Objectives: Facial fractures and associated traumatic brain injuries represent a worldwide public health concern. Therefore, we aimed to determine the pattern of brain injury accompanying facial fractures by comparing adult patients with and without facial fractures in terms of demographic, clinical, and imaging features. Methods: This single-center, retrospective study included 492 polytrauma patients presenting at our emergency department from January 2019 to July 2023, which were divided in two groups: with facial fractures (FF) and without facial fractures (non-FF). The following data were collected: age, sex, mechanism of trauma (road traffic accident, fall, and other causes), Glasgow Coma Scale (GCS), the evolution of the patient (admitted to a medical ward or intensive care unit, neurosurgery performed, death), and imaging features of the injury. Data were analyzed using descriptive tests, Chi-square tests, and regression analyses. A p-value less than 0.05 was considered statistically significant. Results: In the FF group, there were 79% (n = 102) men and 21% (n = 27) women, with a mean age of 45 ± 17 years, while in the non-FF group, there were 70% (n = 253) men and 30% (n = 110) women, with a mean age 46 ± 17 years. There was a significant association between brain injuries and facial fractures (p < 0.001, AOR 1.7). The most frequent facial fracture affected the zygoma bone in 28.1% (n = 67) cases. The most frequent brain injury associated with FF was subdural hematoma 23.4% (n = 44), and in the non-FF group, the most common head injury was intraparenchymal hematoma 29% (n = 73); Conclusions: Both groups shared similarities regarding gender, age, cause of traumatic event, and outcome but had significant differences in association with brain injuries, ICU admission, and clinical status.

3D rotational angiography is now increasingly used in routine neuroendovascular procedures––in particular, for situations where the analysis of two overlayed sets of volume imaging proves useful for planning the treatment strategy or for confirming the optimal apposition of the intravascular devices used. The aim of this study is to identify and describe the decision algorithm for which the overlay function of 3D rotational angiography volumes, high-resolution contrast-enhanced flat panel detector CT adapted for intravascular devices (VasoCT/DynaCT), non-enhanced flat detector C-arm volume acquisition functionality integrated with the angiography equipment (XperCT/DynaCT), and isovolumetric MRI volumes were all used in treatments performed in a series of 29 patients. Two superposed 3DRA volumes were used in the treatment aneurysms located at the junction of two vascular territories and for arteriovenous malformations with compartments fed from different vascular territories. The superposition function of a preoperatively acquired 3DRA volume and a postoperatively acquired VasoCT volume provides accurate information about the apposition of neuroendovascular endoprostheses used in the treatment of aneurysms. The automatic overlay function generated by the 3D workstation is particularly useful, but in about 50% of cases it requires manual operator-dependent correction, requiring a certain level of experience. In our experience, multimodal imaging brings an important benefit, both in the treatment decision algorithm and in the assessment of neuroendovascular treatment efficacy.

Post-mortem computed tomography (PMCT) is considered to be an useful tool in assessing stabbing injuries, allowing fast location of the lesions, as well as being able to perform an accurate description in relation to the point of entrance, depth and trajectories, especially when vascular lesions are involved. However, PMCT is limited when addressing thin lesions or superficial ones. The authors presented the description of a series of wounds, in cases of stabbing fatalities, which underwent multi-phase postmortem CT angiography (MPMCTA) prior to forensic autopsies. The acquired images were examined through axial views as well as 2D multiplanar and 3D reconstructions. MPMCTA proved to be an important asset in evaluating the wound trajectories and associated lesions, offering useful medico-legal details. When available, MPMCTA should be used as a standard in order to enhance the forensic classic investigation of stabbing deaths.

This study discusses the challenges encountered in implementing a detailed protocol for upper abdominal imaging using magnetic resonance imaging (MRI), ranging from patient preparation and sequence selection to clinical applications. MRI is a valuable non-invasive imaging modality employed both in the early detection of diseases and as a complementary tool for the detailed characterization of various pathologies. Nevertheless, performing an abdominal MRI examination can be challenging; therefore, the understanding of sequences is particularly important, as changing the parameters can not only influence the quality of the images but also optimize scanning time improve patient experience during the examination. The methodology illustrates the purpose of each sequence and the critical role of appropriate patient preparation. Results highlighted the significance of these factors in the evaluation of hepatic lesions, showing that the proper choice of sequences and parameters is essential for distinguishing benign from malignant findings and for achieving an accurate diagnosis. It was also shown that MRI plays an important role as a complementary technique in investigation of upper abdominal pathologies in order to avoid overexposure to radiation.

Background: Our goal was to evaluate the radiological patterns and clinical outcomes of brain injuries related to trauma, offering insight into the distribution of brain injuries, facial fractures and outcomes across road traffic accidents (RTAs), falls and other causes. Methods: Cerebral CT scans of 536 cases obtained between January 2019 and January 2024 were retrospectively reviewed. The collected data included demographics, etiology, transportation groups (driver, car occupant, pedestrian, motorcyclist, bicyclist), GCS (Glasgow Coma Scale), clinical outcome (ICU (intensive care unit) admission, neurosurgical intervention, mortality) and CT imaging features. Images were analyzed independently by two physicians. The findings reflect a selected population of polytrauma patients who underwent cerebral CT at a single emergency hospital. Results: Brain injury was identified in 39% of all subjects, the most frequent type of lesion being intraparenchymal hematoma (24%), followed by subdural hematoma (23%). Brain injury was numerically more frequent among patients with falls (45%) than among those involved in RTAs (37%), although this difference did not reach statistical significance in either unadjusted or age-, sex-, and mechanism-adjusted analysis (p > 0.05). CT patterns differed across transportation categories, with bicyclists showing associations with intraparenchymal hemorrhage and diffuse brain swelling and pedestrians with intraventricular hemorrhage (p < 0.05). However, given the small bicyclist subgroup (n = 6), these findings should be considered exploratory. Car occupants showed lower unadjusted odds of brain injury compared with drivers (OR: 0.50; 95% CI: 0.30–0.80), but this association was attenuated and no longer statistically significant after adjusting for age and sex (adjusted OR: 0.55; 95% CI: 0.27–1.15; p = 0.112). In multivariable analysis of in-hospital mortality, only age and severe GCS category remained independently associated with death; neither injury mechanism nor transportation category showed an independent association once these factors were accounted for. Conclusions: Brain injury was more frequently observed among patients with falls than among those involved in RTAs. Nevertheless, road traffic accidents accounted for the majority of polytrauma admissions. These findings highlight the importance of both road traffic safety measures and fall-prevention strategies, particularly among older adults.