著者

森 美雅 柴田 孝行 梶田 泰一

出版者

Japanese Association for Acute Medicine

雑誌

日本救急医学会雑誌 (ISSN:0915924X)

巻号頁・発行日

vol.7, no.4, pp.191-196, 1996-04-15 (Released:2009-03-27)

参考文献数

10

被引用文献数

2 3

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Four cases of intracranial foreign bodies are reported. The first patient was a 58-year-old male who drove nine nails into his head while drunk. On admission the patient was drowsy, and a plain skull film revealed the nails to be embedded intracranially on both sides of the frontal and temporal regions. Carotid angiography showed no vascular injury. The second patient was a 44-year-old male. The patient had fallen from the third floor of a building under construction, to the ground and a steel rod on the ground had pierced his face. On admission the patient was semi-comatose. The rod had penetrated from the right maxilla to the ipsilateral parietal vertex. The third patient was a 9-year-old boy. He had a fallen while running and his left upper orbit had been penetrated by a wooden chopstick which he had been holding in his hand. On admission the patient wasdrowsy. His left eye was intact but blind, extraocular movement was completely impaired, and there was no sensation in the left upper quadrant of the face. Computed tomography (CT) revealed a fragment of the chopstick extending from the orbit to the middle and posterior cranial fossa through the superior orbital fissure. Carotid and vertebral angiography showed no vascular abnormalities. The fourth patient was a 48-year old male. His head had been penetrated by a nail in a nail-gun accident. On admisson he was fully alert and had no neurological deficits. Only head of the nail was seen beside the occipital midline. CT showed that the tip of the nail was located in the right cerebellar hemisphere and vertebral angiography revealed the nail piercing the right transverse sinus. In all four cases, the foreign bodies were removed by the “open and see” policy. After craniotomy and intradural exploration, the foreign bodies were removed from the injured brain and penetrated major dural sinuses under visual control. The second patient, who had been seriously injured, died of encephalo-meningitis. Good recovery was obtained in the other three cases.