Abstract
IntroductionPenetrating head injuries (PHIs) can have diverse presentations and mechanisms; therefore, treatment methods have not been clearly outlined. Vascular injury is common and foreign body removal is often required. We present three cases to illustrate low-velocity nonmissile penetrating head injuries (NPHIs) and discuss a multidisciplinary approach.MethodsWe present a case series from our institution that illustrates the importance of multidisciplinary treatment of these injuries. All injuries are low- velocity NPHIs with separate mechanisms and anatomical locations.ResultsMultidisciplinary management involving neurosurgery, otolaryngology, and neuroendovascular surgery is represented in our case series with all patients having good clinical outcomes. Our first case is a 34-year-old male who presented neurologically intact after a stabbing in the left temporal region with concerns for external carotid artery injury and maxillary sinus injury. Our second case is a 37-year-old male who presented with a self-inflicted nail gun injury that penetrated the right temporal bone, right temporal lobe, bilateral sphenoid sinus, and left petrous carotid canal with concerns of petrous internal carotid injury. Our third case is a 31-year-old male who presented after an accidental nail gun injury that penetrated through the oral cavity, hard palate, and left sphenoid sinus and ending in the left cavernous sinus with concerns of cavernous internal carotid injury.Conclusion Careful consideration must be taken when evaluating low-velocity NPHIs. Particular attention must be given when an associated vascular injury is suspected. Our case series highlights the importance of a multidisciplinary approach in achieving good clinical outcomes in PHIs.
Highlights
Penetrating head injuries (PHIs) can have diverse presentations and mechanisms; treatment methods have not been clearly outlined
We present our experience with three cases of nonmissile penetrating head injuries (NPHIs) and review the literature on injuries of this nature
We present a case series from our institution that illustrates the importance of multidisciplinary treatment of NPHIs
Summary
We present a case series from our institution that illustrates the importance of multidisciplinary treatment of these injuries. All injuries are low- velocity NPHIs with separate mechanisms and anatomical locations. We present a case series from our institution that illustrates the importance of multidisciplinary treatment of NPHIs. All injuries we present are low-velocity NPHIs with separate mechanisms and anatomical locations. We discuss the relevant literature and similar cases at other institutions. How to cite this article Young M, Putty M, Finneran M M, et al (March 24, 2020) Multidisciplinary Management of Low-velocity Nonmissile Penetrating Head Injuries.
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