penetrating head injury

• 穿通性頭部外傷、脳穿通外傷

関

penetrating brain injury、penetrating cranial trauma、penetrating head trauma

WordNet

1. to go or travel towards; "where is she heading"; "We were headed for the mountains"
2. the length or height based on the size of a human or animal head; "he is two heads taller than his little sister"; "his horse won by a head"
3. the pressure exerted by a fluid; "a head of steam"
4. the tip of an abscess (where the pus accumulates)
5. (nautical) a toilet on board a boat or ship
6. (usually plural) the obverse side of a coin that usually bears the representation of a persons head; "call heads or tails!"
7. a projection out from one end; "the head of the nail", "a pinhead is the head of a pin"
8. a single domestic animal; "200 head of cattle"
9. the striking part of a tool; "the head of the hammer"
10. the upper part of the human body or the front part of the body in animals; contains the face and brains; "he stuck his head out the window" (同)caput
11. a person who is in charge; "the head of the whole operation" (同)chief, top_dog
12. (grammar) the word in a grammatical constituent that plays the same grammatical role as the whole constituent (同)head word
13. a rounded compact mass; "the head of a comet"
14. a user of (usually soft) drugs; "the office was full of secret heads"
15. an individual person; "tickets are $5 per head"
16. that part of a skeletal muscle that is away from the bone that it moves
17. the foam or froth that accumulates at the top when you pour an effervescent liquid into a container; "the beer had a large head of foam"
18. the front of a military formation or procession; "the head of the column advanced boldly"; "they were at the head of the attack"
19. the rounded end of a bone that fits into a rounded cavity in another bone to form a joint; "the head of the humerus"
20. the top of something; "the head of the stairs"; "the head of the page"; "the head of the list"
21. be the first or leading member of (a group) and excel; "This student heads the class" (同)head up
22. be in charge of; "Who is heading this project?" (同)lead
23. be in the front of or on top of; "The list was headed by the name of the president"
24. form a head or come or grow to a head; "The wheat headed early this year"
25. remove the head of; "head the fish"
26. take its rise; "These rivers head from a mountain range in the Himalayas"
27. any physical damage to the body caused by violence or accident or fracture etc. (同)hurt, harm, trauma
28. an act that causes someone or something to receive physical damage
29. wrongdoing that violates anothers rights and is unjustly inflicted
30. an accident that results in physical damage or hurt (同)accidental injury
31. of leafy vegetables; having formed into a head; "headed cabbages"
32. having a head of a specified kind or anything that serves as a head; often used in combination; "headed bolts"; "three-headed Cerberus"; "a cool-headed fighter pilot"
33. having a heading or caption; "a headed column"; "headed notepaper"
34. having a heading or course in a certain direction; "westward headed wagons"
35. the 5th letter of the Hebrew alphabet
36. a line of text serving to indicate what the passage below it is about; "the heading seemed to have little to do with the text" (同)header, head

PrepTutorEJDIC

1. (顔を含めた)『頭』,頭部,首;(髪の生えている部分の)頭 / 『頭脳』,頭の働き,知力,才能;理性 / 『長』,指導者,支配者 / (ある物の)頭,上部,先端,先頭 / (川・泉の)源,水源 / (人・動物の)頭数,一人,1頭 / 『首席』,首位 / 《複数形で》(頭像のある)貨幣の表 / 項目,表題(新聞の)見出し / 《米俗》マリファナ常用者 / 長の,指導者の / …‘の'先頭に立つ,‘を'率いる;…‘の'長である / (…の方へ)…‘を'向ける《+『名』+『for』(『toward』)+『名』》 / (サッカーで)〈ボール〉‘を'頭で受ける,ヘディングする / (…に向かって)進む《+for(toward)+名》・「give a head」で「オーラルセックスをする・相手の性器をなめる」
2. 『負傷』,『損害』,損傷 / (名誉などを)傷つけること,侮辱《+『to』+『名』》
3. 頭[部]のある,見出しのある / (キャベツなどが)結球した / 《複合語を作って》「…の頭を持つ」「頭が…の」の意を表す
4. 彼は,彼が / 《指す人の性別が分からないか,または分かる必要のない場合に》その人,あの人,自分 / 《he who(that)の形で》《文》…するものはだれでも / (動物の)おす(雄)
5. 鬼ごっこ(tag,tick,tig)
6. (章・節などの)表題,見出し

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/01/29 12:56:30」(JST)

wiki en

[Wiki en表示]

Penetrating head injury
Classification and external resources
An 1868 illustration of the injury suffered by Phineas Gage, a railroad worker who had a tamping iron driven through his skull in an 1848 accident.
ICD-10	S01.9
eMedicine	med/2888
MeSH	D020197

A penetrating head injury, or open head injury, is a head injury in which the dura mater, the outer layer of the meninges, is breached. Penetrating injury can be caused by high-velocity projectiles or objects of lower velocity such as knives, or bone fragments from a skull fracture that are driven into the brain. A perforating head injury is one in which the object passes through the head and leaves an exit wound. Head injuries caused by penetrating trauma are serious medical emergencies and may cause permanent disability or death.

Mechanisms

An illustration of a brain after an "encircling" gunshot wound, showing the pattern of injury caused by the bullet's path

In penetrating injury from high-velocity missiles, injuries may occur not only from initial laceration and crushing of brain tissue by the projectile but also from the subsequent cavitation. High-velocity objects create rotations and can create a shock wave that cause stretch injuries, forming a cavity that is three to four times greater in diameter than the missile itself. A pulsating temporary cavity is also formed by a high-speed missile and can have a diameter thirty times greater than that of the missile. Though this cavity is reduced in size once the force is over, the tissue that was compressed during cavitation remains injured. Destroyed brain tissue may either be ejected from entrance or exit wounds or packed up against the sides of the cavity formed by the missile.

Low-velocity objects usually cause penetrating injuries in the regions of the skull's temporal bones or orbital surfaces, where the bones are thinner and thus more likely to break. Damage from lower-velocity penetrating injuries is restricted to the tract of the stab wound, because the lower-velocity object does not create as much cavitation. However, low-velocity penetrating objects such as slow bullets may ricochet inside the skull, continuing to cause damage until they stop moving.

Pathophysiology

Though it is more likely to cause infection, penetrating trauma is similar to closed head injury such as cerebral contusion or intracranial hemorrhage in a number of ways. As in closed head injury, intracranial pressure is likely to increase due to swelling or bleeding, potentially crushing delicate brain tissue. Most deaths from penetrating trauma are caused by damage to blood vessels, which can lead to intracranial hematomas and ischemia, which can in turn lead to a biochemical cascade called the ischemic cascade. The injury in penetrating brain trauma is mostly focal (that is, it affects a specific area of tissue).

Studies with PET scanning and transcranial Doppler imaging have shown that changes in cerebral blood flow, such as hypoperfusion and vasospasm, can follow penetrating head injury. These changes can last for two weeks. An ischemic cascade similar to the course of cellular and metabolic events that follow other head injuries may follow penetrating head injuries. Sometimes in penetrating injuries, the brain releases thromboplastin, which can lead to problems with blood clotting.

While blunt head trauma does not present a risk of shock due to hemorrhage, penetrating head trauma does.

Diagnosis and treatment

3-D CT scan showing a penetrating head injury by a screwdriver

A person with a penetrating head injury may be evaluated using X-ray, CT scan, or MRI (however MRI can only be used when the penetrating object would not be magnetic, because MRI uses magnetism and could move the object, causing further injury).

Surgery may be required to debride or repair the injury or to relieve excessive intracranial pressure. Intracranial pressure is monitored and attempts are made to maintain it within normal ranges. Intravenous fluids are given and efforts are taken to maintain high blood oxygen levels.

Prognosis

The highest-velocity injuries tend to have the worst associated damage. Penetrating injury from any missile such as a bullet has a mortality rate of 92%. Thus, firearms cause the most head injury-related deaths. Perforating injuries have an even worse prognosis.

Penetrating head trauma can cause impairment or loss of abilities controlled by parts of the brain that are damaged. A famous example is Phineas Gage, whose personality appears to have changed (though not as dramatically as usually described) after a penetrating injury to his frontal lobe(s).

People with subarachnoid hemorrhage, a blown pupil, respiratory distress, hypotension, or cerebral vasospasm are more likely to have worse outcomes.

People with penetrating head trauma may have complications such as acute respiratory distress syndrome, disseminated intravascular coagulation, and neurogenic pulmonary edema. Up to 50% of patients with penetrating brain injuries get late-onset post-traumatic epilepsy.

See also

• Brain herniation
• Intracranial hemorrhage
• Intracranial pressure
• Penetrating trauma
• Traumatic brain injury
• Head injury
• Skull fracture

References

UpToDate Contents

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• 1. 急性重度外傷性脳損傷のマネージメント management of acute severe traumatic brain injury?detectedLanguage=en&source=search_result&translation=penetrating+head+injury&search=penetrating+head+injury&selectedTitle=1%7E150&provider=medicamap
• 2. 成人における頭蓋骨骨折 skull fractures in adults?detectedLanguage=en&source=search_result&translation=penetrating+head+injury&search=penetrating+head+injury&selectedTitle=2%7E150&provider=medicamap
• 3. 鈍的または鋭的損傷を受け初期は安定している小児に対するアプローチ approach to the initially stable child with blunt or penetrating injury?detectedLanguage=en&source=search_result&translation=penetrating+head+injury&search=penetrating+head+injury&selectedTitle=3%7E150&provider=medicamap
• 4. 成人外傷患者における入院マネージメントの概要 overview of inpatient management in the adult trauma patient?detectedLanguage=en&source=search_result&translation=penetrating+head+injury&search=penetrating+head+injury&selectedTitle=4%7E150&provider=medicamap
• 5. 幼児および小児における軽微な頭部外傷 minor head trauma in infants and children?detectedLanguage=en&source=search_result&translation=penetrating+head+injury&search=penetrating+head+injury&selectedTitle=5%7E150&provider=medicamap

English Journal

• Good outcome after delayed surgery for orbitocranial non-missile penetrating brain injury.

• Caporlingua A1, Caporlingua F1, Lenzi J1.
• Asian journal of neurosurgery.Asian J Neurosurg.2016 Jul-Sep;11(3):309. doi: 10.4103/1793-5482.179641.
• Nonmissile orbitocranial penetrating brain injuries are uncommonly dealt with in a civilian context. Surgical management is controversial, due to the lack of widely accepted guidelines. A 52-year-old man was hit in his left eye by a metallic foreign body (FB). Head computed tomography (CT) scan show
• PMID 27366265

• Penetrating aerodigestive injuries in the neck: a proposed CT-aided modified selective management algorithm.

• Bodanapally UK1,2, Shanmuganathan K3,4, Dreizin D3,4, Stein D3,5, Reddy AK6, Mirvis SE3,4, Vasquez M3,7, Cardarelli C3,7, Guardiani E3,8.
• European radiology.Eur Radiol.2016 Jul;26(7):2409-17. doi: 10.1007/s00330-015-4050-3. Epub 2015 Oct 22.
• OBJECTIVES: To determine the specific CT findings of penetrating neck wound profile predicting aerodigestive injuries, diagnostic performance of CTA and to propose a modified selective management algorithm to reduce nontherapeutic invasive procedures.METHODS: We retrospectively evaluated CTAs of 102
• PMID 26494643

• Establishing Benchmarks for Resuscitation of Traumatic Circulatory Arrest: Success-to-Rescue and Survival among 1,708 Patients.

• Moore HB1, Moore EE2, Burlew CC3, Biffl WL3, Pieracci FM3, Barnett CC3, Bensard DD3, Jurkovich GJ3, Fox CJ3, Sauaia A4.
• Journal of the American College of Surgeons.J Am Coll Surg.2016 Jul;223(1):42-50. doi: 10.1016/j.jamcollsurg.2016.04.013. Epub 2016 Apr 21.
• BACKGROUND: Attempts are made with emergency department thoracotomy (EDT) to salvage trauma patients who present to the hospital in extremis. The EDT allows for relief of cardiac tamponade, internal cardiac massage, and proximal hemorrhage control. Minimally invasive techniques, such as endovascular
• PMID 27107826

Japanese Journal

• 喉頭筋電図にて甲状披裂筋麻痺の確定診断が得られた症例の臨床的検討

• 宮本 真,宮田 恵里,友田 幸一
• 音声言語医学 55(4), 338-344, 2014
• 反回神経は，後輪状披裂筋，披裂筋，外側輪状披裂筋，甲状披裂筋の順番に分枝を出しており，個々の分枝は非常に局所の障害で影響を受ける可能性がある．理論的には甲状披裂筋麻痺は存在し，この麻痺は部分的喉頭麻痺と呼ばれている．しかし甲状披裂筋麻痺はまれとされている．今回われわれは，甲状披裂筋麻痺の5症例を経験したので，若干の文献的考察を加え報告する．症例は男性3名，女性2名で，うち3名は全身麻酔下の手術後に …
• NAID 130004903383

• A Case of Direct Injury of the Common Carotid Artery due to a Suicide Attempt

• Ohara Kenzo,Wada Tetsuji,Moriai Shigetaka,Kanai Naoki,Harabuchi Yasuaki
• 耳鼻咽喉科臨床　補冊 138(0), 128-129, 2014
• … Most penetrating neck injuries (PNIs) in Japan involve stab wounds. … Neck injuries penetrating the platysma or sternocleidomastoid muscle are rare. … We report herein on a 27-year-old man with a direct injury of the right common carotid artery as the result of a suicide attempt, who was able to leave the hospital with no complications. …
• NAID 130004834010

• Imaging of Penetrating Injuries of the Head and Neck:Current Practice at a Level I Trauma Center in the United States

• Saito Naoko,Hito Rania,Burke Peter A.,Sakai Osamu
• The Keio Journal of Medicine 63(2), 23-33, 2014
• … Penetrating neck injuries are commonly related to stab wounds and gunshot wounds in the United States. … Based on this zonal classification system, penetrating injuries to the head and neck have traditionally been evaluated by conventional angiography and/or surgical exploration. …
• NAID 130004470995

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ウィキペディアの英語版でPenetrating head injuryという用語が挙げてありますが、そこでは、以下の意味で使われています。A penetrating head injury, or open head injury, is a head injury in which the dura mater, the outer layer of the meninges ...

• Penetrating head injury - Top Videos

1 Operative Video of Penetrating Brain Injury By Dr Anoop Singh Yadav::2013/01/08:: 2 Penetrating head injury::2014/06/13:: 3 What is a penetrating head trauma injury? | Cagle Law Firm::2013/01/04:: 4 Penetrating Neck Trauma 01 ...

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★リンクテーブル★

リンク元	「穿通性頭部外傷」「脳穿通外傷」「penetrating cranial trauma」「penetrating head trauma」「penetrating brain injury」
関連記事	「injury」「heading」「penetrating」「head」

「穿通性頭部外傷」

　　[★]

英

penetrating brain injury、penetrating head trauma、penetrating cranial trauma、penetrating head injury

関

脳穿通外傷、穿通性頭蓋外傷

「脳穿通外傷」

　　[★]

英

penetrating brain injury、penetrating head trauma、penetrating head injury

関

穿通性頭蓋外傷、穿通性頭部外傷

「penetrating cranial trauma」

　　[★]

• 穿通性頭部外傷、穿通性頭蓋外傷

関

penetrating brain injury、penetrating head injury、penetrating head trauma

「penetrating head trauma」

　　[★]

• 穿通性頭部外傷、脳穿通外傷

関

penetrating brain injury、penetrating cranial trauma、penetrating head injury

「penetrating brain injury」

　　[★]

• 穿通性頭部外傷、脳穿通外傷

関

penetrating cranial trauma、penetrating head injury、penetrating head trauma

「injury」

　　[★]

• n.

• 傷害、損傷、外傷、受傷
• wound or trauma; harm or hurt; usually applied to damage inflicted on the body by an external force.

関

damage、injure、insult、lesion、spoilage、trauma、traumatic、traumatic injury、wound

　 　 　 　 　

「heading」

　　[★]

• n.

• 頭付け。頭部、上部、正面。(ページ・章の)標題、(小)見出し。項、節。(船首などの)方向、飛行方向/方位。首切り

　 　

「penetrating」

　　[★]

• 穿通性の、貫通性の、浸透性の

関

impregnated、penetrability、penetrant、permeability、permeable、permeant

　

「head」

　　[★]

• n.

• 頭部、頭