著者

Takashi Araki Masato Miyauchi Makoto Suzaki Taro Wakakuri Sonoko Kirinoki Naoko Onodera Taro Saigusa Akihiro Takana Hideya Hyodo Toshihiko Ohara Makoto Kawai Masahiro Yasutake Hiroyuki Yokota

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.82, no.6, pp.295-299, 2015-12-15 (Released:2016-01-27)

参考文献数

10

被引用文献数

1

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Objective: Current data indicate that the rate of trauma in children during gymnastic formation is increasing, especially while creating a structure with a certain height, such as the human pyramid. The goal of the present study was to clarify the clinical characteristics of these injuries. Methods: In this single-institution review, all children treated for a gymnastic formation-related injury at Nippon Medical School Hospital from 2013 through 2015 were identified through the institution's registry. The injury mechanism was classified, and injury severity, interventions, and outcome were examined. Results: Eight children were treated for a gymnastic formation-related injury. They were 7 boys and 1 girl aged 10 to 15 years (mean age, 13.1±1.8 years). Neurotrauma ranging from concussion to spinal cord injury without radiographic abnormality occurred in 6 patients (75%). No intracranial hemorrhagic lesions were detected. The Glasgow Coma Scale score on arrival was 15 in all 8 patients, and neurological deficits were present in 1 patient. No patient required surgical intervention. All patients made a full recovery after discharge from the hospital. No patients died. The average follow-up period was 2.1±0.9 weeks. Conclusions: Neurotrauma is a frequent result of gymnastic formation accidents in children. Healthcare workers and teachers should recognize this type of injury, and public education that targets parents should be introduced.

著者

Ryuta NAKAE Yasuo MURAI Yasuhiro TAKAYAMA Kaoru NAMATAME Yoshiyuki MATSUMOTO Takahiro KANAYA Yu FUJIKI Hidetaka ONDA Go SUZUKI Junya KANEKO Takashi ARAKI Yasutaka NAOE Hidetaka SATO Kyoko UNEMOTO Akio MORITA Hiroyuki YOKOTA Shoji YOKOBORI

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.2022-0226, (Released:2022-10-13)

参考文献数

37

被引用文献数

6

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Coagulopathy, a common complication of traumatic brain injury (TBI), is characterized by a hypercoagulable state developing immediately after injury, with hyperfibrinolysis and bleeding tendency peaking 3 h after injury, followed by fibrinolysis shutdown. Reflecting this timeframe, the coagulation factor fibrinogen is first consumed and then degraded after TBI, its concentration rapidly decreasing by 3 h post-TBI. The fibrinolytic marker D-dimer reaches its maximum concentration at the same time. Hyperfibrinolysis in the acute phase of TBI is associated with poor prognosis via hematoma expansion. In the acute phase, the coagulation and fibrinolysis parameters must be monitored to determine the treatment strategy. The combination of D-dimer plasma level at admission and the level of consciousness upon arrival at the hospital can be used to predict the patients who will "talk and deteriorate." Fibrinogen and D-dimer levels should determine case selection and the amount of fresh frozen plasma required for transfusion. Surgery around 3 h after injury, when fibrinolysis and bleeding diathesis peak, should be avoided if possible. In recent years, attempts have been made to estimate the time of injury from the time course of coagulation and fibrinolysis parameter levels, which has been particularly useful in some cases of pediatric abusive head trauma patients.