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A Case of a Penetrating Brain Injury due to an Explosion of a Construction Machine Kenji IBAYASHI 1 , Kazuo TSUTSUMI 1 , Gakushi YOSHIKAWA 1 , Takeshi UNO 1 , Shiko SHIMADA 1 , Mariko KAWASHIMA 1 , Satoshi KOIZUMI 1 , Yushi OCHIAI 1 1Department of Neurosurgery,Showa General Hospital Keyword: penetrating brain injury , gunshot wound , foreign body , surgical debridement pp.421-427
Published Date 2012/5/10
DOI https://doi.org/10.11477/mf.1436101723
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 Penetrating brain injury caused by a high speed projectile is rather rare in Japan,known for its strict gun-control laws.

 We report a case of a 55-year-old male, who was transferred to our hospital with a foreign body in the brain due to penetrating head injury, which was caused by an explosion of a construction machine. Neurological examination demonstrated severe motor aphagia with no apparent motor paresis. The patient had a scalp laceration on his left forehead with exposed cerebral tissue and CSF leakage.

 Head CT scan and plain skull X-ray revealed a 20 mm×25 mm bolt which had penetrated due to the explosion of the machine. The anterior wall of the left frontal sinus was fractured resulting in dural laceration, and scattered bone fragments were seen along the trajectory of the bolt. Digital subtraction angiography showed no significant vascular injuries including superior sagittal sinus.

 We performed open surgery, and successfully removed the bolt along with the damaged frontal lobe. The patient had no infection or seizure after the surgery, and was transferred for further rehabilitation therapy. We performed a cosmetic cranioplasty six months later.

 Surgical debridement of the damaged cerebral tissue along the trajectory led to successful removal of the bolt with no further neurological deficit.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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