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Article
Accidental penetration of screw driver in the cranial cavity

Authors: Mohammed Saeed --- Ali K. Al-Shalchy
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 2 Pages: 239-240
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: penetrating foreign body is a common problem but penetration by screw driver is very uncommonPatient & method: A nine years old boy presented with penetrating screw driver through the medial canthus of the eyeResult: the foreign body removed under GA with good result.Conclusion: minimal invasive procedure are preferred when we have penetrating head injury.


Article
•Head Injuries due to Motorcycle Accidents in Karbala-Iraq Prospective clinical Study

Author: Husam Ghazi Al-Anbari
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2011 Volume: 4 no 2 Issue: 10 Pages: 1170-1179
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: Head injury is one of the most important causes of death in trauma, preventive measures are widespread but not applied in all countries, and motorcycle accidents account the major problem in Karbala for the last few years.This study is aiming to compare the incidence, severity, outcome and other factors for each of motorcycle accidents from other causes of head injury in Karbala.Methods: 240 patients sustained head injuries admitted to neurosurgical ward and intensive care unit, from 1st of January till the last of August 2008 in Al- Hussein Teaching Hospital, those patients had been divided into five groups according to the cause of head injury, the following parameters were analyzed, which are age, sex, severity of head injury, other systemic injury, type of treatment, and the outcome of each group.Results: the study showed that patients with motorcycle accidents have the highest incidence (No. = 168, 70%), most of them were young, male, and carry the highest morbidity and mortality.Conclusion: motorcycle accidents account for the highest incidence of head injury in Karbala in 2008 which carry high morbidity and mortality.Recommendation:1. Educate motorcyclist about the preventive measures which should be taken like helmet wearing, limitation of the speed of vehicles.2.Strict traffic laws should be applied.


Article
Estimation of Some Trace Elements in Severe Head Injured Patients

Author: Nadhia Kh. Al-Adhami ناهدة خلف الاعظمي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 4 Pages: 482-489
Publisher: Baghdad University جامعة بغداد

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Abstract

Objectives: Severe head injury is the most devastating neurosurgical condition and it is only next to cancers as the leading cause of death in developed countries. Because trace elements (TEs) are involved in most of enzymes that drives the biochemical reactions, so they are considered as a window to the biochemical environment of the body in general and in brain in specific. Aim of the Study: This study measured six TEs (Fe, Zn, Mg, Cu, Mn and Co) in 29 patients with severe head injury (GCS Score 3-9); their ages between 5-50 years. Collection and estimation performed at both Neurosurgical Hospital (NH) in Baghdad and Medical Research Center (MRC) of College of Medicine, Kadhimiyah between January 2004 and August 2004. 17 of healthy Iraqi volunteers of age- and sex- matched were used as a comparable control group in TEs measurement. Results: The analysis showed that serum Cu level has a striking significant positive correlation with GCS (P<0.01) followed by serum Mg (P<0.01), serum Fe (P<0.05) with mode of correlation is linear except for that of serum Fe has three phases of correlation. Serum Mg is the only TE showed statistical significant lower value in patient group than the control group (P<0.01). Zn is the only TE that is correlated with the mode of intake, significantly lower among patient on IVF than those on N/G (P<0.01). Serum zinc correlated in linear relation with serum Mg (P<0.05), serum Fe with serum Mg (P<0.05).


Article
Incidence of Mandibular Fractures Associated with Head Injury in Ninavah Governorate (2006-2007)

Authors: Mohammed K Hasouni --- Ziad H Delemi
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2011 Volume: 11 Issue: 18 Pages: 370-375
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: The aims of the study are to find the incidences, types, sides and sites of mandibular fracture accompanied with head injuries in Ninavah Governorate. Materials and Methods: Data of trauma cases were collected from general, local, private hospitals and health sectors in Ninavah Governorate with a head injury and mandibular fracture for one year duration from June 2006 to May 2007. Age, etiology, types, hospitals, sides and sites, distribution were arranged in tables, chi square and P value used for statistic analysis. Results: The total number of head injury cases was (5828). The total num-ber of fractures mandible with and without head injury was (282) cases means (4.84%) of total number of head injury cases, while mandibular fracture with head injury cases incidence was (76) cases (1.3%) of total number of head injury cases . Conclusions: Children were the most common age group affect-ed by head injury, while geriatric age group was the least. Male showed high percentage than female in a ratio about 2:1. Low incidence of association between head injury and fracture mandible which means that there is no need for delaying maxillofacial treatment. Falls from height and bullet injuries were the common cause of head injury and fracture mandible (dentoalveolar fractures showed high incidence followed by body fractures).


Article
Intracranial Hematomas In Fatal Closed Head Injury A Postmortem Study

Authors: Hayder Qitran Raheem --- Ahmed A Salam Al Atraqchi --- Bassim Hannon Gabbar
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 2 Pages: 32-35
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

BACKGROUND: Intracranial hematomas is an important cause of death in closed head injury, autopsy findings is the final way to determine the types ,extent& associated findings of these hematomas. OBJECTIVE: To compare the incidence of brain pathology as a cause of death in patients with isolated head injury and those with multiple organ injuries. PATIENT & METHODS: One hundred consecutive bodies who were victims of fatal closed head injury(Group A) in the forensic medicine institute from jan.2004 to jan 2007 were included in this study, in addition a control study (Group B) of 100 consecutive victims of closed head & body injury with overt and non overt head injury signs. RESULTS: Group A (patients with pure head injury signs)Fifty five out of one hundred (55%) were having ICH , In which SDH (pure or combined) constitutes 35% of all cases.In addition 45% were having a brain edema &/or herniation.Group B (patients with multiple organ injury signs)The majority 49% were having brain ischemia.CONCLUSION:1-ICH are important causes of death in fatal closed head injury in which SDH are a majority in these hematomas.2-As a non hemorrhagic cause brain edema &/or herniation were a major factor.3-Multiply body injury showed mainly brain ischemia.


Article
Association between skull fractures and types of intracranial hematomas in children with head injury

Author: Hemn Hasan Abdulrahim
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2019 Volume: 23 Issue: 1 Pages: 100-105
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Treating children with head injuries is one of the most frequent causes of admission to the neurosurgical emergency unit in Erbil city. In many cases, the parents ask whether the presence of a skull fracture in their child indicates any association with intracranial hemorrhage. Most of the previous studies focused on the association between skull fractures and intracranial hematomas in the adult population. We conducted this study to determine if there is a statistically significant association between skull fracture and types of intracranial hemorrhage in children. Methods: A descriptive study was conducted between July 2015 and July 2017 at West Erbil Emergency Hospital. The study sample included children with the head injury whose brain Computerized Tomography (CT)-scan showed intracranial hemorrhage. Data collected using a questionnaire prepared by the researcher. Data were analyzed using descriptive and inferential statistical tests.Results: A total of 201 children met the inclusion criteria; their ages ranged between 2 months and 17 years. Male to female ratio was 121:80. Highest percentages (64.7%) of children were 1-5 years old. The most common (72.63%) cause of head injury was fall from height. The most frequent (48.8%) intracranial hematoma encountered was an epidural hematoma, followed by intracerebral hematoma and subdural hematomas. There was a highly significant (P = 0.001) association between skull fractures and types of intracranial hematomas.Conclusion: In children, skull fracture increases the incidence of intracranial hematoma. Most common intracranial hematomas in order of frequency were an epidural hematoma, intracerebral hematoma, and subdural hematoma. The most common cause of head injury was fall from height. Most patients were males between one and five years old.


Article
Cranial computed tomography scan findings in acute head injury
نتائج مسح التصوير المقطعي المحوسب في إصابات الرأس الحادة

Author: Aska Farouq Jamal
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 2 Pages: 273-281
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Head injury is a common injury seen in emergency departments. Early diagnosis and treatment may ameliorate the morbidity and mortality associated with intracranial injury. Computed tomography (CT) scan of the brain is a reliable imaging modality for identification of intracranial lesions in patients with an acute head injury. This study aimed to assess the cranial CT scan findings in patients with acute head injury, find out the main indication for requesting CT scan imaging, detect main etiologic factors and its distribution among different age groups.Methods: This was a prospective cross-sectional study of cranial CT scan findings of 210 patients with acute head injury admitted to an emergency hospital in Hawler during three months. Numerical and graphical descriptors were used to summarize the data.Results: The age of the studied patients ranged from 2 to 67 years with a mean± SD of 29.23±15.1 with males dominating the sample (78.6%).Road traffic accident was the main cause of injury (65.7%).The most common indication for requesting a CT scan was an altered level of consciousness and vomiting. Intracranial CT scan findings related to head injury were seen in 82% of victims of which fractures (50%) and intracranial hematomas (45.2%) were the main findings followed by combined injuries(31.8) and soft tissue injuries (31.6%).Incidental intracranial findings not related to trauma were seen in 6.2% of cases.Conclusion: In patients with acute head injury, CT scan can be used as the initial imaging investigation as it can yield various types of head injuries and their consequences related to trauma.


Article
The Role of Brainstem Auditory Evoked Potential Study in Patients With Moderate Closed Head Injury
دراسة دور كامن جذع الدماغ السمعي المثارفي مرضى اصابات الراس المغلقةالمتوسطة الشدة

Author: Maha K. AlsayadI مها كامل عبد الجليل
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2013 Volume: 55 Issue: 4 Pages: 369-373
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The high prevalence of head injury among civilian populations and the provision of the adequate hospitals services have become matters of worldwide concern. Brain-stem auditory evoked potentials (BAEPs) have been shown to be of highly resistant to systemic factors and toxic or metabolic derangements, making them particularly useful in differentiating reversible brain-stem dysfunction from that due to structural disruption.Objectives: The purpose of this study was to demonstrate the changes in brainstem evoked response (BAER( in patient with moderate closed head injury and assessing again these changes in BAER six months later as follow up indices.Material and methods: This is a prospective study conducted in the unit of Neurophysiology /Hospital of Neurosurgery/Baghdad from November 2010 to February 2012, using Esoata machine. Ninety three patients with moderate closed head injury (49 female and 44 male), with an age range from (5 -51) years, with a mean age of (26±11.95) years, were chosen according to Glasgow coma scale (GCS) (9-12 score) undergo BAER and only 86 patients will be followed up by BAER and both were compared to control group of 55 healthy subject. Results: Central wave latencies of wave III, IV and V of BAER of right and left sides at early measurements were found to be significantly prolonged in comparison to that of healthy subject, Moreover, 6 months later measurements of right and left sides were significantly prolonged as compared to healthy subject at an early measurement, which indicates significant improvement. However 6 months later measurements have significant reduced toward normal when compared to that at early measurements and with control group.Conclusion: This study revealed that head injury had serious effect on the brain functions reflected by changes in brainstem auditory evoked response which needs long time to return to normal levels.Key word: head injury, Brainstem auditory evoked Response.

الخلفية: ان غلبة انتشار اصابات الرأس بين المدنيين و توفير المستشفيات الغطاء الطبي السريري أصبح ذو اهمية عالميه من الناحية الطبية. لقد تبين ان كامن جذع الدماغ السمعي المثار لا يتأثربعوامل الجسم العامةوالمواد السمية والنواتج الأيضية مما جعلها مفيدة بصورة خاصة في تمييز الأختلال الوظيفي المعكوس لجذع الدماغ السمعي عن التمزق التركيبي. اهداف البحث: الغرض من هذه الدراسة هو ايضاح التغييرات في كامن جذع الدماغ السمعي المثارلمرضى اصابات الراس المغلقة المتوسطة الشدة و تقييم هذه التغييرات بعد ستة أشهر من الأصابة كمعيار تقييمي.طريقة اجراء البحث: اجريت هذه الدراسة المستقبلية في قسم الفسلجه العصبية مستشفى جراحة الجملة العصبية في بغداد للفترة من تشرين الأول ٢٠١٠الى شباط ٢٠١٢. اشتملت الدراسة على ٩٣ مصاب يعاني من اصابات الرأس المتوسطة الشدة حسب مقياس كلاسكو للغيبوبة(٩-١٢) ولقد اجري لهم فحص كامن جذع الدماغ السمعي المثار وتم متابعة ٨٦مريض بعد ستة اشهر من الحادث وتم مقارنة المجموعتين مع مجموعة الأصحاء.النتائج:اظهرت الدراسة وجود استطالة في مقدار الموجات المركزية لكامن جذع الدماغ السمعي ،الموجة الثالثة والرابعة والخامسةللجهة اليمنى بعد الحادث مباشرة" بتاثيراصابات الرأس وهذه الاستطاله ذو قيمة احصائية عند مقارنتها مع قيمها عند الأصحاء. بالاضافة الى ذلك فقد وجدت كذلك هذه الاستطالة عند فحص الجهة اليسرى للمرضى عند مقارنتهم مع الاصحاء وهو فرق ذو قيمة احصائية.كما تم متابعة المرضى بعد ستة اشهر من الحادث ومقارنتهم مع الأصحاء ومع النتائج الاولية لمعرفة مقدار التحسن.الاستنتاجات:نستنتج من هذه الدراسة ان اصابات الرأس لها تأثيرخطير على الدماغ ينعكس بالتتغييرات التي تحدث بكامن جذع الدماغ السمعي المستجاب وتحتاج هذه التغييرات الى فترة زمنية طويلة لتعود ال معدلها الطبيعي.مفتاح الكلمات:اصابات الرأس، استجابة كامن جذع الدماغ السمعي المثار.


Article
The effect of head injury on callus formation in fractures of tubular bones
اثر اصابة في الرأس في تكوين الكالس كسور في العظام الأنبوبية

Authors: Firas Tariq Ismaeel --- Arkan Bader Hassen --- Mustafa K. Hameed
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2008 Volume: 1 Issue: 141 Pages: 127-131
Publisher: Tikrit University جامعة تكريت

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Abstract

A study conducted in a 2 years period (2005-2007) in Tikrit Teaching Hospital aiming to find the effect of head injury on radiological evidence of callus formation. The study included 53 patients with head injury and fractures, compared to 30 control patients with fractures without head injury. The study depends on the ratio between the callus diameter to that of the bone, to quantify callus mass. We focused on the femoral, tibial, and humeral fractures for the ease of measuring callus formation. The radiological evidence of callus started in head injured group started earlier, and became more florid than the control group. With radiological resemblance to heterotopic ossification, rather than a normally looking callus. The study reveals that the patients with severe head injuries have abundant callus formed, compared to the lesser degree of head injury. And that patients with fractures have more callus formation; when associated with head injury

دراسة أجريت في فترة السنوات 2 (2005-2007) في مستشفى تكريت التي تهدف إلى العثور على أثر إصابة في الرأس على الأدلة الإشعاعية تكوين الكالس. وشملت الدراسة 53 مريضا مع اصابة في الرأس وكسور، مقارنة مع المرضى الذين التحكم 30 مع كسور من دون اصابة في الرأس. الدراسة يعتمد على النسبة بين القطر الكالس إلى أن من العظام، لتحديد كتلة الكالس. ركزنا على كسور الفخذ، عظام الساق، وعضدي لسهولة قياس تكوين الكالس. بدأت الأدلة الإشعاعية الكالس في مجموعة رأس جرح بدأت في وقت سابق، وأصبح أكثر مزهر من السيطرة على المجموعة. مع الإشعاعية تشابه إلى التحجر منتبذ، بدلا من الكالس يبحث بشكل طبيعي. وتكشف الدراسة أن المرضى الذين يعانون من اصابات بالغة في الرأس لديها وفرة الكالس شكلت، بالمقارنة مع درجة أقل من اصابة في الرأس. وأن المرضى الذين يعانون من كسور يكون تشكيل أكثر الكالس، وعندما المرتبطة إصابة في الرأس


Article
UNUSUAL CAUSES OF HEAD INJURIES
إصابات الرأس بكيفيات غير معتادة

Author: Walid W.H. Al-Rawi وليد وهيب الراوي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2006 Volume: 5 Issue: 1 Pages: 74-81
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Although the patterns of common causes of head injury (HI) are well established all over the world, however, unusual causes of HI, incurred inadvertently to many patients, do occur every now and then.Objective: To bring to the attention of the practicing neurosurgeon the possibility of an unusual pattern of HI. Furthermore, such injuries may endanger the patient's life.Methods: A retrospective study of 30 HI cases encountered by the author between 1986 – 2003. The Accident and Emergency Hospital in Amara, The Teaching Hospital in Basrah, The Neurosurgical Hospital and The Teaching Hospital at Kadhimiyah, Baghdad. All had 3 standard plain skull X-ray projections: postero-anterior, lateral, and Townes views; occasionally, occipito-mental and orthopentgraphic views were done. Although few cases needed conventional angiographic examination, none of them had the test because of the non-availability of the contrast medium. Few patients had computerized tomography (CT) examination. All cases presented before magnetic resonance (MR) imaging was introduced into the country. Results: Different age groups are represented. Although both sexes were affected, however, most of the victims were males (24, 80%), and most injuries were compound and of a penetrating nature; all calvarial regions are represented in this study. There was no death in this series as all patients made, in due course, an excellent recovery.Conclusions and recommendations: Under certain situations, especially when the financial resources are limited, or up-date neuro-imaging machines are unavailable, plain skull X-ray films prove adequate investigative tool disclosing the extent of bony damages and state of penetration. Domestic animals and tools can, un-expectedly, be harmful; an educational program in this respect is helpful. A protective safety helmet may be mandatory in certain professions when the risk of having a HI is likely. Although most of our patients suffered a certain degree of transient morbidity, however, they were back to normal active life. The practicing neurosurgeon may face an unusual type of HI that may constitute a serious threat to the victim's life. Addressing the management of such events, an urgent non-hesitating attitude is to be practiced by following the standard lines of dealing with penetrating injuries.Key words: Unusual causes of head injury, penetrating injury, plain skull X-ray.

خلفية الدراسة: بالرغم من أنّ الكيفيات الشائعة الحدوث في إصابات الرّأس هي معروفة و مثبّة في مختلف دول العالم، إلاّ أنّه هناك كيفيات غير دائمة الحدوث تحدث عن دون قصدٍ بين الحين و الآخر. هذه دراسة مسترجعة عن كيفيات غير معتادة لإصابات في الرّأس متسبّبة عن دون قصد جمعت خلال سبع عشرة سنة تحت إشراف الباحث بين الأعوام 1986 م – 2003 م.هدف الدراسة: توجيه عناية جرّاح الأعصاب الممارس إلى إحتمال حدوث مثل هذه الكيفيات التي قد تهدّد حياة المصاب.طريقة العمل: شملت الدراسة حالات إصابات بكيفيات غير معتادة واجهت الباحث في مستشفى الطوارىء بالعمارة و المستشفى التعليمي بالبصرة و مستشفى جراحة الأعصاب ببغداد و المستشفى التعليمي بالكاظمية ببغداد أيضاً. كانت معظمها في الجهة اليمنى الصدغية و الجبهوية و غير قاتلة بالرّغم من تهديدها لحياة المصابين. كان معظم كان معظم المصابين من الذكور (24، 80%) و من مختلف الأعمار. و كان سلّم كلاسكو للسبات يتراوح بين 12 – 15. كلّ الاصابات كانت مضاعفة و البعض منها نافذة للتجويف القحفي. أثبتت الفحوص الشعاعية بالأجهزة التقليدية، دون تلوين الأوعية الدموية و قبل توفّرالفحص المحوري الطبقي و الرنين المغناطيسي، جدواها و فائدتها في تقييم الكسور و نفاذية الأجسام الغريبة الى التجويف القحفي. بالرغم من أنّ قسما من كسور الجمجمة كانت خطّية، الاّ أنّ غالبيتها من النوع المنخفضة المهشمّة. لم تكن في أي من المرضى إصابات أخرى خارج الرأس. تم ﺇجراء التداخل الجراحي، بعد إعطائهم مضادّات الصرع و المضادات الحياتية، تحت التخدير العام بتنظيف و هندمة الجرح و رفع الكسر المنخفض و رفع الجسم الغريب و خياطة الأم الجافية (أو ترقيعها باستعمال لفّفة أو صفّاق العضلة الصدغية).النتائج: تحسّن حال جميع المرضى بدون مضاعفات و أظهروا أداءً طبيعياً في النمو و المدرسة و العمل.الإستنتاج: تحت ظروفٍ معيّنةٍ، و خصوصاً عندما تكون الموارد المالية المتاحة محدودة، أو في حال عدم توفّر أجهزة التشخيص الشعاعي الحديثة المتطوّرة، فإنّ جهاز الأشعّة السينية الإعتيادى في فحص الجمجمة يكون كافياً للتحرّي أو كشف مدى التلف العظمي أو نفاذية الجسم الغريب للتجويف القحفي. إن كثيرا من الأدوات و المستلزمات المستعملة يومياً، و كذلك بعض الحيوانات الأليفة، في حالات معينة، قد تسبب أذىً ملحوظاً كإصابات الرأس؛ و لما كان بالإمكان منع مثل هذه الحوادث كاتّخاذ الحيطة و الحذر و بوسائل الارشاد و التثقيف، و حتّى ارتداء خوذة الحماية، فأنّ احتمال حدوثها ينبغي أن يؤخذ على محمل الجدّ و يجب التذكير المستمر بهذه الأخطار التي من الممكن أن تهدّد حياة المصاب. فبالتعرّض للإدارة العلاجية لمثل هذه الحالات، ينبغي على جرّاح الأعصاب عدم التردّد في تطبيق الأسس القياسية عند التعامل مع حالات الإصابات النافذة للتجويف القحفي.مفتاح الكلمات: إصابات الرأس بكيفيات غير معتادة، الاصابات النافذة، الفحوص الشعاعية بالأجهزة التقليدية

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