Brembilla Carlo, Lanterna Luigi Andrea, Gritti Paolo, Costi Emanuele, Dorelli Gianluigi, Moretti Elena, Bernucci Claudio
Department of Neurosurgery, Pope John XXIII Hospital, OMS Square No. 1, 24100 Bergamo, Italy.
Department of Anesthesia and Intensive Care, Pope John XXIII Hospital, OMS Square No. 1, 24100 Bergamo, Italy.
Case Rep Emerg Med. 2015;2015:623405. doi: 10.1155/2015/623405. Epub 2015 Oct 26.
Penetrating injuries to the spine, although less common than motor vehicle accidents and falls, are important causes of injury to the spinal cord. They are essentially of two varieties: gunshot or stab wounds. Gunshot injuries to the spine are more commonly described. Stab wounds are usually inflicted by knife or other sharp objects. Rarer objects causing incidental spinal injuries include glass fragments, wood pieces, chopsticks, nailguns, and injection needles. Just few cases of penetrating vertebral injuries caused by pencil are described. The current case concerns a 42-year-old man with an accidental penetrating stonemason pencil injury into the vertebral canal without neurological deficit. After the self-removal of the foreign object the patient complained of a disabling orthostatic headache. The early identification and treatment of the intracranial hypotension due to the posttraumatic cerebrospinal fluid (CSF) sacral fistulae were mandatory to avoid further neurological complications. In the current literature acute pattern of intracranial hypotension immediately after a penetrating injury of the vertebral column has never been reported.
脊柱穿透伤虽然不如机动车事故和跌倒常见，但却是脊髓损伤的重要原因。它们主要有两种类型：枪伤或刺伤。脊柱枪伤的描述更为常见。刺伤通常由刀或其他尖锐物体造成。导致意外脊柱损伤的罕见物体包括玻璃碎片、木块、筷子、射钉枪和注射针。仅有少数关于铅笔导致脊柱穿透伤的病例报道。本病例是一名42岁男性，意外被石匠铅笔穿透伤至椎管，无神经功能缺损。患者自行取出异物后，主诉有导致功能障碍的直立性头痛。对于创伤后脑脊液（CSF）骶部瘘引起的颅内低压，早期识别和治疗对于避免进一步的神经并发症至关重要。在当前文献中，从未报道过脊柱穿透伤后立即出现的急性颅内低压模式。
