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
|
Abstract
ABSTRACT Rubber bullets have long been known to cause, on rare occasions, traumatic brain injury (TBI). However, neurosurgical literature on this occurrence is limited, and no focused review of this injury pattern has been conducted. The authors present the case of a 28-year-old male struck by a rubber bullet in the left periorbital region, causing TBI in addition to complete left visual loss and complex facial fractures. After developing a cerebrospinal fluid (CSF) leak, the patient was taken to the operating room for combined neurosurgical-craniofacial intervention. Utilizing frameless intraoperative computation tomography navigation assistance, a successful repair was made of both the patient's CSF leak and complex craniofacial injuries. TBI due to a rubber bullet is a rare but severe occurrence. Unfortunately, much of the limited literature on this topic is bereft of demographic, clinical course, injury pattern, and imaging data. Presented here is the first operative case report of TBI due to a rubber bullet. Volume rendered imaging is provided to demonstrate the extent of trauma incurred. Additionally, a methodology for frameless intraoperative computation tomography navigation assistance is shared for consideration, as it served as a helpful adjunct for a combined intracranial-craniofacial surgical repair. The experience of treating the patient's traumatic CSF leak in the context of severe craniofacial and ophthalmologic injuries highlights the need for a multidisciplinary surgical approach that may arise when treating patients with TBI due to a rubber bullet.
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
|
Rzaev DA, Danilin VE, Letyagin GV, Istomina TK, Chishchina NV. [Penetrating orbitocranial injury: a review of the literature and a case report of injury by a watercolor brush in a 3-year-old child]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2017; 81:77-87. [PMID: 28524129 DOI: 10.17116/neiro201781277-87] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We present a rare case of orbitocranial penetrating injury by a watercolor brush in a 3-year-old child. Injuries of this localization can affect important orbital structures (eyeball, blood vessels, nerves, muscles) and cause severe intracranial damages. In some cases, diagnosis of these injuries in children may be difficult due to the lack of marked clinical manifestations. The presented clinical case illustrates the approaches for choosing methods for diagnosis of injury in childhood and subsequent treatment options.
Collapse
Affiliation(s)
- D A Rzaev
- Federal Center of Neurosurgery, Novosibirsk, Russia
| | - V E Danilin
- Federal Center of Neurosurgery, Novosibirsk, Russia
| | - G V Letyagin
- Federal Center of Neurosurgery, Novosibirsk, Russia
| | - T K Istomina
- Federal Center of Neurosurgery, Novosibirsk, Russia
| | | |
Collapse
|
5
|
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
|
6
|
Sarkar S, Modi S, Seth AK, Panja S. An Unusual Transorbital Penetrating Injury by House-key (lock): A Case Report with a Small Review of Literature. J Clin Diagn Res 2015; 9:PD08-9. [PMID: 26500948 DOI: 10.7860/jcdr/2015/14257.6434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 07/25/2015] [Indexed: 11/24/2022]
Abstract
Penetrating injuries of the brain are quite uncommon, comprising approximately 0.4% of all head injuries. In our case, a four-year-old boy who fell forward on a house-key (lock) accidentally while playing with some other children sustained a left sided penetrating transorbital brain injury. After hospital admission, the patient had a Glasgow Coma Scale (GCS) score of 15/15, no visual loss but restriction of upward gaze (left eye) and profuse bleeding from the wound site. Firstly, the metallic key was removed in emergency operation theatre and haemostasis secured. Next day we did a combined surgical approach with neurosurgeons, Eye-surgeons and general surgeons after having CT scan report. We report this case because penetrating head injury is rare and transorbital penetrating head injury is even rarer and a predicament in emergency surgical practice with controversial management.
Collapse
Affiliation(s)
- Santanu Sarkar
- Clinical Tutor, Department of General Surgery, Burdwan Medical College & Hospital , West Bengal, India
| | - Sandeep Modi
- PG Resident, Department of General Surgery, Burdwan Medical College & Hospital , West Bengal, India
| | - Arup Kumar Seth
- PG Resident, Department of General Surgery, Burdwan Medical College & Hospital , West Bengal, India
| | - Soumyajyoti Panja
- PG Resident, Department of General Surgery, Burdwan Medical College & Hospital , West Bengal, India
| |
Collapse
|
7
|
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
|
8
|
Agrawal A. Trans-orbital penetrating head injury. INDIAN JOURNAL OF NEUROTRAUMA 2014. [DOI: 10.1016/j.ijnt.2014.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
9
|
Transorbital stab injury with retained knife: a narrow escape. Case Rep Crit Care 2014; 2014:754053. [PMID: 25328717 PMCID: PMC4189941 DOI: 10.1155/2014/754053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 09/14/2014] [Indexed: 11/22/2022] Open
Abstract
Transorbital penetrating injuries are unusual but may cause severe brain damage if cranium is entered. These kinds of injuries are dangerous as the walls of orbit are very thin, hence easily broken by the otherwise innocent objects. Because of the very critical anatomical area involved, these injuries pose a serious challenge to the physicians who first receive them as well as the treating team. These may present as trivial trauma or may be occult and are often associated with serious complications and delayed sequel. Prompt evaluation by utilizing best diagnostic modality available and timely interference to remove them are the key aspects to avoid damage to vital organs surrounding the injury and to minimize the late complications. We report a case of transorbital assault with a 13 centimeter long knife which got broken from the handle and the blade was retained. The interesting aspect is that there was no neurological deficit on presentation or after removal.
Collapse
|
10
|
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
|
11
|
Xu F, Li J, Sun S, Guo E, Hao S, Hou Z, Leung GKK, Liu B. The surgical management of a penetrating orbitocranial injury with a Bakelite foreign body reaching the brain stem. Brain Inj 2013; 27:951-6. [DOI: 10.3109/02699052.2013.775502] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|