Bertani Raphael, Perret Caio M, Alberto Almeida Filho José, Souza Luiz Felipe, Góes Pedro, Monteiro Ruy, Paiva Wellingson Silva
Department of Neurosurgery, Miguel Couto Municipal Hospital Rio de Janeiro, Brazil.
Laboratory of Neuroprotection and Neuroregeneration Strategies, Federal University of Rio de Janeiro Rio de Janeiro, Brazil.
Int J Burns Trauma. 2019 Feb 15;9(1):19-22. eCollection 2019.
Gunshot injury is the most common cause of penetrating brain injury. The in-hospital mortality for civilians with penetrating craniocerebral injury is 52-95%. There are many surgical techniques suitable for the treatment of survivors. We report a surgical technique consisting of neuronavigation guidance for wound treatment with smaller incisions and craniotomies, followed by bullet removal if feasible. We report case of a 15 year old male patient who sustained an accidental firearm injury to the occipital region, submitted to surgical treatment that consisted in a minimally invasive approach guided by neuronavigation. Immediate neurological examination showed inferior homonymous quadrantanopsia alone as a clinical finding. Patient was discharged after one week, and no complications arised in follow-up. We conclude that using neuronavigation as a tool was effective in the reported case and that minimally invasive neurosurgical techniques may be a safe and efficient option for the treatment of traumatic brain injuries caused by firearm projectiles.
枪伤是穿透性脑损伤最常见的原因。穿透性颅脑损伤的平民患者院内死亡率为52% - 95%。有许多手术技术适用于幸存者的治疗。我们报告一种手术技术，包括在神经导航引导下采用较小切口和开颅术处理伤口，若可行则随后取出子弹。我们报告一例15岁男性患者，其枕部意外遭受火器伤，接受了在神经导航引导下的微创治疗。即刻神经检查仅发现下象限同向偏盲这一临床体征。患者一周后出院，随访期间未出现并发症。我们得出结论，在所报告的病例中使用神经导航作为工具是有效的，并且微创神经外科技术可能是治疗火器投射物所致创伤性脑损伤的一种安全有效的选择。
