Penetrating Brain Injury after Suicide Attempt with Speargun
Penetrating cranial injury by mechanisms other than are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here we present a case of penetrating brain injury by the low velocity mechanism of a harpoon...
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2014-07-01
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doaj-585a888faa82408e97c7b594766a39d22020-11-24T23:07:03ZengFrontiers Media S.A.Frontiers in Neurology1664-22952014-07-01510.3389/fneur.2014.0011387160Penetrating Brain Injury after Suicide Attempt with SpeargunJohn Ross Williams0Daniel eAghion1Daniel eAghion2G Rees Cosgrove3G Rees Cosgrove4Curtis eDoberstein5Curtis eDoberstein6Wael F Asaad7Wael F Asaad8Wael F Asaad9Warren Alpert School of Medicine at Brown UniversityWarren Alpert School of Medicine at Brown UniversityRhode Island HospitalWarren Alpert School of Medicine at Brown UniversityBrown Institute for Brain SciencesWarren Alpert School of Medicine at Brown UniversityRhode Island HospitalWarren Alpert School of Medicine at Brown UniversityRhode Island HospitalBrown Institute for Brain SciencesPenetrating cranial injury by mechanisms other than are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here we present a case of penetrating brain injury by the low velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of lower-velocity penetrating brain injury (LVPBI), including benefit in delaying foreign body removal to allow for tamponade; the importance of history taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using DECT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher velocity forms of intracranial injury.http://journal.frontiersin.org/Journal/10.3389/fneur.2014.00113/fullneurotraumaTraumatic brain injury (TBI)seizure prophylaxisNeurovascular injurypenetrating brain injuryBallistic Injury |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
John Ross Williams Daniel eAghion Daniel eAghion G Rees Cosgrove G Rees Cosgrove Curtis eDoberstein Curtis eDoberstein Wael F Asaad Wael F Asaad Wael F Asaad |
spellingShingle |
John Ross Williams Daniel eAghion Daniel eAghion G Rees Cosgrove G Rees Cosgrove Curtis eDoberstein Curtis eDoberstein Wael F Asaad Wael F Asaad Wael F Asaad Penetrating Brain Injury after Suicide Attempt with Speargun Frontiers in Neurology neurotrauma Traumatic brain injury (TBI) seizure prophylaxis Neurovascular injury penetrating brain injury Ballistic Injury |
author_facet |
John Ross Williams Daniel eAghion Daniel eAghion G Rees Cosgrove G Rees Cosgrove Curtis eDoberstein Curtis eDoberstein Wael F Asaad Wael F Asaad Wael F Asaad |
author_sort |
John Ross Williams |
title |
Penetrating Brain Injury after Suicide Attempt with Speargun |
title_short |
Penetrating Brain Injury after Suicide Attempt with Speargun |
title_full |
Penetrating Brain Injury after Suicide Attempt with Speargun |
title_fullStr |
Penetrating Brain Injury after Suicide Attempt with Speargun |
title_full_unstemmed |
Penetrating Brain Injury after Suicide Attempt with Speargun |
title_sort |
penetrating brain injury after suicide attempt with speargun |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2014-07-01 |
description |
Penetrating cranial injury by mechanisms other than are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here we present a case of penetrating brain injury by the low velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of lower-velocity penetrating brain injury (LVPBI), including benefit in delaying foreign body removal to allow for tamponade; the importance of history taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using DECT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher velocity forms of intracranial injury. |
topic |
neurotrauma Traumatic brain injury (TBI) seizure prophylaxis Neurovascular injury penetrating brain injury Ballistic Injury |
url |
http://journal.frontiersin.org/Journal/10.3389/fneur.2014.00113/full |
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