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Skull Base Rep 2011; 1(1): 039-046
DOI: 10.1055/s-0031-1275257
© Thieme Medical Publishers

Management of Nonmissile Penetrating Brain Injuries: A Description of Three Cases and Review of the Literature

Justin M. Sweeney1 , Jonathon J. Lebovitz1 , Jorge L. Eller1 , Jeroen R. Coppens1 , Richard D. Bucholz2 , Saleem I. Abdulrauf1
  • 1Center for Cerebrovascular and Skull Base Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri
  • 2Department of Neurosurgery, Saint Louis University School of Medicine, Saint Louis, Missouri
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Publication History

Publication Date:
14 April 2011 (online)

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ABSTRACT

Nonmissile penetrating intracranial injuries are uncommon events in modern times. Most reported cases describe trajectories through the orbit, skull base foramina, or areas of thin bone such as the temporal squama. Patients who survive such injuries and come to medical attention often require foreign body removal. Critical neurovascular structures are often damaged or at risk of additional injury resulting in further neurological deterioration, life-threatening hemorrhage, or death. Delayed complications can also be significant and include traumatic pseudoaneurysms, arteriovenous fistulas, vasospasm, cerebrospinal fluid leak, and infection. Despite this, given the rarity of these lesions, there is a paucity of literature describing the management of neurovascular injury and skull base repair in this setting. The authors describe three cases of nonmissile penetrating brain injury and review the pertinent literature to describe the management strategies from a contemporary cerebrovascular and skull base surgery perspective.

KEYWORDS

Penetrating trauma - brain - skull base - pseudoaneurysm

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Saleem I AbdulraufM.D. 

Center for Cerebrovascular and Skull Base Surgery, Saint Louis University

3635 Vista Ave, 5th Floor DT, St. Louis, MO 63110

Email: absdulsi@slu.edu

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