Zarachi Athina, Vartholomatos Evrysthenis, Tsikou Alkistis, Komnos Ioannis, Papoudou-Bai Alexandra, Lampri Evangelia, Liontos Angelos, Ragos Vasilios
Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Neurosurgical Institute, Medical School, University of Ioannina, Ioannina, Greece.
Maedica (Bucur). 2025 Mar;20(1):120-123. doi: 10.26574/maedica.2025.20.1.120.
Penetrating brain trauma represents about 0,4% of traumatic brain injuries. In the literature, there is a number of case studies and case-series on non-missile penetrating injuries management, but reports on penetrating brain injuries through a craniectomy are lacking. A 44-year-old male was transferred to the Emergency Room in a comatose state after being stabbed on the head by a sharp object at an area where a previous decompressive craniectomy took place years ago. Computed tomography of the head showed an extensive intracerebral hemorrhage with intraventricular extension and diffuse subarachnoid bleeding. He was immediately transferred to the operating room for hematoma evacuation and hemostasis. Postoperatively, a slight improvement in his neurological status was initially noted, but the patient's clinical course was complicated by a central nervous system infection. Following a long stay and multiple re-operations, he eventually died due to septic shock and multiorgan failure. Non-missile penetrating brain injuries can be life threatening. Prognosis is dismal in those with pre-existing skull defect and severe brain damage despite aggressive medical and surgical treatment.
穿透性脑外伤约占颅脑损伤的0.4%。在文献中，有许多关于非导弹穿透性损伤治疗的病例研究和病例系列报道，但缺乏关于经颅骨切除术治疗穿透性脑损伤的报告。一名44岁男性在数年前曾进行过减压颅骨切除术的区域被尖锐物体刺伤头部后，昏迷状态被转入急诊室。头部计算机断层扫描显示广泛的脑内出血并延伸至脑室内，以及弥漫性蛛网膜下腔出血。他立即被送往手术室进行血肿清除和止血。术后，最初注意到其神经状态略有改善，但患者的临床病程因中枢神经系统感染而复杂化。经过长时间住院和多次再次手术，他最终因感染性休克和多器官功能衰竭死亡。非导弹穿透性脑损伤可能危及生命。尽管进行了积极的药物和手术治疗，但对于存在颅骨缺损和严重脑损伤的患者，预后仍然不佳。
