Laura M. Criddle

Epidemiology of intracranial aneurysm and subarachnoid hemorrhage.

&NA; Intracranial aneurysmal hemorrhage is a common but devastating condition associated with significant morbidity and mortality. Epidemiologic studies have identified risk factors associated with this condition. Genetic factors involve family history and the presence of certain heritable connective tissue disorders such as Ehlers‐Danlos syndrome, Marfans syndrome, neurofibromatosis, and polycystic kidney disease. Acquired factors include traumatic brain injury, sepsis, smoking, and hypertension. Management of these patients consists of prevention, patient screening, and prophylactic aneurysm repair.

A case of postpartum cerebral venous thrombosis

Cerebral venous thrombosis, also known as cortical venous, cerebral sinus, cerebral venous sinus, or dural sinus thrombosis, results from clot formation in one of the many outflow tracts of the brain. Obstruction of flow causes venous hypertension, which is responsible for clinical findings associated with this condition. Signs and symptoms of cerebral venous thrombosis include headache, nausea, mental status changes, seizures, and focal neurologic deficits. Although cerebral venous thrombosis can occur at any time during life, women are particularly vulnerable before delivery and during the postpartum period because of the hypercoagulable state that accompanies pregnancy. This case study describes the challenging clinical course of one postpartum patient who developed venous thrombosis of the sagittal sinus.

The injured drunk driver in central Texas: Incidence, demographics, and legal ramifications

INTRODUCTION This study was designed to define 1 trauma centers drunk driver patient population, determine the incidence of alcohol intoxication in motorists admitted to the hospital following a collision, and ascertain the frequency of the Driving Under the Influence (DUI) charges filed against this population. METHODS Hospitalized motorists were divided into 2 groups--those who did and did not have blood alcohol levels measured--then further classified into 3 subsets based on serum ethanol values. A 2-year retrospective trauma registry review established patient demographics, outcomes, hospital costs, blood alcohol levels, and concomitant drug use. Local police records were accessed to determine the number of patients cited for DUI. RESULTS Eighty percent of those intoxicated were men. On the average, drunk drivers were 1.7 years younger than were sober patients. Minimally to moderately intoxicated motorists had the highest overall injury severity scores and hospital costs and were the most likely to concomitantly abuse illegal drugs. Patients who did not have ethanol levels measured had the highest mortality rate. DISCUSSION Overall, 60% of admitted injured drivers who were tested had positive results for 1 or more substances known to impair driving ability, yet only 16% of those with a blood alcohol level of > or = 100 mg/dL were charged with DUI. This finding supports previously published data suggesting that injury and transport to a hospital protect the alcohol-impaired driver from legal consequences.