Perforating brain injury from a speargun. A case report

Abarca-Olivas, Javier; Baño-Ruiz, E.; Caminero-Canas, M.A.; Navarro-Moncho, J.A.; Botella-Asunción, Carlos; Concepción-Aramendía, L.A.

doi:10.1016/s1130-1473(11)70025-2

Cited by 17 publications

(20 citation statements)

References 17 publications

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“…Most injuries by spear gun occur accidentally but a few cases of suicide were published earlier (2). Although the injuries that caused by spear gun have high risk of mortality and morbidity, fortunately our patient had no severe deficit compared to some cases published before (2,10,11). Maxillofacial injuries that caused by spear gun are very rare conditions.…”

Section: Discussionmentioning

confidence: 46%

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A Child with Maxillofacial Injury by Three Pronged Spear Gun

Çağlar¹,

Er²,

Demirdöver³

et al. 2015

Turk J Ped Em Int Care Med

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ÖZETBu raporda, nadir görülen, mortalite ve morbidite ile sonuçlanabilecek zıpkına bağlı maksillofasiyal bir yaralanma olgusu sunulmaktadır. Bu tip hastalarda nasıl müdahale edilmesi gerektiğini bilmek büyük önem taşımaktadır. Olgu, yüzünden zıpkın ile vurulma nedeni ile çocuk acil servisine başvurdu. İlk bakıda bilinci açık, oryantasyonu tam, solunum ve dolaşım bulguları stabildi. Üç mızraklı zıpkın, yüzün sol malar bölgesine saplanmıştı. Zıpkını hastanın yüzünden çıkarmak için gerekli müdahale yapılmadan önce beyin tomogra si ile değerlendirildi ve herhangi bir nörovasküler penetrasyon olmadığı belirendi. Operasyon sırasında hastanın entübasyonu sağlayabilmek için öncelikle zıpkının bağlantı noktası hidrolik kesici ile kesildi ve zıpkının alt parçası acil serviste kontrollü bir şekilde çıkarıldı. Kalan parçalar genel anestezi altında ameliyathane şartlarında çıkarıldı. Hasta 3 gün sonra herhangi bir sekel kalmadan taburcu edildi. Zıpkın oldukça tehlikeli ve çocuklarda tarafından kolayca ulaşılabilen bir ekipmandır. Bu tür vakaların yönetimi farklı zıpkın türlerine göre değişiklik göstermektedir. Bu vaka, acil serviste zıpkına bağlı bir yaralanmaya nasıl müdahale edilmesi gerektiğini ortaya koymaktadır. CAYD 2015;2(1):45-48. Anahtar Kelimeler: Zıpkın, maksillofasiyal, çocuk, travma, acil SUMMARY This report illustrates a rare maxillofacial injury by spear gun that can cause mortality and morbidity. It's important to know how to intervene such a patient. He was conscious and oriented when he administered to the emergency department (ED), his respiration and circulation was stable. Three pronged spear was stuck into left malar region. Computed tomography was performed before manipulation of spear gun and no neurovascular penetration was determined. The external part of the spear gun was cut out by a hydraulic cutter to facilitate patient's intubation. The lower fragment of the harpoon was removed in ED. The rest of the spear was removed in operation room under general anesthesia. The patient healed with no de cit and discharged three days after operation. Spear guns are very dangerous equipment that children can easily access. Management of cases can be di erent according to the di erent kind of spear guns. This case demonstrates management to the spear gun injuries in ED. CAYD 2015;2(1):45-48.

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Section: Discussionmentioning

confidence: 46%

“…The spear gun needed to be removed in OR, under general anesthesia but elective intubation was not possible due to inability to open oral cavity. In some cases, cutting the outer part of object that penetrates to maxillofacial region can be necessary as in ours (8,10). This process has some risks for the patients.…”

Section: Discussionmentioning

confidence: 99%

A Child with Maxillofacial Injury by Three Pronged Spear Gun

Çağlar¹,

Er²,

Demirdöver³

et al. 2015

Turk J Ped Em Int Care Med

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“…In other cases presented in the literature, 8,9 it has been shown how it is possible to survive for some time after being shot by a similar weapon.…”

Section: Discussionmentioning

confidence: 91%

Suicide Due to Four Speargun Shots

Bonsignore

Bernucci

Canepa

et al. 2013

American Journal of Forensic Medicine &Amp; Pathology

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In the literature, only a few cases of deaths related to the use of atypical firearms are present and even more rare are cases of suicide due to multiple lesions.In the present case, the authors report a rare occurrence of suicide due to 4 speargun shots, 3 to the chest and 1 to the head.A complete forensic approach led to attribute the death to acute cardiac failure due to hemopericardium after the injury of the left coronary artery.Scene investigation and autoptic findings allowed authors to hypothesize that injury to the head was a last attempt of suicide, elapsed during the progression of cardiac tamponade.With this report, the authors would like to share knowledge with the forensic community about speargun-related lesions distinguishing them from the very similar ones produced by cold steels.It also shows how it is possible to survive for some time after being shot by such a weapon.

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“…However, LVPBI patients warrant extra care in history-taking as the mechanism of injury frequently reflects objectionable and/or illegal behavior. The case presented here and another with an injury by the same mechanism are examples of such behavior in the form of failed suicide attempts ( 18 ). Other cases of LVPBI have involved unsupervised children playing with harpoon guns similar to the one used by the patient described in this report ( 19 , 20 ), a young man constructing a homemade explosive device ( 14 ), and poorly attended children falling with pointed objects in hand ( 15 , 21 ).…”

Section: Discussionmentioning

confidence: 94%

Penetrating Brain Injury after Suicide Attempt with Speargun: Case Study and Review of Literature

et al. 2014

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Penetrating cranial injury by mechanisms other than gunshots are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here, we present a case of penetrating brain injury by the low-velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of low-velocity penetrating brain injury (LVPBI), including benefit in delaying foreign body removal to allow for tamponade; the importance of history-taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using dual-energy CT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher-velocity forms of intracranial injury.

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Perforating brain injury from a speargun. A case report

Cited by 17 publications

References 17 publications

A Child with Maxillofacial Injury by Three Pronged Spear Gun

A Child with Maxillofacial Injury by Three Pronged Spear Gun

Suicide Due to Four Speargun Shots

Penetrating Brain Injury after Suicide Attempt with Speargun: Case Study and Review of Literature

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