Perforating brain injury from a speargun: A case report

Abstract

A case of a perforating brain injury caused by a speargun in a suicide attempt is described. Although this kind of injuries has been previously reported, the present case is specially interesting because the patient showed no neurological deficit after surgery. Some advices about the medical and surgical management are proposed based on this case and our literature review. The use of antibiotics and antiepileptic drugs and the anterograde extraction of the harpoon aided by the performance of a craniotomy surrounding the exit point are recommended. KEY WORDS. Speargun. Perforating injury. Cranial trauma. Traumatismo craneal perforante por arpón de pesca. A propósito de un caso Resumen Describimos un caso de traumatismo craneo-encefálico perforante causado por un arpón de pesca submarina tras intento de autolisis. Aunque traumatismos parecidos han sido publicados previamente, el presente caso es especialmente interesante dada la escasa repercusión neurológica que el paciente presentó tras la cirugia. Basándonos en esta experiencia y en nuestra revisión bibliográfica proponemos algunos consejos que pueden ser de utilidad en el manejo médico y quirúrgico. El uso de antibióticos y antiepilépticos así como la extracción anterógrada del arpón con la ayuda de una craneotomía rodeando su punto de salida son algunas de estas recomendaciones. PALABRAS CLAVE. Arpón. Traumatismo perforante. Traumatismo craneal.

Intracerebral Hemorrhage due to Venous Thrombosis of Developmental Venous Anomaly during Pregnancy

“…Only 5 case reports stated that the hypercoagulable state in the puerperium period or the use of an oral contraceptive might have contributed to the thrombosis of a DVA. [5][6][7][8][9] To our knowledge, thrombosis of DVA during the first trimester of pregnancy has never been reported.…”

Penetrating Brain Injury by Multiple Low-Velocity Objects: Report of Two Rare Cases and Review of Literature

“…Penetrating injuries by rod, knife, and smear guns are reported earlier. [1][2][3] Few reported cases of scissors in the brain to treat psychiatric problems 4 ; self-inflicted rods in psychiatric patients were seen. 1 Our cases are rare as there were multiple penetrations with low-velocity rods.…”

“…Immediate CT scan should be recommended for better information on the brain matter injury along its trajectory. 3 If there is a hematoma or any subarachnoid hemorrhage, there is possibility of vascular injury. In that case, cerebral angiography is recommended preoperatively.…”

“…Increased severity of injury as determined by the Glasgow Outcome Scale grade is a ss o c i ate d w i t h i n c r e a s e d r i sk o f s ei z u r e. 1 1 -1 3 Antiepileptics should be given in proper dose in the preand postoperative period. 3,12,13 Some delayed complications may be anticipated in such penetrating injuries such as pneumocephalus, cerebrospinal fluid leak, sepsis, and pseudoaneurysms. 14 There was no neurodeficit in our cases postoperatively, and similar cases without any deficit following PBI have been reported earlier.…”

“…Penetrating brain injury (PBI) by means other than gunshot is quite uncommon, and its management is a challenge to a neurosurgeon. This type of injuries can be suicidal, 1 homicidal, 2 accidental, 3 or warfare related. In the literature, we have seen few cases of PBI following suicidal attempts, PBI as part of quack treating psychiatric patient, and also violence-related incidences.…”