Greene K A, Dickman C A, Smith K A, Kinder E J, Zabramski J M
Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, AZ 85013.
Surg Neurol. 1993 Dec;40(6):499-503. doi: 10.1016/0090-3019(93)90054-5.
Reports of intracranial self-mutilation by psychotic individuals are associated with severe mental disorders, criminality, or both. We describe a psychotically depressed male who drove a ballpoint pen through his right medial canthus and into his intracranial compartment. The patient developed a cavernous sinus syndrome and a traumatic dissection of the cavernous portion of the carotid artery. The pen was removed intraoperatively. Postoperatively, the patient was placed on a course of broad-spectrum antibiotics, antidepressants, and antipsychotic medications, and he has received long-term psychiatric follow-up. The literature related to these unusual cases is reviewed, and relevant surgical, medical, and psychiatric aspects of treatment are discussed.
精神病患者颅内自残的报告与严重精神障碍、犯罪行为或两者皆有关联。我们描述了一名患有精神病性抑郁症的男性，他将一支圆珠笔经右侧内眦插入颅内。患者出现了海绵窦综合征以及颈内动脉海绵窦段的外伤性夹层。术中取出了笔。术后，患者接受了广谱抗生素、抗抑郁药和抗精神病药物治疗，并接受了长期的精神科随访。本文回顾了与这些罕见病例相关的文献，并讨论了治疗相关的外科、医学和精神科方面的问题。
