Nakayama Y, Tanaka A, Arita T, Kumate S, Yoshinaga S
Department of Neurosurgery, Chikushi Hospital, Fukuoka University, Japan.
No To Shinkei. 1995 Dec;47(12):1192-4.
A case of penetrating head injury caused by weed was reported. A 69-year-old man fell from a bicycle and was stuck by the hard stalk of weed through the right nasal cavity. On admission the patient was fully alert and with no neurological deficits. The weed was pulled out at an out-patient department and then he became semicomatose and hemiplegic on the left side together with an occurrence of nasal bleeding. Subsequent computed tomographic (CT) scan showed an intracerebral hematoma in the right frontal lobe. The hematoma was immediately evacuated and the dural defect, lateral to the cribriform plate, was closed. It is stressed that neuroradiological evaluation with CT scan and/or magnetic resonance imaging (MRI) is mandatory because an information about an anatomical location of penetrating objects and intracranial complications are essential to a decision-making of surgical strategy. The objects should be urgently removed in a surgical exposure of the intracranial lesion and the contused brain should be debrided with a repair of the lacerated dura mater.
报告了一例由杂草导致的穿透性头部损伤病例。一名69岁男性从自行车上跌落，被杂草的硬茎穿过右侧鼻腔刺入。入院时患者神志清醒，无神经功能缺损。杂草在门诊被拔出，随后他出现半昏迷状态，左侧偏瘫，并伴有鼻出血。随后的计算机断层扫描（CT）显示右侧额叶脑内血肿。血肿立即被清除，筛板外侧的硬脑膜缺损处被缝合。强调必须进行CT扫描和/或磁共振成像（MRI）的神经放射学评估，因为穿透物体的解剖位置和颅内并发症的信息对于手术策略的决策至关重要。在手术暴露颅内病变时应紧急取出异物，对挫伤的脑组织进行清创，并修复撕裂的硬脑膜。
