儿童低能性穿透性颅脑外伤后血管痉挛。
Vasospasm following low-velocity penetrating pediatric intracranial trauma.
机构信息
Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada.
Division of Neurosurgery, Royal Columbian Hospital, New Westminster, BC, Canada.
出版信息
J Med Case Rep. 2022 Feb 6;16(1):48. doi: 10.1186/s13256-022-03254-5.
BACKGROUND
BB guns or non-powder guns created in the modern era are able to reach exceedingly fast velocities as a result of advances in compressed-gas technology. While missile penetrating trauma has been well documented in neurosurgical literature, penetrating intracranial injury secondary to non-powder guns, along with their associated complications and treatments, is not well described, and even less so in the pediatric population.
CASE PRESENTATION
Here, we describe an unusual case of a 6-year-old Indigenous child who was accidentally shot with a BB gun to the head. He subsequently developed delayed acute right-sided weakness due to symptomatic vasospasm. His symptoms resolved following hypertensive therapy, balloon angioplasty intervention, and intra-arterial milrinone therapy.
CONCLUSIONS
This case highlights the unique complication of delayed symptomatic vasospasm in a child following a non-missile intracranial penetrating injury. Intracranial vasospasm needs to be considered in the presence of delayed neurological deficit given its potential reversibility. This case also emphasizes the importance of gun safety and education when handling and storing these potential weapons around children.
背景
由于压缩气体技术的进步，现代制造的气枪或非火药枪能够达到极高的速度。虽然在神经外科学文献中已经详细记录了导弹穿透性创伤，但由于非火药枪引起的穿透性颅内损伤及其相关并发症和治疗方法尚未得到很好的描述，在儿科人群中更是如此。
病例介绍
在这里，我们描述了一个不寻常的病例，一名 6 岁的土著儿童头部意外被气枪击中。他随后因症状性血管痉挛导致右侧急性延迟性无力。他的症状在高血压治疗、球囊血管成形术干预和动脉内米力农治疗后得到缓解。
结论
本病例强调了儿童非导弹穿透性颅内损伤后延迟性症状性血管痉挛的独特并发症。由于其潜在的可逆转性，在出现延迟性神经功能缺损时应考虑颅内血管痉挛。本病例还强调了在处理和储存这些潜在武器时，枪支安全和教育的重要性。
Zotero 插件