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Journal Article

Citation

Young M, Putty M, Finneran MM, Johnson R, Schaible K, Farhat H. Cureus 2020; 12(3): e7388.

Affiliation

Neurological Surgery, Advocate Christ Medical Center, Oak Lawn, USA.

Copyright

(Copyright © 2020, Curēus)

DOI

10.7759/cureus.7388

PMID

32337115

PMCID

PMC7179989

Abstract

Introduction Penetrating head injuries (PHIs) can have diverse presentations and mechanisms; therefore, treatment methods have not been clearly outlined. Vascular injury is common and foreign body removal is often required. We present three cases to illustrate low-velocity nonmissile penetrating head injuries (NPHIs) and discuss a multidisciplinary approach.

METHODS We present a case series from our institution that illustrates the importance of multidisciplinary treatment of these injuries. All injuries are low- velocity NPHIs with separate mechanisms and anatomical locations.

RESULTS Multidisciplinary management involving neurosurgery, otolaryngology, and neuroendovascular surgery is represented in our case series with all patients having good clinical outcomes. Our first case is a 34-year-old male who presented neurologically intact after a stabbing in the left temporal region with concerns for external carotid artery injury and maxillary sinus injury. Our second case is a 37-year-old male who presented with a self-inflicted nail gun injury that penetrated the right temporal bone, right temporal lobe, bilateral sphenoid sinus, and left petrous carotid canal with concerns of petrous internal carotid injury. Our third case is a 31-year-old male who presented after an accidental nail gun injury that penetrated through the oral cavity, hard palate, and left sphenoid sinus and ending in the left cavernous sinus with concerns of cavernous internal carotid injury.

CONCLUSION  Careful consideration must be taken when evaluating low-velocity NPHIs. Particular attention must be given when an associated vascular injury is suspected. Our case series highlights the importance of a multidisciplinary approach in achieving good clinical outcomes in PHIs.

Copyright © 2020, Young et al.


Language: en

Keywords

arterial injury; endoscopic approach; low velocity non-missile penetrating head injury; neuroendovascular management

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