神経外傷
Online ISSN : 2434-3900
症例報告
Hybrid emergency room(ER)にて初期治療したクロスボウによる頭部穿通性外傷の1例
大山 裕太大井川 秀聡大貫 隆広指田 涼平木倉 亮太井上 雄貴中里 一郎廣川 佑川口 愛高屋 善德藤原 廉朝見 正宏後藤 芳明石川 久宇野 健志田中 純一大山 健一小野田 恵介山根 文孝安心院 康彦三宅 康史坂本 哲也松野 彰辛 正廣
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2021 年 44 巻 2 号 p. 44-49

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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.

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