TY  - JOUR
PY  - 2018//
TI  - Neurosurgical management of self-inflicted cranial crossbow injury
JO  - World neurosurgery
A1  - Kulwin, Charles G.
A1  - DeNardo, Andrew
A1  - Khairi, Saad
A1  - Payner, Troy
SP  - 69
EP  - 71
VL  - 116
IS  - 
N2  - 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>
LA  - en
SN  - 1878-8750
UR  - http://dx.doi.org/10.1016/j.wneu.2018.05.048
ID  - ref1
ER  -