| 1. |
- Aare, Magnus, et al.
(författare)
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Injuries from motorcycle- and moped crashes in Sweden from 1987 to 1999.
- 2003
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Ingår i: Injury control and safety promotion. - : Informa UK Limited. - 1566-0974 .- 1744-4985. ; 10:3, s. 131-8
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this paper is to study injuries from motorcycle and moped crashes in Sweden from 1987 to 1999. Databases at the National Board for Health and Welfare and codes from both ICD9 and ICD10 systems were used, including patterns of age, gender, E-code and type of injury. Length of hospital stay, type of injuries and trends over time was evaluated. To get a more detailed picture of the age distribution, type of vehicle used and number of killed, data from the Swedish National Road Administration were also used. In Sweden, 27,122 individuals received in-patient care due to motorcycle and moped injuries between 1987 and 1999. The motorcycle and moped injury rate was reduced in the second half of the studied period and so were the total days of treatment per year. Males had eight times the incidence of injuries compared to females. Riders under the age of 26 and in particular those at an age of 15 had the highest incidence rate. Head injuries were the most frequent diagnosis, followed by fractures to the lower limbs. Concussion was the most frequent head injury. Focal and diffuse brain injuries combined showed the same frequency as concussion. It is concluded that more preventative strategies must be presented before the injury rate can be reduced.
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| 2. |
- Carroll, L. J., et al.
(författare)
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Prognosis for mild traumatic brain injury : Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury
- 2004
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 43, s. 61-
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Forskningsöversikt (refereegranskat)abstract
- We searched the literature on the epidemiology, diagnosis, prognosis, treatment and costs of mild traumatic brain injury. Of 428 studies related to prognosis after mild traumatic brain injury, 120 (28%) were accepted after critical review. These comprise our best-evidence synthesis on prognosis after mild traumatic brain injury. There was consistent and methodologically sound evidence that children's prognosis after mild traumatic brain injury is good, with quick resolution of symptoms and little evidence of residual cognitive, behavioural or academic deficits. For adults, cognitive deficits and symptoms are common in the acute stage, and the majority of studies report recovery for most within 3-12 months. Where symptoms persist, compensation/litigation is a factor, but there is little consistent evidence for other predictors. The literature on this area is of varying quality and causal inferences are often mistakenly drawn from cross-sectional studies.
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| 3. |
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| 4. |
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| 5. |
- Halldin, Peter, 1968-, et al.
(författare)
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Improved helmet design and test methods to reduce rotational induced brain injuries
- 2003
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Konferensbidrag (refereegranskat)abstract
- Accidental impacts to the human head are often a combination of translational and rotational accelerations. The most frequent severe brain injuries from accidents are diffuse axonal injury (DAI) and subdural hematoma that both are reported to arise from rotational violence to the head. Most helmet standards used today do only take the translational accelerations into account. It is therefore suggested that an oblique impact test that measures both translational and rotational accelerations should be a complement to the helmet standards used today. This study investigates the potential to reduce the risk for DAI by improving the helmet design by use of an oblique helmet impact test rig. The method used is a detailed finite element (FE) model of the human head. The FE model is used to measure the maximum principal strain in the brain which is suggested as a measurement for the risk to get DAI. The results clearly show the importance of testing a helmet in oblique impacts. Comparing a pure vertical impact with a 45 degree oblique impact with the same initial impact energy shows that the strain in the central parts of the brain is increased with a factor of 6. It is therefore suggested that a future helmet impact standard should include a rotational component so that the helmet is designed for both radial and tangential forces. Such a test method, an oblique impact test, was used to compare two different helmet designs. One helmet was manufactured with the shell glued to the liner and one helmet was designed with a low friction layer between the shell and the liner (MIPS). It was shown that the strain in the FE model of the human head was reduced be 27% comparing the MIPS helmet to the glued helmet design.
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| 6. |
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| 7. |
- Halldin, Peter, 1968-, et al.
(författare)
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Reduced risk for DAI by use of a new safety helmet
- 2003
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Konferensbidrag (refereegranskat)abstract
- Accidental impacts to the human head are often a combination of translational and rotational accelerations. The most frequent severe brain injuries from accidents are diffuse axonal injury (DAI) and subdural hematoma that both are reported to arise from rotational violence to the head. Most helmet standards used today do only take the translational accelerations into account. It is therefore suggested that an oblique impact test that measures both translational and rotational accelerations should be a complement to the helmet standards used today. This study investigates the potential to reduce the risk for DAI by improving the helmet design by use of an oblique helmet impact test rig. The method used is a detailed finite element (FE) model of the human head. The FE model is used to measure the maximum principal strain in the brain which is suggested as a measurement for the risk to get DAI. The results clearly show the importance of testing a helmet in oblique impacts. Comparing a pure vertical impact with a 45 degree oblique impact with the same initial impact energy shows that the strain in the central parts of the brain is increased with a factor of 6. It is therefore suggested that a future helmet impact standard should include a rotational component so that the helmet is designed for both radial and tangential forces. Such a test method, an oblique impact test, was used to compare two different helmet designs. One helmet was manufactured with the shell glued to the liner and one helmet was designed with a low friction layer between the shell and the liner (MIPS). It was shown that the strain in the FE model of the human head was reduced be 27% comparing the MIPS helmet to the glued helmet design.
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| 8. |
- Höybye, Charlotte, et al.
(författare)
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Transsphenoidal surgery in Cushing disease : 10 years of experience in 34 consecutive cases
- 2004
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Ingår i: Journal of Neurosurgery. - : Journal of Neurosurgery Publishing Group (JNSPG). - 0022-3085 .- 1933-0693. ; 100, s. 634-638
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Tidskriftsartikel (refereegranskat)abstract
- Object. Cushing disease is a rare disorder. Because of their small size the adrenocorticotropic hormone (ACTH)—producing tumors are often not detectable on neuroimaging studies. To obtain a cure with transsphenoidal surgery (TSS) may therefore be difficult. In this report the authors present 10 years of experience in the treatment of patients with Cushing disease who were followed up with the same protocol and treated by the same surgeon.Methods. Thirty-four patients, 26 of them female and eight of them male (mean age 40 years, range 13–74 years) were studied. All had obvious clinical signs and symptoms of Cushing syndrome. Magnetic resonance (MR) imaging was performed in all patients, and inferior petrosal sinus (IPS) sampling was done in 14.In 12 patients MR imaging indicated a pituitary tumor; 10 were microadenomas and two were macroadenomas. In six patients with no visible tumor, the results of IPS sampling supported the diagnosis. All patients underwent TSS; the mean follow-up duration was 6 ± 0.5 years. Selective adenomectomy was performed in 32 and hemihypophysectomy in the other two patients. A cure was obtained in 31 patients (91%) after one TSS and in two more patients after further TSS; one patient was not cured despite two TSSs and one underwent bilateral adrenalectomy. Disease recurrence was seen in two patients after 3 years, and they were successfully treated with stereotactic gamma knife surgery. Half of the patients had an ACTH deficiency postoperatively, whereas one third had other pituitary hormone insufficiencies. There were no serious complications attributable to the surgical intervention.Conclusions. Transsphenoidal surgery with selective adenomectomy is an effective and safe treatment for Cushing disease. In the patients presented in this study, the surgical outcome seemed to depend on careful preoperative evaluation and the surgeon's experience. For optimal results in this rare disease the authors therefore suggest that the endocrinological, radiological, and surgical procedures be coordinated in a specialized center.
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| 9. |
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| 10. |
- Kleiven, Svein, et al.
(författare)
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Consequences of head size following trauma to the human head
- 2002
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Ingår i: Journal of Biomechanics. - 0021-9290 .- 1873-2380. ; 35:2, s. 153-160
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the present study was to evaluate whether variation of human head size results in different outcome regarding intracranial responses following a direct impact. Finite Element models representing different head sizes and with various element mesh densities were created. Frontal impacts towards padded surfaces as well as inertial loads were analyzed. The variation in intracranial stresses and intracranial pressures for different sizes of the geometry and for various element meshes were investigated. A significant correlation was found between experiment and simulation with regard to intracranial pressure characteristics. The maximal effective stresses in the brain increased more than a fourfold, from 3.6 kPa for the smallest head size to 16.3 kPa for the largest head size using the same acceleration impulse. When simulating a frontal impact towards a padding, the head injury criterion (HIC) value varies from the highest level of 2433 at a head mass of 2.34 kg to the lowest level of 1376 at a head mass of 5.98 kg, contradicting the increase in maximal intracranial stresses with head size. The conclusion is that the size dependence of the intracranial stresses associated with injury, is not predicted by the HIC. It is suggested that variations in head size should be considered when developing new head injury criteria.
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