PowerPoint Presentation Management of penetratingPowerPoint演示文稿管理渗透.pptVIP

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PowerPoint Presentation Management of penetratingPowerPoint演示文稿管理渗透.ppt

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PowerPoint Presentation Management of penetratingPowerPoint演示文稿管理渗透

Management of penetrating craniocerebral injuries from nail-gun use S K Selvanathan1, T Goldschlager2, J McMillen3, S Campbell3. 1Department of Surgery, Manchester Royal Infirmary, UK. 2Royal Alfred Hospital, Melbourne, Australia. 3Department of Neurosurgery, Royal Brisbane Hospital, Australia. Introduction Numerous reports of nail-gun injuries and fatalities.1 Penetrating craniocerebral nail-gun injuries have also been reported.2 Careful clinical assessment and imaging followed by removal of the foreign body with vascular control. 1Thomas MD, Siu K. An unusual cranial injury caused by an industrial nail-gun. Med J Aust. 1987; 147(11-12): 602-3. 2Jithoo R, Govender ST, Nathoo N. Penetrating nail gun injury of the head and chest with incidental pericallosal artery aneurysm. S Afr Med J. 2001; 91(4): 316-7. Introduction Patients survived with good neurological outcome provided if brain stem and major vessels are spared. Meningitis and cerebral abscess risk. Antibiotics are strongly advocated.3 Risk of secondary missile formation as a result of skull bone fragment.2 Other complications include intracranial haemorrhage and false aneurysm formation.2 2Jithoo R, Govender ST, Nathoo N. Penetrating nail gun injury of the head and chest with incidental pericallosal artery aneurysm. S Afr Med J. 2001; 91(4): 316-7. 3Sani S, Jobe KW, Byrne RW. Successful repair of an intracranial nail-gun injury involving the parietal region and the superior sagittal sinus. Case report. J Neurosurg. 2005; 103(3): 567-9. Introduction A foreign body that has completely penetrated into the brain needs to be removed via craniotomy. Extraction of a foreign body with both intracranial and extracranial extensions remains contentious. Several different techniques have been used to remove a foreign body under direct vision.4,5 Spennato et. al., (2005) described a technique known as double concentric craniotomy (one around the point of penetration and then a larger bone flap aroun