@article{ref1,
title="Neurosurgical management of self-inflicted cranial crossbow injury",
journal="World neurosurgery",
year="2018",
author="Kulwin, Charles G. and DeNardo, Andrew and Khairi, Saad and Payner, Troy",
volume="116",
number="",
pages="69-71",
abstract="BACKGROUND: While gun-related penetrating traumatic brain injuries make up the majority of cranial missile injuries, low-velocity penetrating injuries present significant clinical difficulties that cannot necessarily be identically managed. Bow hunting is an increasingly popular pastime, and a crossbow allows a unique mechanism to cause a self-inflicted cranial injury with a large, low-velocity projectile. Historically, arrow removal is described in an operating room setting, which provides limited knowledge of the location of vascular injury in the setting of post-removal hemorrhage, and may represent an inefficient use of operating room availability. CASE DESCRIPTION: Two patients presented after self-inflicted cranial crossbow injuries. Both were neurologically salvageable. Initial assessment with CTA allowed triage into likely or unlikely vascular injury. Arrow removal was performed in a radiology setting rather than in the operating room to allow immediate post-removal imaging to localize hemorrhage. While an operating room was on standby, neither patient required neurosurgical operative intervention. Both patients made a good recovery with no further injury caused by arrow removal. <br><br>CONCLUSIONS: We describe a novel approach to retained cranial arrow removal in a radiologic, rather than operative setting, and describe its relative benefits over traditional removal in the operating room.<br><br>Copyright © 2018 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1878-8750",
doi="10.1016/j.wneu.2018.05.048",
url="http://dx.doi.org/10.1016/j.wneu.2018.05.048"
}