2021 年 44 巻 2 号 p. 44-49
Background: We experienced a case of head penetrating injury caused by a crossbow that was initially treated in the Hybrid Emergency Room (ER).
Case: A 25–year–old male who lost consciousness and was collapsed in his room with penetrating crossbow in his head, was transported to our hospital. After routine checkups, the patient was immediately move to the Hybrid ER. A head CT and digital subtraction angiography (DSA) was performed and no obvious injury in the intracranial major vessels was confirmed. The crossbow was safely removed there. The patient was then moved to the central operating room and underwent a relevant surgical procedure. Postoperative diffusion–weighted MRI showed a high–signal area in the corpus callosum and disorders of consciousness continued for a while. The corpus callosum lesion was determined to be cytotoxic lesion and the patient was followed up. His conscious state gradually improved and the abnormal signal in the corpus callosum disappeared on the 40th hospital day. On the 91st hospital day, the patient was transferred for additional rehabilitation.
Conclusion: A Hybrid ER is one of a surgical unit installing CT and DSA. The ability of multimodal medical treatment is useful to traumatic brain injury, especially penetrating head injury for which we often need to carry out flexible surgical procedure.