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Ota K, Kobata H, Tomonishi S, Ota K, Takasu A. Self-inflicted very-low-velocity penetrating head injury: A CARE-compliant case report. Medicine (Baltimore) 2024; 103:e37896. [PMID: 38701288 PMCID: PMC11062694 DOI: 10.1097/md.0000000000037896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/22/2024] [Indexed: 05/05/2024] Open
Abstract
RATIONALE Low-velocity penetrating head injury (PHI) is rare, comprising 0.2% to 0.4% of head traumas, but can be devastating and is associated with significant morbidity and mortality. No previous case of very-low-velocity PHI due to self-inflicted stabbing with a gimlet has been reported. PATIENT CONCERNS A 62-year-old man was admitted to the hospital with bleeding head and abdominal wounds after stabbing his abdomen with a gimlet, and then hammering the same gimlet into his forehead and removing the gimlet himself. DIAGNOSES Upon examination at admission, stab wounds were present on the forehead and the right upper quadrant. Computed tomography (CT) of the head revealed a bone defect in the left frontal bone and showed the intracranial path of the gimlet surrounded by mild hemorrhage and pneumocephalus. Magnetic resonance imaging (MRI) confirmed a small amount of hemorrhage with pneumocephalus but no vascular injury. INTERVENTIONS Conservative treatment without surgery. OUTCOMES Follow-up MRI on hospital day 58 showed no abscess or traumatic intracranial aneurysm. The patient achieved full recovery of motor and mental functions with conservative treatment and was discharged on hospital day 69. LESSONS Very-low-velocity PHI might be successfully treated with conservative treatment.
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Affiliation(s)
- Koshi Ota
- Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Hitoshi Kobata
- Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Shunsuke Tomonishi
- Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Kanna Ota
- Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Akira Takasu
- Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
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Darwazeh R, Darwazeh M, Elzain MA, Hoz SS, Al-Kanash R. Rubber bullet-related craniocerebral injuries. Br J Surg 2022; 110:403-405. [PMID: 36073201 DOI: 10.1093/bjs/znac316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/10/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Rami Darwazeh
- Department of Neurosurgery, Arab Women’s Union Hospital , Nablus , Palestine
| | - Mazhar Darwazeh
- Department of Neurosurgery, Arab Women’s Union Hospital , Nablus , Palestine
| | - Mohammed A Elzain
- Department of Neurosurgery, King Saud Medical City , Riyadh , Saudi Arabia
| | - Samer S Hoz
- Department of Neurosurgery, University of Cincinnati , Cincinnati, Ohio , USA
| | - Rasha Al-Kanash
- Endoscopic Spine Department, Razi Spine Clinic , Amman , Jordan
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Abstract
ABSTRACT Rubber bullets have long been known to cause, on rare occasions, traumatic brain injury (TBI). However, neurosurgical literature on this occurrence is limited, and no focused review of this injury pattern has been conducted. The authors present the case of a 28-year-old male struck by a rubber bullet in the left periorbital region, causing TBI in addition to complete left visual loss and complex facial fractures. After developing a cerebrospinal fluid (CSF) leak, the patient was taken to the operating room for combined neurosurgical-craniofacial intervention. Utilizing frameless intraoperative computation tomography navigation assistance, a successful repair was made of both the patient's CSF leak and complex craniofacial injuries. TBI due to a rubber bullet is a rare but severe occurrence. Unfortunately, much of the limited literature on this topic is bereft of demographic, clinical course, injury pattern, and imaging data. Presented here is the first operative case report of TBI due to a rubber bullet. Volume rendered imaging is provided to demonstrate the extent of trauma incurred. Additionally, a methodology for frameless intraoperative computation tomography navigation assistance is shared for consideration, as it served as a helpful adjunct for a combined intracranial-craniofacial surgical repair. The experience of treating the patient's traumatic CSF leak in the context of severe craniofacial and ophthalmologic injuries highlights the need for a multidisciplinary surgical approach that may arise when treating patients with TBI due to a rubber bullet.
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Cai Z, Xia Y, Bao Z, Mao H. Creating a human head finite element model using a multi-block approach for predicting skull response and brain pressure. Comput Methods Biomech Biomed Engin 2018; 22:169-179. [DOI: 10.1080/10255842.2018.1541983] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Zhihua Cai
- School of Electromechanical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - Yun Xia
- School of Electromechanical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - Zheng Bao
- School of Electromechanical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - Haojie Mao
- Department of Mechanical and Materials Engineering and School of Biomedical Engineering, Western University, London, ON, Canada
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Giran G, Bertin H, Koudougou C, Sury F, Croisé B, Laure B. About a pediatric facial trauma. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 120:154-156. [PMID: 30439549 DOI: 10.1016/j.jormas.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/29/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022]
Abstract
Less-lethal weapon are more and more used in law enforcement to neutralize combative individuals and to disperse riot crowds. Even if this type of weapon has been created to be less damaging than classical firearms, it has been incriminated many times in cases of facial injuries with functional consequences, even death. In many countries, these guns can be possessed by average citizens. They could be extremely harmful when handled by inexperienced users and cannot be considered solely as defense weapons. Interestingly, little literature is available concerning facial injuries caused by the less-lethal weapons. We report the case of a ballistic wound on a 3-year-old child.
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Affiliation(s)
- G Giran
- Department of maxillofacial surgery, Nantes university hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
| | - H Bertin
- Department of maxillofacial surgery, Nantes university hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - C Koudougou
- Department of maxillofacial surgery, Nantes university hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - F Sury
- Department of maxillofacial and plastic surgery, Tours university hospital, 37170 Tours, France
| | - B Croisé
- Department of maxillofacial and plastic surgery, Tours university hospital, 37170 Tours, France
| | - B Laure
- Department of maxillofacial and plastic surgery, Tours university hospital, 37170 Tours, France
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Guérant M, Vaz MA, Peoc'h M, Gaillard Y, Boyer B. Suicidal shot in the mouth with rubber bullets. Leg Med (Tokyo) 2018. [PMID: 29523001 DOI: 10.1016/j.legalmed.2018.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Rubber bullets weapons can have tragic consequences when used at short range and on vulnerable body areas. A man in his forties was found deceased at his house, covered in blood. A "non-lethal" firearm was found near the bed: the «SAPL GC27». This is a single shot handgun with mini Gomm Cogne ammunition: 12 rubber spherical pellets, 7.4 mm in diameter. The findings were consistent with an intra buccal shot, and an ingestion-inhalation of blood and projectiles. Cause of the death was linked to both the hemorrhage due to mouth and aero digestive crossroad trauma, responsible of a mechanical asphyxia, and blood absorption in lungs. This case insists on the deadly potential of this weapon if misused. Fortunately, the term "non-lethal" has been progressively replaced, but sometimes still can be seen, especially in gunsmith and webstores. It should be deleted to avoid confusion among inexperienced people, and at best, this weapon should be restricted to certain professions.
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Affiliation(s)
- Malou Guérant
- Service de Médecine Légale, CHU de Clermont-Ferrand, 58 rue Montalembert, 63003 Clermont Ferrand, France.
| | - Marie-Aude Vaz
- Service de Radiologie, CHU de Clermont-Ferrand, 58 rue Montalembert, 63003 Clermont Ferrand, France
| | - Michel Peoc'h
- Service d'Anatomie et de Cytologie Pathologiques, CHU de St Etienne, bd Pasteur, 42055 St Etienne, France
| | - Yvan Gaillard
- Laboratoire LAT LUMTOX, 07800 La Voulte Sur Rhône, France
| | - Baptiste Boyer
- Service de Médecine Légale, CHU de Clermont-Ferrand, 58 rue Montalembert, 63003 Clermont Ferrand, France
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Hiquet J, Gromb-Monnoyeur S. Severe craniocerebral trauma with sequelae caused by Flash-Ball® shot, a less-lethal weapon: Report of one case and review of the literature. MEDICINE, SCIENCE, AND THE LAW 2016; 56:237-240. [PMID: 26130748 DOI: 10.1177/0025802415587320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The use of Flash-Ball® as a non-lethal weapon by several special units within the police and police forces started in France in 1995. Little literature is available concerning injuries caused by Flash-Ball® shooting. However, we report the case of a healthy 34-year-old male victim of a Flash-Ball® shooting during a riot following a sports event. This young man presented serious craniocerebral injuries with a left temporal fracture, moderate cerebral oedema, fronto-temporal haemorrhagic contusion along with an extra-dural hematoma and subarachnoid hemorrhage requiring neurological and rehabilitation care for two months leaving important sequelae. Although the risk is obviously lower than with firearms, Flash-Ball® is nonetheless potentially lethal and may cause serious physical injuries, particularly after a shot to the head.
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Affiliation(s)
- Jean Hiquet
- Laboratory of Forensic Medicine, Ethic and Medical Law, France
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Dhar SA, Dar TA, Wani SA, Maajid S, Bhat JA, Mir NA, Dar IH, Hussain S. Pattern of rubber bullet injuries in the lower limbs: A report from Kashmir. Chin J Traumatol 2016; 19:129-33. [PMID: 27321289 PMCID: PMC4908224 DOI: 10.1016/j.cjtee.2015.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Rubber bullets are considered a non-lethal method of crowd control and are being used over the world. However the literature regarding the pattern and management of these injuries is scarce for the forensic pathologist as well as for the traumatologist. The objective of this report was to add our experience to the existing literature. METHODS From June 2008 to August 2010 the Government Hospital for Bone and Joint Surgery Barzulla and the Department of Orthopaedics, SKIMS Medical College/Hospital Bemina Srinagar received 28 patients for management of their orthopaedic injuries caused by rubber bullets. We documented all injuries and also recorded the management issues and complications that we encountered. RESULTS All patients weremales with an age range of 11e32 years and were civilians who had been hit by rubber bullets fired by the police and the paramilitary forces. Among them, 19 patients had injuries of the lower limbs and 9 patients had injuries of the upper limbs. All patients were received within 6 h of being shot. CONCLUSION Our findings suggest that these weapons are capable of causing significant injuries including fractures and it is important for the surgeon to be well versed with the management of such injuries especially in areas of unrest. The report is also supportive of the opinion that these weapons are lethal and should hence be reclassified.
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Affiliation(s)
- Shabir Ahmed Dhar
- Department of Orthopaedics, SKIMS Medical College/Hospital Bemina, Srinagar 190001, Kashmir, India
- Corresponding author.
| | - Tahir Ahmed Dar
- Department of Orthopaedics, SKIMS Medical College/Hospital Bemina, Srinagar 190001, Kashmir, India
| | | | - Saheel Maajid
- Department of Orthopaedics, SKIMS Medical College/Hospital Bemina, Srinagar 190001, Kashmir, India
| | - Jawed Ahmed Bhat
- Department of Orthopaedics, SKIMS Medical College/Hospital Bemina, Srinagar 190001, Kashmir, India
| | - Naseer Ahmed Mir
- Department of Orthopaedics, SKIMS Medical College/Hospital Bemina, Srinagar 190001, Kashmir, India
| | - Imtiyaz Hussain Dar
- Government Hospital for Bone and Joint Surgery Barzulla, Srinagar 190001, Kashmir, India
| | - Shahid Hussain
- Department of Orthopaedics, SKIMS Medical College/Hospital Bemina, Srinagar 190001, Kashmir, India
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Bone beveling caused by blunt trauma: a case report. Int J Legal Med 2015; 130:771-5. [PMID: 26585737 DOI: 10.1007/s00414-015-1293-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
Abstract
The authors report a fatal case of blunt trauma to the skull caused by a rib of a beach umbrella. The skull displayed a round hole in the right temporal bone with typical internal beveling. Blunt trauma mimicking a gunshot wound (round perforation of the skull with internal beveling) is very rarely reported in the forensic literature.
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