Unusual Case of Low-Velocity Large Object Penetrating the Frontal Bone with Favorable Outcome: A Case Report in Pediatric Patient

Elvita Rahmi Daulay

doi:10.3889/oamjms.2021.6805

Authors

Elvita Rahmi Daulay Department of Radiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6805

Keywords:

Case report, Penetrating object, Frontal bone, Outcome

Abstract

BACKGROUND: Penetrating head injury is one of the deadliest forms of head trauma; the outcome is usually low, and patients who survive long enough require complex medical treatment. Immediate imaging assessment with appropriate management can improve patient recovery.

CASE REPORT: We reported a case of head penetration trauma on a 12-year-old child with embedded cylindrical iron that enters the skull without any signs of neurological deficit.

CONCLUSIONS: This case shows that aggressive diagnostic imaging and emergency care followed by proper immediate head surgery management and postoperative intensive care to monitor and intervene in possible surgical and medical complications could significantly improve patient outcomes.

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References

Fahde Y, Laghmari M, Skoumi M. Penetrating head trauma: 03 Rare cases and literature review. Pan Afr Med J. 2017;28(1):305. https://doi.org/10.11604/pamj.2017.28.305.10376 DOI: https://doi.org/10.11604/pamj.2017.28.305.10376

Zhang D, Chen J, Han K, Yu M, Hou L. Management of penetrating skull base injury: A single institutional experience and review of the literature. Biomed Res Int. 2017;2017:2838167. https://doi.org/10.1155/2017/2838167. PMid:28828384 DOI: https://doi.org/10.1155/2017/2838167

Buitendag JJ, Ras A, Kong VY, Bruce JL, Laing GL, Clarke DL, Brysiewicz P. An overview of penetrating traumatic brain injuries at a major civilian trauma centre in South Africa. South Afr J Surg. 2019;57(1):37-42. https://doi.org/10.17159/2078-5151/2018/v57n1a2711 DOI: https://doi.org/10.17159/2078-5151/2018/v57n1a2711

Iaccarino C, Carretta A, Nicolosi F, Morselli C. Epidemiology of severe traumatic brain injury. J Neurosurg Sci. 2018;62(5):535- 41. https://doi.org/10.23736/S0390-5616.18.045 32-0 PMid:30182649 DOI: https://doi.org/10.23736/S0390-5616.18.04532-0

Moussa WM, Abbas M.Management and outcome of low velocity penetrating head injury caused by impacted foreign bodies. Acta Neurochir (Wien). 2016;158(5):895-904; discussion 904. https://doi.org/10.1007/s00701-016-2764-x PMid:26973055 DOI: https://doi.org/10.1007/s00701-016-2764-x

Lan ZG, Richard SA, Li J, Yang C. Nonprojectile penetrating iron rod from the oral cavity to the posterior cranial fossa: A case report and review of literature. Int Med Case Rep J. 2018;11:41-5 https://doi.org/10.2147/IMCRJ.S157237 PMid:29563841 DOI: https://doi.org/10.2147/IMCRJ.S157237

Li XS, Yan J, Liu C, Luo Y, Liao XS, Yu L, et al. Nonmissile penetrating head injuries: Surgical management and review of the literature. World Neurosurg. 2017;98:873.e9-25. https://doi.org/10.1016/j.wneu.2016.11.125 PMid:27931948 DOI: https://doi.org/10.1016/j.wneu.2016.11.125

Vakil MT, Singh AK. A review of penetrating brain trauma: Epidemiology, pathophysiology, imaging assessment, complications, and treatment. Emerg Radiol. 2017;24(3):301-9. https://doi.org/10.1007/s10140-016-1477-z PMid:28091809 DOI: https://doi.org/10.1007/s10140-016-1477-z

Zyck S, Toshkezi G, Krishnamurthy S, Carter DA, Siddiqui A, Hazama A, et al.Treatment of penetrating nonmissile traumatic brain injury. Case series and review of the literature. World Neurosurg. 2016;91:297-307. https://doi.org/10.1016/j.wneu.2016.04.012 PMid:27072332 DOI: https://doi.org/10.1016/j.wneu.2016.04.012

Schweitzer AD, Niogi SN, Whitlow CT, Tsiouris AJ. Traumatic brain injury: Imaging patterns and complications. Radiographics. 2019;39(6):1571-95. https://doi.org/10.1148/rg.2019190076 PMid:31589576 DOI: https://doi.org/10.1148/rg.2019190076

Young L, Rule GT, Bocchieri RT, Walilko TJ, Burns JM, Ling G. When physics meets biology: Low and high-velocity penetration, blunt impact, and blast injuries to the brain. Front Neurol. 2015;6:89. https://doi.org/10.3389/fneur.2015.00089 PMid:25999910 DOI: https://doi.org/10.3389/fneur.2015.00089

Van Wyck DW, Grant GA, Laskowitz DT. Penetrating traumatic brain injury: A review of current evaluation and management concepts. J Neurol Neurophysiol. 2015;6(6):336-43. DOI: https://doi.org/10.4172/2155-9562.1000336

AbdulAzeez MM, Dolachee AA, Huber PZ, Romario MF, Obaid H, Arakwazi AH, et al. Intracranial ricocheted-bullet injuries: An overview and illustrative case. J Acute Dis. 2018;7(5):1862018. https://doi.org/10.4103/2221-6189.244165 DOI: https://doi.org/10.4103/2221-6189.244165

Galgano M, Toshkezi G, Qiu X, Russell T, Chin L, Zhao LR. Traumatic brain injury: Current treatment strategies and future endeavors. Cell Transplant. 2017;26(7):1118-30. https: //doi.org/10.1177/0963689717714102 PMid:28933211 DOI: https://doi.org/10.1177/0963689717714102

Rincon-Guio C. The role of computed tomography as a prognostic tool in traumatic brain trauma, Hospital; 1971.

Temple N, Donald C, Skora A, Reed W. Neuroimaging in adult penetrating brain injury: A guide for radiographers. J Med Radiat Sci. 2015;62(2):122-31. https://doi.org/10.1002/jmrs.101 PMid:26229677 DOI: https://doi.org/10.1002/jmrs.101

Kommaraju K, Haynes JH, Ritter AM. Evaluating the role of a neurosurgery consultation in management of pediatric isolated linear skull fractures. Pediatr Neurosurg. 2019;54(1):21-7. https://doi.org/10.1159/000495792 PMid:30673671 DOI: https://doi.org/10.1159/000495792

Mackel CE, Morel BC, Winer JL, Park HG, Sweeney M, Heller RS, et al. Secondary overtriage of pediatric neurosurgical trauma at a level i pediatric trauma center. J Neurosurg Pediatr. 2018;22(4):375-83. https://doi.org/10.3171/2018.5.PEDS182 PMid:29957140 DOI: https://doi.org/10.3171/2018.5.PEDS182

Addioui A, Saint-Vil D, Crevier L, Beaudin M. Management of skull fractures in children less than 1 year of age. J Pediatr Surg. 2016;51(7):1146-50. https://doi.org/10. 1016/j.jpedsurg.2016.01.007 DOI: https://doi.org/10.1016/j.jpedsurg.2016.01.007