Cranial injuries secondary to assault with a machete

Enicker, Basil; Madiba, T. E.

doi:10.1016/j.injury.2014.04.036

Cited by 22 publications

(14 citation statements)

References 12 publications

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“…Machete injuries to the head are common in parts of Africa. These may cause compound depressed fractures with neurological deficit [ 38 ]. The principles of surgery for craniocerebral stab wounds are the same as for GSW.…”

Section: Craniocerebral Stab Woundsmentioning

confidence: 99%

Current Concepts in Penetrating and Blast Injury to the Central Nervous System

2014

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AimTo review the current management, prognostic factors and outcomes of penetrating and blast injuries to the central nervous system and highlight the differences between gunshot wound, blast injury and stabbing.MethodsA review of the current literature was performed.ResultsOf patients with craniocerebral GSW, 66–90 % die before reaching hospital. Of those who are admitted to hospital, up to 51 % survive. The patient age, GCS, pupil size and reaction, ballistics and CT features are important factors in the decision to operate and in prognostication. Blast injury to the brain is a component of multisystem polytrauma and has become a common injury encountered in war zones and following urban terrorist events. GSW to the spine account for 13–17 % of all gunshot injuries.ConclusionsUrgent resuscitation, correction of coagulopathy and early surgery with wide cranial decompression may improve the outcome in selected patients with severe craniocerebral GSW. More limited surgery is undertaken for focal brain injury due to GSW. A non-operative approach may be taken if the clinical status is very poor (GCS 3, fixed dilated pupils) or GCS 4–5 with adverse CT findings or where there is a high likelihood of death or poor outcome. Civilian spinal GSWs are usually stable neurologically and biomechanically and do not require exploration. The indications for exploration are as follows: (1) compressive lesions with partial spinal cord or cauda equina injury, (2) mechanical instability and (3) complications. The principles of management of blast injury to the head and spine are the same as for GSW. Multidisciplinary specialist management is required for these complex injuries.

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Section: Craniocerebral Stab Woundsmentioning

confidence: 99%

Current Concepts in Penetrating and Blast Injury to the Central Nervous System

2014

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“…The PCNIs presenting with ventricular lodgement of the foreign body are rarely seen in our practice, in spite of numerous cases of penetrating craniocerebral trauma, which are managed in our unit [6,7]. Nails typically cause focal tissue damage due to their small diameter [2].…”

Section: Discussionmentioning

confidence: 99%

Delayed presentation of a penetrating craniocerebral nail injury with the weapon lodged in the ventricle

Mnguni¹,

Enicker²,

Msomi³

2016

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. We report an unusual case of a 57-year-old female treated for delayed presentation of a penetrating craniocerebral nail injury following an assault. The admission Glasgow coma scale (GCS) was 14/15. The nail was lodged within the ventricle, requiring emergency removal, which was performed successfully. However, she developed ventriculitis and Escherichia coli was cultured from the cerebrospinal fluid. The GCS dropped to 8/15 necessitating an urgent CT brain scan, which showed hydrocephalus, requiring insertion of an external ventricular drain. Targeted antibiotic therapy was administered. However, she deteriorated further and demised on the fourth day of admission as a result of intracranial sepsis. Conclusion:Penetrating craniocerebral nail injury presenting with the weapon lodged in the ventricle requires urgent surgical intervention and targeted antibiotic therapy to ensure a favorable outcome.

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“…7 Elevation and repair of an open depressed fracture is often thought of as an emergency procedure. 8 Timeous intervention and good surgical principles are advocated to prevent secondary infection and further neurological deterioration. 9,10 Jannett et al, reported 5% infection incidence in early and 37% infection incidence in late surgery.…”

Section: Introductionmentioning

confidence: 99%

The frequency of infection in early versus late surgery of compound depressed skull fractures in adults

2018

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Background: The treatment of penetrating head injuries and depressed skull fracture has shown a gradual change over the past decades. A proper debridement and closure of scalp wounds and dural tears have been shown to decrease infection and mortality rate of compound skull fractures. This study has been designed to determine the frequency of infection in early versus late surgery of compound depressed skull fractures in adults.Methods: A total of 226 (113 in each group) patients with compound depressed skull fracture were taken. Group A was managed by early surgery while group B underwent late surgery. Data were entered and analyzed using computer program SPSS version 18.Results: Out of these 226 study cases, 143(63.3%) were male, while 83 (36.7%) were females. The mean age of study cases was 37.50±10.58. The mean duration of presentation at the hospital was 6.76±2.41 hours. Roadside accident was noted to be a major etiological factor, i.e. 132 (58.4%) presented with the history of roadside accident. Base of the skull was a major site of wound, i.e. 79 (35.0%). The mean size of the wound was 13.79±3.49cm. Wound infection was seen in 51 (22.56%) of present study cases. Wound infection in group A was seen in 11 (9.7%) out of 113 patients while in group B it was 40 (35.4%) out of 113 patients (p=0.000).Conclusions: The findings of the current study have indicated that early surgery among the targeted population is associated with significantly less frequent wound infection.

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Cranial injuries secondary to assault with a machete

Cited by 22 publications

References 12 publications

Current Concepts in Penetrating and Blast Injury to the Central Nervous System

Current Concepts in Penetrating and Blast Injury to the Central Nervous System

Delayed presentation of a penetrating craniocerebral nail injury with the weapon lodged in the ventricle

The frequency of infection in early versus late surgery of compound depressed skull fractures in adults

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