Blast injury causing extensive brain injury and elevated skull fracture

Abstract

Blast injuries are caused by rapid chemical transformation of a solid or liquid into a gas resulting in a high-pressure wave exceeding the speed of sound. We discuss a case 28 year gentleman who sustained severe traumatic brain injury and elevated skull fracture secondary to a blast of refrigeration gas cylinder.

Keywords

Blast injury - Explosions - Fractures - Biomechanics - Forensics

• References

• 1 Born C.. Blast trauma: the fourth weapon of mass destruction. Scand J Surg 2005; 94: 279
• 2 Kocsis J.D., Tessler A.. Pathology of blast-related brain injury. J Rehabil Res Dev 2009; 46: 667-672
• 3 Murray C.K., Reynolds J.C., Schroeder J.M., Harrison M.B., Evans O.M., Hospenthal D.R.. Spectrum of care provided at an echelon II Medical Unit during Operation Iraqi Freedom. Mil Med 2005; 170: 516-520
• 4 DePalma R.G., Burris D.G., Champion H.R., Hodgson M.J.. Blast injuries. N Engl J Med 2005; 352: 1335-1342
• 5 Stapczynski J.S.. Blast injuries. Ann Emerg Med 1982; 11: 687-694
• 6 Phillips Y.Y.. Primary blast injuries. Ann Emerg Med 1986; 15: 1446-1450
• 7 Wightman J.M., Gladish S.L.. Explosions and blast injuries. Ann Emerg Med 2001; 37: 664-678
• 8 Ramasamy A., Hill A.M., Masouros S., Gibb I., Bull A.M.J., Clasper J.C.. Blast-related fracture patterns: a forensic biomechanical approach. J R Soc Interface 2011; 08: 689-698
• 9 Selvan V., Ganpule S., Kleinschmit N., Chandra N.. Blast wave loading pathways in heterogeneous material systems – experimental and numerical approaches. J Biomech Eng 2013; 135: 61002-61014
• 10 Cernak I., Wang Z., Jiang J., Bian X., Savic J.. Cognitive deficits following blast injury-induced neurotrauma: possible involvement of nitric oxide. Brain Inj 2001; 15: 593-612
• 11 Courtney A.C., Courtney M.W.. A thoracic mechanism of mild traumatic brain injury due to blast pressure waves. Med Hypotheses 2009; 72: 76-83
• 12 Cheng M.-F., Chen L.-J., Cheng J.-T.. Decrease of Klotho in the kidney of streptozotocin-induced diabetic rats. J Biomed Biotechnol 2010; 2010: 513853
• 13 Rafaels K., Bass C.R.D., Salzar R.S.. et al Survival risk assessment for primary blast exposures to the head. J Neurotrauma 2011; 28: 2319-2328
• 14 Bolander R., Mathie B., Bir C., Ritzel D., VandeVord P.. Skull flexure as a contributing factor in the mechanism of injury in the rat when exposed to a shock wave. Ann Biomed Eng 2011; 39: 2550-2559
• 15 Moss W.C., King M.J., Blackman E.G.. Skull flexure from blast waves: a mechanism for brain injury with implications for helmet design. Phys Rev Lett 2009; 103: 108702
• 16 Bhattacharjee Y.. Neuroscience. Shell shock revisited: solving the puzzle of blast trauma. Science (New York, NY) 2008; 319: 406-408
• 17 Cernak I., Savic J., Ignjatovic D., Jevtic M.. Blast injury from explosive munitions. J Trauma 1999; 47: 96-103 discussion 103
• 18 Cernak I., Wang Z., Jiang J., Bian X., Savic J.. Ultrastructural and functional characteristics of blast injury-induced neurotrauma. J Trauma 2001; 50: 695-706
• 19 Finkel M.F.. The neurological consequences of explosives. J Neurol Sci 2006; 249: 63-67
• 20 Hull J.B.. Blast: injury patterns and their recording. J Audiov Media Med 1992; 15: 121-127
• 21 Gans L., Kennedy T.. Management of unique clinical entities in disaster medicine. Emerg Med Clin North Am 1996; 14: 301-326
• 22 Hull J.B., Cooper G.J.. Pattern and mechanism of traumatic amputation by explosive blast. J Trauma 1996; 40: S198-S205
• 23 Talha K.A., Selvapandian S., Asaduzzamman K., Selina F., Rahman M., Riad M.. Compound elevated skull fracture with occlusion of the superior sagittal sinus. A case report. Kobe J Med Sci 2008; 54: E260-E263
• 24 Sharma R., Kumar A., Bhat D.I., Devi B.I.. Compound elevated skull fractures in adults: a series of five patients and review of literature. Indian J Neurotrauma 2012; 09: 112-116
• 25 Ralston B.L.. Compound elevated fractures of the skull. J Neurosurg 1976; 44: 77-79
• 26 Chhiber S.S., Wani M.A., Kirmani A.R.. et al Elevated skull fractures in pediatric age group: report of two cases. Turk Neurosurg 2011; 21: 418-420
• 27 Garg N., Devi B.I., Maste P.. Elevated skull fracture. Indian J Neurotrauma 2007; 04: 133
• 28 Adeolu A.A., Shokunbi M.T., Malomo A.O., Komolafe E.O., Olateju S.O., Amusa Y.B.. Compound elevated skull fracture: a forgotten type of skull fracture. Surg Neurol 2006; 65: 503-505
• 29 Borkar S.A., Sinha S., Sharma B.S.. Post-traumatic compound elevated fracture of skull simulating a formal craniotomy. Turk Neurosurg 2009; 19: 103