Hebecker R, Sola St, Lenz J H, Just T, Piek J
Department of Neurosurgery, University of Rostock, Rostock, Germany.
Cent Eur Neurosurg. 2009 Feb;70(1):48-51. doi: 10.1055/s-2008-1080942. Epub 2009 Feb 5.
Injuries relevant to neurosurgeons in central Europe are rarely caused by wild animal attacks, whereas dog bites in urban areas and farm-related attacks from cattle and horses are well-known to cause sometimes fatal head injuries. The authors describe the first case of a perforating frontobasal injury caused by a wild deer's antler. Associated lesions involved the endonasal area and the left orbit. A multidisciplinary approach was used to address all lesions in a one-stage operation resulting in a full recovery of the patient. Apart from the problem of a possible contamination of the head wound, injuries caused by wild animal attacks should be treated the same way as comparable "regular" cases. Adequate coverage of dural and bone defects with autologous material via a bifrontal intradural approach and meticulous debridement of the intracranial wound usually gives good functional and cosmetic results.
在中欧，与神经外科医生相关的损伤很少由野生动物攻击造成，而城市地区的狗咬伤以及与农场相关的牛和马的攻击导致的头部损伤有时是致命的，这是众所周知的。作者描述了首例由野生鹿的鹿角造成的额底穿通伤。相关病变累及鼻内区域和左侧眼眶。采用多学科方法在一期手术中处理所有病变，患者得以完全康复。除了头部伤口可能被污染的问题外，野生动物攻击造成的损伤应与类似的“常规”病例以相同方式处理。通过双额硬膜内入路用自体材料充分覆盖硬膜和骨缺损，并对颅内伤口进行细致清创，通常能取得良好的功能和美容效果。
