Surgical Management of Non-Missile Penetrating Brain Injury
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- Category: Vol. 85, June 2017
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Surgical Management of Non-Missile Penetrating Brain Injury, HESHAM ABO RAHMA and AHMED AZAB
Abstract
Introduction: Non missile penetrating brain injury sec-ondary to car crashes or industrial accidents are not infrequent neurosurgical emergencies. The management of such cases is characterized by many challenges, not only from the surgical point of view, but also for the different and sometimes bizarre dynamics by which they present. We report our experience in surgical planning to treat such.
Material and Method: Total of 32 patients were treated at Neurosurgery Department, Menofyia University, all of them were presented by non missile penetrating brain injury age ranged from 5 to 52 years, 17 males and 5 females, industrial injury was the most common followed by assault and car crashes. Plain skull X-ray standard views, plain CT brain, CT brain angiography done for cases where the foreign body is suspected to be in the vicinity of major vessels.
Results: Wide craniotomy under broad spectrum antibiot-ics, with preservation of the non damaged brain tissues, adequate haemostasis, packing of the air sinuses, good recon-struction of the skull base if involved, dura reconstruction are the main surgical tricks to grantee excellent outcome.
Conclusions: Adequate preoperative planning aided with full radiological assessment with preservation of the non damaged brain tissues and proper surgical techniques are the main keys of getting surgical outcome in such challenging neurosurgical emergency.