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Neurologic consequences of traumatic asphyxia
W R Jongewaard1, T H Cogbill, J Landercasper
1Department of Surgery, Gundersen Clinic, Ltd., La Crosse, WI 54601.
Insights
Traumatic asphyxia, caused by severe crush injuries, can lead to temporary neurologic issues like confusion and seizures. Fortunately, this study found no long-term neurologic damage in patients with traumatic asphyxia.
Area of Science:
- Trauma Surgery
- Neurology
- Emergency Medicine
Background:
- Traumatic asphyxia is a rare but severe condition resulting from blunt force trauma to the chest.
- Understanding the incidence and neurological consequences is crucial for patient management.
Purpose of the Study:
- To determine the incidence and neurological sequelae of traumatic asphyxia.
- To analyze the mechanisms of injury and associated clinical presentations.
Main Methods:
- Retrospective study of patients treated for traumatic asphyxia over a 10-year period.
- Inclusion criteria: thoracic crush injuries from objects >1,000 pounds.
- Data collection included injury mechanism, clinical signs, and neurological assessments.
Main Results:
- 14 patients (ages 4-73) with traumatic asphyxia were identified.
- Common injury mechanisms included farm implements, vehicles, and large objects.
- All patients presented with craniocervical cyanosis and subconjunctival hemorrhage.
- Neurologic abnormalities observed: loss of consciousness (8), confusion (5), seizures (2), visual disturbances (2).
- No deaths or long-term neurologic sequelae were observed in this cohort.
Conclusions:
- Traumatic asphyxia can cause transient neurologic symptoms.
- Prompt and thorough neurologic assessment is vital in these patients.
- Exclusion of other neurological causes is recommended.
Abstract:
Patients with traumatic asphyxia treated at a single institution during a 10-year period were studied to determine the incidence and sequelae of neurologic impairment associated with this entity. Traumatic asphyxia was identified in 14 patients from 4 to 73 years old. Each had sustained thoracic crush injuries from objects weighing more than 1,000 pounds. The mechanism of injury was crush by farm implement in six patients, entrapment beneath a vehicle in five, compression by a large hay bale in one, crush by a farm animal in one, and a ditch cave-in in one. Craniocervical cyanosis and subconjunctival hemorrhage were apparent in all patients. Associated chest wall and intrathoracic injuries were present in 11 (79%) patients. Neurologic abnormalities included loss of consciousness in eight patients, prolonged confusion in five, seizures in two, and pronounced visual disturbances in two. There were no deaths in this series and no long-term neurologic sequelae were evident. However, careful serial neurologic assessment should be performed in these patients and other causes of neurologic symptoms excluded.