Case Report of International Journal of Case Reports
Case of severe head trauma caused by a car accident
Liliana Dragomir1*; Virginia MARINA2; Mihaela Anghele3
1MD. Liliana DRAGOMIR, CLINICAL-MEDICAL Department, « Dunarea de jos » University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania.
2PH.D. Virginia MARINA, MEDICAL Department of Occupational Health, « Dunarea de jos » University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania.
3MD. Mihaela ANGHELE, CLINICAL-MEDICAL Department, « Dunarea de jos » University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania.
According to the literature, the term “poly-trauma” was first used by Tscherne et.al, in 1966 for patients who demonstrated a combination of at least two “severe head, chest or abdominal injuries” or “one of them in association with an extremity injury. Trauma, despite all efforts to control its impact, is now a recurrent cause of high incidence of mortality and morbidity worldwide. Studies show that road traffic injuries are currently the leading cause of death among people aged between 1 and 45-years old. Only 21 countries in the WHO (World Health Organization), European Region have implemented legislative changes regulating drink-driving, with blood alcohol test limits varying between ≤0.02 g/dl and ≤0.05 g/dl.
INTRODUCTION: It is well known that poly-trauma is a challenge for the clinician, regardless of specialization. In this regard, we wanted to present this case to raise an alarm on the approach to poly-trauma, which involves, in addition to the pre-hospital, hospital and follow-up stages, the follow-up of victims after discharge, in an attempt to identify possible causes of death and their prevention.
CASE PRESENTATION: In this clinical case, we present the outcome of a 44-year-old patient who presented to the emergency room with multiple trauma injuries resulting from a road traffic accident. During her admission to the neurosurgery department of the Emergency “Sfântul Apostol Andrei”, Clinical Hospital of Galati, the patient underwent numerous clinical and imaging investigations, which provided findings statistically associated with increased mortality and morbidity rates.
CONCLUSION: The management of patients presenting with poly-trauma is continuous, dynamic and extremely challenging in terms of the staff involved, the multidisciplinary team that will monitor the patient’s progress. All this is a goal that can only be achieved through good interdisciplinary and inter-hospital communication, providing standards of care and quality-oriented cooperation, increasing efficiency through the use of existing resources, regulating the financial aspects of inter-hospital transfers, cooperating in a common system of continuous training.
Keywords: Poly-trauma, traumatic brain injury, multiple fracture sites, Bronchopneumonia, Pulmonary contusions
How to cite this article:
Liliana Dragomir; Virginia MARINA; Mihaela Anghele. Case of severe head trauma caused by a car accident. International Journal of Case Reports, 2021; 5:220. DOI: 10.28933/ijcr-2021-05-2905
1. Border, J., LaDuca, J. and Seibel, R., 1975. Priorities in the management of the patient with polytrauma. Prog. Surg., 14, pp.84-120.
2. Kroupa, J., 1990. K definici polytraumatu a polytraumatismu [Definition of “polytrauma” and “polytraumatism”]. Acta Chir Orthop Traumatol Cech, 57(4), pp.347-360.
3. Oestern, H., Regel, G., Tscherne, H. and Regel, G., 1997. ” Klinische Behandlung Des Schwer- verletzten” Unfallchirurgie: Trauma Management. Chapter 9, Berlin, Heidelber, New York : Springer, pp.225-238.
4. Boyd, C., Tolson, M. and Copes, W., 1987. Evaluating trauma care: The TRISS method. Trauma Score and the Injury Severity Score. J. Trauma, 27, pp.370-378.
5. Sikand, M., Williams, K., White, C. and Moran, C., 2005. The financial cost of treating polytrauma: Implications for tertiary referral centres in the United Kingdom. Injury, 36, pp.733-737.
6. McLain, R., 2004. Functional outcomes after surgery for spinal fractures: Return to work and activity. 7. Spine 29, 470–47, 29, pp.470-547.
7. Road accident fatalities – statistics by type of vehicle – Statistics Explained, 2020.
8. Bruns J, Jr, Hauser WA. The epidemiology of traumatic brain injury: A review. Epilepsia. 2003 ;44 :2–10. [PubMed] [Google Scholar]
9. Thurman DJ, Alverson C, Dunn KA, et al. Traumatic brain injury in the United States: A public health perspective. J Head Trauma Rehabil. 1999; 14:602–15. [PubMed] [Google Scholar]
10. Ruchholtz, S., Ulrike, L., Debus, F., Mand, C., Siebert, H. and Kuhne, C., 2014. Trauma- Netzwerk DGU1: Optimizing patient flow and management. Injury, Int. J. Care Injured, 45, pp.89-92.
11. Lefering, R., Paffrath, T., Bouamra, O., Coats, T., Woodford, M., Jenks, T., Wafaisade, A., Nienaber, U. and Lecky, F., 2012. Epidemiology of in-hospital trauma deaths. 2012 Feb;38(1):3-9. Eur J Trauma Emerg Surg, 38(1), pp.3-9.
12. Sturm, J., Pape, H. and Dienstknecht, T., 2013. Trauma care in Germany: an inclusive system. Clin Orthop Relat Res, 471(9), pp.2912-2923.
13. Patton, G., Coffey, C., Sawyer, S., Viner, R., Haller, D., Bose, K. and et al, 2009. Global patterns of mortality in young people: a systematic analysis of population health data. The Lancet, 374(9683), pp.881-892.
14. Mergoni, M, Saccani A, Salvadori A, Grattag- liando C, Paglari S, Bertone L, Peumonia in severe head injury. A prospective study. Minerva – Anesthesial, 1993, apr., 59/4, p. 187-192.
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