Penetrating skull injury with six inch fence rod

Kothari, Kamlesh; Singh, Amit Kumar; Das, Sankha Subhra

doi:10.4103/0975-5950.111384

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…There have been other reports of bizarre transcranial penetrating objects, including transorbital chopsticks, transcranial nails and transfontanelle needles. However, we were unable to identify a previously reported case of a child with a retained object penetrating and exiting the skull, involving the supratentorial and infratentorial compartments and crossing the midline [3,4,5,6,7,8,9,10,11,12,13,14,15]. …”

Section: Discussionmentioning

confidence: 85%

Bilateral Through-and-Through Trajectory of a Low-Velocity Transcranial Penetrating Foreign Object in a Twelve-Month-Old

Heiferman

Hayward²,

Ashley³

2015

Pediatr Neurosurg

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A 12-month-old girl sustained a penetrating intracranial trauma of a thin aluminum rod traversing from the left frontal bone and exiting the right occipital bone. The rod entered the left anterior frontal lobe, traveled through the ventricular system, narrowly missed the right posterior cerebral artery by less than 1 mm and exited through the right cerebellum. The rod was surgically extracted, and the child remained neurologically intact. Pre- and postoperative vascular imaging, antibiotics, seizure prophylaxis and surgical planning are paramount to successful care of these delicate cases.

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Section: Discussionmentioning

confidence: 85%

Bilateral Through-and-Through Trajectory of a Low-Velocity Transcranial Penetrating Foreign Object in a Twelve-Month-Old

Heiferman

Hayward²,

Ashley³

2015

Pediatr Neurosurg

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“…Nonprojectile penetrating skull injuries as a result of fall from heights are very rare and seldom reported in literatures. A penetrating head injury occurs when the dura mater is breached as a result of either high-velocity objects like bullets and missiles or lower velocity objects such as knife (most common) and rarely nails, keys, pencils, and chopsticks and/or 1 , 11 – 14 wooden, stony, glassy, and other industrial or environmental objects. 3 , 15 – 18 In most cases, the bone fragments from a skull fracture are driven into the brain.…”

Section: Discussionmentioning

confidence: 99%

“…Penetrating head injury arises when a projectile or nonprojectile object breaks through the cranium and its contents. 1 – 5 They are relatively unusual wounds that constitute about only 0.4% of all head injuries. 2 These kinds of injuries usually occur as a result of gunshot, missiles or nonmissiles, or wooden or metal objects leading to closed or open wounds, although motor vehicle accidents or occupational accidents and suicidal attempts may also occur.…”

Section: Introductionmentioning

confidence: 99%

Nonprojectile penetrating iron rod from the oral cavity to the posterior cranial fossa: a case report and review of literature

Lan¹,

Richard²,

Li³

et al. 2018

IMCRJ

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IntroductionNonprojectile penetrating skull base injuries as a result of falls have rarely been confronted in normal neurosurgery although a few nonmissile injuries have been reported. These kinds of injuries represent a life-threatening emergency.Case presentationWe present an unusual case of a 25-year-old male construction worker who suffered an accidental penetrating skull base injury when he fell on a metal rod while he was walking on a 2-meter-high platform. He was clinically stable at presentation. Skull radiograph showed a solid metallic bar, 30 cm long, that penetrated through the right anguli oris eminence and was lodged low in the right occipital bone.ConclusionPenetrating injury to the head is considered a form of severe traumatic brain injury. Although case of penetrating head injuries as a result of fall from heights are very rare, we anticipate the construction works on high-rise buildings are at maximum risk. We advise that removal of this kind of foreign bodies be done in the theater and not outside because of risk of involvement of larger vessels leading to fatal hemorrhage. We further suggest that patients with nonprojectile injuries should undergo a preoperative computed tomography-angiography to rule out any vascular injury.

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“…Posttraumatic epilepsy (PTE) is also a complication of penetrating brain injuries. [ 20 26 27 28 29 ] In two series involving military personnel,[ 16 30 ] the total combined incidence of early and late posttraumatic seizures ranged from 33% to 53% and was highest with penetrating head injuries. While the etiopathogenesis of PTE is still an enigma shrouded in mystery, the high rate of PTE after penetrating brain injury is probably due to direct traumatic injury to the cerebral cortex with subsequent cerebral scarring.…”

Section: Discussionmentioning

confidence: 99%

Nonmissile anterior skull-base penetrating brain injury: Experience with 22 patients

Lan

Richard

et al. 2018

Asian J Neurosurg

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Background: Nonmissile anterior skull-base penetrating brain injuries (NASBPBIs) have specific characteristic features that are different from missile injuries. Our study presents our experiences on the characteristic features as well as management of NASBPBI. Materials and Methods: We retrospectively reviewed 22 consecutive patients with NASBPBI managed at our institute during a 13-year period. The mechanism of injury, clinical investigations, and complications were analyzed, with more emphasis on diagnostic and treatment regimen. Results: The 22 cases included in our study comprise of 20 males and 2 females. Majority (72.7%) of the patients were adults with a mean age of 27.5 years. The mechanisms of injury often include accidental fall, either onto a small-diameter sharp object (10 cases) or while carrying such an object in the hand (4 cases). The other common mechanisms were stabbing, accident, or during an altercation (8 cases). Clinical manifestations included periorbital hematoma (10 cases, 45.5%) and cerebrospinal fluid rhinorrhea or orbitorrhea (4 cases, 18.2%) as well as signs of embedded foreign object (8 cases, 36.4%). We performed emergency craniotomy in 21 cases and skin debridement in one case. Postoperative complications were abscess (1 case), epilepsy (1 case), and traumatic carotid-cavernous fistula (1 case). Conclusion: Nonmissile injuries are generally on the rise and therefore deserve more attention. We observed that clinical outcomes were excellent in 14 (Glasgow Outcome Scale [GOS] score of 5) and good in the remaining 8 patients (GOS of 4) during 6-month–10-year (mean 4.6 years) follow-ups.

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Penetrating skull injury with six inch fence rod

Cited by 6 publications

References 8 publications

Bilateral Through-and-Through Trajectory of a Low-Velocity Transcranial Penetrating Foreign Object in a Twelve-Month-Old

Bilateral Through-and-Through Trajectory of a Low-Velocity Transcranial Penetrating Foreign Object in a Twelve-Month-Old

Nonprojectile penetrating iron rod from the oral cavity to the posterior cranial fossa: a case report and review of literature

Nonmissile anterior skull-base penetrating brain injury: Experience with 22 patients

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