Brain Injuries in Children with Eye Damage

Brain Injuries in Children with Eye Damage

People use their eyes to observe the world around them and to see the ones that they love. When brain injuries occur, they can be accompanied by damage to the eyes as well.
There are many different ways that someone can suffer a traumatic injury to the eye. Sometimes, if someone goes blind, these injuries can be catastrophic. For this reason, it is important to understand the different ways that a child can sustain an injury to his or her eye.

Auto Accident: Those who are involved in an auto accident can injure their eye. If the windshield shatters, this can lead to sharp fragments of glass that fly through the vehicle. As the glass falls through the cabin, it is possible that one of these fragments could penetrate the eye of one of the occupants.

Blunt Trauma: People can also injure their eyes with blunt trauma to the side of the head. It is easy for people to slip and fall on a wet floor or patch of ice, striking their head on the ground. This can damage the bone that surrounds the eye. This can lead to skull fractures and even a traumatic brain injury, as a recent case report has described.

Sports: Eye injuries are also possible while a child is playing sports. Some sports such as hockey and lacrosse make the players wear face masks. In other sports such as football, these masks are optional. These are important for protecting players from getting poked or struck in the eye while competing and can prevent a serious injury from occurring.

A Case Report: Pediatric Eye Damage and Brain Injury

A team of medical professionals recently published a case report describing an auto accident involving a family of four. One of the parents was driving a minivan down the interstate when they collided with a construction barrier and the car flipped. An accident ensued and the windshield shattered. Emergency personnel were called to the scene and found that one of the children had sustained multiple serious injuries. The child was taken to a local hospital and evaluated. A piece of glass had penetrated the child's right eye. There were multiple bruises on the skull as well. Further evaluation showed that the child had suffered a brain injury not only due to the blunt trauma but also due to the glass that had penetrated the eye. The child was taken into emergency surgery and the injuries were repaired. With rehabilitation, the child regained vision in his right eye and made a full cognitive recovery.

Multiple Complications Can Occur

There are many complications that someone can see with an eye injury. Some of the complications that could occur with an injury to the eye include vision loss (potentially blindness), pain, and infection. The loss of vision can occur if someone has trauma that damages the retina or the optic nerve. The retina is a vital part of the eye structure because it transmits the image seen from the front of the eye to the brain. The optic nerve serves many functions and importantly helps the pupil dilate and constrict. This controls the clarity of the image by regulating how much light strikes the eye. Infection can also be a serious complication. Those who sustain serious injuries may require urgent surgery to repair their injuries. Any hospital stay can be complicated by infection, and infection of the eye or the skull can transmit itself back to the brain. If this happens, it is possible for someone to sustain permanent or even life-threatening complications as a result. Because of this, everyone needs to be vigilant about eye injuries and any potential complications that might result.

Image Attribution: The retinal image on this page was saved locally on Wikimedia Commons and is shown here with permission of the CC BY SA license, version 2.0.
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Fracture Dislocations of the Hip in Children: A Case Report

Fracture Dislocations of the Hip in Children: A Case Report

Among the injuries that someone could sustain in a car accident, fracture dislocations of the hip are both common and severe. This can inhibit someone's ability to move effectively and could even make it difficult to exit the vehicle in the event of an accident.

There are many different types of auto accidents, and they can range widely in their severity from single-car scrapes to massive multi-vehicle pileups. Someone involved in a car crash can suffer from several different types of bone fractures, including pelvic injuries and hip dislocations. When people see an accident about to happen in front of them, they often slam on their brakes with extreme force, trying to get their car to stop and avoid the objects and cars in front of them. This locks out their knees at the front of the vehicle. When their car collides with the vehicle in front of them, their legs do not bend to absorb the force because they have been locked out. The force starts at the bottom of their feet and transmits through their legs and into their hips, causing a severe injury. In many cases, the head of the femur is forced through the hip socket and out the back of the hip. This leads to a femur fracture but also a hip dislocation and, in many cases, a hip fracture. This is termed a fracture dislocation of the hip and can be a severe or even life-threatening injury.

A Case Report: Open Hip Fracture Dislocations

A team of medical professionals published the case of a 15-year old female who was involved in an auto accident and sustained polytrauma. Among her numerous injuries was a serious fracture dislocation of the hip. She was rapidly transported to the emergency room where she was scanned, and her various injuries were diagnosed. She had a severe fracture dislocation of her hip and was transported to the operating room rapidly for emergent treatment. There was blood on hold for a transfusion in the operating room just in case. The fractures were repaired, and the head of the femur was placed in the appropriate location in the hip socket. After the procedure, she had to undergo an extensive amount of physical therapy and treatment to learn how to walk again. The case report went on to discuss several other facets that people should be aware of regarding this type of injury.

Proper Management is Vital for the Avoidance of Complications

When people sustain a fracture dislocation of their hip in the pelvis, there are a handful of complications that could happen. The most notable complication that the report addresses is necrosis of the head of the femur. This occurs when someone develops avascular necrosis of the hip. This is a serious complication where the blood vessels that feed the head of the femur are severed in a traumatic injury. In this situation, the femur is deprived of all of the important nutrients supplied by the vessels and patients could be forced into an emergency hip replacement. Another notable complication that can happen is a bone infection of the hip joint and socket itself, called osteomyelitis. This infection develops when the wound has been exposed for an extended period of time and bacteria are allowed to colonize the area. This can happen either at the scene of the auto accident or from a complication due to surgery. Patients could require an extended course of antibiotics. This could keep them in the hospital for weeks on end in addition to possibly requiring an extra trip to the operating room for debridement of the wound.

Moving Forward: Management of Injuries in the Future

This case resulted in a successful procedure and recovery. However, several lessons can be taken from this case. The first is that speed is important in traumatic injuries such as this hip fracture dislocation. If the patient is quickly diagnosed, treatment can start immediately. This also allows for any complication or ancillary injuries to be caught early in the process as well. The second is that this injury can be more serious in kids. When kids have leg injuries, it is possible that the growth plates could be damaged. If they are, their legs can grow unevenly, resulting in leg-length discrepancies. This can lead to major quality of life issues down the road.

Image Attribution: The x-ray image at the top has been reproduced under the Universal Creative Commons License, version 2.0. The picture was first found on Wikimedia Commons.
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