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DOI: 10.1055/s-0031-1275257
Management of Nonmissile Penetrating Brain Injuries: A Description of Three Cases and Review of the Literature
Publikationsverlauf
Publikationsdatum:
14. April 2011 (online)
ABSTRACT
Nonmissile penetrating intracranial injuries are uncommon events in modern times. Most reported cases describe trajectories through the orbit, skull base foramina, or areas of thin bone such as the temporal squama. Patients who survive such injuries and come to medical attention often require foreign body removal. Critical neurovascular structures are often damaged or at risk of additional injury resulting in further neurological deterioration, life-threatening hemorrhage, or death. Delayed complications can also be significant and include traumatic pseudoaneurysms, arteriovenous fistulas, vasospasm, cerebrospinal fluid leak, and infection. Despite this, given the rarity of these lesions, there is a paucity of literature describing the management of neurovascular injury and skull base repair in this setting. The authors describe three cases of nonmissile penetrating brain injury and review the pertinent literature to describe the management strategies from a contemporary cerebrovascular and skull base surgery perspective.
KEYWORDS
Penetrating trauma - brain - skull base - pseudoaneurysm
REFERENCES
- 1 Dempsey L C, Winestock D P, Hoff J T. Stab wounds of the brain. West J Med. 1977; 126 1-4
- 2 Mason F. Case of a young man who had a pitchfork driven into his head four inches who speedily got well. Lancet. 1870; 1 700-701
- 3 Penfield W, Buckley R C. Punctures of the brain. Arch Neurol Psychiatry. 1928; 20 1-13
- 4 Pilcher C. Penetrating wounds of the brain: an experimental study. Ann Surg. 1936; 103 173-198
- 5 Farhadi M R, Becker M, Stippich C, Unterberg A W, Kiening K L. Transorbital penetrating head injury by a toilet brush handle. Acta Neurochir (Wien). 2009; 151 685-687
- 6 Kurt G, Börcek A O, Kardeş O, Aydincak O, Ceviker N. Transcranial arrow injury: a case report. Ulus Travma Acil Cerrahi Derg. 2007; 13 241-243
- 7 Matsuyama T, Okuchi K, Nogami K, Hata M, Murao Y. Transorbital penetrating injury by a chopstick—case report. Neurol Med Chir (Tokyo). 2001; 41 345-348
- 8 Vaicys C, Hunt C D, Heary R F. Successful recovery after an orbitocranial injury. J Trauma. 2000; 49 788
- 9 Tiwair S M, Singh R G, Dharker S R, Chaurasia B D. Unusual craniocerebral injury by a key. Surg Neurol. 1978; 9 267
- 10 Markham J W, McCleve D E, Lynge H N. Penetrating craniocerebral injuries. Report of two unusual cases. J Neurosurg. 1964; 21 1095-1097
- 11 Dooling J A, Bell W E, Whitehurst Jr W R. Penetrating skull wound from a pair of scissors. Case report. J Neurosurg. 1967; 26 636-638
- 12 Lichter H, Snir M, Segal K, Yassur Y. Penetrating orbitocranial knife injury. J Pediatr Ophthalmol Strabismus. 1999; 36 44-46
- 13 Chibbaro S, Tacconi L. Orbito-cranial injuries caused by penetrating non-missile foreign bodies. Experience with eighteen patients. Acta Neurochir (Wien). 2006; 148 937-941 discussion 941-942
- 14 Campbell E, Kuhlenbeck H. Mortal brain wounds; a pathologic study. J Neuropathol Exp Neurol. 1950; 9 139-149
- 15 MacEwen C J, Fullarton G. A penetrating orbitocranial stab wound. Br J Ophthalmol. 1986; 70 147-149
- 16 Saint-Martin P, Prat S, Bouyssy M, Sarraj S, O'Byrne P. An unusual death by transcranial stab wound: homicide or suicide?. Am J Forensic Med Pathol. 2008; 29 268-270
- 17 Smely C, Orszagh M. Intracranial transorbital injury by a wooden foreign body: re-evaluation of CT and MRI findings. Br J Neurosurg. 1999; 13 206-211
- 18 Gupta P K, Thajjuddin B A, Al Sikri N E, Bangroo A K. Penetrating intracranial injury due to crochet needle. Pediatr Neurosurg. 2008; 44 493-495
- 19 Gutiérrez-González R, Boto G R, Rivero-Garvía M, Pérez-Zamarrón A, Gómez G. Penetrating brain injury by drill bit. Clin Neurol Neurosurg. 2008; 110 207-210
- 20 Martin S, Raup G H, Cravens G, Arena-Marshall C. Management of embedded foreign body: penetrating stab wound to the head. J Trauma Nurs. 2009; 16 82-86
- 21 Grobbelaar A, Knottenbelt J D. Retained knife blades in stab wounds of the face: is simple withdrawal safe?. Injury. 1991; 22 29-31
- 22 Nath F P, Teasdale E, Mendelow A D. Penetrating injury of the tuberculum sellae. Neurosurgery. 1984; 14 598-600
- 23 Okay O, Dağlioğlu E, Ozdol C, Uckun O, Dalgic A, Ergungor F. Orbitocerebral injury by a knife: case report. Neurocirugia (Astur). 2009; 20 467-469
- 24 Benoit B G, Wortzman G. Traumatic cerebral aneurysms. Clinical features and natural history. J Neurol Neurosurg Psychiatry. 1973; 36 127-138
- 25 Parkinson D, West M. Traumatic intracranial aneurysms. J Neurosurg. 1980; 52 11-20
- 26 Horiuchi T, Nakagawa F, Miyatake M, Iwashita T, Tanaka Y, Hongo K. Traumatic middle cerebral artery aneurysm: case report and review of the literature. Neurosurg Rev. 2007; 30 263-267 discussion 267
- 27 Kieck C F, de Villiers J C. Vascular lesions due to transcranial stab wounds. J Neurosurg. 1984; 60 42-46
- 28 Acosta C, Williams Jr P E, Clark K. Traumatic aneurysms of the cerebral vessels. J Neurosurg. 1972; 36 531-536
- 29 Litvack Z N, Hunt M A, Weinstein J S, West G A. Self-inflicted nail-gun injury with 12 cranial penetrations and associated cerebral trauma. Case report and review of the literature. J Neurosurg. 2006; 104 828-834
- 30 Haddad F S, Haddad G F, Taha J. Traumatic intracranial aneurysms caused by missiles: their presentation and management. Neurosurgery. 1991; 28 1-7
- 31 Levy M L, Rezai A, Masri L S et al.. The significance of subarachnoid hemorrhage after penetrating craniocerebral injury: correlations with angiography and outcome in a civilian population. Neurosurgery. 1993; 32 532-540
- 32 Maras D, Lioupis C, Magoufis G, Tsamopoulos N, Moulakakis K, Andrikopoulos V. Covered stent-graft treatment of traumatic internal carotid artery pseudoaneurysms: a review. Cardiovasc Intervent Radiol. 2006; 29 958-968
- 33 Heininger A D, Will B E, Krueger W A, Kottler B M, Unertl K E, Stark M. Detection and identification of the pathogenic cause of a brain abscess by molecular genetic methods. Anaesthesist. 2004; 53 830-835
- 34 van Dellen J R, Lipschitz R. Stab wounds of the skull. Surg Neurol. 1978; 10 110-114
- 35 Nathoo N, Boodhoo H, Nadvi S S, Naidoo S R, Gouws E. Transcranial brainstem stab injuries: a retrospective analysis of 17 patients. Neurosurgery. 2000; 47 1117-1122 discussion 1123
Saleem I AbdulraufM.D.
Center for Cerebrovascular and Skull Base Surgery, Saint Louis University
3635 Vista Ave, 5th Floor DT, St. Louis, MO 63110
eMail: absdulsi@slu.edu