[Spine injuries due to horse riding accidents - an analysis of 30 cases]. / Reitunfallbedingte Wirbelsäulenverletzungen - eine Analyse von 30 Fällen.

INTRODUCTION: Horseback riding entails several risk factors that predispose the participant to injury. Especially craniocerebral as well as spinal trauma were common reasons for severe injuries. Hence, it is important to use effective protective gear during riding activities. However, the protective effect of actual safety vests and helmets in case of accident is still unknown. In the present study reasons, mechanisms and patterns of equine-related spine injuries were analyzed. Based on these data the effectiveness of used protective gear during accident was assessed. MATERIAL AND METHODS: 30 equestrians took part in a questionnaire survey. Based on these answered questionnaires reasons, mechanisms and patterns of equine-related injuries as well as used protective gear during accident were evaluated and analyzed. RESULTS: 24 patients (80 %) were female and 6 (20 %) were male. The median age at the time of injury was 36 years (range 14 - 72 years). The causalities suffered from 18 fractures (60 %) and 11 discoligamentous injuries (37 %), in one case a bone-bruise-injury (3 %) was found. 7 equestrians (23 %) wore a safety vest at time of injury. DISCUSSION: Despite wearing a safety vest, the spine can get damaged when accident occurred. It is not possible to create vests for equestrians capable of protecting against all spine injuries in all accidents. If the energy impact is too high, serious injuries can result, even though protective body gear is worn. But the development of improved safety vests is necessary to reduce the number of severe spine injury in the future.

[Complicating neonatal Escherichia coli meningitis]. / Subdurale gekammerte Abszesse nach neonataler Colimeningitis - Fallbericht über eine erfolgreiche konservative Therapie -

Neonatal Escherichia coli meningitis is a serious disease with high mortality and poor outcome. Ventriculitis, brain abscess and subdural empyema are frequent, with no homogeneous recommendations available for these complications. The case of a newborn infant who developed sepsis and meningitis caused by E. coli is presented. During intravenous treatment with ampicillin, cefotaxime and gentamycin in recommended doses, the patient developed severe subdural abscesses detected on MRI. After consequent antibiotic therapy over 2 months with fosfomycin, amikacin and meropenem the patient improved clinically and the abscesses regressed and disappeared without neurosurgical intervention. At the age of 6.5 months the infant is healthy and well developed. The conservative treatment of subdural abscesses complicating neonatal Escherichia coli meningitis without neurosurgical intervention is possible. The treatment of the individual case should be discussed between pediatrician and neurosurgeon.