Strong but not Unbeatable: Two Cases of Healed Severe Skull Trauma in Males Buried in Medieval Mass Graves (Kutná Hora-Sedlec, Czech Republic)

This paper presents two cases of healed skull trauma recovered from medieval mass burial sites in Kutná Hora-Sedlec (Kutná Hora District/CZ). These recently unearthed burial pits are historically and contextually associated with two key catastrophes: (1) a famine in the early 14th century; and (2) the Black Death in the mid-14th century. The first skull presents evidence of survival from severe cranial injury with highly probable surgical intervention. The second one presents evidence of successful skull surgery, confirming the practice of trepanation performed by a skilled specialist in a given region at a given time in history. Although both individuals had been robust enough to withstand the pain and strain of the treatment, indicating considerable resilience to survive the skull trauma, they succumbed to mass infection or famine that killed a large number of inhabitants of this prominent medieval mining region.

Effect of Concomitant Extra cranial Injury in outcome of moderate and severe head injury patients admitted to a tertiary care hospital in western Nepal

Background: Polytrauma is a term used to describe the patients those are severely injured associated with other injuries (i.e. two or more severe injuries in at least two areas of the body), less often with a multiple injury (i.e. two or more severe injuries in one body area). More than 40% of the patient of Traumatic Brain Injury (TBI) dies due to extra cranial causes. We hypothesized that extra cranial injuries with polytrauma may alter TBI outcomes and perform the study. Materials and methods: An analytical study was done with the patient of moderate to severe head injury admitted to neurosurgery Intensive Care Unit (ICU) of Manipal Teaching Hospital in between January to December 2019. The objective of the study was to assess the impact of concomitant extra cranial injury (Polytrauma) in the outcome of Moderate to severe head injury. Results: In our study it is seen that, those individuals who have presented delayed in emergency department from the time of incidence under the influence of alcohol, likewise with mean Glasgow Coma Scale (GCS) below 8.16+/-3.22 and abnormal pupils, high injury severity score (ISS), and with polytrauma have poorer outcomes. Conclusion: Concomitant extra cranial injuries, injury severity score(ISS),injuries associated under the influence of alcohol, delayed presentation in emergency after incident, GCS below 9 during presentation in ER and abnormal pupils during examinations are the strong predicting factors for the poor outcome of patient with traumatic brain injury.

Penetrating Craniocerebral Injury by the Hook of a School Desk

<b><i>Introduction:</i></b> Although penetrating cranial injuries are rare in pediatric patients, these injuries can lead to morbidity and mortality. Removal of a gigantic foreign body from the cranium requires proper management as it has high risk of further brain damage and seizures. <b><i>Case Presentation:</i></b> We report the case of a patient with cranial injury caused by hitting the head to the hook of a school desk. Due to the extreme nature of the injury, the following additional steps were necessary: taking help from a local firefighter team to cut the desk, surgical removal of the foreign body, and cranioplasty after 6 months. Following this, he was discharged without neurological deficits. <b><i>Discussion/Conclusion:</i></b> Neurotrauma is one of the major causes of death in children. The damage and effect of the injuring foreign body depends on its size, shape, velocity, trajectory, and entry point. It should be kept in mind that any high-frequency processes applied on the extracranial parts of conductive objects, such as metal bars, may trigger seizures. Preoperative extracranial intervention for huge penetrating foreign bodies should be performed under anticonvulsant administration and intubation to decrease the risk of epileptic seizures and its complications.

The current state of the science of aphasia

VIII.The Grashey case and its implications.A patient with Grashey, in the face of a cranial injury, fell ill with a disorder of the tongue of a sensory character, which soon gave way to another peculiar disorder. The patient did not find the names of the objects around him, except by resorting to the following means; he gazed intently at the known object, and recalled in order the individual letters of the given word; He wrote these letters in order, according to the time he remembered them, and only after all the letters written in this way made up a word, the patient could pronounce the given word. If the object was removed earlier, before he had time to draw the name, then to bring the name, displaying consistently one sign after another, he could not and, thus, could not, of course, pronounce this word. If the patient was pronounced the word by syllable, then, having reached the last syllable, he no longer remembered the first, because of which he could not repeat it.

Metallic Axe Causing Cranial Injury: A Case Report

Axe as the weapon holds features of both sharp and blunt forces. Physical assault in our community is generally noticed but with such unique weapon is not frequently heard. Homicidal inflicting injury to the head is common in physical assault. Many cases are being admitted with a history of head injury with blunt objects and sharp objects but very few cases are being documented in literature about the use of axe as a weapon. Here is presented a case of 46-year-old right handed male patient form a village in Siraha was brought to the emergency department with the history of physical assault with sharp edged metallic axe.