包丁による頭部刺創の1例

Stab Injury of the Brain by Kitchen Knife

Ⅰ．は じ め に

　頭部への刺創は稀な事故であり，多くは暴力行為で起こるが，自殺企図や労災事故などでも起こりうる．症状は軽微な場合もあるが，致死的となる場合も少なくない．刺入物としては先端が鋭利なものほど刺入しやすいと思われるが，刃物であることが多い⁵⁾．今回われわれは，自殺企図で前額部より包丁（kitchen knife）を刺入し意識障害により搬送された症例を経験したが，本症例は来院同日の手術により神経学的異常所見なく独歩退院した．これまで国内外に同様の頭部刺創症例が散見されることから，文献的考察を加え報告する．

A 32-year-old male attempted suicide by stabbing his forehead with a kitchen knife,and was sent to our hospital. On admission,he was confused (20-30/JCS),but was able to move his both extremities. Skull X-p,CT scan indicated that the kitchen knife penetrated the frontal bone,reached the cerebrum by way of the frontal sinus. Cerebral angiography was performed,and showed no vascular lesions. Emergent craniotomy was performed and the kitchen knife was removed with minimum movement. Traumatic intracerebral hematoma was removed,and injured frontal sinus,dura mater and frontal bone were repaired. Postoperative course was excellent and he was discharged with the wounds well healded,no neurological deficits on the 17th day after the operation. There are several reported cases of such stab injury. Stab injury of the brain was discussed in the literature.