Ota Koshi, Kobata Hitoshi, Tomonishi Shunsuke, Ota Kanna, Takasu Akira
Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan.
Medicine (Baltimore). 2024 May 3;103(18):e37896. doi: 10.1097/MD.0000000000037896.
Low-velocity penetrating head injury (PHI) is rare, comprising 0.2% to 0.4% of head traumas, but can be devastating and is associated with significant morbidity and mortality. No previous case of very-low-velocity PHI due to self-inflicted stabbing with a gimlet has been reported.
A 62-year-old man was admitted to the hospital with bleeding head and abdominal wounds after stabbing his abdomen with a gimlet, and then hammering the same gimlet into his forehead and removing the gimlet himself.
Upon examination at admission, stab wounds were present on the forehead and the right upper quadrant. Computed tomography (CT) of the head revealed a bone defect in the left frontal bone and showed the intracranial path of the gimlet surrounded by mild hemorrhage and pneumocephalus. Magnetic resonance imaging (MRI) confirmed a small amount of hemorrhage with pneumocephalus but no vascular injury.
Conservative treatment without surgery.
Follow-up MRI on hospital day 58 showed no abscess or traumatic intracranial aneurysm. The patient achieved full recovery of motor and mental functions with conservative treatment and was discharged on hospital day 69.
Very-low-velocity PHI might be successfully treated with conservative treatment.
低速穿透性头部损伤（PHI）较为罕见，占头部创伤的0.2%至0.4%，但可能具有毁灭性，且与显著的发病率和死亡率相关。此前尚无因用手钻自伤导致的极低速度PHI病例报道。
一名62岁男性在先用手钻刺伤腹部，然后将同一手钻锤入前额并自行拔出后，因头部和腹部出血入院。
入院检查时，前额和右上腹有刺伤。头部计算机断层扫描（CT）显示左额骨有骨缺损，并显示手钻的颅内路径，周围有轻度出血和气颅。磁共振成像（MRI）证实有少量出血和气颅，但无血管损伤。
非手术保守治疗。
住院第58天复查MRI显示无脓肿或创伤性颅内动脉瘤。患者经保守治疗后运动和精神功能完全恢复，于住院第69天出院。
极低速度的PHI可能通过保守治疗成功治愈。
