• Title/Summary/Keyword: Penetrating head injury

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Penetrating Orbitocranial Injury of a Pencil in a Pediatric Patient (소아에서 발생한 연필에 의한 관통 뇌손상)

  • Hwang, Sun-Chul
    • Journal of Trauma and Injury
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    • v.25 no.1
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    • pp.28-31
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    • 2012
  • Pencils are common instruments for children to use and play with. This report describes an unusual penetrating orbitocranial injury in a 5-year-old girl who was struck in her facewith a pencil. She was holding it at a desk, and her friend pushed her back. The pencil penetrated the left lower eyelid and went deep into the right frontal lobe through the base of the skull. It was removed at the emergency room, after which brain CT was performed to detect the development of an intracranial hematoma. No complications occurred after conservative management with antibiotics and an antiepileptic drug. Pencils can be hazardous to children, and a penetrating head injury with a pencil may be managed without cranial surgery.

Clinical Analysis of Penetrating Neck Injury: Review of 42 Operated Cases (관통성 경부 손상에 관한 임상적 고찰)

  • Choe, Hwan;Hong, Seok-Jin;Kim, Yeon-Soo;Cho, Jae-Gu;Baek, Seung-Kuk;Woo, Jeong-Soo;Jung, Kwang-Yoon;Kwon, Soon-Young
    • Korean Journal of Bronchoesophagology
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    • v.16 no.2
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    • pp.121-125
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    • 2010
  • Background: Penetrating neck injuries are potentially dangerous and require emergency management because of the presence of vital structures in the neck. The risk of airway, vascular, neurological, and pharyngoesophageal injuries leads to many difficult diagnostic decisions. The purpose of this retrospective study is to evaluate our experience with management of penetrating neck injuries, and to assess treatment outcome. Material and Method: Forty-two consecutive patients were identified (26 patients from Korea university Ansan hospital, 16 patients from Guro hospital) as having penetrating neck injuries from 2003 to 2009. With review of medical records, variables were collected and evaluated including the location of injury, mechanism of injury, number of significant injuries, diagnostic modalities, duration of hospital stay and outcome. Results: The location of injury was zone I (lower neck) in 13 cases (31%), zone II (midportion of the neck) in 22 (52%), and zone III (upper neck) in 7 (17%). Injuries were caused by stab wounds in 23 patients, penetrating foreign bodies in 12. Among 35 patients who had deep injuries that violated the platysma, significant injuries, including major vascular (20), trachea (5) Pharyngoesophageal injuries (5) were identified in 24 patients. The mean hospital stay was 9.5 days. Conclusion: The penetrating trauma in the neck may show various degrees of severity. However, Cervical penetrating injury should not be underestimated in spite of the minimal width of the lesion.

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Analysis of Human Body Injury by Non-penetrating Ballistic Impact Using a Finite Element Model of the Head and Neck (근육 모델이 고려된 두부 및 경추 유한요소모델을 이용한 비관통 피탄 충격에 의한 인체 상해 해석)

  • Kang, Moon Jeong;Jo, Young Nam;Chae, Jeawook;Yoo, Hong Hee
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.41 no.1
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    • pp.1-6
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    • 2017
  • Ballistic impact on a soldier wearing a helmet can induce fatal injury, even if the helmet is not penetrated. Although studies on this type of injury have been performed, most of them have used an analytical model focused on head injury only. The injury of the neck muscles and cervical vertebrae by non-penetrating ballistic impact affects the survivability of soldiers, despite not inflicting fatal injury to the human body. Therefore, an analytical model of the head and neck muscles are necessary. In this study, an analysis of human body injury using the previously developed head model, as well as a cervical model with muscles, was performed. For the quantitative prediction of injury, the stress, strain, and HIC were compared. The results from the model including the cervical system indicated a lower extent of injury than the results from the model excluding them. The results of head injury were compared with other references for reliability.

Post-Traumatic Cerebral Infarction Following Low-Energy Penetrating Craniocerebral Injury Caused by a Nail

  • Chen, Po-Chuan;Tsai, Shih-Hung;Chen, Yu-Long;Liao, Wen-I
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.293-295
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    • 2014
  • Post-traumatic cerebral infarction (PTCI) is a secondary insult which causes global cerebral hypoxia or hypoperfusion after traumatic brain injury, and carries a remarkable high mortality rate. PTCI is usually caused by blunt brain injury with gross hematoma and/or brain herniation. Herein, we present the case of a 91-year-old male who had sustained PTCI following a low-energy penetrating craniocerebral injury due to a nail without evidence of hematoma. The patient survived after a decompressive craniectomy, but permanent neurological damage occurred. This is the first case of profound PTCI following a low-energy penetrating craniocerebral nail injury and reminds clinicians of possibility this rare dreadful complication for care of head-injured patients.

Urgent Intracranial Carotid Artery Decompression after Penetrating Head Injury

  • Kim, Seong Joon;Park, Ik Seong
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.180-182
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    • 2013
  • We describe a case of intracranial carotid artery occlusion due to penetrating craniofacial injury by high velocity foreign body that was relieved by decompressive surgery. A 46-year-old man presented with a penetrating wound to his face. A piece of an electric angular grinder disc became lodged in the anterior skull base. Computed tomography revealed that the disc had penetrated the unilateral paraclinoid and suprasellar areas without flow of the intracranial carotid artery on the lesion side. The cavernous sinus was also compromised. Removal of the anterior clinoid process reopened the carotid blood flow, and the injection of glue into the cavernous sinus restored complete hemostasis during extraction of the fragment from the face. Digital subtraction angiography revealed complete recanalization of the carotid artery without any evidence of dissection. Accurate diagnosis regarding the extent of the compromised structures and urgent decompressive surgery with adequate hemostasis minimized the severity of penetrating damage in our patient.

Medulla Oblangata Injury Caused by Non-Penetrating Trauma by Chopsticks (젓가락에 의한 비관통성 외상에 의해 유발된 연수 손상 1예)

  • Jin, Hyeon-Ju;Yu, Jae-Seong;Kim, Yu-Kyung;Gang, Ho-Seok;Lee, Se-Jin
    • Journal of Yeungnam Medical Science
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    • v.27 no.2
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    • pp.122-126
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    • 2010
  • It is common m childhood that children suffer intracavity or head injury, falling down backward, having chopsticks in their mouth. But most of them have paralysis of upper and lower extremity because of secondary damage by penetrating injury of brainstem and spine. We could not find this case which have shown infaction of medulla oblangata on MRI and paralysis by impact only without clear penetrating evidence. So the authors report this case with study of literature because we experience one case that have high signal density in brainstem on MRI, Loss of consciousness, and left hemiplegia without clear penetrating evidence after falling down backward, having chopsticks in her mouth and regard it rare case.

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Serious Penetrating Craniocerebral Injury Caused by a Nail Gun

  • Jeon, Yong Hyun;Kim, Dong Min;Kim, Sung Hoon;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.537-539
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    • 2014
  • Penetrating cerebral injuries caused by foreign bodies occur rarely due to the substantial mechanical protection offered by the skull. Throughout most of history, the brain, residing in a "closed box" of bone, has not been vulnerable to external aggression. Recently, we encountered a serious penetrating craniocerebral injury caused by a nail gun. Total excision of the offending nail via emergency craniotomy was performed, but the patient's neurologic status was not improved in spite of aggressive rehabilitative treatment. Here, we report on this troublesome case in light of a review of the relevant literature.

Visual Disturbance Caused by a Nail Gun-Induced Penetrating Brain Injury

  • Ye, Jin Bong;Sul, Young Hoon;Kim, Se Heon;Lee, Jin Young;Lee, Jin Suk;Kim, Hong Rye;Yoon, Soo Young;Choi, Jung Hee
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.203-207
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    • 2021
  • Penetrating brain injury caused by a nail gun is an uncommon clinical scenario reported in the literature. A 36-year-old male presented with a nail that had penetrated through the occipital bone. He was alert and neurologically intact except for visual disturbance. Computed tomography (CT) of the brain showed the nail lodged at the occipital lobe and the parietal lobe, with minimal intracerebral hemorrhage. The nail was placed in the occipital lobe close to the superior sagittal sinus. We removed the nail with craniotomy since the entrance of the nail was close to the superior sagittal sinus. There were no newly developed neurological deficits postoperatively. Immediate postoperative CT showed no newly developed lesions. The patient recovered well without any significant complications. Two weeks postoperatively, magnetic resonance imaging showed no remarkable lesions. The visual disturbance was followed up at the outpatient department. To summarize, we report a rare case of penetrating head injury by a nail gun and discuss relevant aspects of the clinical management.

Clinical Evaluation of Traumatic Diaphragmatic Injuries (Reports of 40 Cases) (외상성 횡경막 손상에 대한 임상적 고찰 -40례 보고-)

  • 정황규
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.471-478
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    • 1988
  • We evaluated forty cases of traumatic diaphragmatic injuries that we have experienced from Jan. 1972 to Dec. 1987. 28 patients were male and 12 were female[M:F=2.3:1]. The age distribution was ranged from 4 to 71 years with mean age of 26. The diaphragmatic injuries were due to blunt trauma in 27 cases[traffic accident 22, fall down 3, others 2] and penetrating trauma in 13 cases[stab wound 11, gun shot 1, other 1]. In the blunt injury,14 cases of 17 were diagnosed and treated within 24 hours in the left diaphragmatic injury but only 3 cases of 7 cases in the right diaphragmatic injury were diagnosed and treated within 24 hours. All cases except one in penetrating injury were diagnosed and treated within 12 hours. In the blunt injury, the rupture site was located in the left in \ulcorner7 cases and in the right in 7 cases. In the penetrating injury, the rupture site was located in the left in 11 cases and in the right in 2 cases. The repair of 37 cases were performed with thoracic approach in 20 cases, thoracoabdominal approach in 12 cases and abdominal approach in 5 cases. Over all mortality was 17.5%[7/40] and postoperative mortality was 11%[4/37]. The causes of death were hypovolemic shock[3], combined head injury[2], acute renal failure[1] and septic shock with ARDS[1].

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An Unusual Case of Cerebral Penetrating Injury by a Driven Bone Fragment Secondary to Blunt Head Trauma

  • Lee, Jae-Il;Ko, Jun-Kyeung;Cha, Seung-Heon;Han, In-Ho
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.532-534
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    • 2011
  • Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right temple while cutting the rod. Initial brain computed tomography (CT) and magnetic resonance imaging demonstrated scanty subdural hematoma at right temporal lobe and left falx and intracerebral hematoma at both frontal lobes. Facial CT with 3-D reconstruction images showed a small bony defect at the right sphenoid bone's greater wing and a small bone fragment at the left frontal lobe, crossing the falx. We present the unusual case of a temple trauma patient in whom a sphenoid bone fragment migrated from its origin upward, to the contralateral frontal lobe, producing hematoma along its trajectory.