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An unexpected intracranial blade.

Benoît Vivien1, Lionel Lamhaut, Pierre Carli

  • 1SAMU de Paris, Département d'Anesthésie-Réanimation, Hôpital Necker, Enfants Malades, Université Paris Descartes, Paris, France. benoit.vivien@nck.aphp.fr

Prehospital Emergency Care
|September 21, 2012
PubMed
Summary
This summary is machine-generated.

A schizophrenic man self-amputated his hand and sustained a severe intracranial blade injury. This rare case highlights unusual self-harm behaviors in psychiatric patients, leading to fatal outcomes.

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Area of Science:

  • Neurology
  • Psychiatry
  • Trauma Surgery

Background:

  • Self-mutilation is common in psychiatric disorders like schizophrenia.
  • Suicidal stab wounds, especially to the skull, are exceptionally rare.

Observation:

  • A 34-year-old male with schizophrenia presented with self-amputation of his right hand.
  • Initial assessment revealed only a facial laceration, with no other apparent injuries.
  • Subsequent decline in neurological status prompted a CT scan.

Findings:

  • Computed tomography (CT) unexpectedly revealed an 11-cm intracranial blade in the left temporal lobe.
  • The blade's tip was lodged deep within the cerebral tissue.
  • Surgical intervention was deemed futile due to the severity of cerebral injury.

Implications:

  • This case underscores the potential for extreme and unusual self-harm behaviors in schizophrenia.
  • It highlights the importance of comprehensive imaging in cases of severe self-mutilation with unexplained neurological decline.
  • The fatal outcome emphasizes the challenges in managing complex psychiatric emergencies with severe physical trauma.