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用大砍刀穿透硬脑膜和大脑的创伤性脑损伤:来自墨西哥东南部的病例报告。

Traumatic brain injury with a machete penetrating the dura and brain: Case report from southeast Mexico.

作者信息

Del Castillo-Calcáneo Juan D, Bravo-Angel Ulises, Mendez-Olan Raúl, Rodriguez-Valencia Francisco, Valdés-García Javier, García-González Ulises, Broc-Haro Guy G

机构信息

Neurosurgery, National Autonomous University of Mexico (UNAM), Mexico City, Mexico; Neurosurgery Department, Mexican Oil Company (Pemex) High Specialty Hospital, Mexico City, Mexico.

Neurosurgery Department, Mexican Oil Company (Pemex) Regional Hospital, Villahermosa, Tabasco, Mexico; Neurosurgery Department, Social Security Institute of Tabasco (ISSET) Medical Specialty Center "Julian A Manzur Ocaña", Villahermosa, Tabasco, Mexico.

出版信息

Int J Surg Case Rep. 2016;23:169-72. doi: 10.1016/j.ijscr.2016.04.037. Epub 2016 Apr 28.

Abstract

INTRODUCTION

Traumatic Brain Injury (TBI) is a major cause of death and disability in our society, we present the first case report of non-missile penetrating (NMP) cranial trauma with a machete in Mexico, and our objective by presenting this case is to prove the usefulness of recently proposed algorithms in the treatment of NMP PRESENTATION OF CASE: We present the case of a 47 year old woman who received a machete hit to the right side of her head during an assault., she arrived fully conscious to the emergency department (ED), computed tomography was performed and based on the findings of this study and in accordance to recently proposed algorithms for managing NMP cranial trauma a craniotomy was performed, at follow-up the patient presented wtih minor neurological disability in the form of left hemiparesis.

DISCUSSION

Non-missile penetrating (NMP) lesions are defined as having an impact velocity of less than 100m/s, causing injury by laceration and maceration, An algorithm for treating NMP cranial trauma has been recently published in the Journal World Neurosurgery by De Holanda et al., in this case we followed the algorithm in order to provide best care available for our patient with good results.

CONCLUSION

The use of current algorithms for managing NMP cranial trauma has proved to be very useful when applied on this particular case. GCS on admission is an important prognostic factor in NMP cranial trauma.

摘要

引言

创伤性脑损伤(TBI)是我们社会中导致死亡和残疾的主要原因。我们报告了墨西哥首例使用大砍刀造成的非投射性穿透性(NMP)颅脑创伤病例。我们呈现此病例的目的是证明最近提出的算法在治疗NMP方面的有效性。

病例介绍

我们报告一例47岁女性病例,该患者在一次袭击中头部右侧被大砍刀砍伤。她抵达急诊科时意识清醒,进行了计算机断层扫描,基于该研究结果并根据最近提出的管理NMP颅脑创伤的算法进行了开颅手术。随访时,患者出现轻度神经功能残疾,表现为左侧偏瘫。

讨论

非投射性穿透性(NMP)损伤定义为撞击速度小于100米/秒,通过撕裂和浸软造成损伤。De Holanda等人最近在《世界神经外科杂志》上发表了一种治疗NMP颅脑创伤的算法。在此病例中,我们遵循该算法以便为患者提供最佳治疗,结果良好。

结论

事实证明,在该特定病例中应用当前管理NMP颅脑创伤的算法非常有用。入院时的格拉斯哥昏迷评分(GCS)是NMP颅脑创伤的一个重要预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b096/5022070/32fc8cf1eff7/gr2.jpg

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