Abstract
Introduction
A penetrating head injury belongs to the most severe traumatic brain injuries, in which communication can arise between the intracranial cavity and surrounding environment.
Discussion
The authors present a literature review and typical case reports of a penetrating head injury in children. The list of patients treated at the neurosurgical department in the last 5 years for penetrating TBI is briefly referred. Rapid transfer to the specialized center with subsequent urgent surgical treatment is the important point in the treatment algorithm. It is essential to clean the wound very properly with all the foreign material during the surgery and to close the dura with a water-tight suture. Wide-spectrum antibiotics are of great use. In case of large-extent brain damage, the use of anticonvulsants is recommended.
Conclusion
The prognosis of such severe trauma could be influenced very positively by a good medical care organization; obviously, the extent of brain tissue laceration is the limiting factor.
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References
Geller E, Yoon MS, Loiselle J, Crisci KL, Bierbrauer KS (1997) Head injuries in children from plastic hairbeads. Pediatr Radiol 27:790–793
González AL, Marín AG, Garijo JAA, Mengual MV (2006) Penetrating head injury in a paediatric patient caused by an electrical plug. Childs Nerv Syst 22:197–200
Mandat TS, Honey CR, Peters DA, Sharma BR (2005) Artistic assault: an unusual penetrating head injury reported as a trivial facial trauma. Acta Neurochir 147:331–333
Lopez F, Martínez-Lage JF, Herrera A, Sánchez-Solís M, Torres P, Palacios MI, Poza M (2000) Penetrating craniocerebral injury from an underwater fishing harpoon. Childs Nerv Syst 16:117–119
Pappano D, Murray E, Cimpello LB, Conners G (2008) Penetrating missile type head injury from a defective badminton racquet. Eur J Pediatr Sep 6. In press
Kanagarajan A, Sgouros S (2007) Unusual penetrating craniocerebral injuries in children from mains plugs. Childs Nerv Syst 23:1181–1183
Jacob JT, Cohen-Gadol AA, Maher CO, Meyer FB (2005) Transorbital penetrating brainstem injury in a child: case report. J Neurosurg 102(3 Suppl):350–352
Paucić-Kirincić E, Prpić I, Gazdik M, Kriz M, Vojniković B, Golubović V (1997) Transorbital penetrating brain injury caused by a toy arrow: a case report. Pediatr Rehabil 1(3):191–193
Agrawal AP, Agrawal CS, Kumar A, Rupakheti S (2007) Transorbital orbitocranial penetrating injury due to bicycle brake handle in a child. Pediatr Neurosurg 43:498–500
Lauterbach A, Hausmann R, Betz P (2006) Fatal impalement injury of the head due to a curtain rail. Int J Leg Med 120(6):380–382
Bhatjiwale MG, Goel A, Muzumdar DP (2001) Transnasal intracranial entry of a flying wire fragment. Br J Neurosurg 15(3):256–258
Chan WW, Choudhari KA (2008) Penetrating head injury caused by a dart. Ir Med J 101(8):255–256
Mohan AL, Slim M, Benzil DL (2005) Knife wound to the posterior fossa in a child. Childs Nerv Syst 21:255–258
Solarino B, Reckentwald K, Burrows-Beckham AM (2008) An unusual case of child head injury by coat hanger. J Forensic Sci 53(5):1188–1190
Kumar A, Singh H, Sharma KH (2006) Penetrating head injury from a pedestal fan rotor blade in a child—an unusual case. Pediatr Neurosurg 42:391–394
Pascual-Castroviejo I, Pascual-Pascual SI, Viano J (2006) Diplegia due to transcranial knife-blade injury in a 20 month old child. J Child Neurol 21:340–341
Brichtová E (2008) Analýza souboru pacientů s kraniocerebrálním poraněním léčeným na Pracovišti dětské medicíny FN Brno v období let 2000–2007. Čes Slov Neurol Neurochir 71:466–471
Brichtová E (2008) Kraniocerebrální poranění v dětském věku. Triton, Praha, pp 79–84
Smrčka M (2001) Poranění mozku. Grada, Praha, p 71
Mraček Z (1988) Kraniocerebrální poranění. Avicenum, Praha, pp 116–120
Eckstein M (1995) The prehospital and emergency department management of penetrating head injury. Neurosurg Clin N Am 6:741–751
Aarabi B, Taghipour M, Haghnegahdar A, Farokhi MR, Mobley L (2000) Prognostic factors in the occurrence of posttraumatic epilepsy after penetrating head injury suffered during military service. Neurosurg Focus. [online] 2000;8(1). Available at: http://www.neurosurgery.org/focus
Young B, Rapp RE, Norton JA, Haack D, Walsh JW (1983) Failure of prophylatically administered phenytoin to prevent post traumatic seizures in children. Childs Brain 10:185–193
Temkin NR, Dikmen SS, Wilenski AJ, Keihm J, Chabal S, Winn HR (1990) A randomized double- blind study of phenytoin for the prevention of post-traumatic seizures. N Engl J Med 323:497–502
Albright AL, Pollack IF, Adelson PD (1999) Principles and practise of pediatric neurosurgery. Thieme, New York, p 842
Plánka L, Starý D, Škvařil J, Gál P (2008) Národní registr dětských úrazů(R). Úraz Chir 16:65–68
Karabagli H (2005) Spontaneous Movement of Bullets in the Interhemispheric Region. Pediatr Neurosurg 41:148–150
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Mackerle, Z., Gal, P. Unusual penetrating head injury in children: personal experience and review of the literature. Childs Nerv Syst 25, 909–913 (2009). https://doi.org/10.1007/s00381-009-0901-z
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DOI: https://doi.org/10.1007/s00381-009-0901-z