Endoscopic Treatment of Transnasal Intracranial Penetrating Foreign Body

Lee, Dong Hoon; Seo, Bo Ra; Lim, Sang Chul

doi:10.1097/scs.0b013e31822e829f

Cited by 22 publications

(11 citation statements)

References 13 publications

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“…3,5,12–16 Endoscopic surgery has allowed for a safe and minimally invasive approach for removal of the FB. 3,5,12–16 In our case, the skull base was exposed endoscopically with the i n situ FB, which allowed for visualization during removal and subsequent repair. Familiar endoscopic techniques can then be used for repair of CSF leaks with a high success rate because traumatic CSF leaks often heal well.…”

Section: Discussionmentioning

confidence: 99%

Presentation, Workup, and Management of Penetrating Transorbital and Transnasal Injuries: A Case Report and Systematic Review

Ghadersohi

Ference

Detwiller

et al. 2017

Am J Rhinol�Allergy

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Section: Discussionmentioning

confidence: 99%

Presentation, Workup, and Management of Penetrating Transorbital and Transnasal Injuries: A Case Report and Systematic Review

Ghadersohi

Ference

Detwiller

et al. 2017

Am J Rhinol�Allergy

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“…Neuroendoscopy is a useful operative tool, which can be employed to remove foreign body or repair the dural defect causing CSF rhinorrhoea, 5 whenever conservative management fails. Craniotomy may be warranted if there is a sizable abscess or cerebral haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Transnasal penetrating intracranial injury with a chopstick

Chan

Pang²,

Wong³

2014

Hong Kong Med J

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A 49-year-old Chinese man, who was a psychiatric in-patient, self-inserted a wooden chopstick into his A B S T R A C TWe report the first case of a transnasal penetrating intracranial injury in Hong Kong by a chopstick. A 49-year-old man attempted suicide by inserting a wooden chopstick into his left nose and then pulled it out. The chopstick caused a transnasal penetrating brain injury, confirmed by contrast magnetic resonance imaging of the brain. He was managed conservatively. Later he developed meningitis without a brain abscess and was prescribed antibiotics for 6 weeks. He enjoyed a good neurological recovery. This case illustrates that clinician should have a high index of suspicion for penetrating intracranial injury due to a nasally inserted foreign body, even though it had already been removed. In such cases left nose and then pulled it out in November 2012. He was subsequently assessed by an ear, nose and throat surgeon. No nasal foreign body was seen and there was no epistaxis. Brain computed tomography (CT) 6 hours after the injury showed a trace amount of haemorrhage over the right gyrus rectus and a small amount of pneumocephalus over the right anterior fossa (Fig 1), and hence the neurosurgical unit was consulted. Six hours after the incident his vital signs were stable and he was afebrile; his Glasgow Coma Scale score was E4M6V4. His speech appeared confused, as if in a premorbid state. There was no neurological deficit, and no cerebrospinal fluid (CSF) rhinorrhoea upon stress testing. Contrast magnetic resonance imaging (MRI) of the brain was performed on the next day, which showed a long haemorrhagic tract extending from right paramidline anterior skull base, coursing postero-superiorly across medial right frontal lobe, closely adjacent to the right frontal horn, and ending at the vertex region (Fig 2), and a trace of intraventricular haemorrhage. On the same day he developed fever. Lumbar puncture yielded turbid CSF, with the presence of Gram-positive cocci, as well as low CSF glucose and high CSF protein concentrations. Conservative management was adopted. On an empirical basis, intravenous ceftriaxone, vancomycin, and metronidazole were prescribed. Prophylactic anticonvulsant therapy (phenytoin) was also given. The CSF culture grew Staphylococcus aureus and Citrobacter koseri. The antibiotic regimen was switched to intravenous ceftriaxone and oral metronidazole. The patient's recovery was excellent, as reflected by normalisation of body temperature and inflammatory markers. On

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“…Intracranial foreign bodies such as metallic objects, wood and bone are usually due to penetrating injuries through the cranial bones, orbit, and ear [1,2]. Sewing needles are among the more unusual foreign bodies that may be found in the brain.…”

Section: Historymentioning

confidence: 99%

“…Penetrating trauma secondary to gunshot wounds are a common cause of injury in neurosurgical practice [3]. Penetrating craniocerebral injuries from objects such as needles, metal chopsticks,pieces of wood and nails, however, are rare [1,4]. Another common cause is insertion of foreign bodies through the anterior fontanelle in attempted infanticide [5].…”

Section: Introductionmentioning

confidence: 99%

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Intracranial foreign body through the sagittal sinus: case report and review of literature

et al. 2016

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Objective: To investigate therapeutic effect of surgery that removes an intracranial foreign body through the intracranial sagittal sinus with help of intraoperative navigation and intraoperative fluorescein angiography. Methods: We performed operation on a patient with intracranial foreign body. Under guidance of intraoperative navigation, combined with intraoperative fluorescein angiography to avoid sagittal sinus damage, we opened the dura mater and removed the foreign body with minimally invasive technique. Results: Surgical positioning was very accurate with neuronavigation, intraoperative fluorescein angiography displayed the venous drainage along the sagittal sinus in order to prevent its rupture; the intracranial foreign body was removed successfully without any post-operative complications. Conclusion: Intraoperative navigation and intraoperative fluorescein angiography technologies to guide the removal of the foreign metal body inserted through the sagittal sinus have the following advantages: Accurate positioning, minimally invasive, reliable curative effect, quick postoperative recovery and overall fewer complications.

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Endoscopic Treatment of Transnasal Intracranial Penetrating Foreign Body

Abstract: Transnasal intracranial penetrating injury is rare. We report a case of transnasal intracranial penetrating metallic chopstick, which was removed successfully by endoscopic approach, and management of transnasal intracranial penetrating injuries.

Cited by 22 publications

References 13 publications

Presentation, Workup, and Management of Penetrating Transorbital and Transnasal Injuries: A Case Report and Systematic Review

Presentation, Workup, and Management of Penetrating Transorbital and Transnasal Injuries: A Case Report and Systematic Review

Transnasal penetrating intracranial injury with a chopstick

Intracranial foreign body through the sagittal sinus: case report and review of literature

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