Sui generis head trauma: a case with intracerebral phalanges

Area of Science:

• Trauma Surgery
• Combat Medicine
• Neurosurgery

Background:

• Physicians in conflict zones face diverse and uncommon trauma.
• Antipersonnel mines pose significant risks, causing blast and fragmentation injuries.

Purpose of the Study:

• To report a unique case of polytrauma from an antipersonnel mine explosion.
• To highlight the potential for self-inflicted injury from blast shockwaves.

Main Methods:

• Case report of a 30-year-old male Army sergeant with polytrauma.
• Computed tomography (CT) scans to identify intracerebral osseous objects.
• Surgical debridement of cranial wounds and dural repair.

Main Results:

• Patient sustained polytrauma including loss of right eyeball and facial injuries from fragmentation missiles and shockwave.
• CT scans revealed osseous objects (phalanges) within the cerebral parenchyma.
• Surgical exploration confirmed and removed phalangeal fragments from the brain.

Conclusions:

• This case represents the first documented instance of combat-related blast trauma where a victim's own phalanges acted as intracerebral missiles.
• Explosive devices can cause severe autoinflicted trauma, with body parts acting as dangerous projectiles.
• Highlights the need for comprehensive management of complex blast injuries in military settings.