Transoral Crossbow Injury: An Unusual Case of Central Nervous System Foreign Body

Kaye, Kory; Kilgore, Kevin P.; Grorud, Craig

doi:10.1097/01.ta.0000044628.62168.b0

Cited by 10 publications

(5 citation statements)

References 8 publications

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“…[7][8][9][10][11][12] The finding of bilateral cranial nerve deficits in our patient was particularly significant as it suggested that the clamp had crossed the midline. A transcranial trajectory in penetrating injury has been identified as a predictor of increased morbidity and mortality.…”

Section: Discussionmentioning

confidence: 90%

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

Kjelland

Thirsk

2011

CJEM

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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.

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Section: Discussionmentioning

confidence: 90%

“…Removal of foreign bodies with undetermined trajectories in close proximity to vital structures should generally be done only under the most controlled circumstances possible. 10 Foreign bodies in situ can provide temporary tamponade of vascular injuries, and this possibility guided our approach to a delayed and controlled removal.…”

Section: Discussionmentioning

confidence: 99%

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

Kjelland

Thirsk

2011

CJEM

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“…In recent years the number of criminal incidents involving crossbows in the UK has become more apparent, with many incidents resulting in either injuries or fatalities [1][2][3][4][5]. Whilst the apparent increase of these incidents could potentially be attributed to media reporting bias, their reporting in academic literature has risen over the last few years [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Although the majority of incidents involving injury occur within open environments, there is evidence that individuals within vehicles are at risk [21,22].…”

Section: Introductionmentioning

confidence: 99%

The effects of crossbow impacts onto a common automotive vehicle side window—a preliminary study

2019

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In recent times, the number of criminal incidents involving crossbows in the UK has increased with many incidents resulting in either injuries or fatalities. Whilst the effects of crossbow bolts on the body are well understood, there is a limited understanding on how these projectiles interact with the wider environment. One area of particular interest is the interaction between common vehicle side windows and bolts. In this study, the penetrability of two distinct bolts using an off-the-shelve crossbow against a common automotive side window was explored, where velocity loss up to 25 m/s post impact was recorded. All windows failed through radial glass fracture at a rate up to 1600 m/s, whilst bolt damage varied from tip holder decoupling, shaft damage, and traumatic fletching removal. No distinct relationship between bolt type, velocity, and window damage was identified.

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“…Crossbow injuries also result in a much larger retained foreign body than more traditional gun injuries. The majority of low velocity missile and non-missile TBIs in the literature undergo foreign body removal in an operating room setting 2,4,5 . In this technical study we describe our approach for foreign body removal in a radiological setting in two patients with self-inflicted crossbow injuries, and discuss the rationale and benefits of this approach over direct removal in the operating room.…”

Section: Introductionmentioning

confidence: 99%