Reiber Cody, Stein Alan A, Miller Ivan, Tarawneh Omar, Kazim Syed Faraz, Schmidt Meic H, Cole Chad D, Bowers Christian A
School of Medicine, New York Medical College, Westchester, USA.
Neurosurgery, New York Medical College, Westchester, USA.
Cureus. 2021 Aug 11;13(8):e17104. doi: 10.7759/cureus.17104. eCollection 2021 Aug.
Background Despite their devastating nature, injuries due to tree-related- traumas are sparsely reported in the literature. Over the last several years, the incidence of tree-related traumatic injuries presenting to our level one trauma center, in Westchester, New York, has been concerning. The present study was undertaken to evaluate the clinical presentation, injury pattern, and outcomes of tree-related neurotrauma at our institution. In addition, we describe the injury pattern and medical management of several relevant cases of tree-related neurotrauma. Methods We conducted a retrospective analysis of tree-related neurotrauma over a five-year period from January of 2014 to March of 2019 at Westchester Medical Center (WMC) and Maria Fareri Children's Hospital, a level one trauma center. Patients presenting with neurotrauma that necessitated neurosurgical care were eligible for inclusion in this case series. Tree-related injury was defined as any trauma that was sustained as a direct result of collision with a tree. Results We identified 21 patients who sustained tree-related trauma. The cohort age ranged from 15 to 68 (mean=38 years). Injuries included seven skull fractures, four cases of subdural hematoma (SDH), six cases of intracranial hemorrhagic contusion, 14 spinal fractures, three cases of epidural hematoma (EDH), one case of spinal cord contusion, three vascular injuries, one case of dural laceration, and one case of pneumocephalus, with several patients suffering multiple injuries. Of the 21 patients, seven were female, and 12 were injured when their motor vehicle struck a tree. All but four patients were taken to the operating room for neurosurgical treatment, and nine of 21 patients were taken emergently to the operating room upon arrival. Conclusion The potential for serious head injuries with long-term neurologic sequelae exists with tree-related trauma. Clinicians should be advised of the challenging management of injuries secondary to tree-related trauma, and a greater emphasis should be placed on raising awareness of these accidental, but devastating injuries. Finally, a great majority of these injuries can be prevented or reduced in severity through helmet use and by adhering to safety guidelines.
尽管与树木相关的创伤具有毁灭性，但此类损伤在文献中的报道却很少。在过去几年中，纽约韦斯特切斯特一级创伤中心收治的与树木相关创伤性损伤的发生率令人担忧。本研究旨在评估我院与树木相关的神经创伤的临床表现、损伤模式及预后。此外，我们还描述了几例相关神经创伤病例的损伤模式及医疗处理。方法：我们对2014年1月至2019年3月在韦斯特切斯特医疗中心（WMC）和玛利亚·法雷里儿童医院（一级创伤中心）的五年间与树木相关的神经创伤进行了回顾性分析。出现需要神经外科治疗的神经创伤的患者符合纳入本病例系列的条件。与树木相关的损伤定义为因与树木直接碰撞而遭受的任何创伤。结果：我们确定了21例遭受与树木相关创伤的患者。队列年龄从15岁至68岁（平均38岁）。损伤包括7例颅骨骨折、4例硬膜下血肿（SDH）、6例颅内出血性挫伤、14例脊柱骨折、3例硬膜外血肿（EDH）、1例脊髓挫伤、3例血管损伤、1例硬脑膜撕裂和1例气颅，数名患者有多处损伤。21例患者中，7例为女性，12例在机动车撞上树木时受伤。除4例患者外，其余患者均被送往手术室接受神经外科治疗，21例患者中有9例在抵达后被紧急送往手术室。结论：与树木相关的创伤存在导致严重头部损伤及长期神经后遗症的可能性。应告知临床医生与树木相关创伤所致损伤的挑战性管理，并应更加强调提高对这些意外但具有毁灭性损伤的认识。最后，通过使用头盔和遵守安全指南，这些损伤中的绝大多数可以预防或减轻严重程度。
