A case of unusual craniocerebral penetrating injury
Watanabe, O.; Nakajima, S.; Tamachi, S.
No Shinkei Geka. Neurological Surgery 9(6): 727-731
1981
ISSN/ISBN: 0301-2603 PMID: 7279123 Document Number: 177291
An unusual case of a craniocerebral penetrating wound was reported, in a 10 yr old girl hit in the head by an iron ground peg on nylon rope, accidentally pulled out of the ground and hurled into the air. The iron ground peg, 1.5 cm in diameter and 19 cm in length, travelled some 7 m in the air before hitting the girl. Craniograms showed complete penetration of the iron peg from the parasagittal frontal convexity down to the midline submandibular region, passing through the brain, frontal base, nasal structures, hard palate and tongue. Bilateral carotid angiograms showed complete obstruction of both anterior cerebral arteries. An emergency bifrontal craniotomy was done and the iron peg was successfully removed under direct vision, sparing both anterior cerebral arteries. The girl made a complete recovery from the initial paraplegia and threat of intracranial infection. Postoperative CT showed low density areas in the territory of the both anterior cerebral arteries. Three years after the injury, the girl is on anti-epileptic medication for posttraumatic epilepsy, but is otherwise doing well at home and school.