Penetrating arrow injuries of the head-and-neck region: Case series and review of literature

Abstract

Penetrating arrow injuries of the head-and-neck region are rare in the developed countries, but they are common in the rural communities of our country. Arrow shot to the head-and-neck region can be life-threatening due to the presence of major vessels and vital organs. Management of arrow injury to the head-and-neck region is seriously challenging, extraction of the arrows are usually difficult due to the proximity to vital structures, unskilled removal may worsen the existing injury or result in inadvertent damage to the vital structures. We presented the four cases of arrow shot to the head-and-neck region, three were managed successfully, and one was brought in dead probably due to attempt at the removal at home or poisonous nature of the arrow. Therefore, the aim of this report is to highlight our experience and challenges in the management of penetrating arrow injuries to head-and-neck region and to review some literature reports.

A hunting arrow traumatism to the head: A case report from Niger

“…Our patient was clinically stable and had received a complete and unremarkable clinical examination. CT scan is an essential examination for lesion assessment in patients with arrowhead trauma to the head 1 . It is usually indicated in patients who are hemodynamically stable, which was the case with our patient.…”

“…Poisoned arrows cause paralysis or severe infection of the wound, depending on the type of poison 2 . Brain and spinal cord injuries can result in paraplegia, quadriplegia, ventricular hemorrhage, or immediate death 1 . The good news is that in our patient, the path of the arrow was exclusively extracranial and the large vessels were not involved.…”

“…Nevertheless, in developing countries, arrow injuries are still a reality. 1,2 In developing countries, for example, penetrating head injuries occur most often after fights and conflicts between farmers, and these situations are much more frequent in practice than the rarity of reported cases would suggest. 2,3 Arrow injuries are very rare.…”

“…With advances in technology, arrows as weapons of war are now almost abandoned in developed countries. Nevertheless, in developing countries, arrow injuries are still a reality 1,2 …”

“…All areas of the body can be targets, including the cephalic region, and the severity of which depends on several factors. Among these factors, we cite, the distance at which the arrow was shot, the degree of penetration of the arrow and the application or not of poison on the arrowhead, which is a common practice 1 . These injuries can affect any part of the human body, including the head and neck and can be fatal 6 .…”