Original ArticleNonmissile Penetrating Injury to the Head: Experience with 17 Cases
Section snippets
Materials and Methods
We retrogradely studied patients with a nonmissile, low-velocity penetrating injury to head (brain, orbit, skull base, and face) who were admitted and managed in the Department of Neurosurgery, Dhaka Medical College Hospital, Dhaka, Bangladesh between July 2006 and July 2013. The recorded data of the patients with penetrating head injuries were carefully studied for cause of injury, type of object, type and extent of penetration, GCS on admission, other clinical issues, investigations, interval
Results
Management details of the 17 patients are presented in Table 1 and Figure 2, Figure 3, Figure 4, Figure 5, Figure 6, Figure 7, Figure 8, Figure 9, Figure 10, Figure 11, Figure 12, Figure 13, Figure 14. The male-female ratio was 2.4:1, and the average age was 29 years (range, 10–53 years). The average duration of follow-up was 6 years (range, 9 to 3.5 years). Causes of injury were accidental penetration in 6 cases, family violence in 2 cases, stabbing by a hijacker in 2 cases, and interpersonal
Discussion
Penetrating injuries of the skull and brain are relatively uncommon, representing only roughly 0.4% of all head injuries worldwide. Gunshot wounds account for the majority of penetrating skull and brain injuries in Western countries, but not in developing and third-world countries. These injuries are defined as wounds that involve a smaller area with relatively low-velocity impact. Regardless of the size of the penetrating object, penetrating skull injuries are rarely associated with major
Conclusion
Primary injury caused by a nonmissile penetrating object cannot be reversed and may cause death, but in most cases is not fatal. In such cases, secondary damage can be easily prevented with a very good ultimate outcome. The presenting picture of nonmissile penetrating injury to the head may be very daunting, but these cases can be managed with very good results by proper (clinical and radiologic) evaluation and simple neurosurgical techniques.
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Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.