中部额头,斜鼻和额叶的螺栓枪伤害:一个案例报告
Ning Zhu1, Rondhir Jithoo2, Jeffrey V Rosenfeld2
1Department of Neurosurgery, The Alfred Hospital, Melbourne, Australia.
International journal of surgery case reports
|June 24, 2025
概括
螺栓枪头部受伤很少见,但严重,往往导致高死亡率或严重的缺陷. 这种病例表现出了显著的恢复,迅速进行手术和预防性抗生素.
科学领域:
- 神经外科 神经外科
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
背景情况:
- 螺栓枪头部受伤不常见,通常与高死亡率 (80-90%) 或幸存者的严重神经缺陷有关.
- 这些伤害往往是自我造成的,涉及从加工肉类中使用的工业工具中穿透螺栓,造成严重的头骨和脑部创伤.
研究的目的:
- 报告一个自我伤害头部螺栓枪伤害的案例,并概述成功的管理策略.
- 要突出关键因素,有助于一个有利的结果在一个罕见的和严重的类型的头部创伤.
主要方法:
- 一名24岁的男性在额头上自杀了螺栓枪伤,立即接受了稳定治疗,包括输管治疗和转移到第三级创伤中心.
- 诊断成像包括CT和CT血管造影 (CTA/V),以评估脑损伤的程度,出血和血管干扰 (上部斜鼻).
- 手术管理包括双额头切除术,伤口的脱bridement,血瘤疏散,和ICP监视器放置,以及预防性宽谱抗生素.
主要成果:
- 脑电图显示中线前额骨缺陷,前额叶有8.5厘米的伤口通道,内出血,以及受影响的碎片.
- CTA/V显示上部斜鼻受伤,但动脉血管完好无损.
- 患者在受伤后3个月经历了显著的康复,只有轻微的认知障碍.
结论:
- 成功管理螺栓枪头部伤害依赖于及时诊断和干预.
- 关键的策略包括术前CT血管造影以进行血管评估,指定的骨切除术以减压,精细的脱bridement以预防感染,以及预防性抗生素.
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