Non-missile penetrating brain injuries: cases registry in Sohag University Hospital

Abstract

Background: Non-missile penetrating brain injuries are rarely seen in the surgical practice and few international literatures' reported case reports or small case series, and it comprises a small percentage of head trauma cases. We reported a group of 18 cases of penetrating injuries with different tools and various mechanisms. We reported their epidemiological criteria, mechanism of trauma, complications, and their prognosis. Aim: The purpose of this study is to report different patients' criteria and the method of trauma and the prognosis.Patients and methods: A retrospective study was done in Trauma unit, Sohag University, between November 2012 and October 2014. Eighteen patients were reported with different mechanisms of trauma. All patients were clinically tested and subjected to CT brain. Cautious removal of the penetrating object with debridement of surrounding tissues was done. Patients were transferred to ICU for 48-72 h. Results: Patients were subjected to operative intervention, and they were followed up for 3 years. Males were the predominant gender, 13 cases (72.2%), and the young age was higher than the elderly. The Glasgow outcome score was 15 in 13 patients and was 4 in five patients. Transient epileptic fits occurred in six patients and controlled on antiepileptic drugs. Five patients had a neurological deficit in the form of hemiparesis or monoparesis.Conclusion: Penetrating head injuries, although rare, are dangerous and should be cautiously managed and monitored in the ICU. The prognosis depends mainly on initial GCS and ventricular involvement, but in general, the prognosis is favorable.

Penetrating head injury by stones: a case series and review of the literature based on the type of injury

“…21 Even though the penetrating object was non-organic (knife, nail etc.,), the incidence was as high as 33% noted in the study by Abdelhameid and Saro. 22 In the present study, there were 2 out of 25 patients who developed infection, the incidence being 8%. This incidence was among the least in low-velocity PHI.…”

“…Prophylactic broad-spectrum antibiotics were advised by many authors for 1-2 weeks postoperatively to prevent infection. 22 Vascular injuries which were reported in PHI by various sharp objects were not noted in this review. They were unlikely to be seen in PHI by stones as stones were relatively blunt and might not cause too deep injuries.…”

A Rare Presentation of Triplegia Resulting from Penetrating Brain Trauma by a Hand-Held Dagger

“…Relevant to our case, objects that cross the midline, involve the ventricles & lie in the posterior fossa carry the worse outcome. 2,8 In our experience, we observed a most unusual outcome of triplegia. We have found no similar account in the extensive literature review.…”

“…2,4 Firearm injuries are synonymous with the former & outnumber the latter staggeringly but lowvelocity injuries such as in our case are the subject of rare case reports & series. A drill bit, bike key, screwdriver& even a toothbrush [5][6][7][8] have all been incriminated & depict the potential of these seemingly trivial objects to cause major neurological insults. 4 The extent of the injury is determined by the primary & ensuing secondary injury, which is most pertinent in blunt and missile trauma cases.…”

Unusual Penetrating Head Injury- A Rare Case Report

“…As compared to closed head injuries, penetrating injuries are less common. But when a penetrating injury occurs, it has a late diagnosis with worse prognosis and higher morbidity and mortality rates [1].…”