Timing of Craniotomy in a Patient With Multiple Trauma Including Head Injury
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概要
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A 7-year-old boy suffered blunt multiple injuries to the head, face, chest, and abdomen in a motor vehicle accident. On admission he had impaired consciousness and dyspnea. Radiographic studies revealed facial fracture and pulmonary contusion. Shortly after admission, he fell into shock due to intraabdominal bleeding. Laparotomy revealed spleen rupture. His vital signs remained unstable and bloody drainage from the abdominal cavity continued after surgery. Computed tomography showed traumatic intracerebral hematoma in the right temporal lobe, enlarging and compressing the brainstem. Abdominal reoperation was performed first to control the bleeding and stabilize the hemodynamics, disclosing renal laceration. Then evacuation of the intracerebral hematoma and decompressive craniectomy was performed. Postoperatively, his hemodynamics were stabilized. Clinical course was uneventful and neurological deficits gradually improved. Three months after the trauma, the patient was discharged on foot. This case emphasizes the importance of hemodynamic stability in decisions of neurosurgical indication and timing in patients with multiple trauma including head injury.
- 2009-01-15
著者
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Kamei Ichiro
Department of Forest and Forest Products Sciences, Faculty of Agriculture, Kyushu University
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Kamei Ichiro
Department Of Neurosurgery Japanese Red Cross Society Wakayama Medical Center
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Kamei Ichiro
Department Of Forest And Forest Products Sciences Faculty Of Agriculture Kyushu University
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Itakura Toru
Department of Neurological Surgery, Wakayama Medical University
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Fukai Junya
Department Of Neurosurgery Japanese Red Cross Society Wakayama Medical Center:department Of Neurolog
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Fukai Junya
Department Of Neurological Surgery Wakayama Medical University
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Itakura Toru
Department Of Neurological Surgery Wakayama Medical University School Of Medicine
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Itakura Toru
Department Of Neurological Surgery Wakayama Medical College
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Yoshimura Ryo
Department Of Neurosurgery Japanese Red Cross Society Wakayama Medical Center
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TSUJIMOTO Toshihide
Department of Critical Care Medicine, Japanese Red Cross Society Wakayama Medical Center
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RAIMURA Masaki
Department of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center
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KUWATA Toshikazu
Department of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center
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HYOTANI Genhachi
Department of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center
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YABUMOTO Michio
Department of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center
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Yabumoto Michio
Department Of Neurological Surgery Wakayama Medical College
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Yabumoto Michio
Department Of Neurosurgery Japanese Red Cross Society Wakayama Medical Center
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Hyotani Genhachi
Department Of Neurosurgery Japanese Red Cross Society Wakayama Medical Center
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Hyotani Genhachi
Department Of Neurological Surgery Wakayama Medical College
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Kuwata Toshikazu
Department Of Neurological Surgery Wakayama Medical College
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Kuwata Toshikazu
Department Of Neurological Surgery Hidaka General Hospital
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Kuwata Toshikazu
Department Of Neurosurgery Japanese Red Cross Society Wakayama Medical Center
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Tsujimoto Toshihide
Department Of Critical Care Medicine Japanese Red Cross Society Wakayama Medical Center
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Hyotani Genhachi
Deportment Of Neurosurgery Japanese Red Cross Society Wakayama Medical Center
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Raimura Masaki
Department Of Neurosurgery Japanese Red Cross Society Wakayama Medical Center
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Kamei Ichiro
Department Of Forest And Environmental Sciences Faculty Of Agriculture University Of Miyazaki
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KAMEI Ichiro
Department of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center
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