scholarly journals ANAESTHETIC MANAGEMENT OF PENETRATING BRAIN INJURY CAUSED BY A FOREIGN BODY

2018 ◽  
Vol 5 (13) ◽  
pp. 1218-1220
Author(s):  
Niti Dalal ◽  
Naveen Kundilmadom Vijayan
Keyword(s):  
Brain Injury ◽  
Foreign Body ◽  
Anaesthetic Management ◽  
Penetrating Brain Injury

scholarly journals Case Report: Transorbital approach for the management of an orbito-temporal penetrating brain injury (skull base region) secondary to wooden spikes

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1283
Author(s):  
Tedy Apriawan ◽  
Abdul Hafid Bajamal ◽  
Ditto Darlan ◽  
Yusriandi Ramadhan
Keyword(s):  
Brain Injury ◽  
Foreign Body ◽  
Magnetic Resonance ◽  
Petrous Bone ◽  
Primary Treatment ◽  
Surgical Approaches ◽  
Penetrating Brain Injury ◽  
Body Location ◽  
The Right ◽  
Base Of The Skull

Background and importance: Transorbital penetrating brain injury (PBI) due to a non-projectile foreign body is rare. It can lead to life-threatening severe neurovascular damage. Surgery is the primary treatment choice; however, there are a number of approaches that can be considered based on the patient's condition in terms of foreign body location and state of the patient. Clinical presentation: An 18-year-old male carpenter was hit by a log and sustained transorbital PBI while cutting wood with a machine. Computed tomography (CT) scan showed a wooden spike that was approximately 11 cm from the left medial orbital to the superior part of the posterolateral of the petrous bone, crossing the right side at the base of the skull. CT angiography (CTA), magnetic resonance angiography (MRA), and magnetic resonance venography (MRV) revealed no internal carotid artery (ICA) and cavernous sinus lesions, respectively. We had a 3D-printed model for preoperative planning, and surgery was performed using a transorbital approach to extract the wood 14 days after the accident. The impacted wood was removed without any complications. Conclusion: There are many surgical approaches for transorbital PBI. We decided to perform the transorbital approach because it is perpendicular to the entry zone. Surgeons should consistently perform minimally invasive procedures based on the clinical and radiological findings.

scholarly journals Imaging characteristics and treatment of a penetrating brain injury caused by an oropharyngeal foreign body in a dog

2017 ◽  
Vol 60 (3) ◽  
pp. E24-E28 ◽  
Author(s):  
Jennifer McKenzie ◽  
Megan Cooper Murphy ◽  
Cameron Broome ◽  
Hamaseh Tayari ◽  
Rodrigo Gutierrez‐Quintana
Keyword(s):  
Brain Injury ◽  
Foreign Body ◽  
Penetrating Brain Injury ◽  
Imaging Characteristics

scholarly journals Multiple Brain Abscesses by an Air Gun Shot: A Case Report

2021 ◽  
Author(s):  
Mohammad Jamali ◽  
Iman Ahrari ◽  
Keyvan Eghbal ◽  
Arash Saffarrian ◽  
Abbas Rakhsha ◽  
...  
Keyword(s):  
Brain Injury ◽  
Brain Injuries ◽  
Good Condition ◽  
Signs And Symptoms ◽  
Low Velocity ◽  
Penetrating Brain Injury ◽  
Air Gun ◽  
Gun Shot ◽  
Brain Abscesses ◽  
Air Gun Pellet

Abstract Introduction Low-velocity penetrating brain injury is not prevalent. In some conditions such as childhood, and with the penetration of a pellet in weak spots of skull, low-velocity penetrating brain injury is expected; however, high-velocity projectiles have also been reported as the cause of severe brain injuries. One of the complications of penetrating brain injury is infection, in which different types of microorganisms play a role. The Streptococcus genus is the leading cause of abscess formation in non-traumatic patients. Multiple brain abscesses are not common. Case Presentation A 10-year-old boy with penetrating brain injury caused by an air gun pellet, who developed signs and symptoms of high intracranial pressure 18 days after the trauma. After the imaging scans and the detection of multiple brain abscesses and severe brain edema, prompt surgical intervention was performed for all three lesions in a single operation. The culture of a pus specimen was positive for Streptococcus species, and, with adequate antibiotic therapy, the patient was discharged from the hospital in good condition. Conclusion Brain injury with air gun shot is not prevalent. The penetration of a low-velocity air gun pellet in weak points of the skull (such as the orbit, the squamous portion of the temporal bone, and the cranial suture), specially in children, can cause significant brain injuries.

INTRATHECAL BACLOFEN PUMP FOR SPASTIC HYPERTONIA FOLLOWING PENETRATING BRAIN INJURY

2021 ◽  
pp. 76-78
Author(s):  
Anand Sharma ◽  
Yashbir Dewan
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Brain Injury ◽  
Intrathecal Baclofen ◽  
Gunshot Injury ◽  
Review Of Literature ◽  
Penetrating Brain Injury ◽  
Severe Spasticity ◽  
Cord Injury

Management of severe spasticity following penetrating brain injury is often a difcult problem. Orally administered medications generally offer limited benets. Intrathecally administered baclofen has been shown to be effective in patients with spasticity caused by spinal cord injury and stroke, however, the effectiveness of ITB for spasticity related to penetrating brain injury is not well established. We reported two cases of spastic hypertonia following gunshot injury to brain with brief review of literature upon role of intrathecal baclofen pump (ITB) in cortical spastic hypertonia

Crosstalk between Estrogen Withdrawal and NFκB Signaling following Penetrating Brain Injury

2018 ◽  
Vol 25 (4) ◽  
pp. 193-200 ◽  
Author(s):  
Samarah Cook ◽  
Vanessa Hung ◽  
Kelli A. Duncan
Keyword(s):  
Brain Injury ◽  
Penetrating Brain Injury ◽  
Estrogen Withdrawal

scholarly journals Persistent region-dependent neuroinflammation, NMDA receptor loss and atrophy in an animal model of penetrating brain injury

2012 ◽  
Vol 7 (3) ◽  
pp. 329-339 ◽  
Author(s):  
Rachel Grossman ◽  
Charles M Paden ◽  
Pamela A Fry ◽  
Ryon Sun Rhodes ◽  
Anat Biegon
Keyword(s):  
Animal Model ◽  
Brain Injury ◽  
Nmda Receptor ◽  
Penetrating Brain Injury

scholarly journals The Incidence of Hyperthermia during Craniotomy

2018 ◽  
Vol 46 (4) ◽  
pp. 368-373
Author(s):  
G. Malpas ◽  
J. A. Taylor ◽  
D. Cumin ◽  
A. F. Merry ◽  
S. J. Mitchell
Keyword(s):  
Brain Injury ◽  
Standard Deviation ◽  
Observational Study ◽  
Demographic Data ◽  
Anaesthetic Management ◽  
Temperature Data ◽  
Compelling Evidence ◽  
Mild Hyperthermia ◽  
Potential Harm ◽  
Temperature Reading

There is evidence that even mild hyperthermia may exacerbate brain injury. There seem reasonable grounds for considering patients undergoing craniotomy as ‘at risk’ for brain injury. A retrospective observational study was undertaken to measure the incidence of mild hyperthermia in craniotomy cases in which the patient was initially normothermic. Auckland City Hospital's database of electronic anaesthetic records was searched for adult patients who were normothermic (≤37°C) prior to undergoing craniotomy procedures. For each case, demographic data, intraoperative naso- or oropharyngeal temperature measurements, and paracetamol use were extracted. We identified the proportion of patients whose temperature rose to exceed normal (>37°C) and further subdivided that group into the proportion in whom the temperature rose to ≥38°C. Two thousand, nine hundred and thirty-five craniotomy cases began their operations while normothermic and had adequate temperature data collected. There were 984 (33.5%) cases that had at least one temperature reading >37°C, for a mean (standard deviation [SD]) time of 66.0 (64.6) minutes, and 49 (1.7%) cases that had at least one reading ≥38°C for a mean (SD) time of 40.4 (38.1) minutes. The majority (77.8%) who became mildly hyperthermic remained so at the end of the procedure. New mild hyperthermia occurs commonly during craniotomy. In view of the compelling evidence of potential harm arising from mild hyperthermia in brain injury, these findings suggest an opportunity for practice improvement in the anaesthetic management of craniotomy patients. Reasonable steps should be taken by anaesthetists to avoid intraoperative hyperthermia of any degree.

scholarly journals Mortality and Functional Outcome Predictors in Combat-Related Penetrating Brain Injury Treatment in a Specialty Civilian Medical Facility

2020 ◽  
Vol 185 (5-6) ◽  
pp. e774-e780
Author(s):  
Andrii Sirko ◽  
Grigoriy Pilipenko ◽  
Dmytro Romanukha ◽  
Alexander Skrypnik
Keyword(s):  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Treatment Outcomes ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Glasgow Outcome Scale ◽  
Outcome Predictors ◽  
Septic Complications ◽  
Penetrating Brain Injury ◽  
Injury Treatment

Abstract Introduction The combined use of new types of weapons and new types of personal protective equipment has led to changes in the occurrence, nature, and severity of penetrating brain wounds. The availability of modern equipment, methods of treatment, and trained medical personnel in a civilian hospital, as well as advanced specialty medical care, has improved treatment outcomes. There have been a limited number of publications regarding analysis and predictors of treatment outcomes in patients with combat-related penetrating brain injury in contemporary armed conflicts. The purpose of this study was to analyze the results of surgical treatment of patients with penetrating brain injury and to identify significant outcome predictors in these patients. Materials and Methods This was a prospective analysis of penetrating brain injury in patients who were admitted to Mechnikov Dnipropetrovsk Regional Clinical Hospital, Ukraine, from May 9, 2014, to December 31, 2017. All wounds were sustained during local armed conflict in Eastern Ukraine. The primary outcomes of interest were mortality rate at 1 month and Glasgow Outcome Scale score at 12 months after the injury. Results In total, 184 patients were identified with combat-related brain injury; of those, 121 patients with penetrating brain injury were included in our study. All patients were male soldiers with a mean age of 34.1 years (standard deviation [SD], 9.1 years). Mean admission Glasgow Coma Scale score was 10 (SD, 4), and mean admission Injury Severity Score was 27.7 (SD, 7.6). Mortality within 1 month was 20.7%, and intracranial purulent-septic complications were diagnosed in 11.6% of the patients. Overall, 65.3% of the patients had favorable outcome (good recovery or moderate disability) based on Glasgow Outcome Scale score at 12 months after the injury. The following were predictors of mortality or poor functional outcome at 1 year after the injury: low Glasgow Coma Scale score on admission, gunshot wound to the head, dural venous sinuses wound, presence of intracerebral hematomas, intraventricular and subarachnoid hemorrhage accompanied by lateral or axial dislocation, and presence of intracranial purulent-septic complications. Conclusions Generally, combat-related penetrating brain injuries had satisfactory treatment outcomes. Treatment outcomes in this study were comparable to those previously reported by other authors in military populations and significantly better than outcomes of peacetime penetrating brain injury treatment.

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