title: Head and neck injuries from the Boston Marathon bombing at four hospitals.
abstract: The aim of this study was to evaluate the imaging findings of head and neck injuries in patients from the Boston Marathon bombing. A total of 115 patients from the Boston Marathon bombing presenting to four hospitals who underwent imaging to evaluate for head and neck injuries were included in the study. Twelve patients with positive findings on radiography or cross-sectional imaging were included in the final analysis. The radiographic, computed tomography (CT), and magnetic resonance (MR) imaging features of these patients were evaluated for the presence of shrapnel and morphological abnormality. Head and neck injuries were seen in 12 out of 115 patients presenting to the four hospitals. There were secondary blast injuries to the head and neck in eight patients, indicated by the presence of shrapnel on imaging. In the four patients without shrapnel, there were two with subgaleal hematomas, one with facial contusion and one with mastoid injury. There were two patients with subarachnoid hemorrhage, one with brain contusion, one with cerebral laceration, and one with globe rupture. There was frontal bone, nasal bone, and orbital wall fracture in one patient each. Imaging identified 26 shrapnel fragments, 21 of which were ball bearings. Injuries to the head and neck region identified on imaging from the Boston Marathon bombing were not common. The injuries seen were predominantly secondary blast injuries from shrapnel, and did not result in calvarial penetration of the shrapnel fragments.
authors.affiliation: Division of Emergency Radiology, Department of Radiology, Massachusetts General Hospital, 2 Avery Street, 32H, Boston, MA, 02141, USA. mghpartners@yahoo.com.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Singh
authors.affiliation: Division of Neuroradiology, Department of Radiology, Boston Medical Center, Boston, MA, 02118, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Buch
authors.affiliation: Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02141, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Sung
authors.affiliation: Division of Emergency Radiology, Department of Radiology, Massachusetts General Hospital, 2 Avery Street, 32H, Boston, MA, 02141, USA.
authors.forename: Hani
authors.initials: H
authors.lastname: Abujudeh
authors.affiliation: Division of Neuroradiology, Department of Radiology, Boston Medical Center, Boston, MA, 02118, USA.
authors.forename: Osamu
authors.initials: O
authors.lastname: Sakai
authors.affiliation: Division of Emergency Radiology, Department of Radiology, Brigham and Woman's Hospital, Boston, MA, 02141, USA.
authors.forename: Sodickson
authors.initials: S
authors.lastname: Aaron
authors.affiliation: Division of Emergency Radiology, Department of Radiology, Massachusetts General Hospital, 2 Avery Street, 32H, Boston, MA, 02141, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lev
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001753:Blast Injuries / Q000175:diagnosis*; D001900:Boston; D002648:Child; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D003952:Diagnostic Imaging; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D023481:Terrorism; D014193:Trauma Centers
keywords: Blast injury; Boston Marathon bombing; Shrapnel