Traumatic intracranial pseudoaneurysms （TIPA） are rare and pseudoaneurysm of P3 segment of the posterior cerebral artery （PCA） is extremely rarely reported. A 27-year-old man suffered from blunt head injury and un...Traumatic intracranial pseudoaneurysms （TIPA） are rare and pseudoaneurysm of P3 segment of the posterior cerebral artery （PCA） is extremely rarely reported. A 27-year-old man suffered from blunt head injury and underwent diagnostic procedure with head CT scans, cerebral CT angiograms （CTA） and digital subtraction angiograms （DSA）. An abnormal high-density lesion was detected at the left side of quadrigeminal cistern and a pseudoaneurysm showed at the P3 segment of PCA. The pseudoaneurysm was successfully treated with parent artery occlusion （PAO）. Making an exact preoperative diagnosis of traumatic intracranial pseudoaneurysms is of great importance. Endovascular techniques allow a safe approach to complex intracranial lesion, so endovascular management of PCA pseudoaneurysms becomes safe and effective. However, the pseudoaneurysm may not be amenable to coil placement under some conditions, thus, occlusion of the parent vessel may be a preferable treatment.展开更多
Objective：To evaluate all the possible therapeutic measures concerning the acute management of traumatic brain injury（TBI）mentioned in Cochrane Systematic Reviews published in the Cochrane Database of Systematic Re...Objective：To evaluate all the possible therapeutic measures concerning the acute management of traumatic brain injury（TBI）mentioned in Cochrane Systematic Reviews published in the Cochrane Database of Systematic Reviews（CDSR）.Methods：An exhausted literature search for all published Cochrane Systematic Reviews discussing therapeutic rather than prevention or rehabilitative interventions of TBI was conducted.We retrieved such databases as CDSR and Cochrane Injury Group,excluded the duplications,and eventually obtained 20 results,which stand for critical appraisal for as many as 20 different measures for TBI patients.The important data of each systematic review,including total population,intervention,outcome,etc,were collected and presented in a designed table.Besides,we also tried to find out the possible weakness of these clinical trials included in each review.Results：Analysis of these reviews yielded meanfuling observations：（1）The effectiveness of most ordinary treatments in TBI is inconclusive except that corticosteroids are likely to be ineffective or harmful,and tranexamic acid,nimodipine and progesterone show a promising effect in bleeding trauma,traumatic subarachnoid hemorrhage,TBI or severe TBI.（2）A majority of the systematic reviews include a small number of clinical trials and the modest numbers of patients,largely due to the uncertainty of the effectiveness.（3）The quality of most trials reported in the systematic reviews is more or less questionable.（4）In addition,lots of other complex factors together may lead to the inconclusive results demonstrated in the Cochrane Systematic Reviews.Conclusions：For clinical physicians,to translate these conclusions into practice with caution is essential.Basic medication and nursing care deserve additional attention as well and can be beneficial.For researchers,high quality trials with perfect design and comprehensive consideration of various factors are urgently required.展开更多
High-velocity penetrating pelvic injury is one of the most difficult challenges to trauma surgeons. The injury sites frequently include soft tissue, pelvis, geni- tourinary tract, vascular structures and intraabdomina...High-velocity penetrating pelvic injury is one of the most difficult challenges to trauma surgeons. The injury sites frequently include soft tissue, pelvis, geni- tourinary tract, vascular structures and intraabdominal viscera. We present an unusual case of a male patient suf- fering a collision at night with a deformed steel bar penetrat- ing into his right groin. Careful planning of the surgical approach is important before extracting the foreign body. The possibility ofmultiorgan damage to intrapelvic struc-tures such as colon, urinary bladder, vessels and nerves, frequently necessitates a multidisciplinary involvement and systematic approach. Besides, limited incision as well as modification should be considered, and debridement and perioperative antibiotics can be used to reduce the risk of serious wound infection.展开更多
文摘Traumatic intracranial pseudoaneurysms （TIPA） are rare and pseudoaneurysm of P3 segment of the posterior cerebral artery （PCA） is extremely rarely reported. A 27-year-old man suffered from blunt head injury and underwent diagnostic procedure with head CT scans, cerebral CT angiograms （CTA） and digital subtraction angiograms （DSA）. An abnormal high-density lesion was detected at the left side of quadrigeminal cistern and a pseudoaneurysm showed at the P3 segment of PCA. The pseudoaneurysm was successfully treated with parent artery occlusion （PAO）. Making an exact preoperative diagnosis of traumatic intracranial pseudoaneurysms is of great importance. Endovascular techniques allow a safe approach to complex intracranial lesion, so endovascular management of PCA pseudoaneurysms becomes safe and effective. However, the pseudoaneurysm may not be amenable to coil placement under some conditions, thus, occlusion of the parent vessel may be a preferable treatment.
文摘Objective：To evaluate all the possible therapeutic measures concerning the acute management of traumatic brain injury（TBI）mentioned in Cochrane Systematic Reviews published in the Cochrane Database of Systematic Reviews（CDSR）.Methods：An exhausted literature search for all published Cochrane Systematic Reviews discussing therapeutic rather than prevention or rehabilitative interventions of TBI was conducted.We retrieved such databases as CDSR and Cochrane Injury Group,excluded the duplications,and eventually obtained 20 results,which stand for critical appraisal for as many as 20 different measures for TBI patients.The important data of each systematic review,including total population,intervention,outcome,etc,were collected and presented in a designed table.Besides,we also tried to find out the possible weakness of these clinical trials included in each review.Results：Analysis of these reviews yielded meanfuling observations：（1）The effectiveness of most ordinary treatments in TBI is inconclusive except that corticosteroids are likely to be ineffective or harmful,and tranexamic acid,nimodipine and progesterone show a promising effect in bleeding trauma,traumatic subarachnoid hemorrhage,TBI or severe TBI.（2）A majority of the systematic reviews include a small number of clinical trials and the modest numbers of patients,largely due to the uncertainty of the effectiveness.（3）The quality of most trials reported in the systematic reviews is more or less questionable.（4）In addition,lots of other complex factors together may lead to the inconclusive results demonstrated in the Cochrane Systematic Reviews.Conclusions：For clinical physicians,to translate these conclusions into practice with caution is essential.Basic medication and nursing care deserve additional attention as well and can be beneficial.For researchers,high quality trials with perfect design and comprehensive consideration of various factors are urgently required.
文摘High-velocity penetrating pelvic injury is one of the most difficult challenges to trauma surgeons. The injury sites frequently include soft tissue, pelvis, geni- tourinary tract, vascular structures and intraabdominal viscera. We present an unusual case of a male patient suf- fering a collision at night with a deformed steel bar penetrat- ing into his right groin. Careful planning of the surgical approach is important before extracting the foreign body. The possibility ofmultiorgan damage to intrapelvic struc-tures such as colon, urinary bladder, vessels and nerves, frequently necessitates a multidisciplinary involvement and systematic approach. Besides, limited incision as well as modification should be considered, and debridement and perioperative antibiotics can be used to reduce the risk of serious wound infection.
