Non-missile penetrating brain injuries: cases registry in Sohag University Hospital

Abstract

Abstract Background Non-missile penetrating brain injuries are rarely seen in the surgical practice and few international literatures’ reported case reports or small case series, and it comprises a small percentage of head trauma cases. We reported a group of 18 cases of penetrating injuries with different tools and various mechanisms. We reported their epidemiological criteria, mechanism of trauma, complications, and their prognosis. Aim The purpose of this study is to report different patients’ criteria and the method of trauma and the prognosis. Patients and methods A retrospective study was done in Trauma unit, Sohag University, between November 2012 and October 2014. Eighteen patients were reported with different mechanisms of trauma. All patients were clinically tested and subjected to CT brain. Cautious removal of the penetrating object with debridement of surrounding tissues was done. Patients were transferred to ICU for 48–72 h. Results Patients were subjected to operative intervention, and they were followed up for 3 years. Males were the predominant gender, 13 cases (72.2%), and the young age was higher than the elderly. The Glasgow outcome score was 15 in 13 patients and was 4 in five patients. Transient epileptic fits occurred in six patients and controlled on anti-epileptic drugs. Five patients had a neurological deficit in the form of hemiparesis or monoparesis. Conclusion Penetrating head injuries, although rare, are dangerous and should be cautiously managed and monitored in the ICU. The prognosis depends mainly on initial GCS and ventricular involvement, but in general, the prognosis is favorable. Trial registration IRB#3747 Registered 27/08/2017

Keywords

• Penetrating brain trauma (PBT)
• Traumatic brain injury (TBI)
• Computed tomography (CT)
• Vascular injury
• Dural tear
• Intensive care unit (ICU)