San Diego CIREN Team PowerPoint presentation - april 2002


SLIDE 1:
Brain Injury: The Role of Directionality 
April 25, 2002
Washington, DC


SLIDE 2:
San Diego County Trauma System & Froedtert Hospital - 
Medical College of Wisconsin CIREN Centers
- A. Brent Eastman, MD
- Thomas A. Gennarelli, MD
- Steve Erwin


SLIDE 3:
San Diego County Trauma SystemCIREN Program

Principal Investigators
- Gail F. Cooper 
- A. Brent Eastman, MD, FACS
- David B. Hoyt, MD, FACS


SLIDE 4:
San Diego CIREN Centers
- Childrens Hospital
- Palomar Medical Center
- Scripps Memorial Hospital
- Scripps Mercy Hospital
- Sharp Memorial Hospital
- University of California, San Diego Medical Center
- San Diego County Emergency Medical Services


SLIDE 5:
Froedtert Hospital - Medical College of Wisconsin 
CIREN Program

Principal Investigators
- Thomas A. Gennarelli, M.D. 
- Dennis J. Maiman, M.D., Ph.D.



SLIDE 6:
Map of CIREN network locations


SLIDE 7:
side view of human skull model


SLIDE 8:
computer model of human passenger in vehicle


SLIDE 9:
CIREN 
Case Examples


SLIDE 10:
Crash:
- 1996 Saturn SL2 
- Near side (left)
- Impact with non-breakaway pole

SUBJECT:
- Center rear seat passenger
- 21 month old female
- CRS: toddler, front facing, proper use

PDOF: 320 (-40) degrees


SLIDE 11: 
Details:
- Direct damage width: 66 cm
- Max. crush: 65 cm
- Bowed left

PDOF:  320 (-40)
DV  (BES)  38 kmph (24 mph)


SLIDE 12:
INJURIES
- CLosed head injury
- scalp lacerations
- left parietal and forehead hematoma

- splenic contusion
- liver contusion
- abdominal contusion

- contusions and abrasions on upper legs

SLIDE 13:
- Extra-axial blood in the anterior interhemispheric fissure and posterior falx

- Subarachnoid blood in the interpeduncular cistern

- Contusion & shear injuries - right anterior temporal and inferior frontal lobes

- Frontal scalp lacerations 
Forehead/parietal hematoma


SLIDE 14:
<CT scan> Tiny amount of subarachnoid blood in the interpeduncular cistern 


SLIDE 15:
<CT scan> Tiny amount of extra-axial blood in the anterior interhemispheric fissure and posterior falx


SLIDE 16: 
<CT scan> Mild contusion and shear injuries involving right anterior temporal and inferior frontal lobes


SLIDE 17:
Crash:
- 2000 Pontiac Grand Am
- Near side (right) impact
- Impact with vehicle
    
Subject:
- Front right seat passenger
- 36 year old male
- Air bag deployed 
- 3 point manual belt use


SLIDE 18:
Details:
- Direct damage length 230 cm
- Max. crush  59 CM

PDOF  80 degrees
DV  41 kmph (25 mph)


SLIDE 19:
Injuries
- closed head injury

- rib fractures w/pneumothorax
- pulmonary contusion
- diaphragm lacerations

- liver laceration
- spleen laceration
- kidney contusion
- omental avulsion, colon contusion and mesenteric laceration


SLIDE 21:
Bilateral Central Brain Hemorrhage
<CT scans>


SLIDE 22:
Bilateral Intracranial Hemorrhage
<CT scan on admission>


SLIDE 23:
Left-sided Basilar Skull Fracture


SLIDE 24:
Knott Lab/Lower Extremity Wire Simulations/Wire,far,no belt,slow.avi