No abstract available.
Head Injuries, Penetrating*

Adult ; Head Injuries, Penetrating ; diagnostic imaging ; etiology ; surgery ; Humans ; Male ; Orbit ; injuries ; Tomography, X-Ray Computed

Penetrating cerebral injuries caused by foreign bodies are rare in civilian neurosurgical trauma, although there are various reports of blast or gunshot injuries in warfare due to multiple foreign bodies like pellets and nails. In our case, a 30-year-old man presented to neurosurgery clinic with signs and symptoms of right-sided weakness after suicide bomb attack. The skull X-ray showed a single intracranial nail. Small craniotomy was done and the nail was removed with caution to avoid injury to surrounding normal brain tissue. At 6 months'follow-up his right-sided power improved to against gravity.
Adult ; Explosive Agents ; Head Injuries, Penetrating ; surgery ; Humans ; Male ; Skull ; injuries ; Suicide

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.
Adhesives ; Angiography, Digital Subtraction ; Carotid Arteries ; Cavernous Sinus ; Decompression ; Foreign Bodies ; Head Injuries, Penetrating ; Hemostasis ; Humans ; Skull Base ; Wounds, Penetrating

Pseudoaneurysms of the superficial temporal artery are rare lesions. They present as slowly growing pulsating masses of the face or scalp. The common causes are blunt head trauma, penetrating wounds or interventional procedures. We report here on a rare case of superficial temporal artery pseudoaneurysm in a 44-year-old woman who presented with a pulsating mass, and this mass occurred on the left temporal area 2 weeks after performing a skin punch biopsy.
Adult ; Aneurysm, False ; Biopsy ; Female ; Head Injuries, Penetrating ; Humans ; Scalp ; Skin ; Temporal Arteries

Penetrating brain stem injury is rare, and complete recovery is seldom expected. This case report presents exceptional cases of penetrating brain stem injury with a metal chopstick. The patients were a three-year-old boy and a 60-year-old man, and both patients made a complete recovery after surgical removal of the chopstick.
Brain Stem ; Foreign Bodies* ; Head Injuries, Penetrating* ; Humans ; Male ; Middle Aged

A man attempted suicide by shooting seven nails into his head with a nail gun; five in the right temporal region and two in the left. He subsequently presented at the emergency department with complaints of headache. He was found to be oriented in space and time, with no focal neurological deficits. The patient handed the nail gun to the doctors and informed them that he had earlier attempted suicide. Radiological studies showed the presence of nails arranged like a 'martyr's crown'. The man died six days after the surgical removal of the nails. Autopsy was refused by Italian authorities. We conclude that imaging techniques are an adjuvant to forensic medical diagnosis and forensic autopsies.
Construction Materials ; Foreign Bodies ; diagnostic imaging ; Head ; diagnostic imaging ; Head Injuries, Penetrating ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Radiography ; Suicide

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.
Anti-Bacterial Agents ; Brain ; Child ; Craniocerebral Trauma ; Emergencies ; Eyelids ; Friends ; Frontal Lobe ; Head Injuries, Penetrating ; Hematoma ; Humans ; Preschool Child ; Skull

Traumatic brain injury (TBI) is a highly complex multi-factorial disorder. Animal models of TBI are used to elucidate primary and secondary injury mechanisms and pathophysiological changes and to provide the diagnostic and therapeutical basis for TBI. The choices of animal models depend upon the research objectives. However, various animal models have limitations. The models only can duplicate the pivotal injury mechanisms or a certain important pathophysiological course. The characteristics of human TBI can not fully be reflected by using these models. In the review, animal models of traumatic brain injury are classified as dynamic direct brain injury, indirect dynamic brain injury and combined neuro-traumatic models. Several common models are described for consideration.
Animals ; Biomechanical Phenomena ; Brain/physiopathology* ; Brain Injuries/physiopathology* ; Diffuse Axonal Injury/physiopathology* ; Disease Models, Animal ; Forensic Medicine ; Head Injuries, Closed/physiopathology* ; Head Injuries, Penetrating/physiopathology* ; Humans ; Mice ; Rats ; Reproducibility of Results

PURPOSE: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. METHODS: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 1994 to June 2009 was performed at Samsung Medical Center, Seoul, Korea. RESULTS: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were S. intermedius (n=3), S. aureus (n=3), S. pneumoniae (n=1), Group B streptococcus (n=2), E. coli (n=1), P. aeruginosa (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. CONCLUSION: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.
Abscess ; Brain ; Brain Abscess ; Child ; Early Diagnosis ; Fever ; Head Injuries, Penetrating ; Heart Diseases ; Humans ; Intracranial Pressure ; Korea ; Pneumonia ; Retrospective Studies ; Seizures ; Streptococcus