{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T07:45:09Z","timestamp":1711525509592},"reference-count":26,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Traumatic brain injury (TBI) represents one of the leading public health problems and a significant cause of neurological damage. Unintentional causes of TBI are the most frequent. However, fruit falling over the head causing TBI is extremely rare. In the Amazon region, accidents with ouri\u00e7os, a coconut-like shell fruit, seem relatively common. However, to the best our knowledge, it has never been described in a scientific journal before. Therefore, we aim to evaluate a series of TBI caused by this tropical fruit.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>This study is a retrospective review of 7 TBI cases due to the fall of ouri\u00e7os admitted to two tertiary hospitals in the Amazon region from January 2017 to December 2018. The collected data included: age, Glasgow Coma Scale, skull fracture, venous sinus injury, hematoma, surgical treatment, and outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>All patients were men, with an average age of 38, ranging from 8 to 77-years-old. Four out of seven had skull fractures. Five patients developed an epidural hematoma, and two of them had an associated subdural hematoma. Dura mater injury was observed in two patients, whereas four patients were operated. There was one related death.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>This case series is the first to describe an unconventional but potentially fatal cause of TBI in the Amazon: the falling of the Brazil-nut fruit. Most patients were diagnosed with mild TBI. Nevertheless, patients may have cranial fractures and epidural hematomas, leading to death when there\u2019s a delay in medical assistance.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_279_2021","type":"journal-article","created":{"date-parts":[[2021,8,8]],"date-time":"2021-08-08T19:30:54Z","timestamp":1628451054000},"page":"399","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Traumatic brain injury caused by Brazil-nut fruit in the Amazon: A case series"],"prefix":"10.25259","volume":"12","author":[{"given":"Mylena Miki Lopes","family":"Ideta","sequence":"first","affiliation":[{"name":"Departament of Neurosurgery, Get\u00falio Vargas University Hospital - Federal University of Amazonas, Manaus, AM, Brazil,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise Makarem","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Departament of Neurosurgery, Get\u00falio Vargas University Hospital - Federal University of Amazonas, Manaus, AM, Brazil,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo Lopes","family":"de Castro","sequence":"additional","affiliation":[{"name":"Departament of Neurosurgery, Get\u00falio Vargas University Hospital - Federal University of Amazonas, Manaus, AM, Brazil,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Antonio Leal","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Maradei - Cl\u00ednica dos Acidentados, Bel\u00e9m, PA, Brazil,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik Leonardo Jennings","family":"Sim\u00f5es","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Regional do Baixo Amazonas, Santar\u00e9m, PA, Brazil,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Buzaglo","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Departament of Neurosurgery, Get\u00falio Vargas University Hospital - Federal University of Amazonas, Manaus, AM, Brazil,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robson Luis Oliveira","family":"de Amorim","sequence":"additional","affiliation":[{"name":"Departament of Neurosurgery, Get\u00falio Vargas University Hospital - Federal University of Amazonas, Manaus, AM, Brazil,"},{"name":"Department of Neurosurgery, University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2021,8,9]]},"reference":[{"key":"10.25259\/SNI_279_2021\/ref-1","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1136\/bmj.289.6460.1717","article-title":"Falls from trees and tree associated injuries in rural Melanesians","volume":"289","author":"Barss","year":"1984","journal-title":"Br Med J (Clin 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