Trauma craneoencefálico penetrante por una herida de arpón. Presentación de un caso / Penetrating cranioencephalic trauma due to harpoon wound. Presentation of a case

RESUMEN Las heridas craneocerebrales penetrantes más frecuentes son las provocadas por armas de fuego; las restantes resultan de rara frecuencia. Se presentó un caso que recibió agresión craneoencefálica por arpón, de forma accidental, fuera del agua. Se describieron los detalles del suceso, los exámenes complementarios, la conducta adoptada, el manejo neuroquirúrgico, y la sorprendente evolución postoperatoria del paciente (AU).

ABSTRACT The most frequent penetrating craniocerebral wounds are those caused by firearms; the remaining ones are rare. We presented a case that received accidental cranioencephalic aggression by harpoon, an event that occurred out of the water. Details of the event, complementary examinations, adopted behavior and neurosurgical management that were decided, as well as the surprising post-operative evolution of the patient were described (AU).

An iron rod stuck in the right motor cortex.

Non-missile intracranial injuries caused by foreign bodies are quite uncommon in civilian practice. Nails, knives, screwdrivers and sewing needles are the most commonly reported agents. The authors report a unique case of an adult male patient who suffered a penetrating craniocerebral injury caused by a falling concrete reinforcing iron (rebar) from the fourth floor of a building under construction. The foreign body was safely removed by a right parietal craniectomy as a result of detailed radiological evaluation and preoperative planning. To the best of authors' knowledge, the successful surgical treatment of a penetrating brain injury caused by a rebar has not been reported previously.

Risks and causes of cervical cord and medulla oblongata injuries due to acupuncture.

BACKGROUND: Acupuncture has become one of the most popular alternative medicines in the world today. Some acupuncturists still intentionally embed entire needles deep in the tissue for treatments, and some patients stick needles into their own bodies on their own. CASE DESCRIPTION: Surgical removal of an accidentally broken acupuncture needle due to self-acupuncture that was embedded in the medulla oblongata and cerebellum was performed. The broken needle migrated further into the brain in a few days. Contrary to expectation, it was extremely laborious to find the needle, which turned out to be completely embedded in the brain. No postoperative complications developed. The patient denied any symptoms and was subsequently discharged. RESULTS: Previously reported cases of 25 patients, in addition to our patient, who suffered from cervical or brain injuries due to acupuncture needles, were retrospectively studied. Embedded needles were the most frequent cause of the injuries and comprised 15 patients (57.7%). Accidentally broken needles came in second, comprising 11 patients (42.3%). Five cases (19.2%) were attributed to self-acupuncture. Sixteen (61.5%) patients developed symptoms more than 30 days after the accident. Twenty-three (88.5%) patients complained of sensory deficits, whereas 11 (42.3%) presented with motor weakness. Surgical removals were performed in 21 patients (80.8%), and 10 patients showed signs of recovery. On the other hand, no patients showed improvements in conservatively treated cases. CONCLUSIONS: Embedded needles in the brain should be urgently removed if possible. Both embedded needle acupuncture and self-acupuncture are extremely dangerous and hazardous to health.