症例報告
抜去に難渋した園芸用支柱による経鼻腔穿通性脳損傷の１例
2020 年 43 巻 2 号 p. 57-60
詳細
2020 年 43 巻 2 号 p. 57-60
An 80–year–old man accidentally tripped and fell forward on to a plant support stake, which went up his left nostril and penetrated his head. He was admitted to our hospital as an emergency. On admission, he showed left hemiparesis with Glasgow Coma Scale score of 12 (E4, V2, M6). Skull radiography showed transnasal penetration of the plant support to a depth of 16 cm, and computed tomography (CT) demonstrated contusion of right frontal lobe and acute subdural hematoma. CT angiography showed no damage to the intracranial main arteries and cavernous sinus. Emergent craniotomy was performed to remove the stake with difficulty via the nostril because of the ledge formed by a radiolucent cap attached to the tip of the stake. The subdural hematoma was evacuated, the epidural space washed, and the torn dura closed with the galea. After surgery, antibiotics were infused for 2 weeks and spinal drainage was performed for 10 days. No post–treatment complication such as meningitis, brain abscess, and cerebrospinal fluid leakage occurred. He was discharged with Glasgow Outcome Scale score of 3. This case emphasizes the possibility of radiolucent components of any foreign body causing problems with removal after penetrating head injury.
