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Williams JR, Aghion DM, Doberstein CE, Cosgrove GR, Asaad WF. Penetrating brain injury after suicide attempt with speargun: case study and review of literature. Front Neurol 2014; 5:113. [PMID: 25071701 PMCID: PMC4083241 DOI: 10.3389/fneur.2014.00113] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 06/16/2014] [Indexed: 11/16/2022] Open
Abstract
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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Affiliation(s)
- John R Williams
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA
| | - Daniel M Aghion
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA
| | - Curtis E Doberstein
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA
| | - G Rees Cosgrove
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA ; Department of Clinical Neuroscience, Warren Alpert School of Medicine, Brown University , Providence, RI , USA
| | - Wael F Asaad
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA ; Department of Clinical Neuroscience, Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Brown Institute for Brain Sciences , Providence, RI , USA
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Satyarthee GD, Dawar P, Borkar SA, Sharma BS. Trans-orbital penetrating head injury (TOPHI): Short series of two cases with review of literature. INDIAN JOURNAL OF NEUROTRAUMA 2014. [DOI: 10.1016/j.ijnt.2013.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Santos M, Gutierrez-Nibeyro S, Stewart A, Hyde R, Rodgerson D. Identification of a periorbital wooden foreign body as the cause of chronic ocular discharge in a horse. Aust Vet J 2013; 90:84-7. [PMID: 22339119 DOI: 10.1111/j.1751-0813.2011.00876.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The clinical, diagnostic and therapeutic features of a horse with a wooden foreign body embedded in the deep portion of the right masseter muscle adjacent to the right orbit are presented. The purpose of this report is to describe the clinical presentation, magnetic resonance imaging findings and treatment of a penetrating wooden foreign body in a horse that had no history of trauma or evidence of a puncture wound. This report documents the usefulness of magnetic resonance imaging to detect a wooden foreign body embedded in the soft tissues of a horse with a chronic copious ocular discharge. Two surgical procedures were necessary, which is a frequent complication encountered with wooden foreign bodies.
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Affiliation(s)
- Mp Santos
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Champaign-Urbana, Illinois, USA.
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Tasneem K, Concannon ES, Abulkhir A, Ryan RS, Barry K. Radiolucent wooden foreign body masquerading as a depressed skull fracture. BMJ Case Rep 2011; 2011:bcr.10.2011.4964. [PMID: 22669993 DOI: 10.1136/bcr.10.2011.4964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The following case describes a head injury in an older male patient in which a large wooden foreign body, forming a subcutaneous tract in the scalp, was mistaken for a depressed skull fracture on initial clinical assessment. This foreign body was not visualised on CT brain imaging until specialised views were used retrospectively, after surgical exploration of the scalp laceration. Appropriate radiological techniques for the detection of radiolucent foreign bodies are discussed.
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Affiliation(s)
- Komal Tasneem
- Surgery Department, Mayo General Hospital, Castlebar, Mayo, Ireland
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