Yarandi K Karimi, Jelodar Sina, Khalatbari Mahmoud Reza, Rasras Saleh, Ilkhchi Reza Bahrami, Amirjamshidi Abbas
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Neurosurgery, Arad Hospital, Iran University of Medical Sciences, Tehran, Iran.
Asian J Neurosurg. 2018 Jul-Sep;13(3):754-759. doi: 10.4103/ajns.AJNS_29_18.
Stabbing the head is a rare event. It may occur following an assault or self-inflicted injury. We intend to report our experience with four such cases and review narratively the relevant literature. A treatment algorithm will be delivered.
We have reviewed four of our cases; three were stabbed to the orbit and one to the head.
Enucleation was performed in one case. Vision could be preserved in the other two and brain abscess developed in the other cases due to a retained piece of knife. We made a comparison between our cases and those limited reports in the literature to reach an algorithm.
The temporal region and the orbit are the targets mostly attacked in the craniofacial stabs. Since knives have a sharp and thin edge, they may break when penetrating the skull. The damage to the brain tissue and the retained piece of knife may be missed easily by overlooking the small injury to the scalp. The suggested algorithm would be a contrast-enhanced computed tomography scan of the skull and brain and a kind of brain vascular study are necessary, considering the location of the knife in the skull and brain passing the area with crowded vasculature. The best treatment protocol is surgery accompanied by antibiotic therapy.
头部刺伤是一种罕见事件。它可能发生在袭击或自残之后。我们打算报告我们处理的4例此类病例的经验，并对相关文献进行叙述性回顾。我们将给出一个治疗方案。
我们回顾了我们的4例病例；3例眼眶被刺伤，1例头部被刺伤。
1例进行了眼球摘除术。另外2例视力得以保留，其他病例因刀的碎片残留而发生脑脓肿。我们将我们的病例与文献中的有限报告进行比较以得出一个方案。
在颅面部刺伤中，颞区和眼眶是最常被攻击的部位。由于刀的边缘锋利且薄，刺入颅骨时可能会折断。头皮的小伤口容易被忽视，从而可能轻易漏诊对脑组织的损伤和残留的刀碎片。考虑到刀在颅骨和脑部的位置经过血管密集区域，建议的方案是进行头颅和脑部的增强计算机断层扫描以及某种脑血管检查。最佳治疗方案是手术并辅以抗生素治疗。
