Detecting Foreign Bodies in a Head Laceration

Fowler, Thomas R.; Crellin, Steven J.; Greenberg, Marna Rayl

doi:10.1155/2015/801676

Cited by 7 publications

(7 citation statements)

References 3 publications

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“…Superficial FBs are often easily extractable, but FBs that have penetrated deep are hard to remove. Determination of the proximity of FBs to critical organs is important to find out the risks of FB extraction surgery (8). Detection and localization of FBs are done by taking a precise history, clinical examination and facial imaging (3).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Visibility of Foreign Bodies in the Maxillofacial Region: Comparison of Computed Tomography, Cone Beam Computed Tomography, Ultrasound and Magnetic Resonance Imaging

et al. 2016

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BackgroundDetection of foreign bodies (FBs) is challenging. Selection of a fast and affordable imaging modality to locate the FB with minimal patient radiation dose is imperative.ObjectivesThis study sought to compare four commonly used imaging modalities namely cone beam computed tomography (CBCT), magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound (US) for detection of FBs in the head and neck region.Materials and MethodsIn this in vitro study, iron, glass, stone, wood, asphalt, and tooth samples measuring 0.1 × 0.5 × 0.5 cm were placed in the tongue muscle, soft tissue-bone interface and nasal cavity in a fresh sheep’s head and subjected to MRI, US, CT and CBCT. A total of 20 images were captured by each imaging system from the six materials in the afore-mentioned locations. The images were observed by an expert oral and maxillofacial radiologist and a general radiologist. To assess reliability, 20 images were randomly observed by the observers in two separate sessions. The images were classified into three groups of good visibility, bad visibility and invisible. The data were analyzed using SPSS version 18, Wilcoxon Signed Rank, Pearson chi square, and Fisher’s exact tests.ResultsAll FBs in the tongue and at the soft tissue-bone interface had good visibility on US (P = 1.00). Also, CBCT and CT had significantly different performance regarding FB detection (P < 0.001). All wooden samples in the nasal cavity were invisible on CT scans; while, only 20% of them were invisible on CBCT scans. MRI showed significant differences for detection of FBs in the three locations (P < 0.001). MRI could not locate iron samples due to severe artifacts and only showed their presence (bad visibility) but other FBs except for wood and tooth in the nasal cavity (100% invisible) had good visibility on MRI.ConclusionsUltrasound is recommended as the first choice when FB is located within the superficial soft tissues with no bone around it. In case of penetration of FB into deeper tissues or beneath bone, CT or CBCT are recommended. Otherwise, considering lower dose, CBCT is preferred over CT. We can use MRI if the FB is not ferromagnetic. However, CT is the first choice in emergency situations because of higher sensitivity.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Visibility of Foreign Bodies in the Maxillofacial Region: Comparison of Computed Tomography, Cone Beam Computed Tomography, Ultrasound and Magnetic Resonance Imaging

et al. 2016

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“…The importance of imaging of lacerations had been underscored by a couple of reports [2,6]. However, the Skull X-ray and CT Scan carried out by our patient did not reveal any foreign bodies as he presented with a non-lucent foreign body.…”

Section: Discussionmentioning

confidence: 50%

“…This is particularly more likely in the scalp due to its high vascularity and potential for bleeding when injured. Imaging of lacerations has been advised to enhance the detection of foreign bodies, as they represent potential areas for medicolegal concerns [2]. However, in some cases the imaging may not reveal the foreign bodies, thus necessitating a re-exploration of the wound.…”

Section: Introductionmentioning

confidence: 99%

Foreign body in the scalp: A thorn in the flesh – case report

Ogundipe¹,

Kadiri²,

Rabiu³

et al. 2021

J Clin Images Med Case Rep

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Open scalp wounds are often associated with retained foreign bodies and are poorly reported. Despite meticulous radiological evaluations, foreign bodies can still be missed. Complication such as chronic headache, scalp abscess, chronic osteomyelitis, organic personality disorder had been reported. Coupled with the potential for medicolegal concerns, retained foreign bodied in the scalp thus require critical evaluation and management. Herein we reported a case of a retained stalk of grass (foreign body) in the scalp that is complicated with scalp abscess and chronic headache and call for a high index of suspicious in the management of foreign bodies in the scalp.

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“…This was highlighted by Fowler et al, in their case report. 23 So the wound has to be reopened, debrided and washed thoroughly if there is any suspicion in the radiographs taken, even if the already sutured wound appears good.…”

Section: Discussionmentioning

confidence: 99%

Penetrating head injury by stones: a case series and review of the literature based on the type of injury

thotakura,

velivela,

marabathina

2023

Pan Arab Journal of Neurosurgery

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BACKGROUND: Low velocity penetrating head injury (PHI) is uncommon. PHI due to a stone is rare and we report a case series with a systematic review of the literature. OBJECTIVE:The aim of this study was to evaluate the clinical grade, grade of injury, type of injury and clinical outcome following penetrating head injury with stones. PATIENTS AND METHODS:We included 4 patients from this series and 21 patients from the literature review. They are grouped into 7 patients with type I injury and 18 patients with type II injury, based on the mode of injury. Type I injury is when the stone hits the head and type II injury is when the head falls on the stone and gets injured. The severity of PHI was graded into 6 grades (grade 0 to grade 5) based on depth of injury. The clinical outcome was assessed based on Glasgow outcome scale. RESULTS:The mean age was 22.6 years and 84% were males in the total 25 patients. The commonest cause of injury was road traffic accident (40%) and the commonest site of injury was the frontal region (60%). Most patients presented with mild head injury. Grade 4 was the most common grade of injury. There was a statistically significant difference noted in the clinical grade Glasgow coma scale (GCS) and outcome (p=0.03) between the two groups. CONCLUSION:From the review of the literature, two types of PHI by stones can be concluded. Type I injuries were less common, more severe in the coma scale, injury grade, and had poor outcome compared to type II injuries.

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Detecting Foreign Bodies in a Head Laceration

Cited by 7 publications

References 3 publications

Evaluation of Visibility of Foreign Bodies in the Maxillofacial Region: Comparison of Computed Tomography, Cone Beam Computed Tomography, Ultrasound and Magnetic Resonance Imaging

Evaluation of Visibility of Foreign Bodies in the Maxillofacial Region: Comparison of Computed Tomography, Cone Beam Computed Tomography, Ultrasound and Magnetic Resonance Imaging

Foreign body in the scalp: A thorn in the flesh – case report

Penetrating head injury by stones: a case series and review of the literature based on the type of injury

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