine a method of accurately measuring degree of PC by quantifying contusion volume relative to pulmonary function and outcome. METHODS: Patients with PC from isolated chest trauma who had admission chest computed tomographic scan were identified from the registry of a Level I trauma center over a 1.5-year period. Subsequently, prospective data on all patients admitted to the intensive care unit with PC during a 5-month period were collected and added to the retrospective database. Using computer-generated three-dimensional reconstruction from admission chest computed tomographic scan, contusion volume was measured and expressed as a percentage of total lung volume. Admission pulmonary function variables (Pao2/FiO2, static compliance), injury descriptors (chest Abbreviated Injury Score, Injury Severity Score, injury distribution), and indicators of degree of shock (admission systolic blood pressure, admission base deficit) were documented. Outcomes included maximum positive end-expiratory pressure, ventilator days, pneumonia, and acute respiratory distress syndrome (ARDS). RESULTS: Forty-nine patients with PC (35 bilateral) were identified. The average severity of contusion was 18% (range, 5-55%). Patients were classified using contusion volume as severe PC (> or =20%, n = 17) and moderate PC (< 20%, n = 32). Injury Severity Score was similar in the severe and moderate groups (23.3 vs. 26.5, p = 0.33), as were admission Glasgow Coma Scale score (12 vs. 13, p = 0.30), admission blood pressure (131 vs. 129 mm Hg, p = 0.90), and admission Pao2/Fio2 (197 vs. 255, p = 0.14). However, there was a much higher rate of ARDS in the severe group as compared with the moderate group (82% vs. 22%, p < 0.001). There was a trend toward higher pneumonia rate in the severe group, with 50% of patients in the severe group developing pneumonia as compared with 28% in the moderate group (p = 0.20). CONCLUSION: Extent of contusion volumes measured using three-dimensional reconstruction allows identification of patients at high risk of pulmonary dysfunction as characterized by development of ARDS. This method of measurement may provide a useful tool for the further study of PC as well as for the identification of patients at high risk of complications at whom future advances in therapy may be directed.

Abbreviated Injury Scale↗
PubMed2002

[Eye contusions caused by a bottle cap. A retrospective study based on the Erlangen Ocular Contusion Register (EOCR)].

BACKGROUND: Perforating ocular injuries due to exploding beverage bottles are well known. However, bottle caps alone may also induce severe ocular damage due to ocular contusions while opening carbon dioxide-containing beverage bottles. We studied this type of ocular contusion. PATIENTS AND METHODS: Retrospectively, we examined all findings, operations, and tension profiles of 400 consecutive patients with ocular contusion who had been hospitalized in the Department of Ophthalmology, University Erlangen-Nürnberg, using the Erlangen ocular contusion registry (EOCR). RESULTS: Seven patients were injured by bottle caps (1.8%) while attempting to open a beverage bottle. The bottle caps were screw caps in six patients and crown corks in one patient. The patient age was 34 +/- 22 years (range: 16-68 years). Four patients were female, three male. We found the following morphological changes: hyphema (seven patients), iridodialysis (two patients), traumatic cataract (two patients), vitreous prolapse (one patient), vitreous hemorrhage (two patients), and retinal detachment (two patients). Intraocular pressure was higher than 21 mmHg in three patients. Visual acuity was hand motion in two patients, lower then 0.4 in two, and 1.0 in three on the admission day. Five patients read 1.0 on the day of discharge. CONCLUSIONS: Bottle cap injuries are not as harmless as supposed. Bottle caps may induce severe ocular damage due to the high-impact energy.

Adolescent↗
PubMed2001

[Retrospective analysis of 417 cases of contusion and rupture of the globe with frequent avoidable causes of trauma: the Erlangen Ocular Contusion-Registry (EOCR) 1985 - 1995].

BACKGROUND: Ocular trauma is the cause of every third enucleation. Blunt injuries belong to the most frequent causes. We analysed blunt ocular injuries to collect detailed epidemiological data. PATIENTS AND METHODS: Retrospective analysis of 417 inpatients of the university-eye-hospital Erlangen from 1985-1995 with ocular contusion or globe rupture (EOCR - Erlangen Ocular Contusion-Registry). RESULTS: One third of the injuries occurred during work time, more than 40 % during leisure time. 85 % of the patients were male. One half was 10 to 29 years old. Visual impairment of less than 20/200 was more frequently associated with severe damage of intraocular structures: 53 times more ruptures of the globe, 33 times more lens luxation, 17 times more retinal detachment. Visual acuity was lower following traumas due to fall and grinding. Visual impairment was rarely induced by large objects like soccer balls. Morphological findings included: hyphema (73 %), rebleeding (4 %), angle recession (71 %), iris sphincter tears (20 %), iridodialysis (10 %), cyclodialysis (3,4 %), traumatic aniridia (1 %), lens dislocation (15 %), traumatic cataract (10 %), choroidal rupture (7 %), retinal tear or detachment (7 %), Berlin's edema (35,5 %), globe rupture (4,6 %), blow-out-fracture (8,3 %). Vitreal prolapse (7,5 %) was often associated with vitreal hemorrhage (57 %), hyphema (86 %), globe rupture (20 %), iris sphincter tear (44 %), iridodialysis or cyclodialysis (43 %), traumatic cataract (41 %), lens dislocation (93 %) and retinal tear or detachment (29 %). CONCLUSIONS: Blunt ocular injuries frequently induce severe ocular damage. Only consequent attention to industrial safety act, general preference given to rounded edges and the urgent information about safety eyeware for hobbyists may reduce the number of ocular injuries with permanent morphological and functional damage.

Accidental Falls↗