Skull stab wound from a metal railroad nail perforating the right frontal lobe

Carrillo-Ruíz, José Damián; Frade-García, A.; Bolaños-Jiménez, Rodrigo

doi:10.3109/02699052.2013.794959

Cited by 12 publications

(10 citation statements)

References 19 publications

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“…34,35 In cases of intracranial perforating foreign bodies, osteoclastic trepanation, craniotomy, and craniectomy offer different advantages for removing the foreign body. 36,37 Overall, optimal planning of foreign body removal is crucial for preservation and restoration of the surrounding anatomical structures. Precise reconstruction of soft tissue injuries will help achieve the best possible…”

Section: Foreign Body Removalmentioning

confidence: 99%

Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge

Voß

Thieme

Doll

et al. 2018

Craniomaxillofacial Trauma & Reconstruction

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Penetrating foreign bodies of different origins in the head and neck are rare and potentially dangerous injuries, which might pose problems for their detection, primary care, and final treatment. Depending on the severity of the underlying trauma, some injuries present a higher risk for the presence of foreign bodies. Minor wounds, including common lacerations, are likely to be contaminated with loose gravel debris or dental fragments, and need to be distinguished from severe wounds caused by impalement, shootings, stabbings, and explosions. Blast injuries resulting from terror attacks are challenging recent therapeutic concepts. Even though these injury patterns are uncommon, they carry the risk of impacted objects with dramatic consequences. Despite improving medical imaging techniques, detection remains a challenge as it is dependent on the material of the foreign body, the affected anatomical site, and the injury severity. Therefore, a detailed history of the circumstances leading to trauma is essential when foreign objects are not visible during clinical examination. Precise detection of the foreign body, its anatomical position, and the affected surrounding structures are vital, especially for impalement injuries of the head and neck area. Therefore, an interdisciplinary planning approach is essential prior to removal of the foreign object. Finally, tension-free anatomical adaptation of the corresponding structures is crucial for maintaining and restoring aesthetic and function. Here, we give an overview of the diagnosis and treatment of cases of foreign body injuries encountered in our department.

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Section: Foreign Body Removalmentioning

confidence: 99%

Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge

Voß

Thieme

Doll

et al. 2018

Craniomaxillofacial Trauma & Reconstruction

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“…The force required to penetrate the skull is about 11 times higher in the fronto-parietal region than the force needed to perforate the skin [5]. Extra care is important in history taking to define the exact mechanism of injury [6].…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

JNSK

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Penetrating intracranial injuries are uncommon in the civilian medical environment. The most common types of such injuries include occupational incidents, and criminal assaults. A 34-year-old prisoner with an intracranial injury produced by a nail is presented. Imaging studies showed that the nail had penetrated 1 cm lateral to the midline and 4.5 cm deep into the right frontal region with the tip in the third ventricle. Despite a 2-week delay in the treatment, the patient experienced a remarkably good recovery in a 2 years follow up.

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“…Knives pulled from the victim of stabbings by the perpetrator or inexperienced medical team members in the field tend to be jarred and twisted unnecessarily, causing additional trauma to affected structures. Penetrating knives removed by trained physicians in a fully equipped medical care setting have been shown to have better outcomes than those pulled in the field ( 32 , 33 ). A portion of the penetrating objects can remain partially outside of the cranial vault.…”

Section: Discussionmentioning

confidence: 99%

“…Vascular complications have been reported to range from 5 to 40% ( 27 , 33 ) in both high- and low-velocity penetrating injury, with traumatic aneurysm formation being the most commonly reported vascular injury ( 10 , 14 , 27 , 29 , 32 – 36 ). True aneurysms have been reported in high-velocity PBI, but the majority of these vascular injuries take the form of pseudoaneurysms, though this is based on data from high-velocity head wounds in wartime ( 10 , 37 – 39 ), and the incidence has not been well-documented in low-velocity PBI.…”

Section: Discussionmentioning

confidence: 99%

Penetrating Brain Injury after Suicide Attempt with Speargun: Case Study and Review of Literature

et al. 2014

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Penetrating cranial injury by mechanisms other than gunshots are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here, we present a case of penetrating brain injury by the low-velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of low-velocity penetrating brain injury (LVPBI), including benefit in delaying foreign body removal to allow for tamponade; the importance of history-taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using dual-energy CT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher-velocity forms of intracranial injury.

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Skull stab wound from a metal railroad nail perforating the right frontal lobe

Cited by 12 publications

References 19 publications

Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge

Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge

Untitled

Penetrating Brain Injury after Suicide Attempt with Speargun: Case Study and Review of Literature

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