prikaz prve stranice dokumenta Surgical Management of a Penetrating Brain Wound and Associated Perforating Ocular Injury Caused by a Low-Velocity Sharp Metallic Object: A Case Report and Literature Review
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Scientific paper - Case study
Surgical Management of a Penetrating Brain Wound and Associated Perforating Ocular Injury Caused by a Low-Velocity Sharp Metallic Object: A Case Report and Literature Review
Acta clinica Croatica, 61 (2022), 3; 537-546. https://doi.org/10.20471/acc.2022.61.03.21
Splavski, Bruno; Iveković, Renata; Bošnjak, Ivan; Splavski Jr, Brano; Rotim, Ante; Rotim, Krešimir

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Splavski, B., Iveković, R., Bošnjak, I., Splavski Jr, B., Rotim, A. & Rotim, K. (2022). Surgical Management of a Penetrating Brain Wound and Associated Perforating Ocular Injury Caused by a Low-Velocity Sharp Metallic Object: A Case Report and Literature Review. Acta clinica Croatica, 61. (3), 537-546. doi: 10.20471/acc.2022.61.03.21

Splavski, Bruno, et al. "Surgical Management of a Penetrating Brain Wound and Associated Perforating Ocular Injury Caused by a Low-Velocity Sharp Metallic Object: A Case Report and Literature Review." Acta clinica Croatica, vol. 61, no. 3, 2022, pp. 537-546. https://doi.org/10.20471/acc.2022.61.03.21

Splavski, Bruno, Renata Iveković, Ivan Bošnjak, Brano Splavski Jr, Ante Rotim and Krešimir Rotim. "Surgical Management of a Penetrating Brain Wound and Associated Perforating Ocular Injury Caused by a Low-Velocity Sharp Metallic Object: A Case Report and Literature Review." Acta clinica Croatica 61, no. 3 (2022): 537-546. https://doi.org/10.20471/acc.2022.61.03.21

Splavski, B., et al. (2022) 'Surgical Management of a Penetrating Brain Wound and Associated Perforating Ocular Injury Caused by a Low-Velocity Sharp Metallic Object: A Case Report and Literature Review', Acta clinica Croatica, 61(3), pp. 537-546. doi: 10.20471/acc.2022.61.03.21

Splavski B, Iveković R, Bošnjak I, Splavski Jr B, Rotim A, Rotim K. Surgical Management of a Penetrating Brain Wound and Associated Perforating Ocular Injury Caused by a Low-Velocity Sharp Metallic Object: A Case Report and Literature Review. Acta clinica Croatica [Internet]. 2022 [cited 2024 October 31];61(3):537-546. doi: 10.20471/acc.2022.61.03.21

B. Splavski, R. Iveković, I. Bošnjak, B. Splavski Jr, A. Rotim and K. Rotim, "Surgical Management of a Penetrating Brain Wound and Associated Perforating Ocular Injury Caused by a Low-Velocity Sharp Metallic Object: A Case Report and Literature Review", Acta clinica Croatica, vol. 61, no. 3, pp. 537-546, 2022. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:220:894579. [Accessed: 31 October 2024]

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Title (english)Surgical Management of a Penetrating Brain Wound and Associated Perforating Ocular Injury Caused by a Low-Velocity Sharp Metallic Object: A Case Report and Literature Review
Title (croatian)Operacijsko liječenje penetrirajuće rane mozga i pridružene perforirajuće ozljede oka uzrokovane metalnim objektom male brzine kretanja: prikaz slučaja i uvid u literaturu
AuthorBruno Splavski https://orcid.org/0000-0002-4483-9364
AuthorRenata Iveković
AuthorIvan Bošnjak
AuthorBrano Splavski Jr
AuthorAnte Rotim
AuthorKrešimir Rotim
Author's institution(Sestre milosrdnice University Hospital Center)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Neurology
Abstract (english)
Penetrating traumatic brain injury accompanied by perforating ocular injury caused by low-velocity foreign bodies is a life-threatening condition, a surgical emergency and a major challenge in surgical practice, representing a severe subtype of non-missile traumatic brain injury, which is a relatively rare pathology among civilians. Optimal management of such an injury remains controversial, requiring full understanding of its pathophysiology and a multidisciplinary expert approach. Herein, we report a case of penetrating brain and associated perforating eye injury and discuss relevant literature providing further insight into this demanding complex multi-organ injury. We present a case of 39-year-old male patient with transorbital penetrating brain and perforating ocular injury undergoing emergency surgery to remove a retained sharp metallic object from the left parietal lobe. Following appropriate and urgent diagnostics, a decompressive left-sided fronto-temporo-parietal craniectomy was immediately performed. A retained sharp metallic object (a slice of a round saw) was successfully removed, while primary left globe repair and palpebral and fornix reconstruction were performed afterwards by an ophthalmologist. A prophylactic administration of broad-spectrum antibiotics was applied to prevent infectious complications. Early postoperative recovery was uneventful. The patient was discharged on day 45 post-injury having moderate right-sided motor weakness, ipsilateral facial nerve central palsy, and light motoric dysphasia. The vision to his left eye was completely and permanently lost. In conclusion, management of non-missile transorbital penetrating brain injury can be satisfactory when proper clinical and radiologic evaluation, and amply, less radical surgical approach is performed early. A multidisciplinary routine is a prerequisite in achieving a favorable management outcome.
Abstract (croatian)
Penetrirajuća ozljeda mozga i pridružena perforirajuća ozljeda oka uzrokovana stranim tijelima male brzine kretanja po život je opasno, hitno kirurško stanje koje predstavlja veliki izazov u kirurškoj opskrbi, kao i tešku podvrstu mirnodopske ozljede mozga, koja je relativno rijetka u civilnoj populaciji. Optimalno liječenje ovakve ozljede i nadalje je dvojbeno te zahtijeva potpuno razumijevanje patofiziologije njezinog razvoja, kao i multidisciplinarni ekspertni pristup. U ovom radu donosimo prikaz slučaja penetrirajuće ozljede mozga i pridružene perforirajuće ozljede oka te uvid u recentnu literaturu, kako bi podrobno raspravili o ovoj zahtjevnoj i složenoj višeorganskoj ozljedi. Muškarac u dobi od 39 godina zadobio je transorbitalnu penetrirajuću ozljedu mozga i perforirajuću okularnu ozljedu zbog čega je podvrgnut hitnom kirurškom liječenju kako bi se uklonilo oštar metalni objekt zaostalo u području lijevog tjemenog režnja. Nakon provedene žurne dijagnostike, odmah je učinjena dekompresijska ljevostrana fronto-temporo-parijetalna karniektomija te je uspješno uklonjeno zaostalo metalno strano tijelo (odsječak cirkularne pile), nakon čega je po oftalmologu učinjena primarna opskrba ozljede lijeve očne jabučice i rekonstrukcija vjeđa i forniksa kroz slojeve lijevo. Profilaktička primjena antibiotika širokoga spektra provedena je kako bi se spriječio nastanak infekcijskih komplikacija. Rani poslijeoperacijski oporavak bio je zadovoljavajući. Bolesnik je otpušten iz bolnice 45. dan nakon ozljede s umjerenom motoričkom slabošću desnih udova, istostranom centralnom facioparezom i blagom motoričkom disfazijom. Vid na lijevome oku trajno je i potpuno izgubljen. Zaključujemo kako liječenje mirnodopske transorbitalne penetrirajuće ozljede mozga može biti uspješno ako je provedena pravodobna primjerena klinička i radiološka provjera i ako je primijenjen ogovarajući manje radikalan rani kirurški pristup. Multidisciplinarna opskrba preduvjet je postizanju povoljnog učinka liječenja.
Keywords (english)
Keywords (croatian)
Languageenglish
Languagecroatian
Publication typeScientific paper - Case study
Publication statusPublished
Peer reviewPeer review - international
Publication versionPublished version
Journal titleActa clinica Croatica
Numberingvol. 61, no. 3, pp. 537-546
p-ISSN0353-9466
e-ISSN1333-9451
DOIhttps://doi.org/10.20471/acc.2022.61.03.21
URN:NBNurn:nbn:hr:220:894579
Publication2022
Document URLhttps://hrcak.srce.hr/296219
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) icon
Created on2024-06-25 11:30:35