1. Low-velocity penetrating brain injury: a review of the literature and illustrative case.
- Author
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Cook, Richard, Zima, Laura, Khazaal, Jawad, and Williams, John
- Subjects
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ANTIBIOTICS , *CEREBRAL angiography , *HETEROCYCLIC compounds , *COMBINATION drug therapy , *PHYSICAL therapy , *OUTPATIENT services in hospitals , *COMPUTED tomography , *ENZYME inhibitors , *CLAVULANIC acid , *MAGNETIC resonance imaging , *DISCHARGE planning , *AMOXICILLIN , *TREATMENT effectiveness , *MUSCLE weakness , *NEOMYCIN , *BRAIN injuries , *PENETRATING wounds , *ANTICONVULSANTS , *CEFTRIAXONE , *POLYMYXIN B - Abstract
Low-velocity penetrating brain injury (LVPBI) is a class of brain injury where a foreign object violates the skull and damages the brain. Such injuries are rare and consequently understudied. As such, we report an illustrative case of a 29-year-old female with a dense, plastic spike penetrating her right orbit and into her midbrain. After assessment with a CT scan and angiography, the object was removed with careful attention to possible vascular injury. The patient had an uncomplicated post-operative course and received antibiotic and antiepileptic prophylaxis. She was discharged on post-operative day 5, experiencing only mild left-sided weakness. Common concerns regarding LVPBI include infection, post-traumatic epilepsy, and vascular injury. A review of published LVPBI cases over the past 20 years demonstrated that most cases (55.2%) are due to accidents. Of patients undergoing surgery, 43.4% underwent a craniotomy, and 22.8% underwent a craniectomy. Despite the grave nature of LVPBI, only 13.5% of the patients died. Additionally, 6.5% of patients developed an infection over their clinical course. In all, more reported cases further paint a picture of the current state of management and outcomes regarding LVPBI, paving the way for more cohesive guidelines to ensure the best possible patient outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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