Cases reported "Wounds, Penetrating"

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1/44. A surgical method for treating anterior skull base injuries.

    skull base surgery was performed on 18 patients with anterior skull base injuries. The operative technique consisted of opening the operative field in the anterior skull base via a coronal incision and a frontal craniotomy, debridement of the anterior skull base including the injured dura mater, performing drainage from the anterior skull base to the nasal cavity by ethmoidectomy, and reconstructing the resulting dural and anterior skull base defect using bilateral temporal musculo-pericranial flaps and a bone graft. Seventeen of the 18 patients recovered without any complications, although epidural abscesses in the anterior skull base had been present in four patients at the time of the operation. Only one patient developed an epidural abscess in the anterior skull base after the operation. None of the patients developed any other complications including meningitis, recurrent liquorrhoea or cerebral herniation. Satisfactory aesthetic results were achieved in 16 of the 18 patients. In one patient, uneven deformity of the forehead, which was caused by the partial sequestration of the frontal bone due to postoperative infection, was observed. In another patient, a depressed deformity of the forehead, which was caused by the partial loss of the frontalis muscle following the use of the frontal musculo-pericranial flap instead of a temporal musculo-pericranial flap, was observed. Anterior skull base reconstruction using bilateral temporal musculo-pericranial flaps provides excellent results in terms of patient recovery and aesthetics.
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ranking = 1
keywords = abscess
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2/44. Cerebral abscess after presumed superficial periorbital wound.

    Penetrating wounds in the periorbital region may appear superficial and minor at first glance. The unique shape and thin bony roof of the orbit give these injuries a significant risk of associated intracranial penetration. This can initially be asymptomatic, and a high index of suspicion is essential to properly diagnose and treat these injuries. We report a case of an 8-year-old female who presented with delayed seizures from a frontal abscess resulting from such an injury. This article reviews the literature and discusses the appropriate management that should be used by emergency room and military physicians.
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ranking = 2.5
keywords = abscess
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3/44. Unusual parotid gland foreign body.

    A foreign body in the parotid gland whether from the oral cavity or through the skin is extremely uncommon. A case is described of the tip of a golden-colored pencil accidentally piercing the deep lobe after a fall. Emergency surgical removal was performed, and the diagnosis of the foreign body was quite easy. In contrast, determination of the location in the gland had to be done by a microscope, with fluoroscopy during the operation and was quite difficult. During removal, great attention was paid to avoiding facial nerve injury. This was done by identifying the facial trunk at the pointer using a microscope. The dissolved material including copper and zinc metal powder, paste, and clay, was found in the deep lobe associated with the surrounding abscess. Although these materials are assumed to be harmless to human tissues, the complete and immediate removal is to prevent salivary fistule resulting from inflammation.
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ranking = 0.5
keywords = abscess
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4/44. brain abscess related to metal fragments 47 years after head injury. Case report.

    The authors report a case of symptomatic brain abscess in a 51-year-old man who presented with personality changes and generalized seizures. He had survived a grenade explosion injury during the korean war 47 years previously. Computerized tomography scanning revealed multiple conglomerate rim-enhancing lesions and metallic foreign bodies in the right frontal lobe. The mass was totally removed and pseudomonas aeruginosa was isolated from microbial cultures. Retained foreign bodies in the brain, whether bone or metal, should be removed at the time of injury if at all possible. If this cannot be accomplished, patients with such retained foreign bodies should be carefully monitored for life.
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ranking = 2.5
keywords = abscess
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5/44. Craniocerebral injury resulting from transorbital stick penetration in children.

    OBJECTS: Two children were admitted to hospital for treatment of craniocerebral injury with transorbital penetration. methods: One child aged 6 years and 6 months had poked a chopstick in his orbit. There was no report of either a palpebral or an ocular wound. He had subsequently developed a meningeal syndrome with a cerebral abscess managed by needle aspiration biopsy and intravenous antibiotics. The other child, aged 4, had fallen onto a metal rod. He presented with a palpebral wound, motor disorders and coma, all due to a frontal intracerebral hematoma. There was an improvement in outcome without complications of an infectious nature or motor sequelae. CONCLUSIONS: Such head injuries are rare. Clinical, radiological and ophthalmological investigations must be performed, including computed tomography (CT) scan or cerebral magnetic resonance imaging (MRI) with antibiotic treatment for suspected microorganisms.
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ranking = 0.5
keywords = abscess
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6/44. brain abscess following transorbital penetrating injury due to bamboo fragments--case report.

    A 56-year-old female presented with transorbital penetrating injury caused by bamboo fragments, which resulted in brain abscess 2 weeks after the injury. Initial computed tomography (CT) of the head did not reveal the foreign bodies. However, follow-up CT demonstrated a well-defined hyperdense abnormality of 1.0 cm length in the left orbit and brain abscess in the left temporal lobe. The lesion corresponding to the hyperdense abnormality on CT appeared isointense on T1-weighted magnetic resonance (MR) imaging and hypointense on T2-weighted MR imaging. The bamboo fragments were surgically removed, and aspiration and continuous drainage were performed for the brain abscess. The postoperative course was uneventful and the patient was transferred to a local hospital with minor neurological deficits. Bamboo foreign bodies may show changes in properties on CT and MR imaging in the subacute stage. Careful radiological examination and follow-up monitoring are required for the correct diagnosis and treatment of such injuries.
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ranking = 3.5
keywords = abscess
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7/44. Oral wooden stick injury complicated by meningitis and brain abscess.

    meningitis is rarely seen following oral injury. We describe a 3-year-old boy developing meningitis and brain abscess following a penetrating oral wooden stick injury. There was no cerebrospinal fluid rhinorrhea noted. A cerebrospinal fluid culture yielded viridans streptococcus. Brain magnetic resonance imaging and computed tomography revealed a multiloculated ring-enhancing mass. This patient underwent surgical drainage and completed 8-week antibiotic therapy. The patient demonstrated a late and dismal complication of a penetrating oral injury. At 2-year follow-up the patient was in good condition. A penetrating oral wooden stick inury should be regarded as potentially serious.
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ranking = 2.5
keywords = abscess
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8/44. Penetrating injury to the pharynx by a toothbrush in a pediatric patient: a case report.

    Penetrating injury of the pharynx is rare, but it can cause serious sequelae in children. A 12-month-old boy was impaled with a toothbrush in the retropharyngeal space after falling from a baby-bed. The point of the toothbrush was embedded beside the carotid artery and was removed by endoscopic surgical technique. The patient was discharged without neurological complication or abscess formation. We present a rare case of a penetrating injury by a toothbrush and discuss such injuries.
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ranking = 0.5
keywords = abscess
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9/44. Penetrating injuries to the oropharynx.

    A review was made of 12 cases of penetrating injuries to the oropharynx seen at Musashino red cross Hospital during the period from 1984 to 1988, and their records were compared with those of past cases with similar injuries reported in a survey for the period between 1949 and 1959. Most of the patients were children under the age of four and were injured when they fell with a sharp-edged object in the mouth. Penetrating injuries to the oropharynx occasionally cause severe complications, including retropharyngeal abscess and mediastinitis. This type of injury should be called a 'pencil injury'.
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ranking = 0.5
keywords = abscess
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10/44. femoral artery infection associated with a percutaneous arterial suture device.

    This is a case report of a femoral artery infection with fatal outcome after using a percutaneous suture mediated closure device: A 77-year old patient underwent diagnostic angiography of his thoracic and abdominal aortic aneurysm, the puncture site was closed with the Perclose system. He developed a staphylococcal femoral artery infection with groin abscess, requiring surgical intervention with debridement and removal of the Perclose suture. After stent graft exclusion of the thoracic and abdominal aortic aneurysm a staphylococcal sepsis occurred and the patient died of aneurysm rupture months later despite long term antibiotic therapy. Since the use of the Perclose device carries an increased risk of femoral artery infection with septic endarteritis and bacteremia, it should not be used in routine diagnostic angiography.
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ranking = 0.5
keywords = abscess
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