Penetrating head injury caused by a screwdriver

Abstract

Background: Penetrating head injuries (PHI) caused by sharp objects are associated with a high risk of potentially life-threatening complications and are estimated to account for approximately 0.4% of all head injuries. Since not many cases of PHI with a screwdriver have been described in the literature, the treatment of these patients is quite controversial and non-standardized. Therefore, the aim of this paper was to present our experience with treating a patient with a PHI caused by a screwdriver. Case description: The authors present a three-year-old female patient who accidentally sustained a PHI with a screwdriver through the right orbit. A computed tomography scan of the head was performed, which demonstrated the presence of the metal end of a screwdriver in the anterior cranial fossa. The patient underwent emergency surgery and the foreign body was evacuated with the repair of dura and brain injury. The intervention was followed by a complete postoperative recovery without any gross neurological deficits. Follow-up examinations were performed up to three years after the injury, while the patient's condition remained unchanged. Our patient's case supports immediate neurosurgical intervention and removal of a foreign object from the endocranium.

Keywords

• craniocerebral trauma
• awake craniotomy
• paediatric brain injury
• penetrating head injury