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At least 37 records · Page 2Linked to original sources
PubMed1977

[Pulmonary contusion after blunt chest trauma--an experimental model (author's transl)].

A model in the rat for pulmonary contusion after blunt chest trauma is described. It is possible to avoid trauma of the mediastinal organs, liver and spleen; therefore it is possible to produce pulmonary contusion with a good reproducebility. The parameter for the extent of contusion was the lungweight which rose statistically with a specific force of trauma. Simultaneous injection of high doses of prednisolone with the blunt chest trauma inhibits the increase of the lung weight.

Animals↗
PubMed1979

The role of coronary artery injury and perfusion in the development of cardiac contusion secondary to nonpenetrating chest trauma.

Myocardial contusion secondary to nonpenetrating chest trauma can occur in the absence of any identifiable large vessel coronary artery occlusion or injury. It has also been reported in association with coronary artery atheromata, thrombosis, rupture, and fistula formation. After reviewing the clinical and experimental research literature, we conclude that myocardial contusion necrosis results from changes in perfusion of small vessels and the coronary microvasculature. Coronary arteriography and emergency coronary artery bypass surgery do not appear promising as therapeutic modalities to reduce myocardial necrosis in this condition. More appropriate therapeutic emphasis may result from research efforts to develop pharmacologic interventions to preserve contused myocardium similar to those currently being evaluated in the management of patients with ischemic myocardium secondary to coronary artery disease.

Adolescent↗
PubMedDate not supplied

Quadriceps contusions. West Point update.

A 3 year study of 117 quadriceps contusions in West Point cadets was undertaken to document the effectiveness of a three-phased therapy program to return these young athletes to full activity with a normal knee range of motion and without recurrence of injury. The treatment protocol of this study was modeled after the 1973 West Point study of Jackson and Feagin with two major changes: 1) resting the injured leg in flexion (versus extension) and 2) emphasizing early flexion exercises (versus extension). Classification of contusions was based on knee range of motion at 12 to 24 hours after the injury (mild, greater than 90 degrees; moderate, 45 degrees to 90 degrees; severe, less than 45 degrees). The average disability time was 13 days for mild, 19 days for moderate, and 21 days for severe contusions. Myositis ossificans developed in 9% of cadets and was associated with five risk factors (knee motion less than 120 degrees, injury occurring during football, previous quadriceps injury, delay in treatment greater than 3 days, and ipsilateral knee effusion.

Adolescent↗
PubMedDate not supplied

[Problems of treatment of contusions and dislocations of the brain].

The clinical course and prognosis in the event of a severe cerebrocrainial trauma depend, above all, on the extent of the contusion and smashing of the brain sustained. The pathogenetic factor of prime importance determining the severity of the contusion is the development of the local and general cerebral edema. Rapidly accuring edema and turgescence of the brain, rising intracranial pressure lead to the dislocation of the brain attended by a clinical picture of a grave secondary lesion of the brain stem. To eliminate or prevent the emergence of the dislocation syndrome an operative removal of the primary contusion focus and concussory treatment of the brain in combination with the pathogenetic conservative therapy, aimed at preventing further progressive edema of the brain, are indicated in some of such patients.

Brain Edema↗
PubMed1977

[Inversion of intraheptic portal flow in contusions of the liver: a new concept of traumatic arterioportal fistulas (author's transl)].

Inversion of the intrahepatic flow is a phenomenon commonly observed during the initial days of a liver contusion. Its symptomatology combines one direct sign: segmentary, peripheral arterioportal reflux; and two indirect signs: arteriolar hypervascularization and a functional amputation of portal flow on selective arteriography of the superior mesenteric artery in the same territory. The direct sign may be absent, and may not be visualized in the absence of a selective injection. Both indirect signs are always present and enable the diagnosis. In most cases it is a question of a transient phenomenon secondary to a inflammatory reaction released by the contusion of the liver parenchyma; it may be the only sign of liver trauma. It may be a sign of a benign contusion and is not alone an indication for surgery. This concerns a hemodynamic phenomenon which must be clearly differentiated from arterioportal fistulas with which it is often confused.

Adult↗
PubMed1978

Myocardial contusion: effect of intra-aortic balloon counterpulsation on cardiac output.

Intra-aortic balloon counterpulsation (IABCP) improves impaired left ventricular (LV) performance associated with myocardial ischemia. We have evaluated the effect of IABCP on cardiac output (CO) after blunt trauma to the heart where LV performance is impaired by myocardial contusion but coronary blood flow is normal. Contusion of 20 to 40% of the LV in 13 dogs decreased CO by 41% +/- 6.4. A 30-minute period of IABCP was followed by 30 minutes without IABCP with three assist periods in each animal unless death occurred. Immediate IABCP after injury in six dogs increased CO 14% +/- 3.8 (p less than 0.01). Treatment was delayed for 30 minutes in seven dogs, and CO further decreased 0.7% +/- 3.2; initiation of IABCP then increased CO 9.2% +/- 6.5 (p less than 0.05). When CO was decreased less than 25% or greater than 50% after injury, IABCP had no effect on CO. In midrange when CO decreased 25 to 50%, IABCP increased CO 12.5% +/- 3.2 (p less than 0.001 initially, 9.3% +/- 1.3 (p less than 0.005) with second assist, and third assist 5.6% +/- 2(NS). It is concluded that IABCP improves LV performance following myocardial contusion, especially when applied early after injury.

Animals↗
PubMed1992

Evidence that local non-NMDA receptors contribute to functional deficits in contusive spinal cord injury.

To investigate the role of non-N-methyl-D-aspartate (non-NMDA) types of excitatory amino acid (EAA) receptors in traumatic spinal cord injury, we administered 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo(F)-quinoxaline (NBQX), a potent and specific antagonist of non-NMDA receptors, to rats with a standardized contusive spinal cord injury. Focal infusion of NBQX into the injury site significantly reduced long-term hindlimb functional deficits as well as decreasing the time required for the rats to establish a reflex bladder. The results suggest that non-NMDA receptors at or near the injury site are involved in producing a portion of the functional deficits that result from contusive spinal cord injury.

Animals↗
PubMed1992

Forelimb motor performance following cervical spinal cord contusion injury in the rat.

The purpose of this study was to examine the degree, persistence, and nature of forelimb behavioral deficits following cervical spinal cord contusion injury in the rat. Forelimb reaching and pellet retrieval, forehead adhesive sticker removal, and vibrissae-induced forelimb placing were examined for 16 weeks following a weight-drop injury (10.0 g-2.5 cm) at the C4-C5 spinal level. Nine of 13 rats studied were unable to perform the pellet retrieval task due to pronounced forelimb extension hypometria. However, these animals did carry out the forehead sticker removal and vibrissae-induced placing tasks. Therefore, the loss of reaching ability related to pellet retrieval was not due to generalized paralysis. This interpretation was further supported by evaluation of the rostrocaudal extent of relative motoneuron loss from 1-mm divisions through the lesion zone. The extent of motoneuron pathology ranged from 2 to 6 mm but was largely confined to the C4-C5 spinal segments. Morphometric assessments of axonal sparing revealed that pellet retrieval performance during the last month of observation was significantly correlated with fiber sparing in the dorsal columns and ventral white matter, whereas no significant correlation could be demonstrated with regard to dorsolateral white matter. While there were no conspicuous differences in qualitative assessments of damage to interneuron pools (i.e., laminae V to VII) between the nonreaching and retrieval-recovered rats, the possibility of combined white and gray matter pathology contributing to this deficit still exists. These initial findings thus demonstrate that the weight-drop contusion injury model can be adopted to studies of cervical spinal cord trauma in the rat. Such lesions yield permanent deficits in forelimb function lending to future studies of possible therapeutic interventions. Furthermore, performance deficits observed at 1 week postinjury in the placing and forehead sticker removal tasks can be predictive of any potential for long-range spontaneous recovery in pellet retrieval ability.

Animals↗
PubMed1992

Fetal grafts alter chronic behavioral outcome after contusion damage to the adult rat spinal cord.

In the present experiments, we have examined the capacity of intraspinal transplants to effect alterations in certain locomotor behaviors after spinal contusion injuries. An electromechanical impactor that was sensitive to tissue biomechanical characteristics was used to produce rapid (20 ms) compression injuries to the thoracic spinal cord (T8). Suspensions of fetal spinal tissue (14-day) were placed at 10 days postinjury into the intraspinal cavity created by these reproducible spinal injuries. In the pre- and postinjury period, a number of general and sensitive motor behaviors were used to characterize the immediate and long-term progress of hindlimb behavioral recovery over an extended period of time (73 days). Our data reveal that a lasting alteration in some motor behaviors can be achieved by suspension grafts. While little improvement in some generalized motor tasks (inclined plane analysis, grid walking) takes place, fetal transplants precipitate a rapid and enduring change in certain motivated fine motor behaviors (gait analysis). The base of support and stride length of the hindlimbs were improved by 7 days post-transplantation and the effect was stable over time. The angle of rotation was, however, not altered. The lasting effect in two gait parameters noted was accompanied by the presence of well-developed spinal grafts that often fused with the host spinal parenchyma. These results provide the first documentation of an influence of fetal transplants on motivated locomotor capacity in a well-characterized spinal injury model that mimics lesions seen in the contused adult human spinal cord.

Animals↗
PubMed1978

Ureteral contusion and delayed necrosis from gunshot injury.

The blast effect surrounding the path of a gunshot wound near the ureter can cause ureteral contusion with hematuria, no extravasation on the intravenous pyelogram, and an intact ureter found at laparotomy. Subsequent progression of the ureteral contusion to delayed necrosis and urine leakage can occur.

Contusions↗
PubMed1977

Use of the intra-aortic balloon support for refractory low cardiac output in myocardial contusion.

A patient with refractory low cardiac output and recurring ventricular arrhythmias resulting from myocardial contusion was treated with intra-aortic balloon counterpulsation. Use of the intra-aortic balloon resulted in an increased cardiac output and control of the ventricular arrhythmias. After 1 year the patient shows no sequelae of myocardial contusion, although he is still paraplegic.

Assisted Circulation↗
PubMed1992

The clinical significance of myocardial contusion.

In an attempt to identify a group of blunt trauma victims with asymptomatic myocardial contusion (MC) who do not benefit from intensive cardiac monitoring, we prospectively divided 336 patients admitted to the SICU with possible MC following blunt trauma in the 6 years prior to January 1990 into three groups: Group 1 (n = 155, age 30.5 +/- 9 years) consisted of those patients admitted for mechanism of injury, J-point elevation, with or without minor chest injury. None developed arrhythmias. Their SICU length of stay (LOS) was 2.41 +/- 0.77 days. Group 2 (n = 43, age 31.5 +/- 10 years) patients had the same admission criteria as the patients in group 1 plus an abnormal emergency department ECG, i.e., arrhythmia, heart block, ischemia. None had cardiac complications. Their SICU LOS was 2.47 +/- 0.94 days. Group 3 (n = 138, age 40 +/- 20 years) patients had four or more rib fxs, a pulmonary contusion, a flail chest, or extra-thoracic injuries or were greater than 60 years of age. All required SICU admission for their non-cardiac injuries. Nineteen patients had cardiac complications requiring treatment. None had a cardiac death. Their SICU LOS was 10 +/- 22 days. We conclude that young patients with minor blunt thoracic trauma and a normal or minimally abnormal ECG do not benefit from cardiac monitoring.

Adult↗
PubMed1975

A new method of diagnosing myocardial contusion in man by radionuclide imaging.

A new method of diagnosing myocardial contusion was studied in 8 patients in whom the injured mycardium was visualized as an abnormal area of increased activity in the region of the heart one hour after intravenous injection of 10 mCi of 99m-Tc-Sn-polyphosphate or pyrophosphate. Serum enzymes in these patients were elevated, but electrocardiograms were nonspecific for myocardial injury. It is hoped that this new technique of imaging the injured myocardium will provide specific and confirmatory diagnosis of myocardial contusion associated with closed chest injuries.

Animals↗
PubMed1975

Coronary angiographic and scintigraphic findings in experimental cardiac contusion.

Clinical, angiographic, scintigraphic and pathologic observations in myocardial contusion were correlated. Radionuclide imaging of the injured heart with 99mTc-Sn-polyphosphate provides an accurate diagnosis in acute, even mild, myocardial contusion. The study can be carried out without danger to the critically ill patient. The coronary angiographic findings in this study explain what is occurring pathologically in the heart. Since arteriography is a more invasive technique than radionuclide imaging, its use is recommended only when the image is negative if it is neccessary to establish the clinical diagnosis for treatment or when more than one week has elapsed since the injury.

Acute Disease↗
PubMed1977

Repeat angiography in temporal contusions.

In the diagnosis of a temporal contusion bilater filling of the Sylvian vessels permits adequate comparison between the two sides. Such a comparison is important since even at a large contusion with marked upward or medial displacement of the Sylvian vessels no corresponding shift of the midline structure may exist in the acute stage. With increasing interval between trauma and angiography a shift may develop reflecting the true size of the lesion.

Cerebral Angiography↗
PubMed1978

Computer tomography of the brain and spectrophotometry of the CSF in cerebral concussion and contusion.

Computer tomography (CT) and spectrophotometry of CSF were performed in 30 patients with the clinical diagnosis of cerebral concussion or contusion. The patients with concussion all had normal CT-findings. Spectrophotometry of CSF was sometimes positive for cerebral contusion with normal CT-findings, but the two methods were complementary so that the extent of the lesion was determined by CT and spectrophotometry of CSF indicated the cause.

Brain Concussion↗
PubMed1977

Imaging of experimental myocardial contusion: observations and pathologic correlations.

Myocardial contusions of variable severity were experimentally produced by an air-driven piston or serrated clamp in 29 dogs. Two 99mTc-labeled bone-seeking agents (99mTc pyrophosphate and 99mTc tetracycline) were used with cardiac scintigraphy to determine the sensitivity of these agents in detecting different degrees of myocardial damage. Results showed that 99mTc tetracycline was not a suitable scanning agent. 99mTc pyrophosphate produced positive scans in cases of complete (or nearly complete) transmural myocardial necrosis. Positive cardiac scans in clinical myocardial contusion may indicate the severity of the lesions and have prognostic significance.

Animals↗