Tabibkhooei Alireza, Taheri Morteza, Rohani Sadra, Chanideh Iran, Rahatlou Hessam
1 Iran University of Medical Sciences, Rasool Akram Hospital, Iran.
2 Kermanshah University of Medical Sciences, Iran.
Neuroradiol J. 2018 Apr;31(2):203-206. doi: 10.1177/1971400917700669. Epub 2017 Apr 20.
Introduction Penetrating brain injury (PBI) is uncommon among the civilian population. Here, we report two interesting cases of PBI. Case presentation The first patient was a 20-year-old male who sustained a penetrating head injury with a metal bar during an accident at work. The patient underwent early surgical intervention, and related meningitis was treated with antibiotics. The patient was discharged 45 days later with no deficit. The second patient was a 34-year-old male who was the victim of a violence attack and was admitted to hospital. He was struck by a knife to his right temporal bone. A brain computed tomography scan and magnetic resonance imaging (MRI) demonstrated the tract of the knife within the brain parenchyma. The patient underwent conservative treatment. After several weeks, the patient was discharged in good health. Conclusion Although severe PBI has a poorer prognosis than a blunt brain injury, in treating of these patients, aggressive and timely surgical intervention, proper wide-spectrum antibiotic administration, stringent and diligent care in the intensive-care unit and careful management of the associated complications are mandated.
引言
穿透性脑损伤（PBI）在普通人群中并不常见。在此，我们报告两例有趣的PBI病例。
病例介绍
首例患者为一名20岁男性，在一次工作事故中被金属棒穿透头部。患者接受了早期手术干预，相关脑膜炎采用抗生素治疗。45天后患者出院，无功能缺损。
第二例患者为一名34岁男性，是暴力袭击的受害者，被送入医院。他右侧颞骨被刀刺伤。脑部计算机断层扫描和磁共振成像（MRI）显示刀在脑实质内的轨迹。患者接受了保守治疗。几周后，患者健康出院。
结论
尽管严重的PBI预后比钝性脑损伤差，但在治疗这些患者时，必须进行积极及时的手术干预、适当使用广谱抗生素、在重症监护病房进行严格细致的护理以及对相关并发症进行精心管理。
