Intracranial Foreign Body in a Patient With Paranoid Schizophrenia

Andereggen, Lukas; Biétry, Damien; Kottke, Raimund; Andres, Robert H.

doi:10.1097/scs.0000000000003843

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…Primary wound care is a frequent task in any emergency care unit, and careful inspection of any scalp laceration is essential. Retention of a foreign body is not uncommon, and physical examination is in general followed by routine radiography 4,5 . Not infrequently, however, scalp wounds are sutured without further radiological evaluation, and diagnosis of an underlying cranial penetrating injury is not made until local infection or altered consciousness becomes apparent in the patient.…”

Section: Discussionmentioning

confidence: 99%

Overlooked Piece of Wood Served as a Vector Transmitting Clostridium Perfringens: A Case Report Emphasizing the Awareness of Gas-Forming Organisms in Posttraumatic Pneumocephalus

Andereggen

Beck

2021

Journal of Craniofacial Surgery

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reduction in the rate of hypoesthesia with piezoelectric surgery compared to drilling. 13 A retrospective study using piezoelectric device for transantral ION decompression to treat trigeminal neuralgia associated with ''compression syndrome'' showed 78% excellent pain relief, however, 11/14 had mild to severe postoperative ION numbness, with a mean follow up of 29 months. 17 The concern with ION decompression using piezoelectric technology is that the nerve is located within a bony canal that can potentially transmit destructive oscillations to the underlying nerve causing structural and physiologic conduction deficits. The effects of ultrasonic waves transmitted through bone causing nerve injury was demonstrated by Tao et al, 18 who developed a novel mouse model using external ultrasound energy to achieve focal indirect optic nerve injury. Using a microtip probe which transmitted 20 kHz ultrasound waves at the supraorbital ridge, directly above the optic nerve, the ultrasound waves were delivered through the bone at the fixed portion of the optic nerve at the entrance to the optic canal resulting in focal optic nerve injury. Therefore, caution with a piezoelectric device near nerve tissue that is encased within bone is paramount to avoid injury.This case study demonstrates a novel approach for ION decompression to treat chronic hyperesthesia associated with a healed orbital floor fracture. Defining the limits of the healed fracture was facilitated by intraoperative 3D navigation. Piezoelectric device provided precision, minimal bleeding, and no clinical evidence of structural nerve injury. However, we recommend judicious use of this device when in close proximity to the ION during decompression to avoid structural and or physiologic injury.

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Section: Discussionmentioning

confidence: 99%

Overlooked Piece of Wood Served as a Vector Transmitting Clostridium Perfringens: A Case Report Emphasizing the Awareness of Gas-Forming Organisms in Posttraumatic Pneumocephalus

Andereggen

Beck

2021

Journal of Craniofacial Surgery

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“…In this patient, we suspected mental illness based on her statement that she feels pleasure after inserting trimmed wooden toothpicks into the maxillary sinuses and nasal cavity through an oroantral fistula. Andereggen et al 7 reported a paranoid schizophrenic patient who voluntarily inserted a foreign body into the cranial cavity, and Alsarraf and Bailet 8 reported a patient who intentionally placed a foreign body into the sphenoidal sinus. Thus, voluntary insertion of foreign bodies into the body is relatively common among patients with mental illnesses, so evaluating and managing their psychiatric problems during treatment planning is necessary to prevent recurrence.…”

Section: Discussionmentioning

confidence: 99%

A case of foreign bodies self-inserted into the paranasal sinus via an oroantral fistula

Kwok

Cho

Park

et al. 2020

SAGE Open Medical Case Reports

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Foreign bodies in the nasal cavity are rarely seen in adults, and most cases are traumatic in origin. Multiple foreign bodies in adults are particularly rare. Foreign bodies induce pain, bleeding, and infection but are easily removed in most cases. A patient presented with multiple toothpick foreign bodies in the nasal cavity, which were introduced intentionally through an oroantral fistula. We report an adult case with 37 toothpicks in the nasal cavity, which were removed successfully with a nasal endoscope. Oroantral fistula closure was achieved through oral surgery. Voluntary insertion of foreign bodies into the body by patients with mental illnesses is relatively difficult to identify. Evaluating and managing the psychiatric problems of such patients during treatment planning are necessary.

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“…A CT of his brain revealed an 11 cm construction nail passing from the nasal cavity through the ethmoid air cells and into his frontal lobe. This was removed via a bi-frontal craniotomy [19] and the patient received 10 days of ceftriaxone, metronidazole, and flucloxacillin, as well as a tetanus booster. The patient was recommenced on his regular olanzapine which was associated with a significant reduction of his psychotic symptoms.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2019

J Otolaryngol Rhinol

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exploring epistaxis with a psychiatric aetiology. This paper aims to summarise the existing literature documenting the various causes and management of psychiatric epistaxis-an uncommon cause for a common condition. TraumaPsychiatric conditions presenting as traumatically induced epistaxis appear in two distinct groups; chronic trauma due to compulsive behaviours, and acute injuries.Epistaxis secondary to trauma, especially digital trauma, is well established as a common presenting complaint [5]. Compulsive nose picking, termed rhinotillexomania, is a common habit with reported rates of up to 97.5% [6] in adolescents and 91% of adults [7]. Rates of epistaxis secondary to rhinotillexomania in these studies were 25% for adolescents [7] and 18% for adults [6]. Jefferson, et al. also reported a coexistence of nail biting, cuticle picking, hair pulling, and scratching of a specific spot in individuals with frequent rhinotillexomania.Chronic rhinotillexomania is associated with self-mutilation, typically resulting in erosion and/ or perforation of the nasal spectrum, turbinates, ethmoidal sinus, medial orbital wall [8][9][10][11]. The self-reported rate of injuries more serious than a simple bleed ranges from 0.8% to 2% of those with rhinotillexomania [6,7].Self-mutilation is defined as a deliberate act of destruction and/or body alteration without suicidal intent and is noted to occur in a wide variety of psychiatric conditions [12,13]. Major self-mutilation that results in permanent organ loss or dysfunction is

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Intracranial Foreign Body in a Patient With Paranoid Schizophrenia

Cited by 9 publications

References 13 publications

Overlooked Piece of Wood Served as a Vector Transmitting Clostridium Perfringens: A Case Report Emphasizing the Awareness of Gas-Forming Organisms in Posttraumatic Pneumocephalus

Overlooked Piece of Wood Served as a Vector Transmitting Clostridium Perfringens: A Case Report Emphasizing the Awareness of Gas-Forming Organisms in Posttraumatic Pneumocephalus

A case of foreign bodies self-inserted into the paranasal sinus via an oroantral fistula

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