Document Detail


Diagnosis and treatment of penetrating craniocerebral injury.
MedLine Citation:
PMID:  15363217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the clinical characteristics and present the experience in the treatment of patients with penetrating craniocerebral injury (PCCI). METHODS: The data of 7 cases with PCCI by foreign body were retrospectively studied and compared with associated literatures. The strategies of diagnosis and treatment of PCCI were analyzed. In this series, 3 cases underwent emergency debridements and 4 cases underwent craniotomies. All patients received surgical intervention within 3 hours after admission. RESULTS: Outcomes were good in 3 cases, moderate disability was in 2 cases, severe disability in 1 case and persistent vegetative state in 1 case. One case developed wound and intracranial infection, but made good recovery after treatment. During the follow-up period, one patient died one month after discharge and other six patients (range from 8 months to 3 years) recovered well and no epilepsy, leakage of cerebrospinal fluid (CSF), or traumatic vascular disease occurred. CONCLUSIONS: Early diagnosis and prompt debridement are the fundamental factors affecting the outcome of PCCI. CT scans are the mainstay in evaluating PCCI and three dimensional (3D) images reconstructed from spiral CT scans provide more information. Efficient debridement should be performed as early as possible. Minimizing the degree of surgical management of PCCI is preferred when there is no indication for aggressive operation. It is important to stress the rapid and effective management of CSF leakage in early stage of PCCI. Use of prophylactic broad-spectrum antibiotics is recommended for patients with PCCI. Traumatic vascular injury should be paid attention to after PCCI.
Authors:
Ying Tong; Zeng-Bin Xu; Ren-Ya Zhan; Fan-Long Liu
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association     Volume:  7     ISSN:  1008-1275     ISO Abbreviation:  Chin. J. Traumatol.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-14     Completed Date:  2004-12-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100886162     Medline TA:  Chin J Traumatol     Country:  China    
Other Details:
Languages:  eng     Pagination:  259-65     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, the First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, China. tongying216@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Bacterial Agents*
Child
China
Combined Modality Therapy
Craniotomy / methods*
Drug Therapy, Combination / therapeutic use*
Female
Follow-Up Studies
Glasgow Coma Scale
Head Injuries, Penetrating / diagnosis*,  therapy*
Humans
Injury Severity Score
Magnetic Resonance Imaging
Male
Middle Aged
Risk Assessment
Sampling Studies
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

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