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Updated: Aug 18, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Transmastoid pediatric penetrating brain injury, interdisciplinary, and tailored patient's treatment
Tommy Alfandy Nazwar1, Farhad Bal'afif1, Donny Wisnu Wardhana1
1Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universitas Brawijaya/Dr. Saiful Anwar General Hospital, Malang, Indonesia.
Insights
Pediatric penetrating brain injuries (PBIs) are rare but serious. This case highlights the successful diagnosis and surgical removal of a nail from a child
Area of Science:
- Pediatric neurosurgery
- Traumatic brain injury research
- Medical imaging in pediatrics
Background:
- Pediatric penetrating brain injuries (PBIs) are uncommon yet severe traumatic events, frequently involving foreign objects.
- This report focuses on the clinical presentation, diagnostic methods, and treatment approaches for pediatric PBI cases.
- Effective management of pediatric PBI requires a multidisciplinary approach.
Observation:
- A 7-year-old male sustained a PBI from a nail penetrating the left mastoid region after falling from a tree.
- Initial assessment revealed consciousness, stable vital signs, and no neurological deficits.
- Radiological imaging (skull X-rays, head CT) confirmed a 6.5 mm nail penetrating 5.5 cm, causing intraventricular hemorrhage.
Findings:
- CT angiography (CTA) visualized major cerebral arteries, showing no vascular abnormalities despite metal artifacts.
- Surgical removal of the foreign object was achieved through an urgent mastoidectomy and retro sigmoid craniotomy.
- Post-operative recovery was successful, with the patient maintaining full consciousness and no neurological deficits.
Implications:
- Skull X-rays and head CT scans are essential for diagnosing pediatric PBI.
- Combined mastoidectomy and retro sigmoid craniotomy provide a safe and effective method for foreign body removal.
- Personalized treatment strategies are crucial for optimizing outcomes in pediatric PBI cases.
Background:
Pediatric penetrating brain injuries (PBIs) are rare but critical traumatic events, often involving foreign objects. This report will emphasize the clinical presentation, diagnosis, and treatment strategies for pediatric PBI cases.
Case Description:
This report presents a case of a 7-year-old male patient with a PBI resulting from a nail that penetrated the left mastoid region following a fall from a tree. On admission, the patient maintained consciousness, displayed stable vital signs, and showed no neurological deficits. Crucial radiological examinations, including skull X-rays and head computed tomography (CT) scans, revealed a 6.5 mm caliber nail penetrating 5.5 cm into the brain, with intraventricular hemorrhage filling the bilateral posterior horns of the lateral ventricles. In addition, the CT angiography (CTA) of the head provided a visual of the internal carotid arteries and the vertebrobasilar artery system, obscured by metal artifacts but showing no evidence of thrombus, aneurysm, or vascular malformation. The patient underwent an urgent mastoidectomy and retro sigmoid craniotomy to remove a foreign object, involving a multidisciplinary team. Subsequent to the intervention, the patient sustained full consciousness without neurological impairments and received intensive care.
Conclusion:
Radiological tools, notably skull X-rays and head CT scans, are pivotal for the precise diagnosis of pediatric PBI. The combined mastoidectomy and retro sigmoid craniotomy approach offers a safe and efficient means of foreign body removal. Tailoring treatments to individual patient needs enhances outcomes.
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