Penetrating craniofacial trauma from a vice clamp: case report and discussion

Abstract

Penetrating craniofacial trauma, although uncommon, has a high potential for death or serious morbidity from injury to vital neurovascular structures. An in situ facial foreign body, particularly if large, presents significant challenges beyond safe and timely removal. Airway management, stabilization of the object, management of increased intracranial pressure, and identification of injuries to local structures are all issues that may require addressing. We present a case of penetrating facial trauma from a vice clamp, with an in situ foreign body, that illustrates several of these challenges and provides a forum for their discussion. RÉ SUMÉLe traumatisme craniofacial pé né trant, bien qu'il soit rare, pré sente un potentiel é levé de dé cè s ou de morbidité grave en raison de l'atteinte aux structures neurovasculaires vitales. Un corps é tranger in situ au niveau du visage, en particulier s'il est gros, pré sente des dé fis importants hormis son retrait sû r et en temps opportun. La prise en charge des voies respiratoires, la stabilisation de l'objet, la gestion de la pression intracrâ nienne accrue et la dé termination de la pré sence de lé sions aux structures locales sont autant de questions qui devront ê tre ré solues. Nous pré sentons un cas de traumatisme pé né trant au visage causé par un serre-joint, avec un corps é tranger in situ, qui illustre plusieurs de ces dé fis et fournit un forum pour la discussion.

Sympathetic trunk repair following penetrating injury to the neck

“…7 However, in many cases, the neurological deficit persists, which may reflect transection (neurotmesis) of the sympathetic trunk, as was observed in our case. 5,6,8 Neuropraxia cannot be differentiated from a transected nerve based on clinical or radiological assessment. Based on our experience we advocate exploration with a view to identification and repair in cases of sympathetic trunk transection.…”

A spectacular case of penetrating craniocerebral trauma from a rake

“…Cases have been reported by various authors of suicidal or homicidal incidences [2] , where patients were inflicted injury by means of nails and other objects. Other circumstances were reported such as road, domestic, [3] or work accident. [4] They cause a spectacular cranial trauma, all the more the object is voluminous.…”