1
|
Giovannini E, Santelli S, Pelletti G, Bonasoni MP, Innocenti M, Pelotti S, Fais P. Bicycle injuries: A systematic review for forensic evaluation. Forensic Sci Int 2024; 359:112027. [PMID: 38677158 DOI: 10.1016/j.forsciint.2024.112027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
Bicycles are employed as means of transportation across various age groups, from young students to the elderly, for work, education, health, and leisure trips. Despite not achieving high speeds, bicyclists remain vulnerable to severe and even fatal injuries when they are involved in traffic accidents. Although the rising awareness of ecological issues and traffic law enforcement mean that cyclists are increasingly susceptible to road traffic crashes and injuries. Injuries resulting from a traffic accident involving cyclists can show distinct and specific characteristics depending on the manner of occurrence. The aim of this study is to provide a systematic review of the literature on injuries sustained in cyclists involved in road accidents describing and analysing elements useful for forensic assessment. The literature search was performed using PubMed, Scopus, and Web of Science from January 1970 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about traffic accidents involving bicycles. A total of 128 studies satisfied the inclusion criteria and were categorized and analyzed according to the anatomical regions of the body affected (head, neck, thoraco-abdominal, and limb injuries), and the assessment of lesions in reconstruction of the bicycle accident was examined and discussed. This review highlights that injuries resulting from a traffic accident involving cyclists can show distinct and specific characteristics depending on the manner of occurrence and the energy levels involved in the crash. The assessment of injuries offers valuable insights that integrated with circumstantial and engineering data perform the reconstruction of accident dynamics.
Collapse
Affiliation(s)
- Elena Giovannini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna,, Via Irnerio 49, Bologna 40126, Italy
| | - Simone Santelli
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna,, Via Irnerio 49, Bologna 40126, Italy
| | - Guido Pelletti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna,, Via Irnerio 49, Bologna 40126, Italy
| | - Maria Paola Bonasoni
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna,, Via Irnerio 49, Bologna 40126, Italy.
| | - Mattia Innocenti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna,, Via Irnerio 49, Bologna 40126, Italy
| | - Susi Pelotti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna,, Via Irnerio 49, Bologna 40126, Italy
| | - Paolo Fais
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna,, Via Irnerio 49, Bologna 40126, Italy
| |
Collapse
|
2
|
Kumar S, Thanvi S, Beniwal H, Thanvi S, Singh S. Management of Eight Hand Drill Nails Induced Penetrating Brain Injury. INDIAN JOURNAL OF NEUROTRAUMA 2023. [DOI: 10.1055/s-0043-1762598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Abstract
Background Penetrating brain injury (PBI) can be caused by several objects ranging from knives to chopsticks. However, an assault with hand drill while working in a factory is a peculiar accident. Because of its rarity and lack of standard protocol management, the management of PBI is complex.
Case Presentation We presented a case of a 26-year-old male with alleged history of insertion of eight nails from a hand drill machine from right side of head while working in a factory accompanied by loss of consciousness and history of vomiting. Computer tomography demonstrated that nails passed through the right parietal bone and reached up to contralateral hemisphere and posterior cranial fossa. Removal of nails and hematoma evacuation was done timely that led the patient to have a good postoperative recovery.
Conclusion In this case report, we discussed the successful management of a very rare penetrating head injury with a hand drill machine. The goal of this case report is to demonstrate the general management principles in PBI that can improve the patient outcome.
Collapse
Affiliation(s)
- Sandeep Kumar
- Department of Neurosurgery, Mathuradas Mathur Hospital, Jodhpur, Rajasthan, India
| | - Shailesh Thanvi
- Department of Neurosurgery, Mathuradas Mathur Hospital, Jodhpur, Rajasthan, India
| | - Hemant Beniwal
- Department of Neurosurgery, Mathuradas Mathur Hospital, Jodhpur, Rajasthan, India
| | - Sharad Thanvi
- Department of Neurosurgery, Mathuradas Mathur Hospital, Jodhpur, Rajasthan, India
| | - Shelly Singh
- Department of Anaesthesia and Critical Care, Mathuradas Mathur Hospital, Jodhpur, Rajasthan, India
| |
Collapse
|
3
|
Fatal Transorbital Intracranial Penetrating Injury Due to a Bicycle Brake Handle. Am J Forensic Med Pathol 2018; 39:253-256. [PMID: 30028731 DOI: 10.1097/paf.0000000000000419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Transorbital intracranial injuries are uncommon and mostly accidental in nature. These injuries are usually associated with high mortality. The key to preventing this mortality involves an early diagnosis of intracranial injuries and immediate and appropriate management. Any delay can pose a serious risk to the patient's life. A case of a 55-year-old man who had experienced an accidental self-fall while riding a bicycle is presented. Initially, he was treated at a primary health center. He was referred to the tertiary care institute due to unavailability of ancillary investigation at the primary health center. He was declared dead on arrival at the casualty in the tertiary institute. On autopsy, it was observed that the injury above the right side of the upper eyelid was penetrating the right side roof of the orbit and the right cerebral cortex and brainstem. The highlighting feature of the case is that, despite the fatal penetrating brain injury, the eyeball did not sustain any major injury.
Collapse
|
4
|
Gopalakrishnan MS, Indira Devi B. Fatal penetrating orbitocerebral injury by bicycle brake handle. INDIAN JOURNAL OF NEUROTRAUMA 2017. [DOI: 10.1016/s0973-0508(07)80027-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractAccidental penetrating head injuries are rare but significant cause of morbidity in children. We report a case of a nine-year-old who sustained a fatal trans-orbital penetrating injury following a fall from bicycle. The plastic sheath of the metal brake handle was lodged intracranially, injuring the brainstem. The CT scan features and autopsy findings are described.
Collapse
|
5
|
Shi J, Mao Y, Cao J, Dong B. Management of screwdriver-induced penetrating brain injury: a case report. BMC Surg 2017; 17:3. [PMID: 28068964 PMCID: PMC5223301 DOI: 10.1186/s12893-016-0195-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/30/2016] [Indexed: 11/10/2022] Open
Abstract
Background Penetrating brain injury (PBI) can be caused by several objects ranging from knives to chopsticks. However, an assault with long and electric screwdriver is a peculiar accident and is relatively rare. Because of its rarity, the treatments of such injury are complex and nonstandardized. Case presentation We presented a case of a 54-year-old female who was stabbed with a screwdriver in her head and accompanied by loss of consciousness for 1 h. Computer tomography (CT) demonstrated that the screwdriver passed through the right zygomatic bone to posterior cranial fossa. Early foreign body removal and hematoma evacuation were performed and the patient had a good postoperative recovery. Conclusions In this study, we discussed the clinical presentation and successful management of such a unique injury caused by a screwdriver. Our goal is to demonstrate certain general management principles which can improve patient outcomes.
Collapse
Affiliation(s)
- Jia Shi
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, 213003, China
| | - Yumin Mao
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, 213003, China
| | - Jiachao Cao
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, 213003, China
| | - Bo Dong
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, 213003, China.
| |
Collapse
|
6
|
Poroy C, Cibik C, Yazici B. Traumatic Globe Subluxation and Intracranial Injury Caused by Bicycle Brake Handle. ARCHIVES OF TRAUMA RESEARCH 2016; 5:e33405. [PMID: 27800464 PMCID: PMC5078721 DOI: 10.5812/atr.33405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 10/05/2015] [Indexed: 11/16/2022]
Abstract
Introduction Case Presentation Conclusions
Collapse
Affiliation(s)
- Ceren Poroy
- Department of Ophthalmology, Uludag University, Bursa, Turkey
| | - Cansu Cibik
- Department of Ophthalmology, Uludag University, Bursa, Turkey
| | - Bulent Yazici
- Department of Ophthalmology, Uludag University, Bursa, Turkey
- Corresponding author: Bulent Yazici, Department of Ophthalmology, Uludag University, Bursa, Turkey. Tel: +90-2242952415, Fax: +90-2444428070, E-mail:
| |
Collapse
|
7
|
Bone beveling caused by blunt trauma: a case report. Int J Legal Med 2015; 130:771-5. [PMID: 26585737 DOI: 10.1007/s00414-015-1293-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
Abstract
The authors report a fatal case of blunt trauma to the skull caused by a rib of a beach umbrella. The skull displayed a round hole in the right temporal bone with typical internal beveling. Blunt trauma mimicking a gunshot wound (round perforation of the skull with internal beveling) is very rarely reported in the forensic literature.
Collapse
|
8
|
Agrawal A, Reddy VU, Kumar SS, Hegde KV, Rao GM. Transorbital Orbitocranial Penetrating Injury with an Iron Rod. Craniomaxillofac Trauma Reconstr 2015; 9:145-8. [PMID: 27162571 DOI: 10.1055/s-0035-1551545] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/31/2015] [Indexed: 10/23/2022] Open
Abstract
Transorbital orbitocranial penetrating injuries (TOPIs) are relatively rare, can be caused by high-speed projectile foreign bodies to low-energy trauma (which is rarer), and account for 24% of penetrating head injuries in adults and approximately 45% in children. We report an uncommon nonfatal case of TOPI where a 16-year-old male child sustained injury due to accidental penetration of metal bar into the forehead. A bicoronal flap was raised to remove the metal bar. The patient recovered well, had normal vision, and doing well at follow-up.
Collapse
Affiliation(s)
- Amit Agrawal
- Department of Neurosurgery, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
| | - V Umamaheswara Reddy
- Department of Radiology, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - S Satish Kumar
- Department of Emergency Medicine, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - Kishor V Hegde
- Department of Radiology, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - G Malleswara Rao
- Department of Neurosurgery, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
| |
Collapse
|
9
|
Instantaneous death due to transorbital reverse penetration of a screw in an accidental fall: unusual autopsy case report and review of the literature. Am J Forensic Med Pathol 2014; 35:15-9. [PMID: 24457588 DOI: 10.1097/paf.0000000000000079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a peculiar autopsy case of a transorbital penetrating head injury, in a male worker, after an accidental fall onto a screw not completely stuck into a wooden board. A 13-cm screw entered the cranium 9.5 cm deep, penetrating with the flat end, a condition defined in literature as "reverse penetration." The death was instantaneous and caused by a neurogenic shock due to injuries to the brain stem and the right cerebellar hemisphere. These injuries, enabled by the length of the screw, are generally described in literature as due to nontransorbital penetrations, frequently associated with posterior entry and a large intracranial injury. The ocular globe has been, furthermore, perfectly preserved thanks to its mobility in the orbit. Even the dynamic of the incident is peculiar because of the stationary nature of the penetrating object, which the victim actively fell on by accident. To the best of our knowledge, the matter is therefore a very peculiar mortal case of transorbital intracranial penetration, whose verified injuries and dynamics are absolutely atypical. The case is now under discussion, and a review of pertinent literature is performed.
Collapse
|
10
|
Huiszoon WB, Noë PN, Manten A. Fatal transorbital penetrating intracranial injury caused by a bicycle hand brake. Int J Emerg Med 2012; 5:34. [PMID: 22989177 PMCID: PMC3517487 DOI: 10.1186/1865-1380-5-34] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 08/14/2012] [Indexed: 11/10/2022] Open
Abstract
A transorbital penetrating intracranial injury is a rare and severe traumatic brain injury. Patients with this type of injury may present dramatically, but often the injury is subtle and therefore easily overlooked and not recognized in the first place. We present the case of a 45-year-old female admitted to the emergency department after she fell with her bike and the bicycle brake handle penetrated her left eye. A computerized tomography of the cerebrum showed a fracture of the superior orbital roof with multiple bone fragments extending into the brain near the circle of Willis. A pneumocephalus and traumatic frontobasal, intraventricular and subdural hemorrhage was seen. The patient deteriorated suddenly and was transferred to a neurosurgical center where she underwent an emergency craniotomy with evacuation of the intracerebral hematoma and an intraventricular drain was placed. After surgery, the patient's condition deteriorated, and total compression of the brain stem occurred, upon which the patient was declared brain dead. Our case report shows that the Glasgow Coma Scale score at admission is not always a good predictor of the severity of the injury. Even when there is minimal suspicion of a penetrating intracranial injury, a computerized tomography should be performed immediately, independent of the patient's Glasgow Coma Scale score. A direct transfer to a specialized neurosurgical center is recommended because this injury often results in death due to fatal complications such as intracerebral hemorrhage, pneumocephalus and brain stem injury.
Collapse
Affiliation(s)
- Willemijn B Huiszoon
- Department of Critical Care, Meander Medical Center, Utrechtseweg 160, Amersfoort, ES 3818, the Netherlands.
| | | | | |
Collapse
|
11
|
Chattopadhyay S, Sukul B, Das SK. Fatal transorbital head injury by bicycle brake handle. J Forensic Leg Med 2009; 16:352-3. [PMID: 19573849 DOI: 10.1016/j.jflm.2009.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Accepted: 01/14/2009] [Indexed: 12/12/2022]
Abstract
Accidental transorbital head injuries are quite rare. Penetrating head injuries by blunt objects are possible when the site of penetration is through the orbit or the thin temporal bone. The present case is a rare case of transorbital penetrating head injury by a blunt object - bicycle brake handle. Minor external wounds may be misleading and fatal consequences may ensue if cerebral damage is missed on diagnosis. Proper antibiotic coverage to prevent meningitis and neurosurgical intervention can reduce mortality in such cases.
Collapse
Affiliation(s)
- Saurabh Chattopadhyay
- Department of Forensic and State Medicine, Bankura Sammilani Medical College, Bankura, West Bengal, India.
| | | | | |
Collapse
|
12
|
Agrawal A, Pratap A, Agrawal CS, Kumar A, Rupakheti S. Transorbital orbitocranial penetrating injury due to bicycle brake handle in a child. Pediatr Neurosurg 2007; 43:498-500. [PMID: 17992039 DOI: 10.1159/000108794] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Accepted: 10/01/2006] [Indexed: 11/19/2022]
Abstract
Transorbital orbitocranial penetrating injuries (TOPI) are relatively rare and can be caused by a variety of unusual objects. Diagnosis of TOPI should be based on a detailed history and evaluation of available investigations as the penetrating injury may be overlooked. In the present case, a child sustained a penetrating injury with the brake handle of a bicycle due to the accidental fall of the bicycle on him and was managed conservatively.
Collapse
Affiliation(s)
- Amit Agrawal
- Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
| | | | | | | | | |
Collapse
|