Many of the dizziness patients annually visit ENT (ear, nose, throat) clinics because the vestibular function is the major organ to keep body balance and belongs to the Otorhinolaryngology. Nevertheless, many otolaryngologists feel that it is not easy to access the dizziness patients. The reason is that dizziness is not a final diagnosis and it is necessary to start the diagnosis of dizziness and find out the cause. Also, the causes of dizziness belong to multiple medical departments. That is why we need to pay more attention. Among them, traumatic vertigo can be manifested in various ways depending on the injury site and mechanism, and it is often difficult to predict the medical prognosis. Therefore, this review article focuses on traumatic vertigo. In this paper, we discussed its epidemiology and mechanism to help clinicians to treat patients with traumatic vertigo.
Craniocerebral Trauma ; Diagnosis ; Dizziness ; Epidemiology ; Humans ; Nose ; Otolaryngology ; Prognosis ; Vertigo

BACKGROUND: Traumatic brain injury (TBI) is one of the leading causes of pediatric disability that results in many emergency department visits. The risk of TBI is high while playing sports. The aim of this study was to examine the demographics and clinical characteristics of sports-related TBI. METHODS: We performed a multicenter observational study using the Emergency Department–Based Injury In-Depth Surveillance database in Korea. Patients aged 5 to 18 years old, who sustained unintentional, sports-related head injuries between January 2011 and December 2016 were included. The type of sports was the main variable of interest, and it was classified into 6 categories. The primary outcome was TBI, and the secondary outcome was intracranial injury and hospital admission. A multivariable logistic regression analysis was performed to calculate the adjusted odds ratios (aORs) with 95% confidence intervals for the outcomes by sports type. RESULTS: Of the 1,537,617 injured patients, 10,717 (0.7%) patients were included in the study. Most of the patients were male (87.5%), and the most prevalent sports type was field sports (51.2%). The proportion of TBI, intracranial injury, and admission were 15.7%, 1.2%, and 3.5%, respectively. The aORs of TBI, intracranial injury, and admission in bicycle and street sports compared to field sports were 1.77 (1.37–2.28), 4.99 (2.62–9.50), and 2.27 (1.42–3.61) respectively. CONCLUSION: This is the first nationwide epidemiologic study of pediatric sports-related TBI in Korea. The ratios of TBI, intracranial injury and admission were highest in bicycle and street sports. Prevention strategies for pediatric sports-related TBI can be developed according to sports types.
Brain Injuries ; Child ; Craniocerebral Trauma ; Demography ; Emergencies ; Emergency Service, Hospital ; Epidemiologic Studies ; Epidemiology ; Humans ; Korea ; Logistic Models ; Male ; Observational Study ; Odds Ratio ; Sports

OBJECTIVE: Head injury is the main cause of death and severe disability in bicycle-related injuries. The purpose of this study was to compare the demographic characteristics and injury mechanisms of bicycle-related head injuries according to the severity and outcome and determine the main risk factors and common types of accompanying injuries. METHODS: A total of 205 patients who were admitted to the neurosurgery department of our hospital for bicycle-related head injuries between 2007 and 2016 were analyzed. We categorized the patients into two groups according to severity and outcome of head injury, and then identified the differences in age, sex, and cause of injury between the two groups. RESULTS: Collisions with a motor vehicle increased the risk of severe head injury (p=0.011), resulted in poor outcomes (Glasgow Outcome Scale [GOS] ≤3; p=0.022), and caused more accompanying chest/abdominal (p<0.001) and pelvic/lower extremity injuries (p=0.001) than other mechanisms. Older age and high grade of head injury severity resulted in poor outcomes (p=0.028 and p<0.001, respectively), and caused more accompanying chest/abdominal injuries (p<0.032 and p<0.001, respectively) compared with younger age and low grade of head injury severity. CONCLUSION: In bicycle-related head injuries, collision with motor vehicle is one of the most important risk factor for high grade of head injury severity and outcome. In addition, bicycle-related head injuries are often accompanied by injuries of other parts of the body.
Cause of Death ; Craniocerebral Trauma* ; Epidemiology* ; Extremities ; Head* ; Humans ; Motor Vehicles ; Neurosurgery ; Risk Factors*

OBJECTIVE: Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. METHODS: We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery). RESULTS: Among all the 2617 THI patients, total number of pediatric patients was 256. The average age of the subjects was 9.07 (standard deviation±6.3) years old. The male-to female ratio was 1.87 to 1 and male dominance increases with age. The most common cause for trauma were falls and traffic accidents. Age (p=0.007), surgery (p<0.001), mechanism of trauma (p=0.016), subdural hemorrhage (SDH) (p<0.001), diffuse axonal injury (DAI) (p<0.001) were statistically significant associated with severe brain injury. CONCLUSION: Falls were the most common cause of trauma, and age, surgery, mechanism of trauma, SDH, DAI increased with injury severity. There is a critical need for effective fall and traffic accidents prevention strategies for children, and we should give attention to these predicting factors for more effective care.
Accidental Falls ; Accidents, Traffic ; Brain Injuries* ; Cause of Death ; Child ; Craniocerebral Trauma ; Developed Countries ; Diffuse Axonal Injury ; Epidemiology* ; Female ; Glasgow Coma Scale ; Hematoma, Subdural ; Hospitals, University ; Humans ; Korea ; Male ; Mortality* ; Pediatrics ; Republic of Korea ; Trauma Centers

OBJECTIVE: The aim of the present study is to estimate the incidence trend of head injury and the mortality based on traffic accident statistics and to investigate the impacts of rapid industrialization and economic growth on epidemiology of head injury in Korea over the period 1970-2012 including both pre-industrialized and post-industrialized stages. METHODS: We collected data of head injury estimated from traffic accident statistics and seven hospital based reports to see incidence trends between 1970 and 2012. We also investigated the population structure and Gross National Income (GNI) per capita of Korea over the same period. The age specific data were investigated from 1992 to 2012. RESULTS: The incidence of head injury gradually rose in the 1970s and the 1980s but stabilized until the 1990s with transient rise and then started to decline slowly in the 2000s. The mortality grew until 1991 but gradually declined ever since. However, the old age groups showed rather slight increase in both rates. The degree of decrease in the mortality has been more rapid than the incidence on head injury. CONCLUSION: In Korea during the low income stage, rapid industrialization cause considerable increase in the mortality and the incidence of head injury. During the high income stage, the incidence of head injury gradually declined and the mortality dropped more rapidly than the incidence due to preventive measures and satisfactory medical care. Nevertheless, the old age groups revealed rather slight increase in both rates owing to the large population structure and the declining birth rate.
Accidents, Traffic* ; Birth Rate ; Craniocerebral Trauma* ; Economic Development ; Epidemiology ; Head* ; Humans ; Incidence ; Korea* ; Mortality ; Industrial Development

OBJECTIVETo understand the epidemiological characteristics of head injuries in children.

METHODSData was derived from the Chinese National Injury Surveillance System (NISS) in 2014. Method on descriptive analysis was applied to depict general information, injuries events and clinical characteristics of head injuries among children under 18 years of age.

RESULTSA total number of 47 690 cases with child head injuries in 2014 were collected, including 32 542 males and 15 148 females. 43.47% of them were under 1-4 years of age. In October, 06:00 PM appeared the peak time for the injuries to happen. The three leading causes responsible for child head injuries were falls (69.57%), hit by blunt force (14.23%) or road traffic (11.01%). Main locations responsible for the head injuries to happen were:at home (44.98%), at public places (19.65%) or on roads/streets (15.81%). Recreation activates (77.88%), driving (7.32%), sports (5.72%) were the three major activities causing the injuries to take place. Majority of the cases happened unintentionally (95.35%), with bruise (71.69%) or mild injuries (85.27%) and went back home after treatment (90.25%).

CONCLUSIONSIn 2014, child head injuries were seen more in males than in females and mostly occured at home. The leading causes for head injuries would include falls, hit by blunt stuff or road traffic .

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Asian Continental Ancestry Group ; statistics & numerical data ; Automobile Driving ; Child ; China ; epidemiology ; Craniocerebral Trauma ; epidemiology ; Environment ; Female ; Humans ; Male ; Population Surveillance ; Recreation ; Sports ; Transportation ; Wounds and Injuries ; epidemiology

PURPOSE: Many patients who may be treated in primary care clinics resort to emergency centers during the off hours of such clinics. This may cause overcrowding of emergency centers and increased medical expenses. The aim of this study is to consider the optimal management of medical facilities for pediatric patients at night or on holidays. METHODS: The medical records of patients under the age of 16 years who had visited a pediatric emergency medical center during a two-year period between January 2012 and December 2013 were reviewed retrospectively. We examined how factors including the age group, disease/injury distinction, tentative diagnosis, use of the emergency medical service ambulances, and the final disposition of the patients varied depending on the availability of medical facilities. RESULTS: Among the 32,951 pediatric patients, approximately half visited the center on holidays (51.6%), and a quarter were injury patients (26.4%). Fever (38.8%) and head injury (16.1%) were the most frequent tentative diagnosis in diseases and injuries, respectively. More visits of infants and toddlers and disease patients occurred on days and hours of low medical service availability, and there were relatively few injury patients in the late night hours. CONCLUSION: These findings suggest that closing pediatric clinics around midnight is reasonable. More facilities operating at night and on holidays for pediatric patients are needed.
Ambulances ; Craniocerebral Trauma ; Diagnosis ; Emergencies* ; Emergency Medical Services ; Epidemiology ; Fever ; Health Resorts ; Holidays ; Humans ; Infant ; Medical Records ; Pediatrics ; Primary Health Care ; Retrospective Studies

Proper seat belt use saves lives; however, the use rate decreased in Korea. This study aimed to measure the magnitude of the preventive effect of seat belt on case-fatality across drivers and passengers. We used the Emergency Department based Injury In-depth Surveillance (EDIIS) database from 17 EDs between 2011 and 2012. All of adult injured patients from road traffic injuries (RTI) in-vehicle of less than 10-seat van were eligible, excluding cases with unknown seat belt use and outcomes. Primary and secondary endpoints were in-hospital mortality and intracranial injury. We calculated adjusted odds ratios (AORs) of seat belt use and driving status for study outcomes adjusting for potential confounders. Among 23,698 eligible patients, 15,304 (64.6%) wore seat belts. Driver, middle aged (30-44 yr), male, daytime injured patients were more likely to use seat belts (all P < 0.001). In terms of clinical outcome, no seat belt group had higher proportions of case-fatality and intracranial injury compared to seat belt group (both P < 0.001). Compared to seat belt group, AORs (95% CIs) of no seat belt group were 10.43 (7.75-14.04) for case-fatality and 2.68 (2.25-3.19) for intracranial injury respectively. In the interaction model, AORs (95% CIs) of no seat belt use for case-fatality were 11.71 (8.45-16.22) in drivers and 5.52 (2.83-14.76) in non-driving passengers, respectively. Wearing seat belt has significantly preventive effects on case-fatality and intracranial injury. Public health efforts to increase seat belt use are needed to reduce health burden from RTIs.
Accidents, Traffic/mortality/*prevention & control ; Adult ; Aged ; Craniocerebral Trauma/prevention & control ; Databases, Factual ; Emergency Service, Hospital ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Motor Vehicles ; Odds Ratio ; Republic of Korea/epidemiology ; Seat Belts/*utilization ; Young Adult

OBJECTIVEHead injury (HI) is the leading cause of mortality and life-long disability in infants. Infants have different anatomical and pathophysiological brain structures from other age groups. The aim of this study was to survey infant HI patients admitted to Shahid Behest Hospital in Kashan, Iran from 2004 to 2010, and to identify the causes of HIs in this age group.

METHODSIn this retrospective study, all HI patients under the age of two who were hospitalized for more than 24 hours between January 2004 and January 2010 were enrolled in the study. Demographic, etiologic, and injury data were collected and a descriptive analysis was performed.

RESULTSInfants comprised 20.8% of all children (under 15 years old) with HIs and 65.1% of the injuries occurred in the home. Falls were the most common cause of injury (63.4%). In hospital mortality was 6.6 per 100 000 infants. A decreasing trend was seen in home events, but HIs caused by traffic accidents were increasing during the study period. The amount of HI infants resulting from car accidents has tripled from the years 2004 to 2010.

CONCLUSIONAlthough home events and falling are the main causes of infant HIs and need attention, our study showed an increase of HIs caused by road traffic accidents, especially by car accidents, thus legislation for the implementation of protective equipment such as child safety seats and programs is urgently needed.

Accidents, Traffic ; Adolescent ; Child ; Child, Preschool ; Craniocerebral Trauma ; epidemiology ; Humans ; Infant ; Iran ; epidemiology ; Retrospective Studies

OBJECTIVETrauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northern India.

METHODSAn observational study of 748 patients chosen by random assortment was carried out over a period of 1 year (August 2008 to July 2009). Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted.

RESULTSInjuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6:1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries (94.92%) were much more common than penetrating injuries. Among patients with head injury, two-wheeler related accidents were the most common (40.3%). Most spinal cord injuries were caused by falls from height (51.09%). Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than upper limb fractures.

CONCLUSIONStrict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and planning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Craniocerebral Trauma ; epidemiology ; Female ; Humans ; India ; epidemiology ; Male ; Middle Aged ; Spinal Cord Injuries ; epidemiology ; Wounds and Injuries ; epidemiology